MAKING SOCIETY FIT FOR AGEING BULLETIN THE UNIVERSITY OF HONG KONG MAY 2020 VOLUME 21 NO.2 IN THE MIDST OF THE PANDEMIC HKU experts’ leading role in the fight to contain COVID-19 A BREAKTHROUGH IN ASTRONOMY Discovering the origin of globular clusters around giant galaxies
CONTENTS COVER STORY RESEARCH Filling the Vacuum Gut Reaction The Paradox of Information Control in China Lessons from the Past Capital Grains Finding Answers to an Age-Old Question Democracy and Judicial Behaviour in Asia Green Bonds Are on the Money The Sustainable Practice of Backpacking 14 16 18 20 22 24 26 28 30 Making Society Fit for Ageing Embracing an Active Old Age No Place Like Home Techno-Ageing Raising the Alarm on Dementia Mood Enhancers 02 04 06 08 10 12 PEOPLE KNOWLEDGE EXCHANGE Making It Work Hot off the Press HKU’s Virus Experts Called to Action Sink or Swim? 44 46 36 42 TEACHING AND LEARNING Research Lessons from the Emergency Room Equal Opportunity 32 34 06 32 44 36 18 22
MAKING SOCIETY FIT FOR AGEING Hong Kong society is ageing rapidly. In 2018 the city had 1.27 million people over 65, representing 17.9 per cent of the population; by 2038 the number will soar to 2.44 million, or 31.9 per cent of the population. HKU scholars in social sciences, architecture, engineering and medicine have been testing physical and social improvements that would allow the elderly to be more mobile, receive better support for problems like dementia, and have a healthy, meaningful old age. 03 COVER STORY 02 The University of Hong Kong Bulletin | May 2020
People can have active, productive and meaningful lives in their senior years, especially with the right systems and support in place. Hong Kong is getting old. By 2024, the city will officially be a ‘super-aged society’, meaning more than 21 per cent of people are aged over 65. By 2034, we will be ultra-aged, like Japan, with more than 28 per cent over 65. “These numbers mean both challenges and opportunities,” said Dr Vivian Lou Weiqun, Director of HKU’s Sau Po Centre on Ageing, “particularly as they imply a significant change in demographics that challenge our existing infrastructure.” Dr Lou has been investigating active ageing and how to empower people to better enjoy their senior years, and recently received more than HK$12 million from The Hong Kong Jockey Club Charities Trust to bring her strands of research under one umbrella, The Jockey Club Golden Age Journey Project. “Our aim is to promote active ageing and make the process better, healthier and more meaningful. We want to empower older adults through a focus on balancing employment and caregiving, volunteering, and learning. If older adults can become more engaged, this will have positive impacts on individuals, families, communities and society as a whole,” she said. This empowerment is happening at a time when the traditional Chinese model of families looking after their elderly parents has become unsustainable because the nuclear family now dominates and adult children have work and other obligations. As a result, caregiving is a growing concern. “We also don’t have enough professionals to deliver care to the rapidly growing number of elderly,” she said. “Instead, we need to think about a model in which families, community services, volunteers and the healthcare system collaborate and share caregiving for the elderly.” Filling in the blanks The first step is to understand how many people are engaged in caregiving and who they are, including age, gender, relationship with the elder person, labour force participation and other information. The government has not collected this data but following a 2018 study of the problem led by Dr Lou, it is changing tack: a subset of questions about caregivers will be included in the 2021 census. “Without data, evidencebased policy and planning is impossible,” she said. EMBRACING AN ACTIVE OLD AGE The costs of caregiving must also be understood. A study she conducted jointly with HSBC and The Women’s Foundation in 2019 estimated the direct and indirect costs of caregiving (such as reduced labour force participation by unpaid caregivers) will more than triple by 2040 to HK$126 billion (against HK$38.8 billion in 2018). Moreover, there is a need to understand the emotional cost on caregivers who have paid work and fear revealing their caregiving obligation will cause employers or work colleagues to look at them in a negative way. “We need to pool multiple stakeholders, including the commercial sector to look at this very serious challenge,” Dr Lou said. One solution is to train volunteers to share the caregiving load. Dr Lou has developed capacity-building programmes for the ‘youngold’ – retired people in their 60s or early 70s who are healthy and resourceful and who are sent to visit socially-isolated people with mild cognitive impairment. She and her team have also produced guidebooks, websites, apps and videos for both trained volunteers and those families who are taking care of stroke patients recently discharged from hospital or engaged in end-of-life care for loved ones. “We have standardised evidence-based volunteer empowerment by studying who are the most vulnerable groups and training volunteers to help them. My dream is to have specialised volunteers providing partnered care and support for community-dwelling older adults in every neighbourhood in Hong Kong,” she said. Breaking down barriers An added benefit is that volunteering can help the young-old lead more meaningful lives, especially as Hong Kong employers are still reluctant to recruit, retain and retrain them. “Fewer than 10 per cent of those aged over 65 do paid work. Internationally, this figure is not desirable. If we want older adults to have healthier, more meaningful lives, work should be an option,” Dr Lou said. To break down some of the boundaries for the aged, the Sau Po Centre on Ageing launched the Campus Ageing Mix Project for University Students (CAMPUS) last year with support from the ZeShan (HK) Foundation to bring together groups of senior citizens and students in the Faculties of Law, Engineering, Medicine, and Architecture to discuss topics of shared interest and increase the students’ ageing literacy. For example, law students met with seniors to discuss wills and power of attorney, while medical students learned about the daily challenges and experiences of ageing. Dr Lou has also worked with HKU Libraries and the Common Core Team on an inter-generational participatory co-design project supported by a Teaching Development Grant. All these efforts are working towards one goal. “Through our innovative inter-sector, interdisciplinary and international collaborations, we strive to continue our leadership in promoting quality of life in the face of new demographic realities and technological advancements,” she said. The Campus Ageing Mix Project for University Students (CAMPUS) brings together groups of senior citizens and students in different faculties to discuss topics of shared interest. HKU students and community members collaborate in inter-generational projects to design innovations for an ageing society. We need to think about a model in which families, community services, volunteers and the healthcare system collaborate and share caregiving for the elderly. DR VIVIAN LOU WEIQUN 04 The University of Hong Kong Bulletin | May 2020 05 COVER STORY
Elderly residents can feel lost and depressed when redevelopment or changing needs force them from the homes they have lived in for decades. HKU scholars are searching for ways to ease the blow. Many elderly people in Hong Kong and rural China have lived in their homes most of their lives. They know the neighbours, shops, sitting areas and transport links. But instead of enjoying the familiarity and security of their surroundings, some are being uprooted in their twilight years to make way for new developments or because their homes lack facilities they now need, such as wheelchair access and lifts. The situation has attracted interest from HKU researchers, who are looking at how to improve the built environment for the elderly in both new and existing neighbourhoods. “Our goal is to find architectural and planning solutions to some of the challenges that the growing population of elderly might face, whether it be mobility, access to services such as health centres, or opportunities for social connections. We also want to look at the impact that the built environment has on health and other indicators,” said the Dean of Architecture, Professor Chris Webster. Several recent projects are addressing the problem by combining data about the elderly with assessments of the built environment, both in Mainland China and Hong Kong. Banishing the relocation blues Using a natural experiment in Suzhou, China, Professor Webster, Dr Ying Chang and Dr Sun Guibo are studying the physical and mental effects on farmers forced to move due to development that is changing rural environs into new towns, and measuring the health impact of alternative designs. A baseline survey has been administered to more than 2,600 elders, including a control group still living in their village, and health information collected. The first part of the study was completed in November 2019 and yielded rather depressing preliminary results: those who were relocated had statistically higher levels of hypertension and were more likely to be overweight. The researchers hope they can improve such outcomes through more consultative planning as well as better design. “We want to make things better for these residents by looking at the environmental features that are best for their mental, physical and social outcomes. For example, what are the effects of planting greenery outside their buildings, or installing facilities for them to exercise or sit and socialise, or placing roads An interview with an elderly person in the sub-divided flat about their concerns on the coming urban renewal and relocation. NO PLACE LIKE HOME away from these public places? China has invested a lot of money in greening, but is it being spent in ways that the elderly need?” Dr Sun said. The team is also conducting natural experiments in Hong Kong. One project measures impact of the new Tuen Ma Mass Transit Railway (MTR) development on a group of elderly living near a station; another, the impact of relocating elderly residents from sub-divided units (earmarked for development) in To Kwa Wan to high-rise commercial housing. Results are pending but, as with the China study, Dr Sun said they hope to show how changes to the built environment causally affect the mobility and well-being of elderly people. Optimal thresholds Professor Rebecca Chiu Lai-har has also studied the changing living circumstances of Hong Kong’s elderly and her work has had policy impact. The Hong Kong Housing Society (HKHS) adopted her recommendations to include wheelchair access and other support and services to make it easier for the elderly to ‘age in place’ in its estates (see Vol. 19 No.2 of theBulletin ), and to design new housing estates with buildings and services targeted at seniors. The HKHS and government also both recently adopted her recommendation to let elderly homeowners essentially swap flats with other eligible homeowners so they can move into a smaller place, while staying independent. Professors Webster and Chiu also work with Dr Derrick Ho Hung-chak, who is measuring the associations between estate layout, density, air pollution and other environmental features and the health and behaviour of elderly residents. Dr Ho’s early findings show there can be too much of a good thing – too many open spaces put facilities beyond easy walking distance for the elderly, while too many health clinics stigmatise a place for them. “There should be a balance of these things. We’re trying to determine the optimal threshold for different environmental factors around public housing estates that will give older adults high mobility and comfort,” Dr Ho said. Dr Ho and Professor Terry Lum Yat-sang of the Department of Social Work and Social Administration are also looking at how the physical environment of HKHS estates affects the mental health of the elderly. “We want to see if a more stimulating environment can promote more social interaction and physical activity and help slow the deterioration of mental health,” Professor Lum said. The numbers are still being crunched but so far it seems that a sense of community and social support make people more willing to stay in their estate. Professor Lum also works on a Jockey Clubfunded project to help districts develop initiatives that will qualify them for the WHO Global Network for Age-friendly Cities and Communities. An example of his recommendations was to install fold-down chairs at tram stations and seats in MTR stations so the elderly can take a short rest while they wait for transport. Elderly residents doing exercise in the open space of the Choi Hung Estate, a public housing estate built in the 1960s. Installing fold-down chairs at tram stations and seats in metro stations for elderly to take a short rest when waiting for transport are one of the many ways to make the city more age-friendly. Our goal is to find architectural and planning solutions to some of the challenges that the growing population of elderly might face, whether it be mobility, access to services such as health centres, or opportunities for social connections. PROFESSOR CHRIS WEBSTER 07 COVER STORY 06 The University of Hong Kong Bulletin | May 2020
The data will also be able to track the elderly over time and see what types of activities may help in the ageing process. PROFESSOR REYNOLD CK CHENG A user requirements meeting for HINCare application. Professor Terry Lum Yat-sang of the Department of Social Work and Social Administration has been a champion of Hong Kong’s elderly, overseeing multiple funded projects to make the city more age-friendly and improve elderly care. But as a social scientist, he is keenly aware that the best solutions require interdisciplinary approaches – particularly when it comes to technology. Professor Lum has therefore teamed up with the Department of Computer Science on several projects that bring new approaches to improving the lives of the elderly. “When we come together and brainstorm, we can combine both the clinical and data sides and make more exciting solutions for enhancing the well-being of older people,” he said. One example of that is the Time Bank, which Professor Lum has advocated for in Hong Kong, to encourage able senior volunteers to help their more frail counterparts with such things as doctor visits and shopping. The volunteered hours are ‘banked’ for redemption later, when the volunteers themselves may need help. However, the system is not digitised, which makes management of the Time Bank more burdensome for participating nongovernmental organisations (NGOs) and means that useful data for improving the service is not computed. A collaboration between Professor Lum and computer scientist Professor Reynold CK Cheng will change that. Professor Cheng and his team are applying artificial intelligence (AI) to create a heterogeneous information network (HIN) database for the Time Bank that not only matches the elderly and volunteers, but provides a deep well of information about who is using the service, what they use it for, their health conditions and other data that will help NGOs and the government plan services. Like Uber For instance, an app under development will let volunteers input special skills, such as languages spoken and driving license, and allow the elderly to directly ‘book’ volunteers for the time and service that they need. Currently, they need to make arrangements through participating elderly centres. “The system will operate similar to Uber. So if the elderly person uses a wheelchair and needs two people to accompany them next Wednesday to outpatient services, the system will use AI to suggest several names available at the time for the older person to choose,” Professor Cheng said. “The data will also be able to track the elderly over time and see what types of activities may help in the ageing process.” The project, which is funded by the Innovation and Technology Fund under the umbrella title HINCare, is timely given that society is rapidly ageing and there are fewer people to look after the elderly. By 2038, Hong Kong will have only about two working adults for every elderly person, nearly half the rate of 2018. In addition to the Time Bank collaboration, Professor Lum has also joined up with Dr Chuan Wu in Computer Science (see box) to develop a smart sensor system that monitors the trajectory of elderly residents around their home to detect emergency situations, such as a fall, and alert caregivers. The system may also detect longer-term changes, such as changes in gait or patterns of wandering. “Each person has their own gait velocity which indicates how healthy they are. If they develop dementia, this changes,” Professor Lum said. “In working with the computer scientists, we can develop devices like this to help older people in their everyday lives.” The Time Bank app provides intelligent recommendation services and matches volunteers and the elderly in need. After providing services, volunteers can save their time credits in their ‘bank accounts’ for redemption later when they need help. HKU scholars are using robotics and artificial intelligence to develop smart devices and better services for the elderly. TECHNO-AGEING The prototype smart walker can move independently with patients, detect if they are falling, and give them something to hold onto if they fall. A WALKER WITH SMARTS When computer scientist Dr Chuan Wu watched her elderly father struggle to stay mobile with Parkinson’s disease, she felt she had to do something. The disease affects balance and makes it difficult for patients to grasp and push walkers. Dr Wu teamed up with Dr Zheng Wang from Mechanical Engineering to devise a prototype smart walker – a device that can move independently with patients, detect if they are falling, and give them something to hold onto if they fall. “Parkinson’s disease patients tend to lean forward when they walk and they often trip. This device is stable and strong enough to support them so they don’t fall to the ground,” she said. The walker is like a robot with sensors that allow it to move autonomously. It can be controlled by voice or claps, so if people are in their bedroom they can signal the walker to come to them from another room. “The user can even give it a name and call it by that name,” she said. Dr Wu recently received an Innovation and Technology Fund grant to develop the prototype further over the next two years. Her teammate Dr Wang is exploring ‘soft skin’ technology to detect pressure on handrails and perform corresponding actions, a wheel that can go over small curbs, and an adjustable handrail that could lower to chair level to help people stand up. Dr Wu is also working on a mobile app for Parkinson’s patients that would recommend suitable exercises for managing their disease, keep records and send out reminders when it was time to do them. 08 The University of Hong Kong Bulletin | May 2020 09 COVER STORY
About 100,000 people in Hong Kong suffer from dementia, a number that is expected to triple by 2040. Scholars in the Department of Social Work and Social Administration are trying to jumpstart the city’s dementia policy and improve the lives of patients and caregivers. RAISING THE ALARM ON DEMENTIA TIP-CARD researchers participating in a Theory of Change workshop led by the London School of Economics and Political Science to develop a roadmap for dementia policy. The leaflet of the TIP-CARD project includes figures showing the expected growth in the number of people with dementia in Hong Kong, as well as the increasing burden. If the system is not ready, it is difficult to do effective intervention work. But to help people, you have to work within the system. DR GLORIA WONG HOI-YAN Dr Gloria Wong Hoi-yan has worked for years to develop interventions and care management for sufferers of dementia. And while she has had some successes (see box), one stumbling block has loomed in her path. Unlike Taiwan, Macau and other developed societies, Hong Kong does not yet have a specific policy for dealing with dementia, creating a dilemma for her. “If the system is not ready, it is difficult to do effective intervention work. But to help people, you have to work within the system,” she said. Her response has been to try to improve that system. Dr Wong is spearheading a Research Impact Fund-supported project to develop short-, medium- and long-term goals for dementia care in Hong Kong, called the TIP-CARD – for Tool to Inform Policy: Chinese Communities’ Action in Response to Dementia. The three-year project started in April 2019 and Dr Wong and her team have been working with stakeholders to assess the current needs, expectations, priorities and resources for dementia care, the cost to society (including caregivers, who not only need support but may have stepped back from incomegenerating work to look after loved ones), and the policy options. They will develop new tools for policymakers, and not a moment too soon. Within 20 years, nearly one-third of Hong Kong residents will be over 65 years old and about 330,000 people will have dementia. Hong Kong is not alone in facing this problem. “The World Health Organization has declared that dementia is a public health priority,” Dr Wong said. She is thus also collaborating with a London School of Economics project to help lower- and middle-income countries develop dementia policy. Improving services Apart from policy development, HKU scholars are also advising the government on how to improve services for dementia patients. In one project, Dr Wong and a multidisciplinary team from the Social Sciences and Medical Faculties evaluated the pilot Dementia Community Support Scheme, a governmentfunded initiative in which medical and associated professionals provide communitybased support for patients with mild to moderate dementia and their caregivers. The scholars showed this maintained daily living function in patients and reduced the burden on caregivers. With that evidence, the government made the scheme permanent. Team member Professor Terry Lum Yat-sang has also devised a tool to improve the allocation of government-funded long-term care for cognitively impaired individuals. Currently, the system is crude – 86 per cent of those assessed are deemed to have severe impairment, qualifying them for long-term care; the rest are diagnosed with low or mild impairment. “That is a very high proportion getting long-term care. We joke that it might be cheaper for the government not to do the assessment rather than put in this effort,”he said. The tool developed by Professor Lum and his team provides a finer, more precise assessment that he likens to “an MRI machine instead of the low-resolution x-ray they have now”. Older adults are classified into six to eight categories and each level has a protocol for planning the patient’s care. The Legislative Council is expected to endorse this approach this year. In the meantime, 3,000 social workers are being taught how to use it. “This will change the whole landscape of longterm care in Hong Kong,” Professor Lum said, although ultimately the outcome will depend on government support. “The government will need to provide resources for long-term care services. Otherwise, the higher-resolution image will not help clients at all.” BRAIN ACTIVITY Dr Gloria Wong Hoi-yan has been at the forefront in bringing cognitive stimulation therapy (CST) to Hong Kong, a nonpharmacological treatment for dementia patients that has been endorsed in the United Kingdom. She has adapted materials for Cantonese speakers and overseen the training of more than 400 CST facilitators. The therapy brings together patients with mild to moderate dementia in small groups to chat and play games as they would normally do in an elderly centre. However, a trained leader prompts them with questions or tasks to stimulate their brainwaves. For example, as patients reminisce, they may be asked to compare the price of a bowl of wonton noodles in the past versus today, which involves executive functioning. Or play a game where they plan a dinner. Training of local healthcare and social care professionals in cognitive stimulation therapy led by Dr Gloria Wong from HKU and Professor Aimee Spector from the University College London. “Often people with dementia are treated as having no ability. The family takes care of everything so the person has nothing to do but sit at home, which isn’t great for cognitive functioning or quality of life. CST provides a platform for them to be engaged in a social setting in activities they enjoy,” she said. Dr Wong has also received funding to develop new non-pharmacological interventions, including for people with more severe dementia in collaboration with University College London and Peking University. “These people have long been neglected but we think we can at least do something to improve their mood. Improved mood can also improve a person’s cognition,” she said. 10 The University of Hong Kong Bulletin | May 2020 11 COVER STORY
Elderly people and the caregivers of elderly with dementia all have a high risk of depression. Programmes developed at HKU are helping to lift their mood. MOOD ENHANCERS An appreciation gathering was held in December 2019 for peer supporters of the Jockey Club JoyAge project. A workshop for old age home staff to learn about the symptoms of dementia and ways to handle them. Participants in the Wellness Recovery Action Plan facilitator training. About 10 per cent of Hong Kong people aged over 65 show signs of depression, the result of stress, poor health and lack of social engagement. Similar factors can also darken the mood of the family members who look after elderly relatives suffering from dementia. The problem has motivated Professor Terry Lum Yat-sang, Henry G Leong Professor in Social Work and Social Administration, of the Department of Social Work and Social Administration and Dr Chan Wai-chi of the Department of Psychiatry to find ways to improve the mental health of both groups. “Depression is a common mental health challenge for older people, but the current system is not effective in helping them,” said Professor Lum. Moreover, because Hong Kong is an ageing society with fewer working adults available to look after each elderly person, the burden of care falls on families, especially for the elderly with dementia. Dr Chan said a study in the United States found nearly one-third of caregivers met the diagnostic criteria of depression, and caregivers also suffered from more physical problems, such as hypertension. Given that Hong Kong’s over-65 population already numbers more than 1.27 million and is rapidly growing, time is of the essence to get solutions in place that will help the elderly and their caregivers enjoy better mental health. Joy in old age Professor Lum is spearheading the Jockey Club JoyAge project, launched in 2016 to promote collaboration between medical and social services on elderly depression and train social workers and other frontline staff to identify and help at-risk individuals. The project also provides 100 hours of training for ‘peer supporters’ – seniors who visit the elderly who live alone or are at risk, and encourage them to come out into the community, and who provide peer support to older people with depression under the supervision of a professional social worker. The first stage of the project involved about 4,000 elderly in four districts and was supported by six non-governmental organisations and about HK$82 million from the Jockey Club. The results so far have been highly encouraging. “There are two major outcome indicators that we are focussed on. One is preventing older people from falling into depression. The other one is treating people who already have symptoms that we can try to reverse,” he said. Over three years, those who received the JoyAge intervention were two times less likely to become depressed or six times more likely to show significant improvement than the control group that did not participate in the project. That success has convinced the Jockey Club to inject another HK$279 million into JoyAge so it can be implemented in all 18 districts in Hong Kong starting this year. “We are helping to reduce the stigma of getting help for mental health issues and we hope to reach many more people,” Professor Lum said. Helping the helpers Stigma is also a concern for caregivers because dementia is often seen as a mental illness in the Hong Kong community. “Caregivers don’t want other people to know they have relatives with dementia because they worry it will be degrading to their family name and their status in society,” Dr Chan said, so they tend to ’hide’ their caregiving role. Focus groups assessing the concerns of caregivers have highlighted their unhappiness. “It’s not surprising that most caregivers see caregiving as a negative, associated with guilt, embarrassment and shame,” he said, especially given the 24-hour nature of caregiving and the challenge of dealing with people who are aggressive, irritable and difficult. “Some did share positive aspects with us, such as the opportunity to return the favour to their parents who looked after them when they were young by now providing them with companionship. Some find caregiving adds meaning to their lives. But most tell of negative emotions.” To help them cope, Dr Chan developed workshops for caregivers at the David Trench Rehabilitation Centre that is part of Queen Mary Hospital, led by himself and nursing and occupational therapy colleagues. They educate the caregivers about what to expect with dementia and how to deal with the behaviours, such as identifying patterns. For instance, expressions of anger may arise when the patient is hungry but cannot express themselves properly. “We formulate steps that caregivers can take when facing these problems,” he said. He also organises an annual workshop for formal paid caregivers to reinforce their skills in handling such problems as shouting and inappropriate sexual behaviours by patients. Dr Chan also piloted a programme to provide exercise intervention for family caregivers that involved 12 weeks of guided tai chi. The mood of the group was elevated compared to the control group that did not receive the intervention, but after 24 weeks both groups were back to the same levels. “When we were not there to guide them, they didn’t keep it up. Exercise improves endorphins, especially when people do it together,” he said, underscoring the need to help both caregivers and the elderly feel less isolated. This may go a long way to improving their mood. We are helping to reduce the stigma of getting help for mental health issues and we hope to reach many more people. PROFESSOR TERRY LUM YAT-SANG 12 The University of Hong Kong Bulletin | May 2020 13 COVER STORY
Researchers from the University of California, Berkeley showed that heat energy can travel through a complete vacuum thanks to invisible quantum fluctuations. To conduct the challenging experiment, the team engineered extremely thin silicon nitride membranes, which they fabricated in a dust-free clean room, and then used optic and electronic components to precisely control and monitor the temperature of the membranes when they were locked inside a vacuum chamber. (Courtesy of Violet Carter, UC Berkeley) Recent research by HKU’s President and Vice-Chancellor, Professor Xiang Zhang, has caused a stir in the scientific world by demonstrating that vacuums are not empty spaces and by manipulating activity within them. When Professor Xiang Zhang undertook his qualifying PhD examination at the University of Berkeley, California, in 1994, he was asked to explain how his examiner’s voice could be heard across the table. “I answered, ‘it is because your sound travels by vibrating molecules in the air.’ He further asked me, ‘what if we suck all air molecules out of this room? Can you still hear me?’ I replied no, because there would be no medium to vibrate.” But times – and human knowledge – have changed. Two new studies guided by Professor Zhang and involving colleagues from Berkeley have shown that there is indeed much going on in vacuums. The focus of their research is a recent theory based on quantum mechanics, which argues empty space cannot be truly empty because it still contains fluctuating electromagnetic waves that cannot be completely eliminated. These waves produce a force, called the Casimir effect, that connects two objects such that if one object starts shaking or oscillating, the nearby object will be set into motion even in a vacuum. The scientists demonstrated for the first time that the Casimir effect can enable heat transfer, which has implications for high-speed computation and data storage. Furthermore, they proposed and demonstrated that the Casimir effect could also cause objects to repel from each other, which has implications for frictionless mechanics that are important for medical robots and quantum sensors. Hot discovery In the heat transfer study, Professor Zhang and his team overcame the significant hurdle of transmitting heat in a vacuum. They engineered extremely thin, gold-plated silicon nitride membranes in a dust-free clean room, then placed two of these membranes a few hundred nanometres apart inside a vacuum chamber. The temperature of the membranes was precisely controlled and monitored using optic and electronic FILLING THE VACUUM components. As predicted, when one membrane was heated up, the other warmed up, too – in other words, heat leapt from a hot membrane to a colder one inside the vacuum. The size and design of the membranes were important in enabling this thermal transfer, as was the distance between them in order to rule out thermal radiation as the cause. The findings were published inNature . “Although this interaction is only significant at very short lengths – a few hundred nanometres – the implications could be profound for the design of computer chips and other nanoscale electronic components that are affected by heating issues that could limit their performance,” Professor Zhang said. No friction In the study on frictionless mechanics, Professor Zhang and a separate team pushed scientific understanding even further. They proposed creating a ‘Casimir quantum trap’ without energy input by exploiting both attractive and repulsive forces – the attraction between two objects of the same material would be reversed at short distances and preserved at long ones without them ever touching each other. The repulsion effect was confirmed in experiments similar to those for heat transfer, except in this case the objects were coated with Teflon. At short electromagnetic wavelengths Teflon’s low reactivity gave a repulsive force, while at longer waves gold’s higher-refractive index caused an attraction, thus creating the Casimir trap without using additional energy. The finding is important for mechanical systems, which typically experience friction between objects such as gears and wheels that require costly maintenance and replacement. It also has implications for magnetic systems, such as Maglev trains, which have high energy demands. “This quantum trap is totally passive and the trapping distance can be controlled by adjusting the thickness of the coating layer. The same principle can be applied to many other materials,” he said. The discovery was published in Science and selected as a top 10 Breakthrough of the Year 2019 by Physics World , a membership publication of the Institute of Physics in the United Kingdom. Professor Zhang noted that these discoveries were just the beginning. The heat transfer effect is particularly resonant with his PhD examination experience. “Because molecular vibrations are also the basis of the sounds we hear, the discovery opens up the possibility that sounds could also travel through a vacuum. So I was wrong in my 1994 examination. Now, you can shout through a vacuum,” he said. Because molecular vibrations are also the basis of the sounds we hear, the discovery opens up the possibility that sounds could also travel through a vacuum. PROFESSOR XIANG ZHANG In the experiment, the team showed that heat energy, in the form of molecular vibrations, can flow from a hot membrane to a cold membrane even in a complete vacuum. This is possible because everything in the universe is connected by invisible quantum fluctuations. (Courtesy of Zhang Lab, UC Berkeley) The team used highly sensitive optics to monitor the temperature of the silicon nitride membranes during the experiment. (Courtesy of Violet Carter, UC Berkeley) 14 The University of Hong Kong Bulletin | May 2020 15 RESEARCH
The discovery that an individual’s gut microbes may determine how much benefit they get from exercise, has significant implications for preventing diabetes and for improving exercise efficacy in general. GUT REACTION Professor Xu Aimin (second from left, front row) and his research team, including Professor Karen Lam Siu-ling (first from left, front row) and Dr Michael Tse (first from right, second row). Volunteers participating in a 12-week supervised exercise training intervention. Exercise is generally recognised as highly beneficial for your health, but it works better on some people than others. New research suggests that people possessing certain gut microbes may in fact gain better metabolic outcomes from exercise than others. “The prevalence of diabetes (particularly type 2 diabetes) has been reaching epidemic proportions globally,” said Professor Xu Aimin, Chair Professor of Metabolic Medicine in the Department of Medicine. “Although there is no cure for diabetes, it can be prevented by early lifestyle interventions, with exercise being the most cost-effective strategy. However, until now, the molecular transducers mediating the metabolic benefits of exercise have remained largely unclear.” To address this issue, his team – including co-corresponding authors Dr Michael Tse, Director of HKU’s Centre for Sports and Exercise, and Dr Gianni Panagiotou, Head of Systems Biology and Bioinformatics, Hans Knoell Institute – decided to identify exerciseresponsive factors comprehensively using an unbiased multiomics approach. Asked why they concentrated on the gut, Professor Xu said: “Our gut harbours a complex community of over 100 trillion microbial cells which influence human metabolism, nutrition and immune function, while disruption to the gut microbiota has been linked with obesity and diabetes. Therefore, we wanted to investigate whether exercise mediates the metabolic benefits by reshaping gut microbiota, and for those people who do not respond well to exercise, whether their ‘exercise resistance’ is due to maladaptation of gut microbiota.” The research team conducted a 12-week randomised controlled trial (RCT) in the form of a high-intensity exercise training intervention on 39 Chinese men with pre-diabetes. The participants, who had never taken medication for their condition, were randomly assigned to either a sedentary control group, or to a group that underwent the supervised exercise training. All participants were instructed to maintain their usual diet. The results showed that while all the participants exhibited a similar degree of weight and fat mass reduction, only 70 per cent of them showed significant improvements in glucose metabolism and insulin sensitivity, whereas the remaining 30 per cent were not responsive to exercise. “Analysis revealed obvious differences in exercise-induced compositional and functional alterations in gut microbiota and its metabolites between responders and non-responders,” said Professor Xu. “The microbiome of responders exhibited enhanced capacity for biosynthesis of short-chain fatty acids and catabolism of branched-chain amino acids, whereas that of non-responders was characterised by increased production of metabolicallydetrimental compounds. “The results suggest that gut microbiota and its metabolites serve as important contributors to the metabolic benefits of exercise intervention. They also identify maladaptation of gut microbiota as being responsible for those individuals who do not respond to exercise.” Maximising the benefits This is one of the first interventional RCT studies providing clear evidence of the role of gut microbiota on metabolic health. The findings raise the possibility of maximising the benefits of exercise by targeting gut microbiota; and also offer new insight for clinicians and exercise specialists to target the microbiome of exercise non-responders as another means of better enhancing therapeutic interventions. While acknowledging that this discovery has big implications for diabetes sufferers, Professor Xu emphasised that despite the existence of exercise resistance, physical exercise remains the most cost-effective strategy for the prevention and treatment of diabetes. “We observed a quick improvement in insulin sensitivity within only four-week period after commencing the high-intensity training, in the absence of any dietary changes. This finding suggests that glucose metabolism can be improved in a portion of individuals with pre-diabetes by even shortterm modifications to their exercise habits. “For non-responders, exercise alone may not be enough but this doesn’t mean exercise is useless. For these subjects, more intensive interventions, a combination of exercise training and targeted dietary intervention to modulate gut microbiota, are required to achieve a better therapeutic effect,” he said. In addition, the team is looking at the implications for improving the efficacy of exercise for people not suffering from diabetes. “We tried to establish a model from our study, which could first predict the The results suggest that gut microbiota and its metabolites serve as important contributors to the metabolic benefits of exercise intervention. PROFESSOR XU AIMIN probability of whether an individual could benefit from exercise,” Professor Xu said. “If they did not show to benefit from exercise, we could further analyse the unique metabolic characteristics of the gut microbiota and use probiotics, prebiotics or targeted dietary intervention to fine-tune the gut microbiota, thus restoring responsiveness to the metabolic benefits of exercise training. “Interventions could be modified based on our prediction model to classify if one is a responder or a non-responder. By doing so, we are seeking the possibility of people taking some types of supplements to enhance the microbiome to make the gut more responsive to exercise. It also helps exercise practitioners ‘prescribe’ exercise plans and strategies based on an individual’s responsiveness.” 16 The University of Hong Kong Bulletin | May 2020 17 RESEARCH
The COVID-19 coronavirus outbreak that started in Wuhan this past winter triggered deep questions about the flow of information in Mainland China, as officials played down the threat until it became too big to ignore. To those who experienced SARS in 2003, the situation was depressingly familiar. Dr Clement Chen Yongxi of the Faculty of Law was an MPhil student during SARS. In 2002, he had witnessed the drafting of a new freedom of information regulation for Guangzhou – the first of its kind in China – and he was dismayed that it failed to make the municipal government more transparent about the SARS outbreak. The situation prompted his research interest in the gap between law on paper and law in action, and to observe: “What happened with SARS is closely related to what is happening now.” As in Guangzhou, the central government had ostensibly improved freedom of information with the 2007 introduction of the Regulation on Open Government Information (ROGI) which, ironically, was partly motivated by SARS and other cover-ups. But this failed to ensure prompt reporting about COVID-19. Whistleblowing doctors in Wuhan felt compelled to go to social media about the threat rather than official channels such as news agencies, and they were summoned and disciplined by the police for their efforts. So why haven’t the lessons been learned? Dr Chen’s research over the past 12 years sheds light on the flaws – and progress – of information control on the Mainland. No right to monitor government Dr Chen said the ROGI was initially considered a positive step because for the first time in Chinese history, citizens had the right to demand information from their government. But two critical defects have limited its impact. One is that it conflicts with other laws which restrict disclosure of information and prevail over ROGI. The other is that it contains a wide scope of exemptions, including disallowing the disclosure of information that ‘endangers social stability’, which is not defined. This gives government agencies wide discretion to interpret things as they see fit. The judicial response to the government’s denial of access to information has been cautious. Courts examine closely the motive of the applicant, but subject agency claims to various degrees of scrutiny. As a result, they support information requests relating to the applicant’s personal interests, such as their property rights, but refrain from enforcing ‘watchdog requests’ concerning government accountability or the common good. “Some judges have even claimed that the right to information under ROGI does not amount to the right of monitoring the government. This is a bit ironic because the nature of freedom of information laws almost around the world is as an instrument to support democracy and allow citizens to monitor government operations,” he said. “This partly explains why, after 17 years, ROGI doesn’t prevent a public emergency similar to SARS from being covered up.” Dr Chen also finds connections between freedom of information and privacy and the new social credit system. Similar to ROGI requests, court rulings on privacy tend to support individuals seeking to protect Chinese law allows access to information on the one hand but restricts it on the other, which has a troubling impact on everything from virus outbreak controls to the country’s new social credit system. THE PARADOX OF INFORMATION CONTROL IN CHINA themselves from other private entities, such as individuals and corporations, but act differently on privacy claims against agencies holding public power, such as the government. “In the absence of a general law that regulates government collection and use of personal data, citizens find it difficult to sue the government for privacy violation. Nor is there an effective legal mechanism to guard oneself against government surveillance,” including the new social credit system, which is being rolled out across the country, he said. ‘Trustworthiness’ and double punishment The social credit system rates each citizen’s ‘trustworthiness’, but its operation deviates from legal principles such as proportionality and no double punishment. For instance, if a person is deemed ‘untrustworthy’ for failing to pay an administrative fine, that assessment will remain attached to their rating long after they face the legal consequences. As a result, they may encounter bans or difficulty in purchasing airline tickets, unfavourable rates on loans and other punishments. Moreover, the person will usually not be notified about their untrustworthy rating nor why it has been applied – they discover the rating only when they try to use a service, such as book a flight. “In classical administrative law, there should be no double punishment. If I rush a red light, I should be fined, but after I fulfil my legal liability, that is it. I would not be punished twice or three times for a single misbehaviour,” he said. Credit China is the official portal for promulgating policies of the social credit system and sharing data concerning the trustworthiness of individuals and entities. “This is entirely a new, strange way of decision-making. It overly focusses on the deterrent effect but without looking carefully into the rationale or severity of punishment.” Dr Chen is concerned about the challenges facing administrative law in China, given the slow response of the legal system to the datafication of society as demonstrated by the social credit system, and restrictions on freedom of information and privacy. “When ROGI came in, I hoped it could be a game changer for government transparency and accountability. The subsequent developments show otherwise,” he said. What happened with SARS is closely related to what is happening now. DR CLEMENT CHEN YONGXI 18 The University of Hong Kong Bulletin | May 2020 19 RESEARCH
The team of students (and a young aspiring archaeologist) excavating Mediaeval remains at the Vedi Fortress. The Ararat Plain stretches out in the distance. A new major archaeological research programme enables students to study the past of Armenia and the Ancient Near East and to excavate an ancient fortress and other settlements. The project also engages the public directly in field archaeology through an interdisciplinary knowledge exchange initiative. The five-year programme marks the beginning of a collaborative research partnership between HKU and the Institute of Archaeology and Ethnography of the Republic of Armenia’s National Academy of Sciences, as well as multiple cross-faculty collaborations within HKU. “Our international project seeks to apply interdisciplinary approaches to the study of the ancient world,” said Dr Peter J Cobb, Assistant Professor in the Faculties of Education and Arts, who is leading the project in collaboration with Artur Petrosyan and Boris Gasparyan of the Armenian Institute. The trio developed the Ararat Plain Southeast Archaeological Project (APSAP) to advance knowledge about human life and mobility in the Vedi river valley, a tributary valley to the Ararat Plain located south of Yerevan, Armenia’s capital. The Institute’s Hayk Azizbekyan coordinates all on-the-ground activities for the project. Shared heritage “The Ancient Near East is central to our shared human heritage as the region of the world that saw many firsts in societal complexity – from agriculture to writing and cities,” said Dr Cobb. “The Vedi river valley connects the plain and the mountains as an important sub-route within larger historical networks like the Silk Road. Our main site, the Vedi Fortress, controlled local traffic from its central position in the valley. Protected on most sides by cliff faces, the site’s gentle northwestern approach is defended by two lines of massive fortification walls, likely dating to the Late Bronze Age (circa 1500–1150 BCE).” Despite this rich history, the Vedi river valley and its environs have seen comparatively less archaeological attention than other surrounding regions, which means the project presents a unique opportunity to explore new chronological and theoretical questions. The programme collects and analyses data using the latest accurate and efficient digital tools and methods – one more important focus of innovative cross-disciplinary cooperation. “We are collaborating with Professor Wenping Wang from the Faculty of Engineering to explore the latest technologies for rapidly 3D scanning and precisely analysing the shapes of ancient objects, especially ceramics,” said Dr Cobb. In addition, the project has sparked an interdisciplinary knowledge exchange LESSONS FROM THE PAST initiative called ‘Digging the Past Together: International Public Engagement in Near Eastern Archaeological Research’. This initiative brings together faculty members from Engineering, Architecture and Social Sciences, in addition to Education and Arts, and also activates multiple international partnerships. “I am working with Dr Tom McDonald of Social Sciences to supervise a student social media specialist who will help engage the public in conversations about archaeology,” said Dr Cobb. “We are particularly interested in introducing Near Eastern archaeology to East Asian audiences. To create content for our outreach efforts, we have partnered with Dr Serkan Şavk of the Izmir University of Economics’ Department of Cinema and Digital Media. His team is currently developing short films from the first season to introduce our fieldwork and invite the public to participate in our research. “We are also working with Dr Zhu Xu of Architecture to bring an architecture student on to our project to create 3D reconstructions of our site. These models will help the public visualise the past. In addition, we are developing educational activities for schoolchildren in Armenia. This outreach will take place through partnerships with Ms Ani Avagyan and the National Gallery of Armenia and Dr Caitlin Curtis of the University of Wisconsin-Parkside. As part of the Gallery’s summer cultural heritage programme, groups of Armenian children will visit our fieldwork site during the summer, where HKU students will help them learn about archaeology. Through all these knowledge exchange efforts, we hope to increase the impact of our archaeological research on contemporary society.” Initial foray APSAP’s first season took place last summer when a team – which included HKU students from Arts, Architecture and Social Sciences, as well as undergraduates from universities in the United States, Turkey and Armenia – made their initial foray to the Vedi Fortress, a site which had not previously been subject to scientific archaeological excavation. The main discoveries included fragments of ceramic vessels and the remains of stone architecture, which will be analysed to develop a clearer picture of how people lived in this landscape in the past. “Pottery styles inform us about the time periods when sites were occupied, and how sites in the landscape communicated with each other,” said Dr Cobb. “We map the architectural remains to better understand the urban configuration of the site, thus revealing where people lived, what they did in each space, and how they moved from place to place.” The Armenia field project has now become an official credit-bearing undergraduate course ‘Cultural Heritage and Information in the Field’. The class will enable students to gain experience with field archaeology, to learn about the Ancient Near East, and to develop new skills in digital humanities technologies and information management during a complex data collection project. Groups of Armenian children will visit our fieldwork site during the summer, where HKU students will help them learn about archaeology. Through all these knowledge exchange efforts, we hope to increase the impact of our archaeological research on contemporary society. DR PETER J COBB A team from the Izmir University of Economics filming the archaeological fieldwork to share with a public audience. (Courtesy of Yadian Wang) The outer massive fortification wall of the Vedi Fortress is likely to be over 3,000 years old. 20 The University of Hong Kong Bulletin | May 2020 21 RESEARCH
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