Publications by authors named "Chew E"

Article Synopsis
  • Cardiac resynchronization therapy (CRT) is effective for treating heart failure but is under-researched in patients with common comorbidities like atrial fibrillation (AF).
  • The SMART registry enrolled 2035 patients to assess CRT response based on clinical outcomes over 12 months, focusing on factors like all-cause mortality, hospitalizations, and quality of life.
  • Results showed 58.9% of patients improved, but factors like age, AF, and diabetes were linked to lower CRT responsiveness, with patients having AF experiencing higher rates of hospitalizations and mortality compared to those in normal rhythm.
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Background: Set against the backdrop of a rapidly ageing population and growing emphasis on the importance of ageing-in-place, family members often assume the role of a caregiver. Navigating through a complex healthcare system while simultaneously juggling the daily care needs of their care-recipients, caregivers often become worn out by the intense caregiver stress and burden, neglecting their own well-being. This translates to adverse health and economic outcomes such as prolonged hospital stays and increased nursing home placement of care-recipients.

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Purpose: Epidemiological studies and clinical trials have reported inconsistent findings regarding the protective role of omega-3 fatty acids in age-related macular degeneration (AMD), we investigated their association in a prospective cohort and examined causality using Mendelian randomization (MR) analyses.

Design: Prospective cohort study and two-sample MR analyses.

Participants: We included individuals of European descent from UK Biobank with plasma omega-3 and docosahexaenoic acid (DHA) measurement.

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Purpose: With the widespread availability of ultrawide field imaging, peripheral retinal abnormalities in age-related macular degeneration (AMD) have garnered attention. However, longitudinal studies on AMD peripheral findings are limited. This study aims to characterize and quantify these features over five years.

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Aim: We report the epidemiology, treatment and outcomes of acute flaccid myelitis (AFM), including the first two cases of enterovirus (EV) D68 myelitis, in Singapore.

Methods: Retrospective observational study from a paediatric hospital in Singapore, from January 2012 to December 2022. Clinical, laboratory, neuroimaging and outcome data were analysed.

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Parkinson's disease (PD) is an incurable, progressive and common movement disorder that is increasing in incidence globally because of population aging. We hypothesized that the landscape of rare, protein-altering variants could provide further insights into disease pathogenesis. Here we performed whole-exome sequencing followed by gene-based tests on 4,298 PD cases and 5,512 controls of Asian ancestry.

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An increasing number of indications are emerging for point-of-care ultrasound to diagnose and treat musculoskeletal complaints. Low cost, dynamic imaging, immediate results, and added advantage of portability have made ultrasound an important imaging modality in urgent care, emergency department (ED), and other musculoskeletal care clinics. This article reviews the use of musculoskeletal ultrasound to help evaluate articular and periarticular structures to evaluate for mechanical injuries and inflammatory arthritis.

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Purpose: This study aimed to develop an algorithm for automated detection of drusenoid pigment epithelial detachments (DPEDs) in optical coherence tomography (OCT) volumes of patients with age-related macular degeneration (AMD) and to compare its performance against traditional reading center grading on color-fundus photographs (CFPs).

Methods: Eyes with a range of AMD severities, excluding neovascular disease, were imaged using spectral-domain OCT (SD-OCT) and paired CFPs and were followed annually for up to 5 years. DPEDs were automatically identified by segmenting the retinal pigment epithelium (RPE) and Bruch's membrane (BM) layers from the SD-OCT volumes and imposing both a minimum RPE BM height (>75 µm) and a two-dimensional length requirement (>433 µm).

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Current research on thumb polydactyly reconstruction focusses primarily on clinical evaluations. Details on aesthetic outcomes are relatively lacking. This study aims to address this gap by: (1) investigating the effectiveness of surgical treatment in achieving symmetrical thumb size, length and girth; (2) assessing aesthetic outcomes from a caregiver's perspective and (3) identifying key factors that influence aesthetic outcomes to inform strategies to improve surgical reconstruction.

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The aim of this study was to report the natural history of paediatric trigger thumbs, determining the rate and factors predictive of spontaneous resolution. A total of 62 patients presenting with 79 thumbs locked in flexion were observed for a mean of 4.2 years.

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Article Synopsis
  • This study compared the measurement of geographic atrophy (GA) in the macula using two imaging methods: standard 30° field fundus autofluorescence (FAF) and ultrawide field (UWF) FAF.
  • Participants from specific eye disease studies were analyzed over a period of 5 years, focusing on the GA area measured by both imaging techniques.
  • The results showed that GA measurements were typically larger with standard FAF than UWF FAF, but both methods demonstrated similar rates of progression, indicating that UWF FAF can be a valid option for long-term monitoring of GA.
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Age-related macular degeneration (AMD), a complex neurodegenerative disease, is a leading cause of visual impairment worldwide with a strong genetic component. Genetic studies have identified several loci, but few causal genes with functional characterization. Here we highlight multiple lines of evidence which show a causal role in AMD for SLC16A8, which encodes MCT3, a retinal pigment epithelium (RPE) specific lactate transporter.

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Article Synopsis
  • - The study aimed to explore the co-design of remote patient monitoring (RPM) technology for hospitalized patients, assessing its effectiveness, the co-design methods used, and the barriers and facilitators encountered in this process
  • - A systematic review analyzed 3334 reports, ultimately highlighting 17 relevant projects focusing on various monitoring scenarios (like surgical, intensive care, and rehabilitation), but none assessed the efficacy of their RPM technologies
  • - Most projects employed co-design methods such as needs assessment and prototyping, while pilot studies evaluated aspects like usability and satisfaction instead of direct clinical outcomes.
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Article Synopsis
  • Age-related macular degeneration (AMD) is a complex eye disease influenced by both genetic factors and involves a subtype called reticular pseudodrusen (RPD), which increases the risk of severe vision loss.* -
  • A genome-wide association study compared genetic data from individuals with AMD and/or RPD to controls, finding significant associations specifically on chromosome 10, while chromosome 1 did not show this correlation in RPD cases.* -
  • The chromosome 10 region includes a long non-coding RNA related to retinal health, highlighting its potential role in retinal thickness and influencing the outer segment of photoreceptors.*
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Deep learning has enabled breakthroughs in automated diagnosis from medical imaging, with many successful applications in ophthalmology. However, standard medical image classification approaches only assess disease presence , neglecting the common clinical setting of longitudinal imaging. For slow, progressive eye diseases like age-related macular degeneration (AMD) and primary open-angle glaucoma (POAG), patients undergo repeated imaging over time to track disease progression and forecasting the future risk of developing a disease is critical to properly plan treatment.

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Article Synopsis
  • The study develops a new biological ageing marker called RetiPhenoAge using deep learning algorithms that analyze retinal images to predict phenotypic age, surpassing traditional chronological age evaluations.
  • Researchers trained a convolutional neural network on retinal photographs from the UK Biobank to identify patterns linked to various health biomarkers and assess the marker’s effectiveness in predicting morbidity and mortality across three independent cohorts.
  • The study also compares RetiPhenoAge with other ageing markers and investigates its relationship with systemic health conditions and genetic factors, employing various statistical models to evaluate risks associated with mortality and illness.
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Article Synopsis
  • Medical texts are difficult to manage and time-consuming to curate manually, prompting the development of NLP algorithms to automate this process for improved efficiency in the biomedical field.
  • The study introduces Ascle, a user-friendly tool designed for biomedical researchers that offers generative functions like question-answering and text summarization, along with 12 essential NLP functions and search capabilities.
  • After fine-tuning 32 language models and validating through physician assessments, results showed significant improvements in text generation tasks, with notable increases in machine translation and question-answering accuracy.
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Article Synopsis
  • After knee surgery, many people struggle to move their knees properly, which can make them unhappy and limit their activities.
  • This study looked at whether patients could accurately measure their knee movement using a special app on their smartphones instead of needing a healthcare professional.
  • The results showed that almost all patients could use the app easily, and it gave very reliable measurements of knee movement.
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von Hippel-Lindau (VHL) is an autosomal-dominant hereditary tumour susceptibility disease associated with pathogenic germline variants in the tumour suppressor gene. VHL patients are at increased risk of developing multiple benign and malignant tumours. Current CLIA-based genetic tests demonstrate a very high detection rate of germline variants in patients with clinical manifestations of VHL.

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Article Synopsis
  • Reticular pseudodrusen (RPD) are a key factor in vision loss related to age-related macular degeneration (AMD), making their detection essential for effective clinical management.
  • Researchers created a deep learning model that segments RPD from a dataset of 9,800 optical coherence tomography scans, achieving better agreement with retinal specialists compared to their own consensus.
  • The model demonstrated high performance in detecting RPD across multiple test datasets, matching the accuracy of experienced specialists, and is now publicly accessible for use.
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Objective: Music strongly modulates our autonomic nervous system. This modulation is evident in musicians' beat-to-beat heart (RR) intervals, a marker of heart rate variability (HRV), and can be related to music features and structures. We present a novel approach to modeling musicians' RR interval variations, analyzing detailed components within a music piece to extract continuous music features and annotations of musicians' performance decisions.

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Deep learning has enabled breakthroughs in automated diagnosis from medical imaging, with many successful applications in ophthalmology. However, standard medical image classification approaches only assess disease presence at the time of acquisition, neglecting the common clinical setting of longitudinal imaging. For slow, progressive eye diseases like age-related macular degeneration (AMD) and primary open-angle glaucoma (POAG), patients undergo repeated imaging over time to track disease progression and forecasting the future risk of developing a disease is critical to properly plan treatment.

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Upper limb weakness following stroke poses a significant global psychosocial and economic burden. Non-invasive brain stimulation (NIBS) is a potential adjunctive treatment in rehabilitation. However, traditional approaches to rebalance interhemispheric inhibition may not be effective for all patients.

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