MyMedR

Displaying publications 21 - 29 of 29 in total

Abstract:

Sort:

Opposing trends in incidence of esophageal squamous cell carcinoma and adenocarcinoma in a multi-ethnic Asian country

Fernandes ML, Seow A, Chan YH, Ho KY

Am J Gastroenterol, 2006 Jul;101(7):1430-6.
PMID: 16863543

To describe the incidence trends in esophageal squamous cell carcinoma (SCC) and adenocarcinoma among the three major ethnic groups in Singapore from 1968 to 2002.
Fulltext Examining Consumers' Adoption of Wearable Healthcare Technology: The Role of Health Attributes

Cheung ML, Chau KY, Lam MHS, Tse G, Ho KY, Flint SW, et al.

Int J Environ Res Public Health, 2019 Jun 26;16(13).
PMID: 31247962 DOI: 10.3390/ijerph16132257

With the advancement of information technology, wearable healthcare technology has emerged as one of the promising technologies to improve the wellbeing of individuals. However, the adoption of wearable healthcare technology has lagged when compared to other well-established durable technology products, such as smartphones and tablets, because of the inadequate knowledge of the antecedents of adoption intention. The aim of this paper is to address an identified gap in the literature by empirically testing a theoretical model for examining the impact of consumers' health beliefs, health information accuracy, and the privacy protection of wearable healthcare technology on perceived usefulness. Importantly, this study also examines the influences of perceived usefulness, consumer innovativeness, and reference group influence on the adoption intention of wearable healthcare technology. The model seeks to enhance understanding of the influential factors in adopting wearable healthcare technology. Finally, suggestions for future research for the empirical investigation of the model are provided.
Dual pretreatment of mixing H2O2 followed by torrefaction to upgrade spent coffee grounds for fuel production and upgrade level identification of H2O2 pretreatment

Chen WH, Ho KY, Lee KT, Ding L, Andrew Lin KY, Rajendran S, et al.

Environ Res, 2022 Dec;215(Pt 1):114016.
PMID: 35977586 DOI: 10.1016/j.envres.2022.114016

Biochar is a carbon-neutral solid fuel and has emerged as a potential candidate to replace coal. Meanwhile, spent coffee grounds (SCGs) are an abundant and promising biomass waste that could be used for biochar production. This study develops a biochar valorization strategy by mixing SCGs with hydrogen peroxide (H2O2) at a weight ratio of 1:0.75 to upgrade SCG biochar. In this dual pretreatment method, the H2O2 oxidative ability at a pretreatment temperature of 105 °C contributes to an increase in the higher heating value (HHV) and carbon content of the SCG biochars. The HHV and carbon content of biochar increase by about 6.5% and 7.8%, respectively, when compared to the unpretreated one under the same conditions. Maximized biochar's HHV derived via the Taguchi method is 30.33 MJkg-1, a 46.9% increase compared to the raw SCG, and a 6.5% increase compared to the unpretreated SCG biochar. The H2O2 concentration is 18% for the maximized HHV. A quantitative identification index of intensity of difference (IOD) is adopted to evaluate the contributive level of H2O2 pretreatment in terms of the HHV and carbon content. IOD increases with increasing H2O2 pretreatment temperature. Before torrefaction, SCGs' IOD pretreated at 50 °C is 1.94%, while that pretreated at 105 °C is 8.06%. This is because, before torrefaction, H2O2 pretreatment sufficiently weakens SCGs' molecular structure, resulting in a higher IOD value. The IOD value of torrefied SCGs (TSCG) pretreated at 105 °C is 10.71%, accounting for a 4.59% increase compared to that pretreated at 50 °C. This implies that TSCG pretreated by H2O2 at 105 °C has better thermal stability. For every 1% increase in IOD of TSCG, the carbon content of the biochar increases 0.726%, and the HHV increases 0.529%. Overall, it is demonstrated that H2O2 is a green and promising pretreatment additive for upgrading SCG biochar's calorific value, and torrefied SCGs can be used as a potential solid fuel to approach carbon neutrality.
Multi-objective operation optimization of spent coffee ground torrefaction for carbon-neutral biochar production

Chen WH, Lee KT, Ho KY, Culaba AB, Ashokkumar V, Juan CJ

Bioresour Technol, 2023 Feb;370:128584.
PMID: 36610482 DOI: 10.1016/j.biortech.2023.128584

Many energy-intensive processes are employed to enhance biomass fuel properties to overcome the difficulties in utilizing biomass as fuel. Therefore, energy conservation during these processes is crucial for realizing a circular bioeconomy. This study develops a newly devised method to evaluate SCG biochars' higher heating value (HHV) and predict moisture content from power consumption. It is found that the increasing rates of HHV immediately follow decreases in power consumption, which could be used to determine the pretreatment time for energy conservation. The non-dominated sorting genetic algorithm II (NSGA-II) maximizes SCG biochar's HHV while minimizing energy consumption. The results show that producing SCG biochar with 23.98 MJ∙kg-1 HHV requires 20.042 MJ∙kg-1, using a torrefaction temperature of 244 °C and torrefaction time of 27 min and 43 sec. Every kilogram of biochar with an energy yield of 85.93 % is estimated to cost NT$ 12.21.
Biliary ascariasis - A vicious cycle

Che Husin N, Mohamad IS, Ho KY, Soh JY, Syed Aziz SH, Zakaria Z

Malays Fam Physician, 2021 Jul 22;16(2):83-85.
PMID: 34386170 DOI: 10.51866/cr1078

Biliary ascariasis is a rare disease in a non-endemic area. However, it is one of the possible etiological factors for retarded growth as well as malnutrition in children. It may cause intestinal obstruction, appendicitis, biliary obstruction, liver abscess, hepatolithiasis, and pancreatitis in adults. Herein, we report a patient with ascending cholangitis secondary to biliary ascariasis who was successfully managed with Endoscopic Retrograde Cholangio Pancreaticography.
Optimizing Use of Nonalcoholic Fatty Liver Disease Fibrosis Score, Fibrosis-4 Score, and Liver Stiffness Measurement to Identify Patients With Advanced Fibrosis

Chan WK, Treeprasertsuk S, Goh GB, Fan JG, Song MJ, Charatcharoenwitthaya P, et al.

Clin Gastroenterol Hepatol, 2019 11;17(12):2570-2580.e37.
PMID: 30876959 DOI: 10.1016/j.cgh.2019.03.006

BACKGROUND & AIMS: Measuring liver stiffness only in patients with indeterminate or high nonalcoholic fatty liver disease (NAFLD) fibrosis scores (called a 2-step approach) was reported to reduce indeterminate or discordant results while maintaining the accuracy to identify patients with advanced fibrosis. We aimed to validate this approach using data collected from the Gut and Obesity in Asia Workgroup.
METHODS: We performed a retrospective analysis of data from 759 patients with biopsy-proven NAFLD (24% with advanced fibrosis), seen at 10 centers in 9 countries in Asia, from 2006 through 2018. By using liver biopsies as the reference standard, we calculated percentages of misclassifications and indeterminate or discordant results from assessments made based on fibrosis scores (NAFLD fibrosis score [NFS] or Fibrosis-4 score) and liver stiffness measurements (LSMs), alone or in combination. The analysis was repeated using randomly selected subgroups with a different prevalence of advanced fibrosis (histologic fibrosis stage ≥F3).
RESULTS: In groups in which 3.7% and 10% of patients had advanced fibrosis, a 2-step approach (using the NFS followed by LSM only for patients with indeterminate or high NFS) and using a gray zone of 10 to 15 kPa for LSM, produced indeterminate or discordant results for 6.9% of patients and misclassified 2.7% of patients; only 25.6% of patients required LSM. In the group in which 10% of patients had advanced fibrosis, the same approach produced indeterminate or discordant results for 7.9% of patients and misclassified 6.6% of patients; only 27.4% of patients required LSM. In groups in which 24% and 50% of patients had advanced fibrosis, using LSM ≥10 kPa alone for the diagnosis of advanced fibrosis had the highest accuracy and misclassified 18.1% and 18.3% of patients, respectively. These results were similar when the Fibrosis-4 score was used in place of NFS.
CONCLUSIONS: In a retrospective analysis, we found that a 2-step approach using fibrosis scores followed by LSM most accurately detects advanced fibrosis in populations with a low prevalence of advanced fibrosis. However, LSM ≥10 kPa identifies patients with advanced fibrosis with the highest level of accuracy in populations with a high prevalence of advanced fibrosis.
Clinical features and treatment of nonalcoholic fatty liver disease across the Asia Pacific region-the GO ASIA initiative

Chan WK, Treeprasertsuk S, Imajo K, Nakajima A, Seki Y, Kasama K, et al.

Aliment Pharmacol Ther, 2018 Mar;47(6):816-825.
PMID: 29333610 DOI: 10.1111/apt.14506

BACKGROUND: The Gut and Obesity Asia (GO ASIA) workgroup was formed to study the relationships between obesity and gastrointestinal diseases in the Asia Pacific region.
AIM: To study factors associated with nonalcoholic steatohepatitis (NASH) and advanced fibrosis, and medical treatment of biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients.
METHODS: Retrospective study of biopsy-proven NAFLD patients from centres in the GO ASIA Workgroup. Independent factors associated with NASH and with advanced fibrosis on binary logistic regression analyses in a training cohort were used for the development of their corresponding risk score, which were validated in a validation cohort.
RESULTS: We included 1008 patients from nine centres across eight countries (NASH 62.9%, advanced fibrosis 17.2%). Independent predictors of NASH were body mass index ≥30 kg/m2 , diabetes mellitus, dyslipidaemia, alanine aminotransferase ≥88 U/L and aspartate aminotransferase ≥38 U/L, constituting the Asia Pacific NASH risk score. A high score has a positive predictive value of 80%-83% for NASH. Independent predictors of advanced fibrosis were age ≥55 years, diabetes mellitus and platelet count <150 × 109 /L, constituting the Asia-Pacific NAFLD advanced fibrosis risk score. A low score has a negative predictive value of 95%-96% for advanced fibrosis. Only 1.7% of patients were referred for structured lifestyle program, 4.2% were on vitamin E, and 2.4% were on pioglitazone.
CONCLUSIONS: More severe liver disease can be suspected or ruled out based on factors identified in this study. Utilisation of structured lifestyle program, vitamin E and pioglitazone was limited despite this being a cohort of biopsy-proven NAFLD patients with majority of patients having NASH.
Fulltext Management of patients on antithrombotic agents undergoing emergency and elective endoscopy: joint Asian Pacific Association of Gastroenterology (APAGE) and Asian Pacific Society for Digestive Endoscopy (APSDE) practice guidelines

Chan FKL, Goh KL, Reddy N, Fujimoto K, Ho KY, Hokimoto S, et al.

Gut, 2018 03;67(3):405-417.
PMID: 29331946 DOI: 10.1136/gutjnl-2017-315131

This Guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society for Digestive Endoscopy (APSDE). It was developed in response to the increasing use of antithrombotic agents (antiplatelet agents and anticoagulants) in patients undergoing gastrointestinal (GI) endoscopy in Asia. After reviewing current practice guidelines in Europe and the USA, the joint committee identified unmet needs, noticed inconsistencies, raised doubts about certain recommendations and recognised significant discrepancies in clinical practice between different regions. We developed this joint official statement based on a systematic review of the literature, critical appraisal of existing guidelines and expert consensus using a two-stage modified Delphi process. This joint APAGE-APSDE Practice Guideline is intended to be an educational tool that assists clinicians in improving care for patients on antithrombotics who require emergency or elective GI endoscopy in the Asian Pacific region.
Fulltext Current practices in cancer pain management in Asia: a survey of patients and physicians across 10 countries

ACHEON Working Group, Kim YC, Ahn JS, Calimag MM, Chao TC, Ho KY, et al.

Cancer Med, 2015 Aug;4(8):1196-204.
PMID: 25914253 DOI: 10.1002/cam4.471

In order to implement more effective policies for cancer pain management, a better understanding of current practices is needed. Physicians managing cancer pain and patients experiencing cancer pain were randomly surveyed across 10 Asian countries to assess attitudes and perceptions toward cancer pain management. A total of 463 physicians (77.3% oncologists) with a median experience of 13 years were included. Medical school training on opioid use was considered inadequate by 30.5% of physicians and 55.9% indicated ≤ 10 h of continuing medical education (CME). Of the 1190 patients included, 1026 reported moderate-to-severe pain (median duration, 12 months). Discordance was observed between physician and patient outcomes on pain assessment with 88.3% of physicians reporting pain quantification, while 49.5% of patients claimed that no scale was used. Inadequate assessment of pain was recognized as a barrier to therapy optimization by 49.7% of physicians. Additional barriers identified were patients' reluctance owing to fear of addiction (67.2%) and adverse events (65.0%), patients' reluctance to report pain (52.5%), excessive regulations (48.0%) and reluctance to prescribe opioids (42.8%). Opioid use was confirmed only in 53.2% (286/538) of patients remembering their medication. Pain affected the activities of daily living for 81.3% of patients. These findings highlight the need for better training and CME opportunities for cancer pain management in Asia. Collaborative efforts between physicians, patients, policy makers, and related parties may assist in overcoming the barriers identified. Addressing the opioid stigma and enhancing awareness is vital to improving current standards of patient care.