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Since the World Health Organization declared coronavirus disease (COVID-19) a pandemic on March 11, 2020 (1), COVID-19 has infiltrated every continent in the world (2), Hong Kong, a densely populated [...]

Large language models (LLMs) such as ChatGPT have emerged as potential game-changers in nursing, aiding in patient education, diagnostic assistance, treatment recommendations, and administrative task efficiency. While these advancements signal promising strides in healthcare, integrated LLMs are not without challenges, particularly artificial intelligence hallucination and data privacy concerns. Methodologies such as prompt engineering, temperature adjustments, model fine-tuning, and local deployment are proposed to refine the accuracy of LLMs and ensure data security. While LLMs offer transformative potential, it is imperative to acknowledge that they cannot substitute the intricate expertise of human professionals in the clinical field, advocating for a synergistic approach in patient care. [ABSTRACT FROM AUTHOR]

Hong Kong was relatively successful in mitigating transmission early in the outbreak of coronavirus disease (COVID-19). Confirmed cases were first reported in the city of Wuhan, China, in December 2019 [...]

The integration of generative artificial intelligence (AI) into academic research writing has revolutionized the field, offering powerful tools like ChatGPT and Bard to aid researchers in content generation and idea enhancement. We explore the current state of transparency regarding generative AI use in nursing academic research journals, emphasizing the need for explicitly declaring the use of generative AI by authors in the manuscript. Out of 125 nursing studies journals, 37.6% required explicit statements about generative AI use in their authors' guidelines. No significant differences in impact factors or journal categories were found between journals with and without such requirement. A similar evaluation of medicine, general and internal journals showed a lower percentage (14.5%) including the information about generative AI usage. Declaring generative AI tool usage is crucial for maintaining the transparency and credibility in academic writing. Additionally, extending the requirement for AI usage declarations to journal reviewers can enhance the quality of peer review and combat predatory journals in the academic publishing landscape. Our study highlights the need for active participation from nursing researchers in discussions surrounding standardization of generative AI declaration in academic research writing. [ABSTRACT FROM AUTHOR]

The recurrent multiwave nature of coronavirus disease 2019 (COVID‐19) necessitates updating its symptomatology. We characterize the effect of variants on symptom presentation, identify the symptoms predictive and protective of death, and quantify the effect of vaccination on symptom development. With the COVID‐19 cases reported up to August 25, 2022 in Hong Kong, an iterative multitier text‐matching algorithm was developed to identify symptoms from free text. Multivariate regression was used to measure associations between variants, symptom development, death, and vaccination status. A least absolute shrinkage and selection operator technique was used to identify a parsimonious set of symptoms jointly associated with death. Overall, 70.9% (54 450/76 762) of cases were symptomatic with 102 symptoms identified. Intrinsically, the wild‐type and delta variant caused similar symptoms among unvaccinated symptomatic cases, whereas the wild‐type and omicron BA.2 subvariant had heterogeneous patterns, with seven symptoms (fatigue, fever, chest pain, runny nose, sputum production, nausea/vomiting, and sore throat) more frequent in the BA.2 cohort. With ≥2 vaccine doses, BA.2 was more likely than delta to cause fever among symptomatic cases. Fever, blocked nose, pneumonia, and shortness of breath remained jointly predictive of death among unvaccinated symptomatic elderly in the wild‐type‐to‐omicron transition. Number of vaccine doses required for reducing occurrence varied by symptoms. We substantiate that omicron has a different clinical presentation compared to previous variants. Syndromic surveillance can be bettered with reduced reliance on symptom‐based case identification, increased weighing on symptoms predictive of death in outcome prediction, individual‐based risk assessment in care homes, and incorporating free‐text symptom reporting. [ABSTRACT FROM AUTHOR]

To inform the dynamic adjustments of vaccination campaigns, this study examined the transitions among vaccine hesitancy profiles over the COVID‐19 pandemic progression and their predictors and outcomes. The transition patterns among hesitancy profiles over three periods were identified using a latent transition analysis with individuals from a longitudinal cohort study since the emergence of COVID‐19 in Hong Kong. Four profiles (i.e., skeptics, apathetics, fence‐sitters, and believers) emerged consistently over time. From Period 1 (third and fourth pandemic waves) to Period 2 (dormant period, vaccine rollout), 14.17% of believers became fence‐sitters (ambivalization), and 12.11% of fence‐sitters became apathetics (apathetization). From Period 2 to Period 3 (omicron surge and vaccine mandates), 20.21% of believers became fence‐sitters. Lower trust in government predicted a transition to skepticism, whereas higher trust predicted the opposite. Staying as believers was associated with decreased hygienic and social distancing behavior. The stable hesitancy profiles amid the rapid vaccine uptake suggest that structural factors rather than personal agency may drive the surge. Ambivalization and apathetization may signal disengagement in preventive behaviors. Trust in the government is crucial in the pandemic response. Public health interventions may improve compliance with guidelines and prevent skepticism and apathy. [ABSTRACT FROM AUTHOR]

Residents in residential care homes for the elderly (RCHEs) are at high risk of severe illnesses and mortality, while staff have high exposure to intimate care activities. Addressing vaccine hesitancy is crucial to safeguard vaccine uptake in this vulnerable setting, especially amid a pandemic. In response to this, we conducted a cross-sectional survey to measure the level of vaccine hesitancy and to examine its associated factors among residents and staff in RCHEs in Hong Kong. We recruited residents and staff from 31 RCHEs in July–November 2022. Of 204 residents, 9.8% had a higher level of vaccine hesitancy (scored ≥ 4 out of 7, mean = 2.44). Around 7% of the staff (n = 168) showed higher vaccine hesitancy (mean = 2.45). From multi-level regression analyses, higher social loneliness, higher anxiety, poorer cognitive ability, being vaccinated with fewer doses, and lower institutional vaccination rates predicted residents' vaccine hesitancy. Similarly, higher emotional loneliness, higher anxiety, being vaccinated with fewer doses, and working in larger RCHEs predicted staff's vaccine hesitancy. Although the reliance on self-report data and convenience sampling may hamper the generalizability of the results, this study highlighted the importance of addressing the loneliness of residents and staff in RCHEs to combat vaccine hesitancy. Innovative and technology-aided interventions are needed to build social support and ensure social interactions among the residents and staff, especially amid outbreaks. [ABSTRACT FROM AUTHOR]

Suicide notes have been regarded as one of the most informative data sources to understand the reasons why people commit suicide. However, there is a paucity of suicide note studies, leaving researchers with an assumption that this phenomenon remains static over time. This study examines this assumption by comparing the characteristics of note-leavers of the same population at 2 different points in time. The authors investigated the characteristics of 316 note-leavers in 2000 in Hong Kong and compared them to note-leavers in 1992. The proportion of people who left suicide notes increased from 20% to 35% between 1992 and 2000, a change that may be related to changes in suicide methods. Note-leavers in 2000 were characterized as individuals aged 25-59 years old, employed, with no physical illness, no psychiatric illness, and died as a result of charcoal-burning. Present data suggest that reasons for leaving suicide notes may have changed over the 8 years from 1992 to 2000. (Contains 1 table.)

Introduction: Research impact and influence are commonly measured quantitatively by citation count received by research articles. Many institutes also use citation count as one of the factors in faculty performance appraisal and candidate selection of academic positions. Various strategies were recommended to amplify and accelerate research influence, particularly citation counts, by bringing research articles to a wider reach for potential readers. However, no prior empirical study was conducted to examine and valid effects of those strategies on nursing studies. This study examines and verifies the direct effects and mediation effects of some strategies, namely, the use of Twitter, international collaboration, the use of ResearchGate, and open access publishing, for amplifying the citation of research and review articles in nursing studies. Design: Cross‐sectional study design. Methods: Articles published in top nursing journals in 2016 were identified in PUBMED and the citation metrics for individual articles until 2021 were extracted from Scopus. The primary outcome was the citation count of the article, while the tweet count on Twitter of the article was considered a mediator. The predictors included paper type, the total number of authors, the proportion of authors with a ResearchGate account in the article, funding support, open‐accessed article, and the number of different countries stated in the authors' affiliation. A mediation analysis was conducted to examine the predictors' direct and indirect effects (i.e., via tweet count) on the citation count of the article. Results: A total of 2210 articles were included in this study, of which 223 (10.1%) were review articles. The median (IQR) number of Scopus citations, tweets, countries, and percentage of authors with ResearchGate accounts were 12 (6–21), 2 (0–6), 1 (1–1), and 75% (50%–100%) respectively. In the mediation analysis, tweet count, article type, number of countries, percentage of authors with a ResearchGate account, and journal impact factors in 2014 were positively associated with the Scopus citation count. The effects of article type, open access, and journals' impact factors in 2014 on Scopus citation count were mediated by the tweet count. Conclusion: This study provides empirical support for some strategies researchers may employ to amplify the citation count of their research articles. The methodology of our study can be extended to compare research influence between entities (e.g., across countries or institutes). Clinical Relevance: The citation refers to the research work cited by peers and is one of the indicators for research impact. Higher citations implied the research work is read and used by others, therefore, understanding the associated factors with higher citations is critical. [ABSTRACT FROM AUTHOR]

Suicide notes have been regarded as one of the most informative data sources to understand the reasons why people commit suicide. However, there is a paucity of suicide note studies, leaving researchers with an assumption that this phenomenon remains static over time. This study examines this assumption by comparing the characteristics of note-leavers of the same population at 2 different points in time. The authors investigated the characteristics of 316 note-leavers in 2000 in Hong Kong and compared them to note-leavers in 1992. The proportion of people who left suicide notes increased from 20% to 35% between 1992 and 2000, a change that may be related to changes in suicide methods. Note-leavers in 2000 were characterized as individuals aged 25-59 years old, employed, with no physical illness, no psychiatric illness, and died as a result of charcoal-burning. Present data suggest that reasons for leaving suicide notes may have changed over the 8 years from 1992 to 2000.

Aim: Direct kidney involvement in B‐cell lymphoproliferative disease is a rare disorder with only a few studies reported in Caucasian patients. The clinicopathological characteristics and outcome of this entity remain poorly described. Methods: We retrospectively studied all adult Chinese patients who had histology‐proven renal parenchymal infiltration by malignant B‐cells between 1 January 2000 and 31 December 2018 at two tertiary hospitals in Hong Kong. Clinical, pathological and radiological data were collected from 20 patients. Follow‐up data were analysed until 31 December 2019. Results: Median follow‐up duration was 22 (1–171) months. Only seven patients (35%) had established diagnosis of haematological cancer before kidney biopsy. Diffuse large B‐cell lymphoma (DLBCL) was the most common subtype in our cohort (n = 5, 25%). Others included low‐grade B‐cell lymphoma (n = 11), intravascular large B‐cell lymphoma (n = 1), mantle cell lymphoma (n = 1) and multiple myeloma (n = 2). Fourteen patients (70%) presented with AKI while 12 patients (60%) had proteinuria. Seven patients (35%) had unilateral renal mass, one had bilateral renal masses and one had bilateral diffuse nephromegaly in computed tomography. Lymphomatous tubulointerstitial infiltration was the prevalent histological finding. Nine patients (45%) had coexisting renal lesions other than direct tumour infiltration. All but one patient received chemotherapy. Ten patients died and renal responders had a significantly better survival than non‐renal responders (p =.03). Conclusion: Direct tumour infiltration can occur in a wide variety of B‐cell lymphoproliferative disorders. Coexisting immunoglobulin‐related nephropathy is frequently found. Renal biopsy is required for early diagnosis which allows timely and appropriate treatment. SUMMARY AT A GLANCE: The authors report a series of 20 Chinese patients presenting with B‐cell lymphoproliferative diseases directly infiltrating the kidney, which is an uncommon but important condition that requires early tissue diagnosis and specific therapy. The need to be aware of this problem, as hinted by characteristic clinical and pathological features, is highlighted. [ABSTRACT FROM AUTHOR]

To access temporal changes in psychobehavioral responses to the coronavirus disease (COVID-19) pandemic, we conducted a 5-round (R1-R5) longitudinal population-based online survey in Hong Kong during January-September 2020. Most respondents reported wearing masks (R1 99.0% to R5 99.8%) and performing hand hygiene (R1 95.8% to R5 97.7%). Perceived COVID-19 severity decreased significantly, from 97.4% (R1) to 77.2% (R5), but perceived self-susceptibility remained high (87.2%-92.8%). Female sex and anxiety were associated with greater adoption of social distancing. Intention to receive COVID-19 vaccines decreased significantly (R4 48.7% to R5 37.6%). Greater anxiety, confidence in vaccine, and collective responsibility and weaker complacency were associated with higher tendency to receive COVID-19 vaccines. Although its generalizability should be assumed with caution, this study helps to formulate health communication strategies and foretells the initial low uptake rate of COVID-19 vaccines, suggesting that social distancing should be maintained in the medium term. [ABSTRACT FROM AUTHOR]

COVID‐19 has hit the world by surprise, causing substantial mortality and morbidity since 2020. This narrative review aims to provide an overview of the epidemiology, induced impact, viral kinetics and clinical spectrum of COVID‐19 in the Asia‐Pacific Region, focusing on regions previously exposed to outbreaks of coronavirus. COVID‐19 progressed differently by regions, with some (such as China and Taiwan) featured by one to two epidemic waves and some (such as Hong Kong and South Korea) featured by multiple waves. There has been no consensus on the estimates of important epidemiological time intervals or proportions, such that using them for making inferences should be done with caution. Viral loads of patients with COVID‐19 peak in the first week of illness around days 2 to 4 and hence there is very high transmission potential causing community outbreaks. Various strategies such as government‐guided and suppress‐and‐lift strategies, trigger‐based/suppression approaches and alert systems have been employed to guide the adoption and easing of control measures. Asymptomatic and pre‐symptomatic transmission is a hallmark of COVID‐19. Identification and isolation of symptomatic patients alone is not effective in controlling the ongoing outbreaks. However, early, prompt and coordinated enactment predisposed regions to successful disease containment. Mass COVID‐19 vaccinations are likely to be the light at the end of the tunnel. There is a need to review what we have learnt in this pandemic and examine how to transfer and improve existing knowledge for ongoing and future epidemics. See relatedEditorial [ABSTRACT FROM AUTHOR]

Objectives: We conducted a cross-sectional study in Hong Kong community to estimate the carriage prevalence, associated factors and genotypes of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E), methicillin-resistant Staphylococcus aureus (MRSA) and carbapenemase-producing Enterobacteriaceae (CPE).Methods: Seemingly healthy subjects were asked to provide nasal, handprint and stool samples from March to April 2017. Isolates were characterized by molecular methods. We used multivariable logistic regression models within a generalized estimating equation framework to identify risk factors for ESBL-E carriage. Characteristics of MRSA/CPE carriage were summarized.Results: The prevalence of ESBL-E, MRSA and CPE were 52.8% (104/197), 2.5% (5/197) and 0.5% (1/197) respectively. Most ESBL-E isolates were E. coli (85.6%; 113/132). Most ESBL genes belonged to blaCTX-M-G9 (68.9%) and blaTEM (53.0%) types. Self-reported antibiotic consumption (≥2 courses) in the past six months was associated with ESBL-E carriage (adjusted odds ratio: 4.71-5.47).Conclusions: Abundance of ESBL-E in the community are causes of concern, and antibiotic use is associated with its carriage. Presence of MRSA and CPE in community members without clear healthcare exposure hints on a change in their epidemiology. This study establishes a baseline to formulate infection control policies and future studies in combating antimicrobial resistance. [ABSTRACT FROM AUTHOR]

During the early phase of the coronavirus disease epidemic in Hong Kong, 1,715 survey respondents reported high levels of perceived risk, mild anxiety, and adoption of personal-hygiene, travel-avoidance, and social-distancing measures. Widely adopted individual precautionary measures, coupled with early government actions, might slow transmission early in the outbreak. [ABSTRACT FROM AUTHOR]

Artificial Intelligence (AI) has recently stepped into the healthcare world, including travel medicine. This will have the potential to reduce the consultation time for some travellers with good health literacy by providing them the most up-to-date travel health information and preparing a list of questions for their travel medicine specialists. [Extracted from the article]

Byline: Yuan Zhang, Arthur Tang, Tim Palmer, Curt Hazard Virtual Proving Ground (eta/VPGTM) is a unique and integrated computer aided engineering (CAE) technology to conduct full vehicle real time, nonlinear dynamic analyses and simulations. The utilisation of this new technology can greatly improve the analytical results as compared with other conventional CAE tools. VPG can expand CAE applications into many special and important fields where the current CAE methods have no or only limited applications. It can also greatly reduce vehicle development costs and time. Presented in this paper are the VPG concept and the advantages it provides for full vehicle system analysis, simulation, and prototyping. Application examples of vehicle durability and fatigue analysis, NVH analysis, vehicle dynamics analysis and crashworthiness and safety analysis are also provided. Other VPG applications such as road load generation, and CPU requirements for VPG simulations are briefly discussed in the paper.

Objective The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement has been developed as a guideline for reporting systematic reviews and meta-analyses. Despite the prevalent use of the PRISMA statement in medicine and nursing, no studies have examined authors' perception of it. The purpose of this study is to explore the perception of the PRISMA statement of authors who published reviews, meta-analyses, or both in nursing journals. Design Cross-sectional descriptive study. Methods An online survey was conducted among authors who published reviews, meta-analyses, or both in nursing journals between 2011 and 2017. The selected authors' email addresses were extracted from the PUBMED database. A questionnaire--with a 10-point Likert scale (1--not important at all to 10--very important)--was developed to elicit their responses regarding their perception of not only the PRISMA statement as a whole, but also the individual items therein. Results Invitations were sent to 1960 valid email addresses identified, with 230 responses (response rate: 11.7%) and 181 completed responses (completion rate: 9.2%). The average perceived importance of the PRISMA statement was 8.66 (SD=1.35), while the perceived importance for the individual items ranged from 7.74 to 9.32. Six items were rated significantly higher than the average rating, whereas one item was rated significantly lower. Conclusion Most respondents perceived the PRISMA statement as important. Items related to information sources, selection, search-flow presentation, summary of findings, limitations and interpretation were deemed more important while the registration was deemed less so. [ABSTRACT FROM AUTHOR]

She was transferred to intensive care 2 days later and underwent ultrasound-guided temporary haemodialysis catheter insertion into the right internal jugular vein (IJV) (Figure 1A). As real-time fluoroscopic guidance is not always possible in the setting of inserting a temporary catheter, it is prudent to always review the location of the catheter tip by plain X-ray after insertion before proceeding to haemodialysis. [Extracted from the article]

A structured-based neural network (NN) with backpropagation through structure (BPTS) algorithm is conducted for image classification in organizing a large image database, which is a challenging problem under investigation. Many factors can affect the results of image classification. One of the most important factors is the architecture of a NN, which consists of input layer, hidden layer and output layer. In this study, only the numbers of nodes in hidden layer (hidden nodes) of a NN are considered. Other factors are kept unchanged. Two groups of experiments including 2,940 images in each group are used for the analysis. The assessment of the effects for the first group is carried out with features described by image intensities, and, the second group uses features described by wavelet coefficients. Experimental results demonstrate that the effects of the numbers of hidden nodes on the reliability of classification are significant and non-linear. When the number of hidden nodes is 17, the classification rate on training set is up to 95%, and arrives at 90% on the testing set. The results indicate that 17 is an appropriate choice for the number of hidden nodes for the image classification when a structured-based NN with BPTS algorithm is applied. [ABSTRACT FROM AUTHOR]

The endemic threat of methicillin-resistant Staphylococcus aureus (MRSA) in nursing homes poses a serious and escalating challenge to public health administration in infection control. Nursing homes are considered as major reservoirs for MRSA colonization, with considerable high levels of colonization prevalence. We employed a computation model to evaluate effects of three intervention scenarios on MRSA colonization prevalence rate in nursing homes. Simulations were conducted using a deterministic compartmental model featuring heterogeneous contact matrix between residents and health-care workers (HCWs). Contact parameters were derived from a nursing home survey. Three intervention scenarios were simulated: (1) hand-hygiene compliance by HCWs, (2) screening-and-isolation upon admission, and (3) implementing both interventions at the same time. For every 10% reduction in average contamination duration in HCWs, the estimated average reduction in prevalence rate was 1.29 percentage point compared with the prevalence rate before the intervention was implemented. Screening-and-isolation intervention resulted in an average reduction of 19.04 percentage point in prevalence rate (S.D. = 1.58; 95% CI = 18.90–19.18). In intervention scenario 3, synergistic effects were observed when implementing hand-hygiene compliance by HCWs and screening-and-isolation together. Our results provide evidence showing that implementing multiple interventions together has a synergistic effect on colonization prevalence reduction. [ABSTRACT FROM AUTHOR]

A healthy healthcare system requires healthy healthcare workers. Protecting healthcare workers including nurses against COVID-19 is crucial, and vaccination could be a viable future option. However, vaccine hesitancy remains a global challenge. Nurses, as a trustworthy and creditable source of vaccine-related information, may build public confidence in vaccination. Hence, research on vaccine hesitancy among nurses is warranted. This study estimated nurses' influenza vaccination behaviors and intention to receive COVID-19 vaccine when available, and examined their corresponding 5C psychological antecedents (confidence, complacency, constraints, calculation, and collective responsibility). To investigate the impact of COVID-19-related work demands, the mediation effects of work stress on the association between work demands and COVID-19 vaccination intention were also examined. Cross-sectional online survey Nurses were invited to participate via the promotion of a professional nursing organization and by personal referrals during the COVID-19 outbreak in Hong Kong between mid-March and late April 2020. 1,205 eligible nurses (mean age = 40.79, SD = 10.47; 90% being female) were included in the analyses. Demographics, influenza vaccination, intention to have COVID-19 vaccine, the 5C vaccine hesitancy components, work stress and COVID-19-related work demands (insufficient supply of personal protective equipment, involvement in isolation rooms, and unfavorable attitudes towards workplace infection control policies) were reported in the survey. The influenza vaccine uptake rate and the proportion intending to take COVID-19 vaccine were 49% and 63%, respectively. Influenza vaccination was associated with working in public hospitals and all 5C constructs (more confidence, more collective responsibility and less complacency, constraints, and calculation), whereas stronger COVID-19 vaccination intention was associated with younger age, more confidence, less complacency and more collective responsibility. COVID-19-related demands were associated with greater work stress, and hence stronger COVID-19 vaccination intention. The potential uptake rate of COVID-19 vaccine among nurses was suboptimal to achieve herd immunity. The 5C constructs were useful in predicting influenza vaccination and, to a lesser extent, the intention to take COVID-19 vaccine. The uncertain attributes such as effectiveness, side effects, and effective duration of the COVID-19 vaccine may contribute to this discrepancy. With less work stress among nurses in the post-pandemic period, the intention to take COVID-19 vaccine will likely drop. The 5C constructs should be infused in vaccination campaigns. While a COVID-19 vaccine could be ready soon, the nursing profession may not be ready to accept it. More research work is needed to boost the uptake rate. Less than two-third of nurses intended to take COVID-19 vaccine when available. While a COVID-19 vaccine could be ready soon, nursing profession is not ready to accept it. [ABSTRACT FROM AUTHOR]

Competing Interests: Competing interests: We have read and understood BMJ policy on declaration of interests and have the following interests to declare: 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.

Background: Amid the current COVID-19 pandemic, there is an urgent need for both vaccination and revaccination ("boosting"). This study aims to identify factors associated with the intention to receive a booster dose of the coronavirus (COVID-19) vaccine among individuals vaccinated with two doses and characterize their profiles in Hong Kong, a city with a low COVID-19 incidence in the initial epidemic waves. Among the unvaccinated, vaccination intention is also explored and their profiles are investigated., Methods: From December 2021 - January 2022, an online survey was employed to recruit 856 Hong Kong residents aged 18 years or over from an established population-based cohort. Latent class analysis and multivariate logistic regression modeling approaches were used to characterize boosting intentions., Results: Of 638 (74.5%) vaccinated among 856 eligible subjects, 42.2% intended to receive the booster dose. Four distinct profiles emerged with believers having the highest intention, followed by apathetics, fence-sitters and skeptics. Believers were older and more likely to have been vaccinated against influenza. Older age, smoking, experiencing no adverse effects from a previous COVID-19 vaccination, greater confidence in vaccines and collective responsibility, and fewer barriers in accessing vaccination services were associated with higher intentions to receive the booster dose. Of 218 unvaccinated, most were fence-sitters followed by apathetics, skeptics, and believers., Conclusion: This study foretells the booster intended uptake lagging initial vaccination across different age groups and can help refine the current or future booster vaccination campaign. Given the fourth COVID-19 vaccine dose may be offered to all adults, strategies for improving boosting uptake include policies targeting young adults, individuals who experienced adverse effects from previous doses, fence-sitters, apathetics, and the general public with low trust in the health authorities., 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 © 2022 Kwok, Li, Leung, Tang, Chan, Tsoi, Wei, McNeil and Wong.)