Publications by authors named "Nga-Ting Grace Wong"

Background & Aims: Alcohol-associated liver disease (ALD) burden has been rising globally, fueled by increases in high-risk alcohol use following the coronavirus disease 2019 (COVID-19) pandemic. We evaluated trends in annual incidence of alcohol-associated hepatitis (AH) before and following the onset of the COVID-19 pandemic across two geographically distinct populations in the USA and Hong Kong.

Methods: Using US national Veterans Affairs (VA) data and Hong Kong territory-wide data, trends in annual incidence of AH were evaluated from 2000 to 2023.

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Background & Aims: Current international guidelines recommend close monitoring and evaluation of patients with chronic hepatitis B (CHB) in the indeterminate phase, and treatment of patients at high risk of adverse outcomes. Clinical outcomes and the effect of antiviral therapy on the indeterminate phase remain unclear. We performed a systematic review and meta-analysis to study the incidence of adverse clinical outcomes including hepatocellular carcinoma (HCC), cirrhosis, and hepatic decompensation, and the effect of antiviral therapy, in the indeterminate phase.

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Article Synopsis
  • The year 2024 marks the release of new clinical practice and management guidelines for chronic hepatitis B virus (HBV) infection, led by the World Health Organization (WHO) in March.
  • Key international liver disease societies, like the AASLD and EASL, are also updating their HBV guidelines but have not yet published them.
  • The chapter discusses recent developments, particularly focusing on the stringent Chinese guidelines from 2022 that recommend starting antiviral treatment at higher HBV DNA levels, examining the pros and cons of lowering treatment thresholds to prevent complications like hepatocellular carcinoma (HCC).
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The current diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) and its severe form, metabolic dysfunction-associated steatohepatitis (MASH), is suboptimal. Here, we recruited 700 individuals, including 184 from Hong Kong as a discovery cohort and 516 from San Diego, Wenzhou, and Hong Kong as three validation cohorts. A panel of 3 parameters (C-X-C motif chemokine ligand 10 [CXCL10], cytokeratin 18 fragments M30 [CK-18], and adjusted body mass index [BMI]) was formulated (termed N3-MASH), which discriminated patients with MASLD from healthy controls with an area under the receiver operating characteristic (AUROC) of 0.

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Article Synopsis
  • - Oral antiviral therapy with nucleos(t)ide analogues (NUCs) effectively reduces hepatitis B virus (HBV) levels, but achieving a functional cure (clearance of HBsAg) is uncommon.
  • - While stopping NUC treatment can lead to HBsAg loss in 10% to 20% of patients, there's a high risk of virological relapse (50% to 80%) and the need for retreatment (40% to 55%).
  • - Research is ongoing into using viral and immune biomarkers for better patient management post-treatment, along with AI-driven strategies for tailored NUC therapy decisions.
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Objective: Most smokers who achieve short-term abstinence relapse even when aided by evidence-based cessation treatment. Mobile health presents a promising but largely untested avenue for providing adjunct behavioral support for relapse prevention. This paper presents the rationale and design of a randomized controlled trial aimed at evaluating the effectiveness of personalized mobile chat messaging support for relapse prevention among people who recently quit smoking.

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  • The study focuses on analyzing cell-free DNA (cfDNA) to determine its tissue origin, which is important for research and diagnostics, utilizing a new technique called FRAGHA that looks at fragmentation patterns linked to histone modifications.
  • The research demonstrated strong correlations between specific histone modification signals, such as H3K27ac, and various medical conditions, including fetal DNA presence in maternal plasma and liver cancer detection.
  • Machine learning algorithms were employed to improve early detection of liver cancer, showcasing how cfDNA fragmentomics can enhance the effectiveness of liquid biopsies in clinical settings.
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  • Scientists studied a health problem called MASH, which affects people's livers, and worked on two tests to help doctors tell if someone has it.
  • They looked at data from over 3,000 people to make sure their first test, called acMASH, worked well, and then created a new test called acFibroMASH to find more severe cases.
  • The new acFibroMASH test was better at predicting who might have future liver problems compared to another test, showing it's a useful tool for doctors to keep patients healthy.
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Enhanced liver fibrosis (ELF) score is a noninvasive assessment for liver fibrosis. We aimed to evaluate the performance of changes in ELF score 3 years apart in combination with liver stiffness measurement (LSM)-hepatocellular carcinoma (HCC) score to predict HCC in chronic hepatitis B (CHB) patients. This is a prospective cohort study.

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Article Synopsis
  • * Researchers analyzed data from nearly 4,800 patients and found that their model, named PLAN-B-CURE, outperformed existing prediction models significantly in various metrics.
  • * The results indicate that the PLAN-B-CURE model can be utilized for personalized monitoring of patients post-HBsAg seroclearance, improving long-term health management.
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Background Individuals with opioid dependence often experience poor oral health, including dental decay, periodontal disease and mucosal infection, frequently exacerbated by factors such as smoking, alcohol consumption, inadequate oral hygiene and low utilisation of oral health services. This study aimed to assess oral health status and oral health-related quality of life (OHRQoL) among opioid-dependent individuals and explore their potential associations. Methods Participants enrolled in an opioid treatment program (OTP) at three Australian urban clinics were assessed using the validated Oral Health Assessment Tool (OHAT) and Oral Health Impact Profile (OHIP-14).

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Background & Aims: Hepatocellular carcinoma (HCC) risk persists in patients with chronic hepatitis B (CHB) despite antiviral therapy. The relationship between pre-treatment baseline hepatitis B virus (HBV) viral load and HCC risk during antiviral treatment remains uncertain.

Methods: This multinational cohort study aimed to investigate the association between baseline HBV viral load and on-treatment HCC risk in 20,826 noncirrhotic, hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients with baseline HBV DNA levels ≥2000 IU/mL (3.

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Article Synopsis
  • The study focuses on predicting the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B receiving nucleos(t)ide analogues (NAs), emphasizing the importance of serum hepatitis B virus (HBV) RNA as a novel biomarker.
  • Researchers analyzed data from 1,374 NA-treated patients, tracking HBV RNA levels over three years and using a Cox proportional-hazard model to assess the link between HBV RNA declines and HCC risk, finding significant associations.
  • The findings suggest that patients with lower declines in HBV RNA at one and two years have a higher risk of developing HCC, and incorporating these declines into existing risk prediction models can improve their accuracy and help guide patient monitoring strategies
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Breast cancer is the most frequent malignancy in women, constituting 15.2% of all new cancers diagnosed in the United States. Distant breast cancer metastasis accounts for the majority of breast cancer-related deaths; brain metastasis is the third most common site for metastatic breast cancer but is associated with worst prognosis of approximately eight months of survival.

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Introduction: The risk of ischemic stroke and intracerebral hemorrhage (ICH) with intensive lipid control by statins among patients with atrial fibrillation (AF) who require direct oral anticoagulants (DOAC) is unclear. We aimed to determine the risks of ischemic stroke and ICH in AF patients treated with DOAC and statins.

Patients And Methods: In a population-based retrospective cohort study, we identified AF patients concurrently on DOAC and statins from 2015 to 2021 in Hong Kong.

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  • Statins provide multiple benefits for patients with metabolic-associated steatotic liver disease (MASLD), particularly in reducing long-term risks of all-cause mortality and liver-related clinical events (LREs).
  • A study followed 7988 patients for nearly 4.6 years, revealing that statin users had significantly lower risks of mortality (HR=0.233) and LREs (HR=0.380), as well as slower liver stiffness progression rates.
  • While statin usage is linked to a decrease in the progression of liver stiffness, it did not significantly correlate with liver stiffness regression, suggesting a complex relationship in liver health management.
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Background: Hepatocellular carcinoma (HCC) recurrence following surgical resection remains a significant clinical challenge, necessitating reliable predictive models to guide personalised interventions. In this study, we sought to harness the power of artificial intelligence (AI) to develop a robust predictive model for HCC recurrence using comprehensive clinical datasets.

Methods: Leveraging data from 958 patients across multiple centres in Australia and Hong Kong, we employed a multilayer perceptron (MLP) as the optimal classifier for model generation.

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Patients with acutely decompensated heart failure (ADHF) are usually admitted to hospital for management. There is growing interest in delivering intravenous (IV) diuretic therapy at home, in the community or at hospital day-care units; the safety and effectiveness of outpatient-based management (OPM) for ADHF has not been established. We conducted a systematic literature review and meta-analysis to investigate the short-term safety and effectiveness of OPM compared with inpatient management (IPM) of ADHF.

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  • The study aimed to evaluate the effectiveness and tolerability of direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) across different genotypes (GTs) in a global, real-world context, focusing particularly on GT3 and GT6.
  • Researchers analyzed data from 15,849 chronic hepatitis C patients across Asia, North America, and Europe over a seven-year period, noting demographic factors such as age, sex, and prior treatment history.
  • Results showed a high sustained virological response (SVR12) rate of 96.9% overall, with variances by genotype, highlighting that independent factors like advanced age, cirrhosis, and previous treatment failures affected treatment outcomes, while being
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Background And Aims: Mother-to-child-transmission (MTCT) of hepatitis B virus (HBV) may still occur despite birth-dose HBV vaccinations when pregnant women are positive for hepatitis B surface antigen (HBsAg) with high viral loads (HBV DNA ≥ 200 000 IU/mL). A pilot integrated model nurse clinic (IMNC) was started in 2020 to implement the pre-emptive antiviral therapy with tenofovir disoproxil fumarate (TDF). We aimed to evaluate the performance of IMNC on uptake of TDF.

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In managing metabolic dysfunction-associated steatotic liver disease, which affects over 30% of the general population, effective noninvasive biomarkers for assessing disease severity, monitoring disease progression, predicting the development of liver-related complications, and assessing treatment response are crucial. The advantage of simple fibrosis scores lies in their widespread accessibility through routinely performed blood tests and extensive validation in different clinical settings. They have shown reasonable accuracy in diagnosing advanced fibrosis and good performance in excluding the majority of patients with a low risk of liver-related complications.

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Introduction: Oral health is significantly linked with systemic health. Nurses play a crucial role in patient education. Improving oral health literacy in nursing students can pave the way for the seamless integration of oral health into nursing practice.

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