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Displaying publications 21 - 29 of 29 in total

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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.
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.
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.
Young breast cancer and the influence of ethnicity in Sandakan: A 3-year retrospective cross-sectional study

Wong WJ, Zainudin SP, Koo YH, Ho KY, Lee ZJ, Wong KH

Asia Pac J Clin Oncol, 2021 Jun 29.
PMID: 34185957 DOI: 10.1111/ajco.13596

INTRODUCTION: Breast cancer (BC) is the most common cancer in Malaysia, with incidence increasing with age. There have been demonstrated differences in age of presentation and tumour biology when comparing ethnicities. Twenty percent of Caucasian women present before 50 years old, but almost 50% of Southeast Asian (SEA) women present before 50. However, BC in Indigenous sub-groups has not yet been studied. Sandakan is a city in Sabah with a large Indigenous population. Current nationwide screening guidelines are based on the U.S. Preventive Task Force 2009 Guidelines, which may not represent our population. We aim to examine the age of incidence for our local population, for local screening recommendations.
METHOD: Retrospective cross-sectional study, including all consecutive cases of epithelial invasive tumours, from January 2016 to December 2018. Other histological types were excluded. Univariate and multivariate analyses were performed.
RESULT: A total of 115 breast tumours were identified. Ten tumours were excluded (five ductal carcinoma in situ, four phyllodes, and one sarcoma), leaving a study population of 105 patients. Median age of presentation was 53 years (min 30; max 97). A total of 41.9% presented before the age of 50. Patients of Indigenous ethnic origins were 11 years younger at presentation than non-Indigenous women. Tumour grade was more likely to be higher among Indigenous women.
CONCLUSION: Median age of presentation of BC in Sandakan matches regional data; however, patients of Indigenous ethnic groups present even earlier. Screening guidelines should consider the growing evidence of young BC in SEA.
Challenges to diagnostic standardization of Barrett's esophagus in Asia

Soh YSA, Lee YY, Gotoda T, Sharma P, Ho KY, Asian Barrett's Consortium

Dig Endosc, 2019 Nov;31(6):609-618.
PMID: 30892742 DOI: 10.1111/den.13402

Barrett's esophagus (BE), a premalignant condition of the lower esophagus, is increasingly prevalent in Asia. However, endoscopic and histopathological criteria vary widely between studies across Asia, making it challenging to assess comparability between geographical regions. Furthermore, guidelines from various societies worldwide provide differing viewpoints and definitions, leading to diagnostic challenges that affect prognostication of the condition. In this review, the authors discuss the controversies surrounding the diagnosis of BE, particularly in Asia. Differences between guidelines worldwide are summarized with further discussion regarding various classifications of BE used, different definitions of gastroesophageal junction used across geographical regions and the clinical implications of intestinal metaplasia in the setting of BE. Although many guidelines recommend the Seattle protocol as the preferred approach regarding dysplasia surveillance in BE, some limitations exist, leading to poor adherence. Newer technologies, such as acetic acid-enhanced magnification endoscopy, narrow band imaging, Raman spectroscopy, molecular approaches and the use of artificial intelligence appear promising in addressing these problems, but further studies are required before implementation into routine clinical practice. The Asian Barrett's Consortium also outlines its ongoing plans to tackle the challenge of standardizing the diagnosis of BE in Asia.
Global variations in diagnostic guidelines for Barrett's esophagus

Kusano C, Singh R, Lee YY, Soh YSA, Sharma P, Ho KY, et al.

Dig Endosc, 2022 Nov;34(7):1320-1328.
PMID: 35475586 DOI: 10.1111/den.14342

Endoscopic diagnosis of gastroesophageal junction and Barrett's esophagus is essential for surveillance and early detection of esophageal adenocarcinoma and esophagogastric junction cancer. Despite its small size, the gastroesophageal junction has many inherent problems, including marked differences in diagnostic methods for Barrett's esophagus in international guidelines. To define Barrett's esophagus, gastroesophageal junction location should be clarified. Although gastric folds and palisade vessels are landmarks for identifying this junction, they are sometimes difficult to observe due to air entry or reflux esophagitis. The possibility of diagnosing a malignancy associated with Barrett's esophagus <1 cm, identified using palisade vessels, should be re-examined. Nontargeted biopsies of Barrett's esophagus are commonly used to detect intestinal metaplasia, dysplasia, and cancer as described in the Seattle protocol. Barrett's esophagus with intestinal metaplasia has a high risk of becoming cancerous. Furthermore, the frequency of cancer in patients with Barrett's esophagus without intestinal metaplasia is high, and the guidelines differ on whether to include the presence of intestinal metaplasia in the diagnosis of Barrett's esophagus. Use of advanced imaging technologies, including narrow-band imaging with magnifying endoscopy and linked color imaging, is reportedly valid for diagnosing Barrett's esophagus. Furthermore, artificial intelligence has facilitated the diagnosis of Barrett's esophagus through its deep learning and image recognition capabilities. However, it is necessary to first use the endoscopic definition of the gastroesophageal junction, which is common in all countries, and then elucidate the characteristics of Barrett's esophagus in each region, for example, length differences in the risk of carcinogenesis with and without intestinal metaplasia.
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.
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 De Garengeot hernia: a rare case in an elderly woman and a review of operative approaches

Zainudin S, Hayati F, Arumugam T, Ho KY

BMJ Case Rep, 2021 Apr 16;14(4).
PMID: 33863769 DOI: 10.1136/bcr-2020-240557

De Garengeot hernia is a rare finding of the vermiform appendix inside a femoral hernia sac. We report this occurrence in a 73-year-old woman who presented in the acute setting. There are no standardised surgical approaches and many different techniques have been described in case reports in the literature. We conducted a literature review of and found a total of 113 cases with addition of our case 114 unique cases were included for analysis. Inguinal incision was most cited (n=89). Concomitant laparotomy was needed in 13 patients, however, the association between type of incision and additional laparotomy was not significant (p>0.05). Laparoscopic surgery alone was performed in eight patients. Nine patients had hybrid surgery. The most common hernia repair was through suture technique with non-absorbable material (n=31). Mesh repair was used in 28 cases. More laparoscopic surgeries were done when the disease was diagnosed preoperatively (7/39, p<0.05).