The Hong Kong Government released a Reference Framework (RF-HT) for Hypertension Care for Adults in Primary Care Settings since 2010. No studies have evaluated its adoption by primary care physicians ...(PCPs) since its release.
We aimed to evaluate the level of PCPs' adoption of the RF-HT and the potential barriers of its use in family practice.
A cross-sectional study was conducted by a self-administered validated survey among all PCPs in Hong Kong through various means.
We assessed the level of and factors associated with its adoption by multivariate logistic regression modelling.
A total of 3,857 invitation episodes were sent to 2,297 PCPs in 2014-2015. We received 383 completed questionnaires. The average score of adoption was 3.43 out of 4.00, and 47.5% of PCPs highly adopted RF-HT in their daily consultations. Male practitioners (adjusted odds ratio aOR = 0.524, 95% CI = 0.290-0.948, p = 0.033) and PCPs of public sector (aOR = 0.524, 95% CI = 0.292-0.940, p = 0.030) were significantly less likely to adopt the RF-HT. PCPs with higher training completion or being academic fellow are more likely to adopt RF-HT than those who were "nil to basic training completion" (aOR = 0.479, 95% CI = 0.269-0.853, p = 0.012) or "higher trainee" (aOR = 0.302, 95% CI = 0.093-0.979, p = 0.046). Three most-supported suggestions on RF-HT improvement were simplification of RF-HT, provision of pocket version and promoting in patients.
Among PCP respondents, the adoption level of the RF-HT was high. These findings also highlighted some factors associated with its adoption that could inform targeted interventions for enhancing its use in clinical practice.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
A novel scheme for a perfect hyperbolic metamaterial (HMM) absorber is proposed, and experimental verification is provided. It has been shown previously that tapered HMM stacks can provide adiabatic ...waveguiding over a wide spectral range and thus are an ideal opaque absorber. Here, nontapered shape-optimized HMM absorbers are proposed, which facilitates the fabrication and promotes the large-area applications such as thermophotovoltaics (TPV). In the synthesis of the optimal patterns, we use 5-harmonic rigorously coupled wave analysis (RCWA) and experimental trials to shorten the trial-and-error time. The best pattern provides an averaged broadband experimental absorption of 88.38% over λ = 1 μm to λ = 2 μm, which is comparable to the state-of-the-art experimental effort using tapered HMM. The nontapered nature can be easier to fabricate from the semiconductor processing viewpoint. The physics behind the pattern-optimized HMM cavity is the broadband light coupling by the air-cavity and the unbounded photonic density of the states (PDOS) associated with the HMM. The topology optimized air cavity effectively couples the incident photons into the metal-dielectric stacking, eliminating the need of sidewall tapers. We believe the proposed topology-optimization methodology benefits the future design of compact metamaterial perfect absorbers (MPA), sensors, antenna, and thermophotovoltaic emitters, and absorbers.
A composite of polythiophene (PT) and titania nanotubes was synthesized. X-ray diffraction (XRD), scanning electron microscopy (SEM), thermogravimetric analysis (TGA), fourier transformed infrared ...spectroscopy (FTIR) and x-ray photoelectron spectroscopy (XPS) were used to characterize these nanocomposites. The interaction between polythiophene and titania was analyzed by XPS and TGA. The XPS spectra of the composites show that the Ti
2p peak shifts to a lower binding energy and S
2p peak shifts to a higher binding energy. The TGA results also show that phase segregation occured when the nanocomposites contained 35% polythiophene.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Protein aggregation is a hallmark of many diseases, including amyotrophic lateral sclerosis (ALS) where aggregation of copper/zinc superoxide dismutase (SOD1) is implicated in pathogenesis. We report ...here that fully metallated (holo) SOD1 under physiologically relevant solution conditions can undergo changes in metallation and/or dimerization over time and form aggregates that do not exhibit classical characteristics of amyloid. The relevance of the observed aggregation to disease is demonstrated by structural and tinctorial analyses, including the novel observation of binding of an anti-SOD1 antibody that specifically recognizes aggregates in ALS patients and mice models. ALS-associated SOD1 mutations can promote aggregation but are not essential. The SOD1 aggregation is characterized by a lag phase, which is diminished by self- or cross-seeding and by heterogeneous nucleation. We interpret these findings in terms of an expanded aggregation mechanism consistent with other in vitro and in vivo findings that point to multiple pathways for the formation of toxic aggregates by different forms of SOD1.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Censored quantile regression (CQR) has received growing attention in survival analysis because of its flexibility in modeling heterogeneous effect of covariates. Advances have been made in developing ...various inferential procedures under different assumptions and settings. Under the conditional independence assumption, many existing CQR methods can be characterized either by stochastic integral-based estimating equations (see, e.g., Peng and Huang) or by locally weighted approaches to adjust for the censored observations (see, for instance, Wang and Wang). While there have been proposals of different apparently dissimilar strategies in terms of formulations and the techniques applied for CQR, the inter-relationships amongst these methods are rarely discussed in the literature. In addition, given the complicated structure of the asymptotic variance, there has been limited investigation on improving the estimation efficiency for censored quantile regression models. This article addresses these open questions by proposing a unified framework under which many conventional approaches for CQR are covered as special cases. The new formulation also facilitates the construction of the most efficient estimator for the parameters of interest amongst a general class of estimating functions. Asymptotic properties including consistency and weak convergence of the proposed estimator are established via the martingale-based argument. Numerical studies are presented to illustrate the promising performance of the proposed estimator as compared to existing contenders under various settings.
Supplementary materials
for this article are available online.
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BFBNIB, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
The dielectric mirror is an important optical component for optoelectronic devices, passive photonic devices, and solar cells. Unfortunately, the reflection bandwidth of distributed Bragg reflectors ...(DBRs) and high-index contrast mirrors (HCGs) are limited by the index contrast of the material system used. Here, an aperiodic design for dielectric mirrors is proposed, and it is shown that for a fixed index contrast, the bandwidth of the reflection band can be arbitrarily widened by simply incorporating more dielectric layers. This is pronouncedly different from the fixed bandwidth of HCGs and DBRs. The physics behind the broadband reflection for the aperiodic stacking is identified as the photonic bandgap widening due to the annihilation of the quasi-guided modes in nonperiodic structures. This observation applies very well to aperiodic auto-cloned 3-D photonic crystal reflectors, to aperiodic DBRs, and even to diffuse dielectric mirrors that have recently emerged to be very promising for solar cells due to their zero plasmonic absorption nature. Experimentally, the white paint diffuse medium reflectors are applied to SiGe solar cells to confirm their high reflectance and the feasibility of enhancing solar cell efficiency.
•Comparison between anti-reflection coating (ARC) by graded-index and mode coupling.•Graded index ARCs lead to degraded light trapping at long wavelengths.•The observation confirmed by two-way ...reflectance and absorbance calculations.•The appropriate use of ARCs for thin-film and wafer-based photovoltaics.
Solar cell nano-structured anti-reflection coatings based on graded index (GI) and mode coupling are all proposed to significantly reduce the reflection from semiconductor–air interface. In this work, it is shown that purely graded index approach can lead to degradation of long wavelength absorption by eliminating quasi-guided mode excitation. The reason is that the physically graded layer not only provides low reflectance path from air to semiconductor, but also from semiconductor to air, leading to photon escape. This results in out-coupling of photons from the semiconductor to air. On the other hand, anti-reflection coating based on mode coupling does not suffer from degraded long wavelength absorption and it is capable of acting as one-way photon pass coating. It is found that the sidewall thickness of mode coupling anti-reflection coating has significant impact on its effectiveness for anti-reflection, and therefore the selection of process methods is critical for its low reflectance. It is proposed that the purely graded index coating is more suitable for wafer-based photovoltaics where full absorption is possible by two photon traces. The mode coupling coating is suitable for both wafer-based photovoltaics and thin-film photovoltaics since it provides not only low reflectance but also long wavelength quasi-guided mode excitations. In the end, new types of anti-reflection coating and light trapping structure are proposed to further enhance the performance.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Objectives: To examine the validity of routinely collected data in identifying hip fractures (HFs) and to identify factors associated with incorrect coding.
Method: In a prospective cohort study ...between January 2014 and June 2016, HFs were identified using physician diagnosis and diagnostic imaging and were recorded in a Registry. Records of HFs in the health information exchange (HIE) were identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification/Australian Classification of Health Interventions/Australian Coding Standards codes. New HFs were estimated by episode of care, hospital admission and with an algorithm. Data from the HIE and the Registry were compared.
Results: The number of HFs as the principal diagnosis (PD) recorded by episode (864) was higher than by admission (743), by algorithm (711) and in the Registry (638). The sensitivity was high for all methods (90-93%) but the positive predictive value was lower for episode (68%) than for admission (80%) or algorithm (81%). The number of HFs with surgery recorded in the PD by episode (639), algorithm (630) and in the Registry (623) was similar but higher than by admission (589). The episode and algorithm methods also had higher sensitivity (91-92%) than the admission method (84%) for HFs with surgery. Factors associated with coding errors included subsequent HF, long hospital stay, intracapsular fracture, younger age, male, HF without surgery and death in hospital.
Conclusions: When it is not practical to use the algorithm for regular monitoring of HFs, using PD by admission to estimate total HFs and PD by episode in combination with a procedure code to estimate HFs with surgery can produce robust estimations.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Pile/soil setup effect is a natural phenomenon where pile load capacity increases over time as the results of dissipation of pore-water pressure and soil aging. The magnitude of pile/soil setup is ...governed by three main factors, i.e. pile slenderness ratio, elapsed time and type of surrounding soil. In this study, empirical correlations were established based on data compiled from previous case studies. Two forms of empirical equations were proposed to predict the pile/soil setup effect subjected to different slenderness ratios and elapsed times. The proposed equations were subsequently verified by actual field data collected from two sites in Malaysia. Results showed that 80% of the pile capacities increased by 1.150-1.875 times per log time cycle. Piles in fine-grained soils generally exhibited a greater pile/soil setup effect than coarse-grained soils.
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