Displaying publications 1 - 20 of 29 in total

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  1. Liu C, Wang ST, Tan CH, Lin ZE, Lee WJ
    PMID: 38422382 DOI: 10.1080/19440049.2024.2319271
    Glycidyl esters (GEs) and 3-monochloropropanediol esters (3-MCPDEs) are process contaminants commonly found in refined edible oils which are often added to infant formulas. The Taiwan Food and Drug Administration (TFDA) launched regulations for GEs in infant formulas that went into effect on 1 July 2021. To investigate levels of GEs and 3-MCPDEs in infant formula powder, 45 products were sampled and analysed during 2020-2021. The contents of GEs and 3-MCPDEs in formulas of different brands significantly varied, but their concentrations in all of the formulas complied with European Union (EU) regulations. Infant formulas containing palm oil had significantly higher 3-MCPDE levels in both extracted oils and milk powder than those without palm oil. Concentrations of GEs and 3-MCPDEs in infant formula powder and extracted oils were significantly lower in products from Europe than those from Australia and New Zealand. Infants aged 0-1 years in Taiwan who consumed only infant formula showed a margin of exposure (MoE) exceeding 25,000. Mean consumer exposures to 3-MCPDEs stayed below the tolerable daily intake (TDI), while high exposures at the 95th percentile (P95) exceeded the TDI by 1.7-fold. Herein, we present the changing trends in the risk assessment results of infant formula across various countries in the decade. Implementation of regulations and mitigation strategy effectively reduced the risk of infants being exposed to GEs and 3-MCPDEs through infant formula.
  2. Lee WJ, Mohd Tahir NA, Chun GY, Li SC
    Health Qual Life Outcomes, 2024 Feb 02;22(1):14.
    PMID: 38302961 DOI: 10.1186/s12955-023-02221-y
    Understanding consequences of poor chelation compliance is crucial given the enormous burden of post-transfusional iron overload complications. We systematically reviewed iron-chelation therapy (ICT) compliance, and the relationship between compliance with health outcome and health-related quality of life (HRQoL) in thalassaemia patients. Several reviewers performed systematic search strategy of literature through PubMed, Scopus, and EBSCOhost. The preferred reporting items of systematic reviews and meta-analyses (PRISMA) guidelines were followed. Of 4917 studies, 20 publications were included. The ICT compliance rate ranges from 20.93 to 75.3%. It also varied per agent, ranging from 48.84 to 85.1% for desferioxamine, 87.2-92.2% for deferiprone and 90-100% for deferasirox. Majority of studies (N = 10/11, 90.91%) demonstrated significantly negative correlation between compliance and serum ferritin, while numerous studies revealed poor ICT compliance linked with increased risk of liver disease (N = 4/7, 57.14%) and cardiac disease (N = 6/8, 75%), endocrinologic morbidity (N = 4/5, 90%), and lower HRQoL (N = 4/6, 66.67%). Inadequate compliance to ICT therapy is common. Higher compliance is correlated with lower serum ferritin, lower risk of complications, and higher HRQoL. These findings should be interpreted with caution given the few numbers of evidence.
  3. Ong P, Yeh CW, Tsai IL, Lee WJ, Wang YJ, Chuang YK
    PMID: 37531681 DOI: 10.1016/j.saa.2023.123214
    Consumption of agricultural products with pesticide residue is risky and can negatively affect health. This study proposed a nondestructive method of detecting pesticide residues in chili pepper based on the combination of visible and near-infrared (VIS/NIR) spectroscopy (400-2498 nm) and deep learning modeling. The obtained spectra of chili peppers with two types of pesticide residues (acetamiprid and imidacloprid) were analyzed using a one-dimensional convolutional neural network (1D-CNN). Compared with the commonly used partial least squares regression model, the 1D-CNN approach yielded higher prediction accuracy, with a root mean square error of calibration of 0.23 and 0.28 mg/kg and a root mean square error of prediction of 0.55 and 0.49 mg/kg for the acetamiprid and imidacloprid data sets, respectively. Overall, the results indicate that the combination of the 1D-CNN model and VIS/NIR spectroscopy is a promising nondestructive method of identifying pesticide residues in chili pepper.
  4. Yamada M, Lee WJ, Akishita M, Yang M, Kang L, Kim S, et al.
    Arch Gerontol Geriatr, 2023 Dec;115:105132.
    PMID: 37490804 DOI: 10.1016/j.archger.2023.105132
    OBJECTIVE: This study aimed to (1) investigate the clinical practice for the management of sarcopenia among healthcare professionals in Asia, (2) determine the characteristics of clinical care provided by geriatricians versus by other healthcare professionals, and (3) clarify the awareness of sarcopenia.

    METHODS: From December 1 to 31, 2022, an online survey was completed by 1990 healthcare professionals in Asia. The survey comprises demographics and institutional characteristics, basic sarcopenia-related details, and sarcopenia-related assessment and treatment details.

    RESULTS: The mean respondent age was 44.2 ± 10.7 years, 36.4% of the respondents were women, and the mean years of experience in clinical practice were 19.0 ± 10.6 years. The percentages of respondents who were aware of the term "sarcopenia", its definition and the importance of its management were high, at 99.3%, 91.9%, and 97.2%, respectively. The percentages of respondents who had screened patients for, diagnosed patients with, and treated patients for sarcopenia were 42.4%, 42.9%, and 58.8%, respectively. Medical doctors had higher performance rates compared to allied health professionals (45.5% vs. 40.5% for screening, 56.8% vs. 34.5% for diagnosis, and 65.0% vs. 55.0% for treatment) (P 

  5. Low EV, Pathmanathan MD, Chidambaram SK, Kim WR, Lee WJ, Teh ZW, et al.
    Int J Infect Dis, 2023 Oct;135:77-83.
    PMID: 37567557 DOI: 10.1016/j.ijid.2023.08.003
    OBJECTIVE: To determine if nirmatrelvir-ritonavir 300mg/100mg treatment for 5 days in high-risk outpatients with mild to moderate COVID-19 symptoms was associated with a reduction in hospitalization, intensive care unit (ICU) admission, and death.

    METHODS: This 1:1 propensity score matched cohort study from 647 public health clinics in Malaysia included all patients with COVID-19 with positive tests aged 18 years and older, who were eligible for nirmatrelvir-ritonavir treatment within 5 days of illness from July 14, 2022, to November 14, 2022. The exposed group was patients with COVID-19 initiated with nirmatrelvir-ritonavir treatment, whereas those not initiated with the drug served as the control group. Data was analyzed from July 14, 2022 to December 31, 2022.

    RESULTS: A total of 20,966 COVID-19 high-risk outpatients (n = 10,483 for nirmatrelvir-ritonavir group and n = 10,483 for control group) were included in the study. Nirmatrelvir-ritonavir treatment was associated with a 36% reduction (adjusted hazard ratio 0.64 [95% CI 0.43, 0.94]) in hospitalization compared with those not given the drug. There was a single ICU admission for the control group and one death each was reported in the nirmatrelvir-ritonavir and control group, respectively.

    CONCLUSIONS: Nirmatrelvir-ritonavir treatment was associated with reduced hospitalization in high-risk patients with COVID-19 even in highly vaccinated populations.

  6. Tan MC, Tan JL, Lee WJ, Srivathsan K, Sorajja D, El Masry H, et al.
    J Arrhythm, 2023 Oct;39(5):784-789.
    PMID: 37799789 DOI: 10.1002/joa3.12898
    BACKGROUND: Real-world clinical data on the adverse events related to the use of cryoballoon catheter for pulmonary vein isolation remains limited.

    OBJECTIVE: To report and describe the adverse events related to the use of Artic Front cryoballoon catheters (Arctic Front, Arctic Front Advance, and Arctic Front Advance Pro) reported in the Food and Drug Administration's (FDA) Manufacturers and User Defined Experience (MAUDE) database.

    METHODS: We reviewed all the adverse events reported to the FDA MAUDE database over a 10.7-year study period from January 01, 2011 to September 31, 2021. All events were independently reviewed by two physicians.

    RESULTS: During the study period, a total of 320 procedural-related adverse events reported in the MAUDE database were identified. The most common adverse event was transient or persistent phrenic nerve palsy (PNP), accounting for 48% of all events. This was followed by cardiac perforation (15%), pulmonary vein stenosis (8%), transient ischemic attack or stroke (6%), vascular injury (4%), transient or persistent ST-elevation myocardial infarction (3%), hemoptysis (2%), pericarditis (2%), and esophageal ulcer or fistula (1%). There were six reported intra-procedural death events as a result of cardiac perforation.

    CONCLUSION: The two most common procedural adverse events associated with cryoballoon ablation were PNP and cardiac perforation. All cases of procedural mortality were due to cardiac perforation.

  7. Arai H, Maeda K, Wakabayashi H, Naito T, Konishi M, Assantachai P, et al.
    J Cachexia Sarcopenia Muscle, 2023 Oct;14(5):1949-1958.
    PMID: 37667992 DOI: 10.1002/jcsm.13323
    Chronic diseases often lead to metabolic disorders, causing anabolic resistance and increased energy consumption, which result in cachexia. Cachexia, in turn, can lead to major clinical consequences such as impaired quality of life, shortened life expectancy, and increased healthcare expenditure. Existing international diagnostic criteria for cachexia employ thresholds derived from Western populations, which may not apply to Asians due to differing body compositions. To address this issue, the Asian Working Group for Cachexia (AWGC) was initiated. The AWGC comprises experts in cachexia research and clinical practice from various Asian countries and aims to develop a consensus on diagnostic criteria and significant clinical outcomes for cachexia in Asia. The AWGC, composed of experts in cachexia research and clinical practice from several Asian countries, undertook three-round Delphi surveys and five meetings to reach a consensus. Discussions were held on etiological diseases, essential diagnostic items for cachexia, including subjective and objective symptoms and biomarkers, and significant clinical outcomes. The consensus highlighted the importance of multiple diagnostic factors for cachexia, including chronic diseases, either or both weight loss or low body mass index, and at least one of the following: anorexia, decreased grip strength (<28 kg in men and <18 kg in women), or elevated C-reactive protein levels (>5 mg/L [0.5 mg/dL]). The AWGC proposed a significant weight change of 2% or more over a 3-6 month period and suggested a tentative cut-off value of 21 kg/m2 for low body mass index in diagnosing cachexia. Critical clinical outcomes were determined to be mortality, quality of life as assessed by tools such as EQ-5D or the Functional Assessment of Anorexia/Cachexia Therapy, and functional status as measured by the Clinical Frailty Scale or Barthel Index, with significant emphasis on patient-reported outcomes. The AWGC consensus offers a comprehensive definition and user-friendly diagnostic criteria for cachexia, tailored specifically for Asian populations. This consensus is set to stimulate future research and enhance the multidisciplinary approach to managing cachexia. With plans to develop further guidelines for the optimal treatment, prevention, and care of cachexia in Asians, the AWGC criteria are expected to drive research across chronic co-morbidities and cancer in Asia, leading to future refinement of diagnostic criteria.
  8. Le TTB, Vasanthakumaran T, Thi Hien HN, Hung IC, Luu MN, Khan ZA, et al.
    Rev Med Virol, 2023 Jan;33(1):e2398.
    PMID: 36150052 DOI: 10.1002/rmv.2398
    The emergence of the SARS-CoV-2 Omicron variant (B.1.1.529) has created great global distress. This variant of concern shows multiple sublineages, importantly B.1.1.529.1 (BA.1), BA.1 + R346K (BA.1.1), and B.1.1.529.2 (BA.2), each with unique properties. However, little is known about this new variant, specifically its sub-variants. A narrative review was conducted to summarise the latest findings on transmissibility, clinical manifestations, diagnosis, and efficacy of current vaccines and treatments. Omicron has shown two times higher transmission rates than Delta and above ten times more infectious than other variants over a similar period. With more than 30 mutations in the spike protein's receptor-binding domain, there is reduced detection by conventional RT-PCR and rapid antigen tests. Moreover, the two-dose vaccine effectiveness against Delta and Omicron variants was found to be approximately 21%, suggesting an urgent need for a booster dose to prevent the possibility of breakthrough infections. However, the current vaccines remain highly efficacious against severe disease, hospitalisation, and mortality. Japanese preliminary lab data elucidated that the Omicron sublineage BA.2 shows a higher illness severity than BA.1. To date, the clinical management of Omicron remains unchanged, except for monoclonal antibodies. Thus far, only Bebtelovimab could sufficiently treat all three sub-variants of Omicron. Further studies are warranted to understand the complexity of Omicron and its sub-variants. Such research is necessary to improve the management and prevention of Omicron infection.
  9. Liu Y, Lee WJ, Tan CP, Lai OM, Wang Y, Qiu C
    Food Chem, 2022 Mar 15;372:131305.
    PMID: 34653777 DOI: 10.1016/j.foodchem.2021.131305
    High internal phase emulsions (HIPEs) show promising application in food and cosmetic industries. In this work, diacylglycerol (DAG) was applied to fabricate water-in-oil (W/O) HIPEs. DAG-based emulsion can hold 60% water and the emulsion rigidity increased with water content, indicating the water droplets acted as "active fillers". Stable HIPE with 80% water fraction was formed through the combination of 6 wt% DAG with 1 wt% polyglycerol polyricinoleate (PGPR). The addition of 1 w% kappa (κ)-carrageenan and 0.5 M NaCl greatly reduced the droplet size and enhanced emulsion rigidity, and the interfacial tension of the internal phase was reduced. Benefiting from the Pickering crystals-stabilized interface by DAG as revealed by the microscopy and enhanced elastic modulus of emulsions with the gelation agents, the HIPEs demonstrated good retaining ability for anthocyanin and β-carotene. This study provides insights for the development of W/O HIPEs to fabricate low-calories margarines, spread or cosmetic creams.
  10. Li G, Lee WJ, Tan CP, Lai OM, Wang Y, Qiu C
    Food Funct, 2021 Nov 29;12(23):11732-11746.
    PMID: 34698749 DOI: 10.1039/d1fo01883c
    Pickering water-in-oil (W/O) emulsions were fabricated by using medium-long chain diacylglycerol (MLCD)-based solid lipid nanoparticles (SLNs) and the connection between the characteristics of the SLNs and the colloidal stability of the emulsions was established. Via melt-emulsification and ultrasonication, MLCD-based SLNs with particle sizes of 120-300 nm were obtained with or without other surfactants. The particle size of the SLNs was influenced by the chemical properties of the surfactants, and surfactants decreased the contact angle of SLNs at the oil-water interface. Gelation was observed in SLNs modified by sodium stearoyl lactylate and lecithin, whereas the addition of Tween 20 resulted in a homogeneous SLN solution. The adsorption of surfactants onto SLN surfaces caused the production of higher amounts of α crystals accompanied by delayed crystallization onset which contributed to the reduction of particle size, interfacial tension and oil wetting ability. The W/O emulsions with higher rigidity and physical stability can be obtained by varying surfactant types and by increasing SLN mass ratios to 60%, whereby more SLNs are adsorbed at the droplet surface as a Pickering stabilizer. This study provides useful insights for the development of diacylglycerol-based SLNs and Pickering W/O emulsions which have great potential for food, cosmetic and pharmaceutical applications.
  11. Chen WH, Chang CM, Mutuku JK, Lam SS, Lee WJ
    J Hazard Mater, 2021 08 15;416:125856.
    PMID: 34492805 DOI: 10.1016/j.jhazmat.2021.125856
    Inhalation of aerosols such as pharmaceutical aerosols or virus aerosol uptake is of great concern to the human population. To elucidate the underlying aerosol dynamics, the deposition fractions (DFs) of aerosols in healthy and asthmatic human airways of generations 13-15 are predicted. The Navier-stokes equations governing the gaseous phase and the discrete phase model for particles' motion are solved using numerical methods. The main forces responsible for deposition are inertial impaction forces and complex secondary flow velocities. The curvatures and sinusoidal folds in the asthmatic geometry lead to the formation of complex secondary flows and hence higher DFs. The intensities of complex secondary flows are strongest at the generations affected by asthma. The DF in the healthy airways is 0%, and it ranges from 1.69% to 52.93% in the asthmatic ones. From this study, the effects of the pharmaceutical aerosol particle diameters in the treatment of asthma patients can be established, which is conducive to inhibiting the inflammation of asthma airways. Furthermore, with the recent development of COVID-19 which causes pneumonia, the predicted physics and effective simulation methods of bioaerosols delivery to asthma patients are vital to prevent the exacerbation of the chronic ailment and the epidemic.
  12. Chen WH, Chang CM, Mutuku JK, Lam SS, Lee WJ
    Environ Res, 2021 06;197:110975.
    PMID: 33689824 DOI: 10.1016/j.envres.2021.110975
    The deposition phenomenon of microparticle and SAR-CoV-2 laced bioaerosol in human airways is studied by Taguchi methods and response surface methodology (RSM). The data used herein is obtained from simulations of airflow dynamics and deposition fractions of drug particle aerosols in the downstream airways of asthma patients using computational fluid dynamics (CFD) and discrete particle motion (DPM). Three main parameters, including airflow rate, drug dose, and particle size, affecting aerosol deposition in the lungs of asthma patients are examined. The highest deposition fraction (DF) is obtained at the flow rate of 45 L min-1, the drug dose of 200 μg·puff-1, and the particle diameter of 5 μm. The optimized combination of levels for the three parameters for maximum drug deposition is performed via the Taguchi method. The importance of the influencing factors rank as particle size > drug dose > flow rate. RSM reveals that the combination of 30 L min-1, 5 μm, 200 μg·puff- has the highest deposition fraction. In part, this research also studied the deposition of bioaerosols contaminated with the SAR-CoV-2 virus, and their lowest DF is 1.15%. The low DF of bioaerosols reduces the probability of the SAR-CoV-2 virus transmission.
  13. Lee WJ, Goh PS, Lau WJ, Ismail AF, Hilal N
    Membranes (Basel), 2021 Mar 25;11(4).
    PMID: 33806115 DOI: 10.3390/membranes11040235
    Water constitutes one of the basic necessities of life. Around 71% of the Earth is covered by water, however, not all of it is readily available as fresh water for daily consumption. Fresh water scarcity is a chronic issue which poses a threat to all living things on Earth. Seawater, as a natural resource abundantly available all around the world, is a potential water source to fulfil the increasing water demand. Climate-independent seawater desalination has been touted as a crucial alternative to provide fresh water. While the membrane-based desalination process continues to dominate the global desalination market, the currently employed membrane fabrication materials and processes inevitably bring adverse impacts to the environment. This review aims to elucidate and provide a comprehensive outlook of the recent efforts based on greener approaches used for desalination membrane fabrication, which paves the way towards achieving sustainable and eco-friendly processes. Membrane fabrication using green chemistry effectively minimizes the generation of hazardous compounds during membrane preparation. The future trends and recommendations which could potentially be beneficial for researchers in this field are also highlighted.
  14. Yang J, Qiu C, Li G, Lee WJ, Tan CP, Lai OM, et al.
    Food Chem, 2020 Oct 15;327:127014.
    PMID: 32434126 DOI: 10.1016/j.foodchem.2020.127014
    The influence of diacylglycerol (DAG) combined with polyglycerol polyricinoleate (PGPR) on the stability of water-in-oil (W/O) emulsions containing hydrogenated palm oil (HPO) was studied. Polarized light microscope revealed that DAG promoted HPO to crystallize at the water-oil interface, providing the combination of Pickering and network stabilization effects. It was proposed that the molecular compatibility of fatty acids in DAG with HPO accounted for the promotional effect. The interfacial crystallization of DAG together with the surface activity of PGPR led to the formation of emulsions with uniform small droplets and high freeze-thaw stability. Further exploration of physical properties indicated that the combination of DAG and PGPR dramatically improved the emulsion's viscoelasticity and obtained a larger deformation yield. Water droplets in DAG-based emulsions acted as active fillers to improve the network rigidity. Therefore, DAG is a promising material to be used as emulsifier to enhance the physical stability of W/O emulsions.
  15. Wang S, Lee WJ, Wang Y, Tan CP, Lai OM, Wang Y
    J Agric Food Chem, 2020 Aug 05;68(31):8391-8403.
    PMID: 32511921 DOI: 10.1021/acs.jafc.0c01346
    Medium-chain diacylglycerol (MCD), medium-long-chain diacylglycerol (MLCD), and long-chain diacylglycerol (LCD) were prepared through enzymatic esterification using different conditions at temperatures of 55-70 °C and reaction times of 1.5-5 h and in the presence of 5-6% Novozym 435. Subsequently, purification was performed using three different techniques, namely, molecular distillation (MD), deodorization (DO), and silica gel column chromatography (SGCC). Variations in terms of the physicochemical and thermodynamic properties, crystallization properties, and kinetics of the diacylglycerols (DAGs) before and after purification were determined. Irrespective of the DAG chain lengths, SGCC was able to produce samples with high DAG purity (96-99 wt %), followed by MD (58-79 wt %) and DO (39-59 wt %). A higher 1,3-DAG/1,2-DAG ratio was recorded for all samples, with the highest ratio recorded for SGCC purified samples. Regardless of the purification techniques used, the solid fat content (SFC) profiles of crude samples with steep curves were altered post-purification, showing a gradual increment in SFC along with increasing temperature. Modification of the Avrami constant and coefficient suggested the modification of the crystal growth mechanism post-purification. Crystallization and melting temperatures of products with a higher DAG purity were shifted to a higher temperature region. Variations were also reflected in terms of the crystal polymorphism, whereby the α and β' crystals transitioned into the more stable β form in purified samples accompanied by modification in the microstructures and crystal sizes. However, there was insignificant change in the morphology of MLCD crystal after purification, except for the decrease in crystal sizes. In conclusion, synthesis of MCD, MLCD, and LCD comprising different DAG purities had distinctive SFC profiles, thermodynamic properties, crystallization kinetics, and crystal morphologies, which can be further incorporated into the preparation of a variety of fat products to obtain end products with desired characteristics.
  16. Lei M, Zhang N, Lee WJ, Tan CP, Lai OM, Wang Y, et al.
    Food Chem, 2020 May 15;312:126047.
    PMID: 31884300 DOI: 10.1016/j.foodchem.2019.126047
    Formation of foams is critical for tailoring the texture and mouthfeel of fat-based products. Diacylglycerol (DAG) is regarded as a preferable alternative structurant to hydrogenated lipid. Effect of DAG concentration (2-10 wt%) on the characteristics of oleogels and foams including crystal polymorphisms, size and distribution, rheological and thermodynamic properties was investigated. Oleogel prepared with 10 wt% DAG had comparable whipping and foaming stability to that of 6 wt% fully hydrogenated palm oil (FHPO). DAG formed small plate-crystals which tend to occur at the bubble surface, whereas FHPO showed needle-like crystals that were formed mainly in the continuous phase. For the 2 wt% FHPO-8 wt% DAG-based oil foams, interfacial templating crystallization effect contributed to the smaller bubble size and improved rheological properties whereby less oil drainage and foam breakdown occurred. Hence, the non-aqueous foam formed by DAG has broad application prospect because of the thermoresponsive properties and the desirable health benefits.
  17. Lee WJ, Tan CP, Sulaiman R, Hee YY, Chong GH
    Food Chem, 2020 Jan 30;304:125427.
    PMID: 31494501 DOI: 10.1016/j.foodchem.2019.125427
    Solution-enhanced dispersion by supercritical carbon dioxide (SEDS) and spray drying (SD) were used to microencapsulate red palm oil (RPO) to prolong the functionality of carotenes and vitamin E. The protective effects provided by SEDS and SD were evaluated in terms of the oxidative stability (65 °C for 35 days), fatty acid compositions, color change and degradation kinetics of carotenes and vitamin E (25 °C, 45 °C, 65 °C, and 85 °C for up to 198 days). SEDS microcapsules (SEDS-M) were the most oxidatively stable (total oxidation (Totox): 26.5), followed by SD microcapsules (SD-M) (34.9) and RPO (56.7). Degradation of carotenes and vitamin E fitted well a first-order kinetic model (average absolute relative deviation = 2-16%). SEDS-M offered better protection to vitamin E (Ea = 36 kJ/mol), whereas SD-M provided better protection for α + β carotene (Ea = 29 kJ/mol). Overall, encapsulation protected RPO during storage, with SEDS-microencapsulated RPO performing better than SD-microencapsulated RPO.
  18. Koh ZJ, Tai BC, Kow L, Toouli J, Lakdawala M, Delko T, et al.
    Obes Surg, 2019 06;29(6):1781-1788.
    PMID: 30767187 DOI: 10.1007/s11695-019-03716-8
    PURPOSE: Prevalence of obesity in Asia has been on the increasing trend, with corresponding increase in utilisation of bariatric surgery. The objective of this study was to examine differences in weight loss outcomes following bariatric surgery between Asian ethnicities.

    MATERIALS AND METHODS: A retrospective database review was conducted of patients undergoing primary laparoscopic sleeve gastrectomy between 2009 and 2013 in 14 centres from Singapore, Malaysia, Taiwan, Hong Kong, Japan, Korea, India, Australia, Switzerland, and the USA. All patients with available follow-up data at 12 months and 36 months post-surgery were included in this study. Outcome measures used were percentage excess weight loss (%EWL) and percentage total weight loss (%TWL). Differences in outcomes between ethnicities were analysed after adjusting for age, gender, baseline body mass index (BMI), and presence of diabetes.

    RESULTS: The study population (n = 2150) consisted of 1122 Chinese, 187 Malays, 309 Indians, 67 Japanese, 259 Koreans, and 206 Caucasians. 67.1% were female and 32.9% were male. Mean age was 37.1 ± 11.2 years. Mean pre-operative BMI was 40.7 ± 8.1 kg/m2. With the Caucasian population as reference, Japanese had the best %TWL (3.90, 95% CI 1.16-6.63, p 

  19. Lim JA, Lee ST, Moon J, Jun JS, Kim TJ, Shin YW, et al.
    Ann Neurol, 2019 03;85(3):352-358.
    PMID: 30675918 DOI: 10.1002/ana.25421
    OBJECTIVE: There is no scale for rating the severity of autoimmune encephalitis (AE). In this study, we aimed to develop a novel scale for rating severity in patients with diverse AE syndromes and to verify the reliability and validity of the developed scale.

    METHODS: The key items were generated by a panel of experts and selected according to content validity ratios. The developed scale was initially applied to 50 patients with AE (development cohort) to evaluate its acceptability, reproducibility, internal consistency, and construct validity. Then, the scale was applied to another independent cohort (validation cohort, n = 38).

    RESULTS: A new scale consisting of 9 items (seizure, memory dysfunction, psychiatric symptoms, consciousness, language problems, dyskinesia/dystonia, gait instability and ataxia, brainstem dysfunction, and weakness) was developed. Each item was assigned a value of up to 3 points. The total score could therefore range from 0 to 27. We named the scale the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). The new scale showed excellent interobserver (intraclass correlation coefficient [ICC] = 0.97) and intraobserver (ICC = 0.96) reliability for total scores, was highly correlated with modified Rankin scale (r = 0.86, p

  20. Subramaniam S, Jeoung JW, Lee WJ, Kim YK, Park KH
    Jpn. J. Ophthalmol., 2018 Nov;62(6):634-642.
    PMID: 30229404 DOI: 10.1007/s10384-018-0620-7
    PURPOSE: To compare the diagnostic capability of three-dimensional (3D) neuro-retinal rim thickness (NRR) with existing optic nerve head and retinal nerve fiber layer (RNFL) scan parameters using high-definition optical coherence tomography (HD-OCT).

    DESIGN: Retrospective study.

    METHODS: Based on the mean deviation (MD) of the Humphrey Field Analyzer (HFA), the 152 subjects were categorized into mild (MD > - 6 dB, 100), moderate (MD - 6 to - 12 dB, 26), and severe (MD

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