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1. DOFS: A Real-world 3D Deformable Object Dataset with Full Spatial Information for Dynamics Model Learning

Author

Zhang, Zhen, Chu, Xiangyu, Tang, Yunxi, and Au, K. W. Samuel

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Robotics
Abstract

This work proposes DOFS, a pilot dataset of 3D deformable objects (DOs) (e.g., elasto-plastic objects) with full spatial information (i.e., top, side, and bottom information) using a novel and low-cost data collection platform with a transparent operating plane. The dataset consists of active manipulation action, multi-view RGB-D images, well-registered point clouds, 3D deformed mesh, and 3D occupancy with semantics, using a pinching strategy with a two-parallel-finger gripper. In addition, we trained a neural network with the down-sampled 3D occupancy and action as input to model the dynamics of an elasto-plastic object. Our dataset and all CADs of the data collection system will be released soon on our website., Comment: 5 pages, 6 figures, 2024 CoRL Workshop on Learning Robot Fine and Dexterous Manipulation: Perception and Control

Published
2024

2. Needle Segmentation Using GAN: Restoring Thin Instrument Visibility in Robotic Ultrasound

Author

Jiang, Zhongliang, Li, Xuesong, Chu, Xiangyu, Karlas, Angelos, Bi, Yuan, Cheng, Yingsheng, Au, K. W. Samuel, and Navab, Nassir

Subjects
Computer Science - Robotics
Abstract

Ultrasound-guided percutaneous needle insertion is a standard procedure employed in both biopsy and ablation in clinical practices. However, due to the complex interaction between tissue and instrument, the needle may deviate from the in-plane view, resulting in a lack of close monitoring of the percutaneous needle. To address this challenge, we introduce a robot-assisted ultrasound (US) imaging system designed to seamlessly monitor the insertion process and autonomously restore the visibility of the inserted instrument when misalignment happens. To this end, the adversarial structure is presented to encourage the generation of segmentation masks that align consistently with the ground truth in high-order space. This study also systematically investigates the effects on segmentation performance by exploring various training loss functions and their combinations. When misalignment between the probe and the percutaneous needle is detected, the robot is triggered to perform transverse searching to optimize the positional and rotational adjustment to restore needle visibility. The experimental results on ex-vivo porcine samples demonstrate that the proposed method can precisely segment the percutaneous needle (with a tip error of $0.37\pm0.29mm$ and an angle error of $1.19\pm 0.29^{\circ}$). Furthermore, the needle appearance can be successfully restored under the repositioned probe pose in all 45 trials, with repositioning errors of $1.51\pm0.95mm$ and $1.25\pm0.79^{\circ}$. from latex to text with math symbols, Comment: accepted by IEEE TIM. code: https://github.com/noseefood/NeedleSegmentation-GAN; video: https://youtu.be/4WuEP9PACs0

Published
2024

3. Interactive Navigation in Environments with Traversable Obstacles Using Large Language and Vision-Language Models

Author

Zhang, Zhen, Lin, Anran, Wong, Chun Wai, Chu, Xiangyu, Dou, Qi, and Au, K. W. Samuel

Subjects
Computer Science - Robotics, Computer Science - Artificial Intelligence
Abstract

This paper proposes an interactive navigation framework by using large language and vision-language models, allowing robots to navigate in environments with traversable obstacles. We utilize the large language model (GPT-3.5) and the open-set Vision-language Model (Grounding DINO) to create an action-aware costmap to perform effective path planning without fine-tuning. With the large models, we can achieve an end-to-end system from textual instructions like "Can you pass through the curtains to deliver medicines to me?", to bounding boxes (e.g., curtains) with action-aware attributes. They can be used to segment LiDAR point clouds into two parts: traversable and untraversable parts, and then an action-aware costmap is constructed for generating a feasible path. The pre-trained large models have great generalization ability and do not require additional annotated data for training, allowing fast deployment in the interactive navigation tasks. We choose to use multiple traversable objects such as curtains and grasses for verification by instructing the robot to traverse them. Besides, traversing curtains in a medical scenario was tested. All experimental results demonstrated the proposed framework's effectiveness and adaptability to diverse environments., Comment: Accepted by 2024 IEEE International Conference on Robotics and Automation (ICRA), 7 pages, 8 figures

Published
2023

4. Model-Free Large-Scale Cloth Spreading With Mobile Manipulation: Initial Feasibility Study

Author

Chu+, Xiangyu, Wang+, Shengzhi, Feng, Minjian, Zheng, Jiaxi, Zhao, Yuxuan, Huang, Jing, and Au, K. W. Samuel

Subjects
Computer Science - Robotics, Electrical Engineering and Systems Science - Systems and Control
Abstract

Cloth manipulation is common in domestic and service tasks, and most studies use fixed-base manipulators to manipulate objects whose sizes are relatively small with respect to the manipulators' workspace, such as towels, shirts, and rags. In contrast, manipulation of large-scale cloth, such as bed making and tablecloth spreading, poses additional challenges of reachability and manipulation control. To address them, this paper presents a novel framework to spread large-scale cloth, with a single-arm mobile manipulator that can solve the reachability issue, for an initial feasibility study. On the manipulation control side, without modeling highly deformable cloth, a vision-based manipulation control scheme is applied and based on an online-update Jacobian matrix mapping from selected feature points to the end-effector motion. To coordinate the control of the manipulator and mobile platform, Behavior Trees (BTs) are used because of their modularity. Finally, experiments are conducted, including validation of the model-free manipulation control for cloth spreading in different conditions and the large-scale cloth spreading framework. The experimental results demonstrate the large-scale cloth spreading task feasibility with a single-arm mobile manipulator and the model-free deformation controller., Comment: 6 pages, 6 figures, submit to CASE2023

Published
2023

5. Towards Exact Interaction Force Control for Underactuated Quadrupedal Systems with Orthogonal Projection and Quadratic Programming

Author

Wang, Shengzhi, Chu, Xiangyu, and Au, K. W. Samuel

Subjects
Computer Science - Robotics, Electrical Engineering and Systems Science - Systems and Control
Abstract

Projected Inverse Dynamics Control (PIDC) is commonly used in robots subject to contact, especially in quadrupedal systems. Many methods based on such dynamics have been developed for quadrupedal locomotion tasks, and only a few works studied simple interactions between the robot and environment, such as pressing an E-stop button. To facilitate the interaction requiring exact force control for safety, we propose a novel interaction force control scheme for underactuated quadrupedal systems relying on projection techniques and Quadratic Programming (QP). This algorithm allows the robot to apply a desired interaction force to the environment without using force sensors while satisfying physical constraints and inducing minimal base motion. Unlike previous projection-based methods, the QP design uses two selection matrices in its hierarchical structure, facilitating the decoupling between force and motion control. The proposed algorithm is verified with a quadrupedal robot in a high-fidelity simulator. Compared to the QP designs without the strategy of using two selection matrices and the PIDC method for contact force control, our method provided more accurate contact force tracking performance with minimal base movement, paving the way to approach the exact interaction force control for underactuated quadrupedal systems., Comment: 7 pages, 4 figures, submitted to 2023 IEEE International Conference on Robotics and Automation (ICRA)

Published
2022

6. Learning Deep Nets for Gravitational Dynamics with Unknown Disturbance through Physical Knowledge Distillation: Initial Feasibility Study

Author

Lin, Hongbin, Gao, Qian, Chu, Xiangyu, Dou, Qi, Deguet, Anton, Kazanzides, Peter, and Au, K. W. Samuel

Subjects
Computer Science - Robotics
Abstract

Learning high-performance deep neural networks for dynamic modeling of high Degree-Of-Freedom (DOF) robots remains challenging due to the sampling complexity. Typical unknown system disturbance caused by unmodeled dynamics (such as internal compliance, cables) further exacerbates the problem. In this paper, a novel framework characterized by both high data efficiency and disturbance-adapting capability is proposed to address the problem of modeling gravitational dynamics using deep nets in feedforward gravity compensation control for high-DOF master manipulators with unknown disturbance. In particular, Feedforward Deep Neural Networks (FDNNs) are learned from both prior knowledge of an existing analytical model and observation of the robot system by Knowledge Distillation (KD). Through extensive experiments in high-DOF master manipulators with significant disturbance, we show that our method surpasses a standard Learning-from-Scratch (LfS) approach in terms of data efficiency and disturbance adaptation. Our initial feasibility study has demonstrated the potential of outperforming the analytical teacher model as the training data increases.

Published
2022
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7. Towards Safe Landing of Falling Quadruped Robots Using a 3-DoF Morphable Inertial Tail

Author

Tang, Yunxi, An, Jiajun, Chu, Xiangyu, Wang, Shengzhi, Wong, Ching Yan, and Au, K. W. Samuel

Subjects
Computer Science - Robotics, Electrical Engineering and Systems Science - Systems and Control
Abstract

Falling cat problem is well-known where cats show their super aerial reorientation capability and can land safely. For their robotic counterparts, a similar falling quadruped robot problem, has not been fully addressed, although achieving safe landing as the cats has been increasingly investigated. Unlike imposing the burden on landing control, we approach to safe landing of falling quadruped robots by effective flight phase control. Different from existing work like swinging legs and attaching reaction wheels or simple tails, we propose to deploy a 3-DoF morphable inertial tail on a medium-size quadruped robot. In the flight phase, the tail with its maximum length can self-right the body orientation in 3D effectively; before touch-down, the tail length can be retracted to about 1/4 of its maximum for impressing the tail's side-effect on landing. To enable aerial reorientation for safe landing in the quadruped robots, we design a control architecture, which has been verified in a high-fidelity physics simulation environment with different initial conditions. Experimental results on a customized flight-phase test platform with comparable inertial properties are provided and show the tail's effectiveness on 3D body reorientation and its fast retractability before touch-down. An initial falling quadruped robot experiment is shown, where the robot Unitree A1 with the 3-DoF tail can land safely subject to non-negligible initial body angles., Comment: 7 pages, 8 figures, submit to ICRA2023

Published
2022
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8. Inequality Constrained Trajectory Optimization with A Hybrid Multiple-shooting iLQR

Author

Tang, Yunxi, Chu, Xiangyu, Jin, Wanxin, and Au, K. W. Samuel

Subjects
Computer Science - Robotics
Abstract

Trajectory optimization has been used extensively in robotic systems. In particular, iterative Linear Quadratic Regulator (iLQR) has performed well as an off-line planner and online nonlinear model predictive control solver, with a lower computational cost. However, standard iLQR cannot handle any constraints or perform reasonable initialization of a state trajectory. In this paper, we propose a hybrid constrained iLQR variant with a multiple-shooting framework to incorporate general inequality constraints and infeasible states initialization. The main technical contributions are twofold: 1) In addition to inheriting the simplicity of the initialization in multiple-shooting settings, a two-stage framework is developed to deal with state and/or control constraints robustly without loss of the linear feedback term of iLQR. Such a hybrid strategy offers fast convergence of constraint satisfaction. 2) An improved globalization strategy is proposed to exploit the coupled effects between line-searching and regularization, which is able to enhance the numerical robustness of the constrained iLQR approaches. Our approach is tested on various constrained trajectory optimization problems and outperforms the commonly-used collocation and shooting methods., Comment: 8 pages, 5 figures

Published
2021

9. A qualitative case study of ethnic Chinese instrumental music teachers' perceptions of teacher identity and status at an international school in Hong Kong

Author

Au, K. M. C., Timmis, Sue, and Gall, Marina

Abstract

This study aimed to investigate the lived experiences of instrumental teachers of Chinese ethnicity in an international school in Hong Kong, and how these experiences and teachers' Chinese culture and personal educational orientations contribute to the shaping of their teacher status and teacher professional identity. Besides their teaching duties, instrumental teachers of international schools have to face challenges in cultural differences, which include their roles and positions in an international school context, teaching approaches, the struggles in relation to instrumental teacher image and school reputation, and the relationships with school stakeholders and other cultural and racial issues. These challenges are critical to instrumental teachers because they affect how they position themselves within the school and maintaining good relationships with other stakeholders. The qualitative case study involved 11 ethnic Chinese instrumental music teachers of Chinese ethnicity working in an international school in Hong Kong. Face-to-face and online, individual, semi-structured interviews were conducted for data collection; thematic analysis and Gee's theory of identity (2000) were adopted for data analysis and theoretical framework for analysing their teacher identities respectively. The findings of this study showed that instrumental music teachers had different levels of commitment to their duties when trying to maintain their professionalism in teaching. Their teacher authority and dedication to non-teaching duties were also influenced not only by their embedded Chinese educational culture, but also by the respects from and the supports from different school stakeholders and their commitments to the school. Teachers' interactions with different parties in school, the image of the school, the public orientations to education in the society and their Chinese appearances also affected these teachers' sense of belongings to school, personal images and professional status. In conclusion, these teacher's professional identities were shaped and reshaped through the process of interpretation and re-interpretation over the years. Hence every teacher had different understanding of their teacher identity. This research sheds light on the multiple identities and conflicts of instrumental teachers working at international schools. The strengthening of professional instrumental music teacher identity both in the education sector and the society would appear to be the most effective way to enhance the social understanding of these instrumental teachers working at schools.

Published
2022

11. A Reliable Gravity Compensation Control Strategy for dVRK Robotic Arms With Nonlinear Disturbance Forces

Author

Lin, Hongbin, Hui, C. W. Vincent, Wang, Yan, Deguet, Anton, Kazanzides, Peter, and Au, K. W. Samuel

Subjects
Computer Science - Robotics
Abstract

External disturbance forces caused by nonlinear springy electrical cables in the Master Tool Manipulator (MTM) of the da Vinci Research Kit (dVRK) limits the usage of the existing gravity compensation methods. Significant motion drifts at the MTM tip are often observed when the MTM is located far from its identification trajectory, preventing the usage of these methods for the entire workspace reliably. In this paper, we propose a general and systematic framework to address the problems of the gravity compensation for the MTM of the dVRK. Particularly, high order polynomial models were used to capture the highly nonlinear disturbance forces and integrated with the Multi-step Least Square Estimation (MLSE) framework. This method allows us to identify the parameters of both the gravitational and disturbance forces for each link sequentially, preventing residual error passing among the links of the MTM with uneven mass distribution. A corresponding gravity compensation controller was developed to compensate the gravitational and disturbance forces. The method was validated with extensive experiments in the majority of the manipulator's workspace, showing significant performance enhancements over existing methods. Finally, a deliverable software package in MATLAB and C++ was integrated with dVRK and published in the dVRK community for open-source research and development.

Published
2020
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12. Linear relations between logarithmic integrals of high weight and some closed-form evaluations

Author

Au, K. C.

Subjects
Mathematics - Number Theory
Abstract

The focus of our investigation will be integrals of form $\int_0^1 \log^a(1-x) \log^b x \log^c(1+x) /f(x) dx$, where $f$ can be either $x,1-x$ or $1+x$. We show that these integrals possess a plethora of linear relations, and give systematic methods of finding them. In lower weight cases, these linear relations yields remarkable closed-forms of individual integrals; in higher weight, we discuss the $\mathbb{Q}$-dimension that such integrals span. Our approach will not feature Euler sums.

Published
2019

14. Mass estimates from optical modelling of the new TRAPUM redback PSR J1910−5320

Author

Dodge, O.G., Breton, R.P., Clark, C.J., Burgay, M., Strader, J., Au, K.-Y., Barr, E.D., Buchner, S., Dhillon, V.S., Ferrara, E.C., Freire, P.C.C., Griessmeier, J.-M., Kennedy, M.R., Kramer, M., Li, K.-L., Padmanabh, P.V., Phosrisom, A., Stappers, B.W., Swihart, S.J., Thongmeearkom, T., Dodge, O.G., Breton, R.P., Clark, C.J., Burgay, M., Strader, J., Au, K.-Y., Barr, E.D., Buchner, S., Dhillon, V.S., Ferrara, E.C., Freire, P.C.C., Griessmeier, J.-M., Kennedy, M.R., Kramer, M., Li, K.-L., Padmanabh, P.V., Phosrisom, A., Stappers, B.W., Swihart, S.J., and Thongmeearkom, T.

Abstract

Spider pulsars continue to provide promising candidates for neutron star mass measurements. Here we present the discovery of PSR J1910−5320, a new millisecond pulsar discovered in a MeerKAT observation of an unidentified Fermi-LAT gamma-ray source. This pulsar is coincident with a recently identified candidate redback binary, independently discovered through its periodic optical flux and radial velocity. New multicolour optical light curves obtained with ULTRACAM/New Technology Telescope in combination with MeerKAT timing and updated SOAR/Goodman spectroscopic radial velocity measurements allow a mass constraint for PSR J1910−5320. ICARUS optical light curve modelling, with streamlined radial velocity fitting, constrains the orbital inclination and companion velocity, unlocking the binary mass function given the precise radio ephemeris. Our modelling aims to unite the photometric and spectroscopic measurements available by fitting each simultaneously to the same underlying physical model, ensuring self-consistency. This targets centre-of-light radial velocity corrections necessitated by the irradiation endemic to spider systems. Depending on the gravity darkening prescription used, we find a moderate neutron star mass of either 1.6 ± 0.2 or 1.4 ± 0.2 M⊙. The companion mass of either 0.45 ± 0.04 or M⊙ also further confirms PSR J1910−5320 as an irradiated redback spider pulsar.

Published
2024

15. Mass estimates from optical modelling of the new TRAPUM redback PSR J1910-5320

Author

Dodge, O. G., Breton, R. P., Clark, C. J., Burgay, M., Strader, J., Au, K. -Y., Barr, E. D., Buchner, S., Dhillon, V. S., Ferrara, E. C., Freire, P. C. C., Griessmeier, J. -M., Kennedy, M. R., Kramer, M., Li, K. -L., Padmanabh, P. V., Phosrisom, A., Stappers, B. W., Swihart, S. J., Thongmeearkom, T., Dodge, O. G., Breton, R. P., Clark, C. J., Burgay, M., Strader, J., Au, K. -Y., Barr, E. D., Buchner, S., Dhillon, V. S., Ferrara, E. C., Freire, P. C. C., Griessmeier, J. -M., Kennedy, M. R., Kramer, M., Li, K. -L., Padmanabh, P. V., Phosrisom, A., Stappers, B. W., Swihart, S. J., and Thongmeearkom, T.

Abstract

Spider pulsars continue to provide promising candidates for neutron star mass measurements. Here we present the discovery of PSR~J1910$-$5320, a new millisecond pulsar discovered in a MeerKAT observation of an unidentified \textit{Fermi}-LAT gamma-ray source. This pulsar is coincident with a recently identified candidate redback binary, independently discovered through its periodic optical flux and radial velocity. New multi-color optical light curves obtained with ULTRACAM/NTT in combination with MeerKAT timing and updated SOAR/Goodman spectroscopic radial velocity measurements allow a mass constraint for PSR~J1910$-$5320. \texttt{Icarus} optical light curve modelling, with streamlined radial velocity fitting, constrains the orbital inclination and companion velocity, unlocking the binary mass function given the precise radio ephemeris. Our modelling aims to unite the photometric and spectroscopic measurements available by fitting each simultaneously to the same underlying physical model, ensuring self-consistency. This targets centre-of-light radial velocity corrections necessitated by the irradiation endemic to spider systems. Depending on the gravity darkening prescription used, we find a moderate neutron star mass of either $1.6\pm0.2$ or $1.4\pm0.2$ $M_\odot$. The companion mass of either $0.45\pm0.04$ or $0.43^{+0.04}_{-0.03}$ $M_\odot$ also further confirms PSR~J1910$-$5320 as an irradiated redback spider pulsar.radiated redback spider pulsar., Comment: Accepted for publication in Monthly Notices of the Royal Astronomical Society. 18 pages, 9 figures

Published
2024

19. March for unity: A study on an effect of synchronized actions to perceived closeness

Author

Au, K. B. and Lo, L. Y.

Subjects
Autism, Psychology and mental health
Abstract

The ability to imitate allows rapid learning. Through imitation, similarity in behaviors promotes a sense of belonging and closeness among individuals. This study investigated whether the relationship between synchronized movements and psychological closeness is also found from an observer's perspective. Participants in this study generally attributed a higher degree of closeness to demonstrators who shared identical or reverse-synchronized walking patterns. The results suggest that walking synchronicity referred not only to identical movements but also other possible forms of patterned movements. Secondly, participants in three age groups shared similar judgments on closeness, which suggests a basic pattern-hunting tendency which is not constrained by age or experience. Thirdly, even autistic participants showed use of synchronicity cues in closeness ranking judgments. In general, the findings indirectly support the embedded cognition that bodily movement could be one of the factors which are engaged directly in cognitive processing., Author(s): K. B. Au [sup.1], L. Y. Lo [sup.1] Author Affiliations: (1) Department of Counselling and Psychology, Hong Kong Shue Yan University, , 10 Wai Tsui Crescent, Braemar Hill Road, [...]

Published
2020
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20. Mass estimates from optical modelling of the new TRAPUM redback PSR J1910−5320.

Author

Dodge, O G, Breton, R P, Clark, C J, Burgay, M, Strader, J, Au, K -Y, Barr, E D, Buchner, S, Dhillon, V S, Ferrara, E C, Freire, P C C, Griessmeier, J -M, Kennedy, M R, Kramer, M, Li, K -L, Padmanabh, P V, Phosrisom, A, Stappers, B W, Swihart, S J, and Thongmeearkom, T

Subjects
NEUTRON stars, STELLAR mass, LIGHT curves, TECHNOLOGICAL innovations, PULSARS, BINARY pulsars, GAMMA ray astronomy, COINCIDENCE
Abstract

Spider pulsars continue to provide promising candidates for neutron star mass measurements. Here we present the discovery of PSR J1910−5320, a new millisecond pulsar discovered in a MeerKAT observation of an unidentified Fermi -LAT gamma-ray source. This pulsar is coincident with a recently identified candidate redback binary, independently discovered through its periodic optical flux and radial velocity. New multicolour optical light curves obtained with ULTRACAM/New Technology Telescope in combination with MeerKAT timing and updated SOAR/Goodman spectroscopic radial velocity measurements allow a mass constraint for PSR J1910−5320. icarus optical light curve modelling, with streamlined radial velocity fitting, constrains the orbital inclination and companion velocity, unlocking the binary mass function given the precise radio ephemeris. Our modelling aims to unite the photometric and spectroscopic measurements available by fitting each simultaneously to the same underlying physical model, ensuring self-consistency. This targets centre-of-light radial velocity corrections necessitated by the irradiation endemic to spider systems. Depending on the gravity darkening prescription used, we find a moderate neutron star mass of either 1.6 ± 0.2 or 1.4 ± 0.2 M ⊙. The companion mass of either 0.45 ± 0.04 or |$0.43^{+0.04}_{-0.03}$| M ⊙ also further confirms PSR J1910−5320 as an irradiated redback spider pulsar. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Multilayer silicone phantoms for the evaluation of quantitative optical techniques in skin imaging

Author

Saager, RB, Kondru, C, Au, K, Sry, K, Ayers, F, and Durkin, AJ

Subjects
optical phantom, tissue spectroscopy, layered media, optical properties
Abstract

With the development of multilayer models for the analysis of quantitative spectroscopic techniques, there is a need to generate controlled and stable phantoms capable of validating these new models specific to the particular instrument performance and/or probe geometry. Direct applications for these multilayer phantoms include characterization or validation of depth penetration for specific probe geometries or describing layer specific sensitivity of optical instrumentation. We will present a method of producing interchangeable silicone phantoms that vary in thickness from 90 microns up to several millimeters which can be combined to produce multilayered structures to mimic optical properties of physiologic tissues such as skin. The optical properties of these phantoms are verified through inverse addingdoubling methods and the homogeneous distribution of optical properties will be discussed. © 2010 Copyright SPIE - The International Society for Optical Engineering.

Published
2010

26. Dexmedetomidine and Propofol Sedation in Critically Ill Patients and Dose-associated 90-Day Mortality: A Secondary Cohort Analysis of a Randomized Controlled Trial (SPICE III)

Author

Shehabi, Yahya, primary, Serpa Neto, Ary, additional, Bellomo, Rinaldo, additional, Howe, Belinda D., additional, Arabi, Yaseen M., additional, Bailey, Michael, additional, Bass, Frances E., additional, Bin Kadiman, Suhaini, additional, McArthur, Colin J., additional, Reade, Michael C., additional, Seppelt, Ian M., additional, Takala, Jukka, additional, Wise, Matt P., additional, Webb, Steve A., additional, Mashonganyika, C., additional, McKee, H., additional, Tonks, A., additional, Donnelly, A., additional, Hemmings, N., additional, O’Kane, S., additional, Blakemore, A., additional, Butler, M., additional, Cowdrey, K., additional, Dalton, J., additional, Gilder, E., additional, Long, S., additional, McCarthy, L., additional, McGuinness, S., additional, Parke, R., additional, Chen, Y., additional, McArthur, C., additional, McConnochie, R., additional, Newby, L., additional, Bellomo, R., additional, Eastwood, G., additional, Peck, L., additional, Young, H., additional, Boschert, C., additional, Edington, J., additional, Fletcher, J., additional, Smith, J., additional, Nand, K., additional, Raza, A., additional, Sara, T., additional, Bennett-Britton, J., additional, Bewley, J., additional, Bodenham, V., additional, Cole, L., additional, Driver, K., additional, Grimmer, L., additional, Howie, L., additional, Searles, C., additional, Sweet, K., additional, Webster, D., additional, van Berkel, A., additional, Connor, H., additional, Dennett, J., additional, van Der Graaff, M., additional, Henderson, S., additional, Mehrtens, J., additional, Miller, K., additional, Minto, E., additional, Morris, A., additional, Noble, S., additional, Parker, K., additional, Bulfin, L., additional, Hart, N., additional, Shepherd, K., additional, Vij, S., additional, Dickson, S., additional, Elloway, E., additional, Ferguson, C., additional, Jackson, R., additional, MacNaughton, P., additional, Marner, M., additional, Squire, R., additional, Waddy, S., additional, Wafer, P., additional, Welbourne, J., additional, Ashcroft, P., additional, Chambler, D., additional, Dukes, S., additional, Harris, A., additional, Horton, S., additional, Sharpe, S., additional, Williams, P., additional, Williams, S., additional, Bailey, M., additional, Blazquez, E., additional, France, D., additional, Hutchison, R., additional, O’Connor, A., additional, Comadira, G., additional, Gough, M., additional, Tallott, M., additional, Bastick, M., additional, Cameron, R., additional, Donovan, S., additional, Ellis, K., additional, Gaur, A., additional, Gregory, R., additional, Naumoff, J., additional, Turner, E., additional, White, M., additional, Au, K. F. J., additional, Fratzia, J., additional, Treloar, S., additional, Lim, C. H., additional, Maseeda, Y., additional, Tan, A. P., additional, Tang, C. L., additional, Yong, C. Y., additional, Akaltan, M., additional, Berger, S., additional, Blaser, D., additional, Fazlija, L., additional, Jong, M. L., additional, Lensch, M., additional, Ludwig, R., additional, Merz, T., additional, Nettelbeck, K., additional, Roth, M., additional, Schafer, M., additional, Takala, J., additional, Wehr, A., additional, Zacharias, D., additional, Amran, R., additional, Ashraf, H. N., additional, Azmi, N., additional, Basri, N., additional, Burhanuddin, H., additional, Hadinata, Y., additional, Hamdan, A., additional, Kadiman, S., additional, Rashid, A. I. Y. M., additional, Sabran, I. N., additional, Sulaiman, S., additional, Zabidi, I. N., additional, Al-Dawood, A., additional, Aljuaid, M., additional, Anizi, H. Al, additional, Saeedi, A. Al, additional, Arabi, Y., additional, Dbsawy, M., additional, Deeb, A., additional, Hegazy, M., additional, Magdi, I., additional, Clarey, E., additional, Corcoran, E., additional, Finney, C., additional, Harris, C., additional, Hopkins, P., additional, Noble, H., additional, Thompson, L., additional, Williams, T., additional, Dumlao, L. A., additional, Bassam, R., additional, Hassan, M. A., additional, Naseem, N., additional, Al-Kurdi, M. H., additional, Al-Harthy, A. M., additional, Bernard, S., additional, Sebafundi, L., additional, Serban, C., additional, Lim, S. K., additional, Mazidah, N., additional, Saidin, N., additional, Sjamsuddin, N., additional, Tan, I. T. A., additional, Zabidi, N., additional, Brain, M., additional, Mineall, S., additional, Kanhere, M., additional, Soar, N., additional, Kadir, N. Abd, additional, Abdullah, N. H., additional, Awang, R., additional, Emperan, Z., additional, Husin, N. S., additional, Ismail, N. I., additional, Ismail, S. Z., additional, Khadzali, F. N. A. Mohd, additional, Norddin, M. F., additional, Aguila, J., additional, Bold, C., additional, Clatworthy, B., additional, Dias, A., additional, Hogan, C., additional, Kazemi, A., additional, Lai, V., additional, Song, R., additional, Williams, A., additional, Bhatia, D., additional, Elliot, S., additional, Galt, P., additional, Lavrans, K., additional, Ritchie, P., additional, Wang, A., additional, Gresham, R., additional, Lowrey, J., additional, Masters, K., additional, Palejs, P., additional, Seppelt, I., additional, Symonds, F., additional, Weisbrodt, L., additional, Whitehead, C., additional, Babio-Galan, M., additional, Calder, V., additional, Clement, I., additional, Harrison, A., additional, McCullagh, I., additional, Scott, C., additional, Bevan, R., additional, Caniba, S., additional, Hacking, D., additional, Maher, L., additional, Azzolini, M. L., additional, Beccaria, P., additional, Colombo, S., additional, Landoni, G., additional, Leggieri, C., additional, Luca, C., additional, Mamo, D., additional, Moizo, E., additional, Monti, G., additional, Mucci, M., additional, Zangrillo, A., additional, Albania, M., additional, Arora, S., additional, Shi, Y., additional, Abudayah, A., additional, Almekhlafi, G., additional, Al Amodi, E., additional, Al Samarrai, S., additional, Badawi, M., additional, Caba, R. Cubio, additional, Elffaki, O., additional, Mandourah, Y., additional, Valerio, J., additional, Joyce, C., additional, Meyer, J., additional, Saylor, E., additional, Venkatesh, B., additional, Venz, E., additional, Walsham, J., additional, Wetzig, K., additional, Khoo, T. M., additional, Liew, J. E. S., additional, Sakthi, A. N., additional, Zulkurnain, A., additional, Bamford, A., additional, Bergin, C., additional, Carrera, R., additional, Cooper, L., additional, Despy, L., additional, Harkett, S., additional, Mee, L., additional, Reeves, E., additional, Snelson, C., additional, Spruce, E., additional, Cooper, G., additional, Hodgson, R., additional, Pearson, D., additional, Rosbergen, M., additional, Ali, M. N., additional, Bahar, N. I., additional, Ismail, A., additional, Ismail, W. N. W., additional, Samat, N. M., additional, Piah, N. S. M., additional, Rahman, R. Abd, additional, Duroux, M., additional, Ratcliffe, M., additional, Warhurst, T., additional, Buehner, U., additional, Williams, E., additional, Jacques, N., additional, Keating, L., additional, Macgill, S., additional, Tamang, K. L., additional, Tolan, N., additional, Walden, A., additional, Bower, R., additional, Cranshaw, J., additional, Molloy, K., additional, Pitts, S., additional, Butler, J., additional, Dunlop, R., additional, Fourie, C., additional, Jarrett, P., additional, Lassig-Smith, M., additional, Livermore, A., additional, O’Donoghue, S., additional, Reade, M., additional, Starr, T., additional, Stuart, J., additional, Campbell, L., additional, Phillips, M., additional, Stephens, D., additional, Thomas, J., additional, Cooper, D., additional, McAllister, R., additional, Andrew, G., additional, Barclay, L., additional, Dawson, H., additional, Griffith, D. M., additional, Hope, D., additional, Wojcik, G., additional, McCulloch, C., additional, Paterson, R., additional, Ascough, L., additional, Paisley, C., additional, Patrick-Heselton, J., additional, Shaw, D., additional, Waugh, V., additional, Williams, K., additional, Welters, I., additional, Barge, D., additional, Jordan, A., additional, MacIsaac, C., additional, Rechnitzer, T., additional, Bass, F., additional, Gatward, J., additional, Hammond, N., additional, Janin, P., additional, Stedman, W., additional, Yarad, E., additional, Razak, N. A., additional, Dzulkipli, N., additional, Jong, S. L., additional, Asen, K., additional, Voon, W. L., additional, Liew, S., additional, Ball, J., additional, Barnes, V., additional, Dalton, C., additional, Farnell-Ward, S., additional, Farrah, H., additional, Maher, K., additional, Mellinghoff, J., additional, Ryan, C., additional, Shirley, P., additional, Conlon, L., additional, Glover, A., additional, Martin-Loeches, I., additional, O’Toole, E., additional, Ewan, J., additional, Ferrier, J., additional, Litton, E., additional, Webb, S. A., additional, Berry, W., additional, Blanco Alonso, U., additional, Bociek, A., additional, Campos, S., additional, Jawara, S., additional, Hanks, F., additional, Kelly, A., additional, Lei, K., additional, McKenzie, C., additional, Ostermann, M., additional, Wan, R., additional, Al-Soufi, S., additional, Leow, S., additional, McCann, K., additional, Reynolds, C., additional, Brickell, K., additional, Fahey, C., additional, Hays, L., additional, Hyde, N., additional, Nichol, A., additional, Ryan, D., additional, Brailsford, J., additional, Buckley, A., additional, Forbes, L., additional, Maguire, T., additional, Moore, J., additional, Murray, L., additional, Ghosh, A., additional, Park, M., additional, Said, S., additional, Visser, A., additional, Abidin, H. Z., additional, Ali, S., additional, Hassan, M. H., additional, Omar, S. C., additional, Shukeri, W. F. W., additional, Brealey, D., additional, Bercades, G., additional, Blackburn, E., additional, Macallum, N., additional, Macklin, A., additional, Ryu, J. H., additional, Tam, K., additional, Smyth, D., additional, Arif, A., additional, Bassford, C., additional, Morgan, C., additional, Swann, C., additional, Ward, G., additional, Wild, L., additional, Bone, A., additional, Elderkin, T., additional, Green, D., additional, Sach, D., additional, Salerno, T., additional, Simpson, N., additional, Brohi, F., additional, Clark, M., additional, Williams, L., additional, Brooks, J., additional, Cocks, E., additional, Cole, J., additional, Curtin, J., additional, Davies, R., additional, Hill, H., additional, Morgan, M., additional, Palmer, N., additional, Whitton, C., additional, Wise, M., additional, Baskaran, P., additional, Hasan, M. S., additional, Tham, L. Y., additional, Sol Cruz, R., additional, Dinsdale, D., additional, Edney, S., additional, Firkin, C., additional, FitzJohn, F., additional, Hill, G., additional, Hunt, A., additional, Hurford, S., additional, Jones, G., additional, Judd, H., additional, Latimer-Bell, C., additional, Lawrence, C., additional, Lesona, E., additional, Navarra, L., additional, Robertson, Y., additional, Smellie, H., additional, Vucago, A. M., additional, Young, P., additional, Clark, P., additional, Kong, J., additional, Ho, J., additional, Nayyar, V., additional, and Skelly, C., additional

Published
2023
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30. Homophobia in Medical Students of the University of Hong Kong

Author

Kan, R. W. M., Au, K. P., Chan, W. K., Cheung, L. W. M., Lam, C. Y. Y., Liu, H. H. W., Ng, L. Y., Wong, M. Y., and Wong, W. C.

Abstract

Homosexuality is now accepted as a normal variant of human sexuality, but homophobia among healthcare professionals is well documented. Establishment of trustful doctor-patient relationships is impossible in the presence of homophobia. We were interested to examine the extent of homophobia among medical students, the future doctors. This article aims to study attitudes of medical students of the University of Hong Kong towards homosexuality and to identify significant factors affecting their attitudes. A cross-sectional study was performed on students of the University of Hong Kong. Attitudes towards homosexuality were compared between medical and non-medical students. More than 25% of the medical students agreed with the statement "homosexuality is a psychological disorder that requires therapy". More than 15% would avoid any physical contact with homosexuals to minimise the chance of contracting diseases, especially AIDS. Comparison between the medical students and non-medical students showed that the attitudes of the medical students were significantly more homophobic. Factors explaining the difference included the importance of religion in the formation of moral values, gender, experience of working closely with homosexual friends, sexual orientation, experience of the heterosexual sexual act, acquaintance of homosexual friends, and experience of homosexual love relationships. In conclusion, there appeared to be a certain level of homophobia among the medical students. This could possibly be explained by their lack of experience of working closely with homosexual friends. Relevant curriculum modification and development are urgently needed, to provide ongoing opportunities for students to realise their own values that could unconsciously affect their clinical judgements. (Contains 8 tables and 2 figures.)

Published
2009
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31. A qualitative case study of ethnic Chinese instrumental music teachers’ perceptions of teacher identity and status at an international school in Hong Kong

Author

Au, K M C and Au, K M C

Abstract

This study aimed to investigate the lived experiences of instrumental teachers of Chinese ethnicity in an international school in Hong Kong, and how these experiences and teachers’ Chinese culture and personal educational orientations contribute to the shaping of their teacher status and teacher professional identity. Besides their teaching duties, instrumental teachers of international schools have to face challenges in cultural differences, which include their roles and positions in an international school context, teaching approaches, the struggles in relation to instrumental teacher image and school reputation, and the relationships with school stakeholders and other cultural and racial issues. These challenges are critical to instrumental teachers because they affect how they position themselves within the school and maintaining good relationships with other stakeholders. The qualitative case study involved 11 ethnic Chinese instrumental music teachers of Chinese ethnicity working in an international school in Hong Kong. Face-to-face and online, individual, semi-structured interviews were conducted for data collection; thematic analysis and Gee’s theory of identity (2000) were adopted for data analysis and theoretical framework for analysing their teacher identities respectively. The findings of this study showed that instrumental music teachers had different levels of commitment to their duties when trying to maintain their professionalism in teaching. Their teacher authority and dedication to non-teaching duties were also influenced not only by their embedded Chinese educational culture, but also by the respects from and the supports from different school stakeholders and their commitments to the school. Teachers’ interactions with different parties in school, the image of the school, the public orientations to education in the society and their Chinese appearances also affected these teachers’ sense of belongings to school, personal images and profe

Published
2022

33. Molecular and translational advances in meningiomas

Author

Suppiah S., Nassiri F., Bi W. L., Dunn I. F., Hanemann C. O., Horbinski C. M., Hashizume R., James C. D., Mawrin C., Noushmehr H., Perry A., Sahm F., Sloan A., Von Deimling A., Wen P. Y., Aldape K., Zadeh G., Au K., Barnhartz-Sloan J., Brastianos P. K., Butowski N., Carlotti C., Cusimano M. D., Dimeco F., Drummond K., Galanis E., Giannini C., Goldbrunner R., Griffith B., Herold-Mende C., Huang R. Y., James D., Jenkinson M. D., Jungk C., Kaufman T. J., Krischek B., Lachance D., Lafougere C., Lee I., Liu J. C., Mamatjan Y., Mansouri A., McDermott M., Munoz D., Ng H. -K., Pirouzmand F., Poisson L. M., Pollo B., Raleigh D., Saladino A., Santarius T., Schichor C., Schultz D., Schmidt N. O., Selman W., Spears J., Snyder J., Tabatabai G., Tatagiba M., Tirapelli D., Tonn J. C., Tsang D., Vogelbaum M. A., Deimling A. V., Walbert T., Westphal M., Workewych A. M., Suppiah S., Nassiri F., Bi W.L., Dunn I.F., Hanemann C.O., Horbinski C.M., Hashizume R., James C.D., Mawrin C., Noushmehr H., Perry A., Sahm F., Sloan A., Von Deimling A., Wen P.Y., Aldape K., Zadeh G., Au K., Barnhartz-Sloan J., Brastianos P.K., Butowski N., Carlotti C., Cusimano M.D., Dimeco F., Drummond K., Galanis E., Giannini C., Goldbrunner R., Griffith B., Herold-Mende C., Huang R.Y., James D., Jenkinson M.D., Jungk C., Kaufman T.J., Krischek B., Lachance D., Lafougere C., Lee I., Liu J.C., Mamatjan Y., Mansouri A., McDermott M., Munoz D., Ng H.-K., Pirouzmand F., Poisson L.M., Pollo B., Raleigh D., Saladino A., Santarius T., Schichor C., Schultz D., Schmidt N.O., Selman W., Spears J., Snyder J., Tabatabai G., Tatagiba M., Tirapelli D., Tonn J.C., Tsang D., Vogelbaum M.A., Deimling A.V., Walbert T., Westphal M., and Workewych A.M.

Subjects
Cancer Research, Supplement Articles, Genomics, Intracranial Neoplasm, sporadic meningioma, Bioinformatics, World health, Translational Research, Biomedical, Meningioma, 03 medical and health sciences, biomolecular, 0302 clinical medicine, Meningeal Neoplasms, otorhinolaryngologic diseases, medicine, Recurrent disease, Humans, Meningeal Neoplasm, Molecular Targeted Therapy, xenograft, Stage (cooking), neoplasms, MENINGIOMA, business.industry, cell line, Prognosis, medicine.disease, Combined Modality Therapy, nervous system diseases, 3. Good health, Clinical trial, Oncology, 030220 oncology & carcinogenesis, Neurology (clinical), genetic, business, epigenetic, 030217 neurology & neurosurgery
Abstract

Meningiomas are the most common primary intracranial neoplasm. The current World Health Organization (WHO) classification categorizes meningiomas based on histopathological features, but emerging molecular data demonstrate the importance of genomic and epigenomic factors in the clinical behavior of these tumors. Treatment options for symptomatic meningiomas are limited to surgical resection where possible and adjuvant radiation therapy for tumors with concerning histopathological features or recurrent disease. At present, alternative adjuvant treatment options are not available in part due to limited historical biological analysis and clinical trial investigation on meningiomas. With advances in molecular and genomic techniques in the last decade, we have witnessed a surge of interest in understanding the genomic and epigenomic landscape of meningiomas. The field is now at the stage to adopt this molecular knowledge to refine meningioma classification and introduce molecular algorithms that can guide prediction and therapeutics for this tumor type. Animal models that recapitulate meningiomas faithfully are in critical need to test new therapeutics to facilitate rapid-cycle translation to clinical trials. Here we review the most up-to-date knowledge of molecular alterations that provide insight into meningioma behavior and are ready for application to clinical trial investigation, and highlight the landscape of available preclinical models in meningiomas.

Published
2019

34. Life after surgical resection of a meningioma: a prospective cross-sectional study evaluating health-related quality of life

Author

Nassiri F., Price B., Shehab A., Au K., Cusimano M. D., Jenkinson M. D., Jungk C., Mansouri A., Santarius T., Suppiah S., Teng K. X., Toor G. S., Zadeh G., Walbert T., Drummond K. J., Aldape K., Barnhartz-Sloan J., Bi W. L., Brastianos P. K., Butowski N., Carlotti C., Dimeco F., Dunn I. F., Galanis E., Giannini C., Goldbrunner R., Griffith B., Hashizume R., Hanemann C. O., Herold-Mende C., Horbinski C., Huang R. Y., James D., Kaufman T. J., Krischek B., Lachance D., Lafougere C., Lee I., Liu J. C., Mamatjan Y., Mawrin C., McDermott M., Munoz D., Noushmehr H., Ng H. -K., Perry A., Pirouzmand F., Poisson L. M., Pollo B., Raleigh D., Sahm F., Saladino A., Schichor C., Schultz D., Schmidt N. O., Selman W., Sloan A., Spears J., Snyder J., Tabatabai G., Tatagiba M., Tirapelli D., Tonn J. C., Tsang D., Vogelbaum M. A., Deimling A. V., Wen P. Y., Westphal M., Workewych A. M., Nassiri F., Price B., Shehab A., Au K., Cusimano M.D., Jenkinson M.D., Jungk C., Mansouri A., Santarius T., Suppiah S., Teng K.X., Toor G.S., Zadeh G., Walbert T., Drummond K.J., Aldape K., Barnhartz-Sloan J., Bi W.L., Brastianos P.K., Butowski N., Carlotti C., Dimeco F., Dunn I.F., Galanis E., Giannini C., Goldbrunner R., Griffith B., Hashizume R., Hanemann C.O., Herold-Mende C., Horbinski C., Huang R.Y., James D., Kaufman T.J., Krischek B., Lachance D., Lafougere C., Lee I., Liu J.C., Mamatjan Y., Mawrin C., McDermott M., Munoz D., Noushmehr H., Ng H.-K., Perry A., Pirouzmand F., Poisson L.M., Pollo B., Raleigh D., Sahm F., Saladino A., Schichor C., Schultz D., Schmidt N.O., Selman W., Sloan A., Spears J., Snyder J., Tabatabai G., Tatagiba M., Tirapelli D., Tonn J.C., Tsang D., Vogelbaum M.A., Deimling A.V., Wen P.Y., Westphal M., and Workewych A.M.

Subjects
Male, cognition, Cancer Research, medicine.medical_specialty, Cross-sectional study, insomnia, Population, Neurosurgery, Supplement Articles, meningioma, surgery, Meningioma, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Surveys and Questionnaires, Internal medicine, Meningeal Neoplasms, otorhinolaryngologic diseases, medicine, Humans, Longitudinal Studies, Prospective Studies, Prospective cohort study, education, education.field_of_study, business.industry, COGNIÇÃO, Cognition, Middle Aged, Prognosis, medicine.disease, humanities, 3. Good health, health-related quality of life, Cross-Sectional Studies, Oncology, 030220 oncology & carcinogenesis, Quality of Life, Female, fatigue, Neurology (clinical), business, 030217 neurology & neurosurgery, Follow-Up Studies, Cohort study
Abstract

Background Few studies have evaluated the health-related quality of life (HRQoL) of patients with meningiomas. Here, we report the largest prospective, longitudinal cross-sectional cohort study of HRQoL in meningiomas to date, in order to identify possible actionable determinants of global HRQoL. Methods Adults who had undergone resection of a grade I intracranial meningioma and were in routine follow-up at a single large tertiary center underwent HRQoL assessment using the QLQ-C30 questionnaire administered opportunistically at follow-up visits. Averaged transformed QLQ-C30 scores at 12-month intervals were compared with scores from a normative reference population, with reference to known minimal clinically meaningful difference (CMD) in scores. To evaluate for possible determinants of changes in global HRQoL, global HRQoL scores were correlated (Spearman's Rho) with subdomain and symptom scores and with interval time from surgical resection. Results A total of 291 postoperative patients with histologically confirmed and surgically treated grade I meningiomas consented to participation and a total of 455 questionnaires were included for analysis. Patients with meningiomas reported reduced global HRQoL at nearly every 12-month interval with clinically and statistically significant impairments at 12, 48, 108, and 120 months postoperative compared with the normative population (P < 0.05). Meningioma patients at the 12-month interval also reported a reduction of each subdomain of HRQoL assessment (P < 0.05); however, a CMD was only seen in cognitive functioning. Physical, emotional, cognitive, and social subdomains, as well as fatigue and sleep/insomnia, were significantly associated with global HRQoL at the first 12-month interval. Overall, there was no significant correlation between time from surgery and global HRQoL or the subdomain functional or symptom sections of the QLQ-C30. Conclusions Meningioma patients report considerable limitations in HRQoL for more than 120 months after surgery, particularly in cognitive, emotional, and social function, as well as suffering significant fatigue and sleep impairment compared with a normative reference population. The majority of these reported functional impairments and symptoms are strongly associated with global HRQoL and thus can be considered determinants of global HRQoL that if treated, have the potential to improve HRQoL for our meningioma patients. This hypothesis requires future study of targeted interventions to determine their efficacy.

Published
2019

36. Repeat resection in recurrent glioblastoma (3rGBM) Trial: A randomized care trial

Author

Patel, M., primary, Au, K., additional, Easaw, J.C., additional, Davis, F.G., additional, Young, K., additional, Mehta, V., additional, Bowden, G.N., additional, Keough, M.B., additional, Sankar, T., additional, Scholtes, F., additional, Chagnon, M., additional, L’Espérance, G., additional, Yuan, Y., additional, Gevry, G., additional, Raymond, J., additional, and Darsaut, T.E., additional

Published
2022
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47. PO-1016 External validation of a nomogram for chemoirradiation in stage 2 nasopharyngeal carcinoma with IMRT

Author

Yip, P.L., primary, Chan, P., additional, Cheung, K., additional, Chow, C., additional, Lai, W., additional, Lee, H., additional, Lam, K., additional, Chiang, C., additional, Wong, C., additional, Poon, M., additional, Tong, M., additional, Au, K., additional, Ng, W., additional, Ngan, K., additional, Lee, A., additional, and Tung, Y., additional

Published
2021
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48. A cross-sectional study of sub-basal corneal nerve reduction following neurotoxic chemotherapy

Author

Chiang, JCB, Goldstein, D, Trinh, T, Au, K, Mizrahi, D, Muhlmann, M, Crowe, P, O’neill, S, Edwards, K, Park, SB, Krishnan, AV, Markoulli, M, Chiang, JCB, Goldstein, D, Trinh, T, Au, K, Mizrahi, D, Muhlmann, M, Crowe, P, O’neill, S, Edwards, K, Park, SB, Krishnan, AV, and Markoulli, M

Abstract

Purpose: Sub-basal corneal nerves have been shown to change during neuro-toxic chemotherapy treatment. This cross-sectional study investigated corneal nerve morphology in patients who have completed neurotoxic chemotherapy well after treatment cessation and its association with peripheral nerve function. Methods: Central corneal nerve fiber length (CNFL) and inferior whorl length (IWL), average nerve fiber length (ANFL), corneal nerve fiber density (CNFD) and corneal nerve branch density (CNBD), and nerve fiber area (CNFA) were examined using in vivo corneal confocal microscopy in patients with cancer who had completed treatment with either paclitaxel or oxaliplatin between 3 and 24 months prior to assessment in comparison with 2 separate groups of healthy controls. Neurological assessments were conducted including clinician-and patient-reported outcomes, and neurological grading scales. Results: Both paclitaxel-(n = 40) and oxaliplatin-treated (n = 30) groups had reduced IWL and ANFL compared to the respective healthy control groups (n = 15 in each group) (paclitaxel: IWL = P = 0.02, ANFL = P = 0.009; and oxaliplatin: IWL = P = 0.008, ANFL P = 0.02). CNFL and CNFD reduction were observed only in the paclitaxel-treated group compared with healthy controls (P = 0.008 and P = 0.02, respectively), whereas CNFA was reduced in the oxaliplatin-treated group (P = 0.04). IWL reduction correlated with worse fine hand dexterity in chemotherapy-treated patients (r =−0.33, P = 0.007). Conclusions: There is evidence of corneal nerve loss in patients with cancer who have been treated with paclitaxel and oxaliplatin well after treatment cessation associated with worse upper limb function. Translational Relevance: Sub-basal corneal nerve reduction is evident even after cessation of neurotoxic treatment. In vivo corneal confocal microscopy may be useful in the monitoring of nerve function in patients receiving chemotherapy.

Published
2021

49. A cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer

Author

Chiang, JCB, Goldstein, D, Trinh, T, Au, K, Park, SB, Krishnan, AV, Markoulli, M, Chiang, JCB, Goldstein, D, Trinh, T, Au, K, Park, SB, Krishnan, AV, and Markoulli, M

Abstract

Ocular surface dysfunction is common in patients receiving anti-cancer drug treatment. The effects of paclitaxel, a neurotoxic chemotherapeutic drug, on ocular surface discomfort associated with dry eye disease was investigated. Patients with cancer who had completed paclitaxel treatment between 3 and 24 months prior to assessment (n = 29) and age- and sex-matched healthy control subjects (n = 29) were recruited and assessed with the Ocular Surface Disease Index (OSDI) to measure ocular surface discomfort. In-vivo corneal confocal microscopy was used to evaluate corneal nerve parameters in the right eye. Peripheral neurotoxicity was assessed using patient-reported outcomes and clinical grading scales. The paclitaxel group had significantly worse OSDI total scores compared with controls (Median, Md = 19.3 and Md = 0, p = 0.007, respectively). Corneal nerve fiber and inferior whorl lengths were reduced in the paclitaxel group compared with controls (14.2 ± 4.0 and 14.4 ± 4.0 mm/mm2 vs. 16.4 ± 4.0 and 16.9 ± 4.9 mm/mm2, respectively, p = 0.04). When analyzed by presence of peripheral neuropathy, paclitaxel-treated patients with neuropathy showed worse OSDI total scores compared to those without peripheral neuropathy post-treatment (p = 0.001) and healthy controls (p < 0.001). More severe ocular discomfort and worse visual function was associated with greater peripheral neurotoxicity symptoms (r = 0.60, p = 0.001) and neuropathy severity (r = 0.49, p = 0.008), respectively. Patients who have been treated with paclitaxel have a higher risk of ocular surface discomfort associated with dry eye disease, particularly those with peripheral neuropathy. Future longitudinal studies should investigate the clinical impact of corneal nerve reduction in dry eye disease.

Published
2021

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