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Giant odd-parity magnetoresistance in a non-magnetic two-dimensional electron gas
No full textOdd-parity magnetoresistance (OMR), characterized by its asymmetric response to magnetic field reversal, has remained limited in practical use due to its typically small magnitude and limited control in conventional magnetic metals. Here, we report a gate-tunable OMR effect in high-mobility AlGaN/GaN two-dimensional electron gas (2DEG) heterostructures, exhibiting a giant OMR coefficient exceeding 60%. Dual-gate control enables independent tuning of carrier density, achieving a highly linear and reversible OMR response, which is further enhanced by device geometry optimization. The effect arises from spatially engineered gradients of the Hall coefficient and magnetic-field-induced symmetry breaking. These results establish AlGaN/GaN 2DEGs as a robust and tunable platform for high-performance OMR devices, with potential applications in nonreciprocal electronics and magnetic sensing
Investigating L2 learners’ text-to-video resemiotisation in AI-enhanced digital multimodal composing
No full textPhonological awareness and reading impairment in tonal-language speakers with congenital amusia
No full textProject Delivery Methods to Digital Fabrication in Architecture: A Comparative Case Study from a Modularity Perspective
No full textDiverse experiences of university education and entrepreneurship of native-born and immigrants in Canada
No full textPurpose: To understand the relationship between studying abroad, receiving STEM education, completing master’s or doctoral education and the likelihood of becoming entrepreneurs among immigrant and native-born university graduates. Design/methodology/approach: Statistical analysis of the 2016 Canadian Public Use Micro Data. Findings: Despite the small differences between native-born and immigrant populations in the percentages of entrepreneurs, there are considerable differences in the location of study, STEM education and completion of master’s or doctoral education. Multivariate analysis suggests that since a higher percentage of immigrants are educated abroad, the significant difference in the percentage of each group who are entrepreneurs is narrowed, because education abroad is positively related to the likelihood of entrepreneurship. Originality/value: We simultaneously compare the relationship between studying abroad, receiving STEM education and completing master’s or doctoral training and the likelihood of becoming entrepreneurs for immigrant and native-born university graduates
Effectiveness of a Simplified Checklist to Overcome the Inertia of Treatment Implementation in ACS Patients with High Comorbidity Burden
No full textBackground/Objective: High-risk subsets of patients with acute coronary syndrome (ACS) experience decreased access to optimal care and have poor clinical outcomes, reflecting an inertia to the delivery of guideline-directed and evidence-based therapy and implementation of critical care pathways. We aim to investigate the clinical effectiveness of a simplified implementation checklist to counter treatment inertia in patients with high comorbidity burden. Methods: An ACS critical care pathway was simplified and reduced to a minimalistic checklist including only items on GDMT and invasive strategy. A total of 2005 consecutive patients with ACS were evaluated including 1499 patients receiving standard care and 506 patients managed with the checklist. Patients with STEMI undergoing primary percutaneous coronary interventions and patients receiving upfront cardiovascular intensive care were excluded. Multivariate regression spline models were used to study the relationship between comorbidity, expressed as the Charlson Comorbidity Index (CCI) and a management strategy including guideline-directed medical therapy (GDMT) and an early invasive approach. Inverse probability of treatment weighting (IPTW) was used to address confounding factors. The use of GDMT and early invasive therapy were compared in patients receiving standard care and checklists. The 90-day composite outcome of all-cause mortality, recurrent ACS and stroke were compared between patients receiving standard care and those receiving checklists. Results: High CCI was associated with decreased GDMT, invasive strategy and the utilization of critical care pathway. Checklist utilization was unaffected by high CCI and led to sustained and higher use of GDMT and invasive approach in patients despite high CCI. Checklist managed patients have >10% higher rates of prescription of each class of GDMT (p < 0.0001) and more than twice the rate of early invasive approach (51.0% vs. 20.7%, (p < 0.0001) compared to patients receiving standard care. The 90-day composite outcome was lower in checklist management patients compared to patients receiving standard care, adjusted hazard ratio 0.61 (95% CI 0.46–0.81), log-rank p = 0.0006, especially in patients with high CCI, adjusted hazard ratio 0.60 (95% CI 0.38–0.97), log-rank p = 0.035 for CCI 5–6; adjusted hazard ratio 0.53 (95% CI 0.35–0.84), log-rank p = 0.0057 for CCI 7 or more. Conclusions: The use of a simplified checklist is associated with better implementation of GDMT and invasive strategy as well as better 90-day clinical outcomes in ACS patients with high comorbidity burde
Integrated Care Using the ABCstroke Pathway Improves Cardiovascular Outcomes and Survival in Patients with First-Ever Ischaemic Stroke
No full textBackground: A recent position paper of the European Society of Cardiology Council on Stroke proposed an integrated ABCstroke pathway to optimise post-stroke management. We evaluated the impact of ABCstroke pathway adherence on post-stroke cardiovascular outcomes. Methods: Patients with first-ever ischaemic stroke in Hong Kong between 2006 and 2022 were included in this retrospective cohort study. Multivariable Cox regression analysis was performed to evaluate the association between physicians’ adherence to the ABCstroke pathway and the primary outcome, which was a composite of recurrent ischaemic stroke, transient ischaemic attack, haemorrhagic stroke, myocardial infarction, heart failure and all-cause mortality. Results: Of the 9,669 included patients with ischaemic stroke (mean age 69.6 ± 13.4 years; 57.5% male), 58.1% were optimally managed according to all three ABCstroke pillars. After 1 year of follow-up, adherence to the ABCstroke pathway was associated with a lower risk of the primary composite endpoint (hazard ratio (HR): 0.80; 95% confidence interval (CI): 0.72–0.88), as well as a lower risk of haemorrhagic stroke (subdistribution hazard ratio (SHR): 0.50; 95% CI: 0.38–0.67), heart failure (SHR: 0.771; 95% CI: 0.596–0.998), cardiovascular death (SHR: 0.64; 95% CI: 0.45–0.90), and all-cause mortality (HR: 0.72; 95% CI: 0.62–0.85). Risk reductions in the primary endpoint increased progressively with a higher number of ABCstroke criteria obtained. No significant interaction was observed in the association according to age, sex, or stroke severity. Conclusions: In this cohort of Asian patients with first-ever ischaemic stroke, optimal management according to the ABCstroke pathway was associated with a reduction in the risk of adverse outcomes
Increasing Trends of Household Secondhand Smoke Exposure and Widening Socioeconomic Disparities in Hong Kong Adolescents, 2010–2020
No full textIntroduction: The aim of this study is to assess 10-year trends (2010–2020) in household secondhand smoke exposure in Hong Kong adolescents from inside their own homes and from their neighbors and analyze changes by SES. Methods: Data from the 2010–2020 School-based Smoking Survey among students (total responses were 228,623) were analyzed in 2023. Weighted prevalence and temporal trends of secondhand smoke exposure were calculated across years. Prevalence differences and prevalence ratios were used to assess SES disparities. Poisson regression models with robust SEs were used for trend analysis. Results: From 2010 to 2020, the prevalence of secondhand smoke exposure from inside students’ homes and from their neighbors increased by 26.8% (from 23.5% to 29.8%) and 142.3% (from 16.8% to 40.7%), respectively. Any household secondhand smoke exposure from these sources increased from 33.2% to 58.5%. The prevalence of home secondhand smoke exposure was significantly higher in 2018 and 2020 than in 2010. Neighbor secondhand smoke exposure showed a continuous upward trend throughout the period. Students with lower parental education levels and from poorer families were more exposed, with disparities by parental education widening in 2018. Conclusions: Household secondhand smoke exposure in Hong Kong adolescents has increased in recent years, with persistent socioeconomic disparities and a widening in 2018. Targeted policies, such as home smoking bans, are needed to protect adolescents from secondhand smoke exposure and reduce socioeconomic disparities
脆性X綜合症: 香港華人群體的遺傳與臨床特徵分析
Get PDFIntroduction: Fragile X syndrome (FXS) is a common inherited cause of intellectual disability, and FXS testing is recommended as a first-line genetic investigation for global developmental delay or intellectual disability. This retrospective study evaluated the diagnostic yield of FXS testing and clinical features in Chinese patients in Hong Kong. Methods: From 1993 to 2022, 7291 patients referred to the Clinical Genetic Service for neurodevelopmental conditions (eg, developmental delay, autism spectrum disorder, and intellectual disability) underwent FXS testing. In total, 103 individuals from 61 families were confirmed to have an FMR1 full mutation, including 59 index cases and 44 family members. Clinical features of 70 Chinese patients with FXS, including growth, neurobehavioural features, and other co-morbidities, were evaluated. Results: The diagnostic yield of FXS testing was 0.8%. The median age at diagnosis for index cases was 4.1 years, with a trend towards earlier diagnosis in recent years. In 27 families (44.2%), multiple members carried a full mutation. Prenatal diagnosis was arranged in 11% of families. Developmental delay was observed in all males, compared with 45.0% of females. Intellectual disability affected 86.0% of males but only 30.0% of females. Common co-morbidities included obesity, autism spectrum disorder, attention-deficit/hyperactivity disorder, epilepsy, gastrointestinal problems, and sleep disturbances. Features such as strabismus, scoliosis, and mitral valve prolapse were rarely reported. Conclusion: Fragile X syndrome is more than a pure neurodevelopmental disorder. Our findings highlight the importance of early diagnosis and subsequent management, with awareness of relevant surveillance and management guidelines.引言：脆性X綜合症是導致遺傳性智力障礙的常見原因之一。就整體發展遲緩和智力障礙而言，脆性X綜合症檢測是第一線基因檢測的一部分。本回顧性研究旨在評估脆性X綜合症檢測的診斷效益及本港華人患者的臨床特徵。
方法：於1993至2022年間共有7291名患者因神經發展相關疾病（如發展遲緩、自閉症譜系障礙及智力障礙）被轉介至醫學遺傳科進行脆性X綜合症檢測。當中103位來自61個家庭的患者帶有FMR1基因全突變，包括59位先證者及44位家族成員。此研究分析了70位患有脆性X綜合症的華人患者的臨床特徵，包括生長、神經行為特徵及其他共病情況。
結果：脆性X綜合症檢測的診斷陽性率為0.8%。先證者的中位確診年齡為4.1歲，而近年的確診年齡有提早趨勢。在2 7個家庭中（44.2%），有多位成員帶有全突變。11%家庭曾進行產前診斷。所有男性患者均有發展遲緩，而女性則為45.0%；86.0%男性患有智力障礙，而只有30.0%女性患者受到影響。常見共病包括肥胖、自閉症譜系障礙、專注力不足／過度活躍症、癲癇、腸胃問題及睡眠障礙。斜視、脊柱側彎及二尖瓣脫垂等情況則較為少見。
結論：脆性X綜合症不僅是純粹的神經發展障礙。我們的研究結果帶出早期診斷與後續管理的重要性，並喚起對相關監測與治療指引的認知。published_or_final_versio