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Simple Summary: This is a review of the clinical course in 28 Chinese children with pituitary stalk thickening (PST) and endocrinopathies revealed a higher rate of germ cell tumors (GCT) compared to the literature based largely on non-Asian cohorts. Predictors for oncologic etiologies included male sex, severe stalk thickening ≥6.5 mm, central diabetes insipidus or ≥2 pituitary hormone deficiencies as presenting features. Management guidelines for PST should take into account patient ethnicity with a lower threshold of biopsy for Asian children. Multidisciplinary approach with serial monitoring of clinical, tumour markers, endocrinopathies and imaging are essential for diagnosis. Background: With the increasing use of magnetic resonance imaging (MRI) in the evaluation of children with endocrine disorders, pituitary stalk thickening (PST) poses a clinical conundrum due to the potential for underlying neoplasms and challenges in obtaining a tissue biopsy. The existing literature suggests Langerhans cell histiocytosis (LCH) to be the commonest (16%) oncologic cause for PST, followed by germ cell tumors (GCTs, 13%) (CCLG 2021). As the cancer epidemiology varies according to ethnicity, we present herein the incidence and predictors for oncologic etiologies in Hong Kong Chinese children with PST. Methods: Based on a territory-wide electronic database, we reviewed patients aged < 19 years who presented to three referral centers with endocrinopathies between 2010 and 2022. Records for patients who underwent at least one MRI brain/pituitary were examined (n = 1670): those with PST (stalk thickness ≥ 3 mm) were included, while patients with pre-existing cancer, other CNS and extra-CNS disease foci that were diagnostic of the underlying condition were excluded. Results: Twenty-eight patients (M:F = 10:18) were identified. The median age at diagnosis of PST was 10.9 years (range: 3.8–16.5), with central diabetes insipidus (CDI) and growth hormone deficiency (GHD) being the most frequent presenting endocrine disorders. At a median follow-up of 4.8 years, oncologic diagnoses were made in 14 patients (50%), including 13 GCTs (46%; germinoma = 11, non-germinoma = 2) and one LCH (4%). Among patients with GCTs, 10 were diagnosed based on histology, two by abnormal tumor markers and one by a combination of histology and tumor markers. Three patients with germinoma were initially misdiagnosed as hypophysitis/LCH. The cumulative incidence of oncologic diagnoses was significantly higher in boys and patients with PST at presentation ≥6.5 mm, CDI or ≥2 pituitary hormone deficiencies at presentation and evolving hypopituitarism (all p < 0.05 by log-rank). Conclusions: A higher rate of GCTs was observed in Chinese children with endocrinopathy and isolated PST. The predictors identified in this study may guide healthcare providers in Asia in clinical decision making. Serial measurement of tumor markers is essential in management. [ABSTRACT FROM AUTHOR]

A mega-event flagship (MEF) refers to a one-off venue for a mega-event and a pacemaker for regional urban renewal. To achieve this dual mandate requires a clear identification and definition of its functional positions in both short and long terms. Despite repeated suboptimal precedents, scant attention is paid to the actual programming process which lays the groundwork for an MEF to sustain itself and to provide a vital continuity of its affiliated renewal. Hence, the overarching aim of this paper is to understand the significance and strategies of seeking an MEF's dual position through a case study of Performing Arts Center of Expo 2010 as part of the Expo-led urban renewal. The focus is on how the circuitous programming process in a multi-stakeholder environment has impacted on the MEF's transformation into Mercedes-Benz Arena,  now a vibrant cultural and lifestyle destination. The paper concludes that forward thinking in positioning an MEF can effectively avoid ‘premature aging’ that would likely lead to costly remodelling. Four specific lessons are summed up for future practices in reducing the learning curve associated with both organizational and technical aspects. Built upon previous work, this paper marks a continued effort to formulate context-based tools for MEF development. [ABSTRACT FROM AUTHOR]

The international construction business is witnessing a trend toward the delivery of projects through the adoption of innovative procurement systems that allow companies to gain competitive advantages and to potentially deliver enhanced value to society. Notably, Chinese companies are making steady inroads into the international construction market by enhancing competitiveness. However, little is known about how Chinese international construction companies (CICCs) perceive procurement innovation and how this factor may relate to their recent success. This research aims to fill the void based on interviews with nine CICC key decision makers and experts in this area. It is found that CICCs are gradually adopting procurement innovation as a competitive strategy. Although procurement innovation leads to competitive advantage in the long run, CICCs must pay the cost of entering a new market. Thus a 'wait-and-see' attitude exists with respect to a long-term vision. Unlike the traditional win-lose competitive bidding system, competing through procurement innovation can lead to a larger, more suitable market presence. By succinctly describing the CICC story on the international market, this research not only provides CICCs themselves with insights into current procurement innovations existing within the construction sector but also enables other companies to understand the nature of CICCs with which they might compete or collaborate in the near future. [ABSTRACT FROM AUTHOR]

The mega-event flagship (MEF) has enjoyed an increasing global popularity in mega-event catalysed urban renewal practices. Nevertheless, failures of heavily underused MEFs provide a reality check for those ambitious host cities. Even in the wake of the problem being 'globalized', related research is tangential, sporadic and reactive, which puts emerging mega-event hosts in a disadvantageous position. To rectify the imbalance, this article defines the MEF, reveals its nature, discusses its pressing problems and highlights its affiliated difficulties. Through a review of international literature and a case study from China, it is concluded that MEF development has become a global challenge. Host cities should raise their consciousness of crisis by asking 'whether', 'why' and 'how' before using such a high-risk approach. [ABSTRACT FROM AUTHOR]

This study investigates the factors that affect the productive efficiency of construction firms in Hong Kong. Productive efficiency refers to a comparison of the volume of output to that of the resources used to produce the output. This comparison reflects the technological capability of the firm. Not only does such a capability vary across different firms at any point in time, it also changes over time due to technological progress. This study measures the productive efficiency of construction firms using a non-parametric technique — Data Envelopment Analysis (DEA). The results of this study suggest that: (1) economies of scale exist at the firm level; (2) firms that subcontract out more of their work have lower productive efficiency; and (3) more capital intensive firms tend to have lower productive efficiency, although these firms also have higher growth rates in productive efficiency over time. Over the period of observation, the average productive efficiency of all construction firms has increased at a noticeably decreasing rate, thereby confirming the catching-up hypothesis. The results of the study have important implications for practitioners and policymakers. [ABSTRACT FROM AUTHOR]