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Conceptual knowledge is central to human cognition. The left posterior inferior parietal lobe (pIPL) is implicated by neuroimaging studies as a multimodal hub representing conceptual knowledge related to various perceptual–motor modalities. However, the causal role of left pIPL in conceptual processing remains unclear. Here, we transiently disrupted left pIPL function with transcranial magnetic stimulation (TMS) to probe its causal relevance for the retrieval of action and sound knowledge. We compared effective TMS over left pIPL with sham TMS, while healthy participants performed three different tasks—lexical decision, action judgment, and sound judgment—on words with a high or low association to actions and sounds. We found that pIPL-TMS selectively impaired action judgments on low sound–low action words. For the first time, we directly related computational simulations of the TMS-induced electrical field to behavioral performance, which revealed that stronger stimulation of left pIPL is associated with worse performance for action but not sound judgments. These results indicate that left pIPL causally supports conceptual processing when action knowledge is task-relevant and cannot be compensated by sound knowledge. Our findings suggest that left pIPL is specialized for the retrieval of action knowledge, challenging the view of left pIPL as a multimodal conceptual hub. [Display omitted]

Shape-From-Silhouette (SFS) is a shape reconstruction method which constructs a 3D shape estimate of an object using silhouette images of the object. The output of a SFS algorithm is known as the Visual Hull (VH). Traditionally SFS is either performed on static objects, or separately at each time instant in the case of videos of moving objects. In this paper we develop a theory of performing SFS across time: estimating the shape of a dynamic object (with unknown motion) by combining all of the silhouette images of the object over time. We first introduce a one dimensional element called a Bounding Edge to represent the Visual Hull. We then show that aligning two Visual Hulls using just their silhouettes is in general ambiguous and derive the geometric constraints (in terms of Bounding Edges) that govern the alignment. To break the alignment ambiguity, we combine stereo information with silhouette information and derive a Temporal SFS algorithm which consists of two steps: (1) estimate the motion of the objects over time (Visual Hull Alignment) and (2) combine the silhouette information using the estimated motion (Visual Hull Refinement). The algorithm is first developed for rigid objects and then extended to articulated objects. In the Part II of this paper we apply our temporal SFS algorithm to two human-related applications: (1) the acquisition of detailed human kinematic models and (2) marker-less motion tracking.[PUBLICATION ABSTRACT]

Introduction Head and neck cancer (HNC) afflicts >16,000 people in Hong Kong annually. Non-operative treatment for HNC typically involves radiotherapy (with or without concurrent systemic therapy) and is associated with significant acute toxicity. Demography, tumour factors, and co-morbidities each influence treatment outcome and prognosis, but their role in predicting 90-day mortality is less well-known. Methods Demographic, clinical, and co-morbidity data of 725 non-metastatic HNC patients (9.4% stage I/II, 90.6% stage III/IV), who had undergone definitive radiotherapy from 1 January 2016 to 1 March 2020 were collected. Predictors for 90-day mortality were evaluated by simple and multivariable logistic regression. Results We report a 4.6% 90-day mortality rate. Age >60 years(odds ratio [OR] = 3.453, 95% confidence interval [CI] = 1.195-9.928; p = 0.022), Eastern Cooperative Oncology Group performance status (OR = 2.184, 95% CI = 1.071-4.454; p = 0.032) and pre-treatment haemoglobin level (OR = 0.764, 95% CI = 0.596-0.979; p = 0.034) were significant predictors of 90-day mortality on multivariable analysis. Of the eight co-morbidity scores studied, the Adult Comorbidity Evaluation–27 (ACE-27) [OR = 2.177, 95% CI = 1.397-3.393; p = 0.001] and the Taipei Medical University–concurrent chemoradiotherapy Mortality Predictor Score (TMU-CCRT ) [OR = 1.501, 95% CI = 1.134-1.986; p = 0.004) were the most significant predictors of 90-day mortality. Conclusion Both clinical factors and co-morbidities predict early mortality in HNC patients. ACE-27 and TMU-CCRT are appropriate for co-morbidity assessment in relation to early mortality. Further studies to develop prospective models that identify accurately patients at risk of early mortality during treatment are necessary.

The T790M mutation in the epidermal growth factor receptor gene causes most acquired resistance to firstor second-line epidermal growth factor receptor-tyrosine kinase inhibitors in advanced non-small-cell lung cancer. The results of T790M testing can guide subsequent treatment. Despite the availability of guidelines from international organisations, T790M testing practices in Hong Kong must be streamlined and adapted to the Hospital Authority setting. To address this issue, a panel of experts in oncology and pathology met for discussion of key topics regarding T790M testing practices in Hong Kong, including the appropriate timing of testing and re-testing, as well as optimal testing methods. All panel members voted on the results of the discussion to achieve consensus. Items supported by a majority vote were adopted as consensus statements regarding current best practices for T790M testing in Hong Kong. Among the topics discussed, the panel agreed that T790M testing should be initiated upon radiological progression, including symptomatic disease progression or central nervous system-only progression. The experts also preferred initial testing with liquid biopsy, using the widely available digital polymerase chain reaction platform. This document provides the final consensus statements, as well as a testing and treatment workflow, for clinicians in Hong Kong to use as guidance in T790M testing.

In Part I of this paper we developed the theory and algorithms for performing Shape-From-Silhouette (SFS) across time. In this second part, we show how our temporal SFS algorithms can be used in the applications of human modeling and markerless motion tracking. First we build a system to acquire human kinematic models consisting of precise shape (constructed using the temporal SFS algorithm for rigid objects), joint locations, and body part segmentation (estimated using the temporal SFS algorithm for articulated objects). Once the kinematic models have been built, we show how they can be used to track the motion of the person in new video sequences. This marker-less tracking algorithm is based on the Visual Hull alignment algorithm used in both temporal SFS algorithms and utilizes both geometric (silhouette) and photometric (color) information.[PUBLICATION ABSTRACT]

Objective Baseline lymphopenia is associated with poor prognosis in various malignancies. This study aimed to examine the prognostic value of pretreatment lymphocyte count in cervical cancer patients in Hong Kong. Methods A cohort of 198 cases of cervical cancer patients without evidence of metastatic disease (i.e., International Federation of Gynecology and Obstetrics stage IB to IVA), who completed definitive chemoradiotherapy from January 2009 to December 2014 was analysed. Baseline clinical and pretreatment blood test data were collected. Definitive treatment had included external radiotherapy and brachytherapy with concurrent weekly cisplatin 40 mg/m2. Log-rank tests and multivariable Cox regression were used to evaluate the association between haematological parameters and survival. Study endpoints were overall survival (OS), recurrence-free survival (RFS), and late radiation-induced grade 3-4 toxicity. Results Median follow-up period was 6.52 years. A pretreatment absolute lymphocyte count ≤1.7 × 109/L was associated with a significantly worse 5-year OS (68.7% vs. 84.4%, p = 0.005). Multivariate analysis confirmed pretreatment lymphocyte count to be an independent predictor of RFS (adjusted hazard ratio = 0.58; 95% confidence interval [CI] = 0.34-0.99, p = 0.046) and OS (adjusted hazard ratio = 0.47; 95% CI = 0.25-0.88, p = 0.018). Absolute lymphocyte count was not associated with late grade 3-4 radiation toxicity. Conclusion Our data in a local cohort add evidence to findings in other studies that pretreatment absolute lymphocyte count is an independent predictor of both OS and RFS in cervical cancer patients receiving definitive chemoradiotherapy.

Introduction To review the treatment outcomes of patients with chemorefractory metastatic colorectal cancer receiving the multikinase inhibitor regorafenib. Methods This was a retrospective cohort study including patients who received regorafenib after failure of standard irinotecan- and oxaliplatin-based chemotherapy with or without biologics from 2016 to 2018 in a single centre in Hong Kong. Results Fourteen patients met the inclusion criteria. All had good general condition (i.e., Eastern Cooperative Oncology Group score 1). Seven patients had received bevacizumab previously. Median progression-free survival (PFS) was 12.4 weeks and median overall survival (OS) was 26.5 weeks. Eight patients had grade ≥3 adverse events and 10 (71.4%) required temporary treatment suspension. The commonest grade ≥3 adverse events were palmar-plantar erythrodysaesthesia and fatigue (both 28.6%). Patients with a carcinoembryonic antigen drop of ≥50% from baseline enjoyed longer PFS, though not to a significant extent. OS was longer for left-sided primary tumours (202 vs. 57 days, p = 0.001). Two patients with good performance after progression received trifluridine-tipiracil. Their median OS was 400 days. Conclusion Our experience with regorafenib monotherapy for patients with chemorefractory metastatic colorectal cancer was comparable to the landmark trials. The grade ≥3 adverse events were frequent, and dose reduction or treatment delay was required. Potentially favourable prognostic factors included a left-sided primary tumour and a carcinoembryonic antigen drop from baseline. Those who received further treatment after regorafenib enjoyed reasonably long survival. Treatment after regorafenib with newer strategies should be considered in those who remain functional.

BackgroundThe COVID-19 pandemic has led to changes in dietary and lifestyle habits among children and adolescents. This study investigated the prevalence and factors associated with unhealthy dietary habits among 1,475 primary and secondary school students from 2021 to 2022.MethodsA cross-sectional study was conducted in randomly selected primary and secondary schools participating in a project promoting online health education and promotion named GoSmart using self-administered questionnaires. Logistic regression analyses were conducted to investigate the demographic and lifestyle habits associated with various unhealthy dietary habits. This study was approved by Survey and Behavioural Research Ethics (SBRE) [Reference No.: SBRE-21-0052] and funded by Quality Education Fund (QEF#2019/0883).ResultsThe prevalence of inadequate consumption of vegetables and fruits was high among both primary (81.5%) and secondary school students (89.5%) and associated with physical inactivity in both primary (aOR=3.35, 95%CI: 1.41-7.97, p=0.006) and secondary students (aOR=4.30, 95%CI: 1.51-12.25, p=0.006). A substantial prevalence of breakfast skipping was observed among primary students (22.9%) who spent two or more hours on video games or social media (aORs=1.84-2.27); and among secondary students (23.7%) who consumed two or more hours on social media, alcohol consumption, and consumption of unhealthy food (aORs=1.42-2.79). Consumption of unhealthy food was reported by 43.9% and 48.2% for primary and secondary students respectively, with primary and secondary students who spent two or more hours on video games or social media (aORs=1.62-2.27) and secondary students who perceived themselves as underweight (aOR=1.79, 95%CI: 1.13-2.83, p=0.012) having a higher frequency of consumption.ConclusionsThere was a high prevalence of unhealthy dietary habits among schoolchildren in Hong Kong. Alarming results were observed with physical inactivity being associated with a higher risk of unhealthy dietary habits among primary and secondary students, which may increase the risk of obesity. Moreover, the apparent interrelationship between unhealthy habits highlights the need for a comprehensive approach to promoting healthy habits through education in this population.

Objective To review the outcomes of gemcitabine plus nanoparticle albumin-bound (nab)-paclitaxel for patients with inoperable pancreatic cancer. Methods The data of patients treated with this regimen at a single oncology centre in Hong Kong between December 2014 and December 2017 were retrospectively reviewed. Patient data assessed included serial tumour markers (carbohydrate antigen 19-9 and/or carcinoembryonic antigen) and ultrasound, computed tomography, or positron emission tomography-computed tomography scans. The primary objective was to evaluate progression-free and overall survival. The secondary objective was to evaluate the rate of treatment-related toxicities. All adverse events were graded with the Common Terminology Criteria for Adverse Events version 5. Results The data of a total of 35 patients were analysed. The median age was 61 years and the majority (77%) had stage IV disease. Histological diagnosis was available in 74% of patients. The median number of cycles received was three. A total of 31% of patients required dose reduction of nab-paclitaxel. Median progression-free survival was 4.9 months (95% confidence interval [CI] = 3.4-6.4), and median overall survival was 7.5 months (95% CI = 5.6-9.4). Overall, 51% of patients received second-line or third-line chemotherapy following disease progression. Grade ≥3 neutropoenia occurred in 29% of patients and febrile neutropoenia in 6%. Grade ≥3 peripheral neuropathy occurred in 9% of patients. Conclusion Gemcitabine plus nab-paclitaxel doublet chemotherapy is an effective and safe treatment for inoperable pancreatic cancer. Data from our centre are comparable to literature published to date. However, prognosis remains poor for this disease.

A macrocephalic girl presented with generalised epilepsy due to focal cortical dysplasia. She later developed multiple hamartomatous lesions and was diagnosed to have Cowden syndrome. The diagnosis was confirmed by identification of a novel frameshift mutation in the PTEN gene of the patient.