Publications by authors named "Stephen Chan"

Our case involved a 28-year-old man who presented with life-threatening haematochezia. Computed tomography angiogram revealed contrast extravasation from the appendix pooling in the caecum. Management via laparoscopic stapled partial caecectomy was successful.

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  • Pulmonary arterial hypertension (PAH) is a disease caused by inflammation and dysfunction in blood vessel cells, leading to changes in the lungs' blood vessels.
  • The study highlights the role of the protein IFI16 in promoting inflammation in these endothelial cells, especially when triggered by the inflammatory molecule IL-1b.
  • Additionally, the research suggests that changes in m6A modification of IFI16 may serve as a potential biomarker for identifying PAH in patients, as increased m6A levels were found in their blood cells compared to healthy controls.
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  • Sleep deprivation is linked to significant health risks, including an increased likelihood of influenza, particularly following acute sleep deprivation events (ASDEs) identified in a large population study.
  • The study used data from Fitbit users to analyze sleep patterns and health outcomes, revealing a correlation between political/non-political events and instances of decreased sleep.
  • Genetic factors related to sleep duration were found to influence both the severity of sleep deprivation and the risk of subsequent health issues, emphasizing the need for awareness of health impacts during major national events.
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  • * Recent advancements in targeted therapy and immune-checkpoint inhibitors are now becoming available for treating unresectable HCC and preventing recurrence after curative procedures.
  • * This clinical practice guideline aims to provide updated recommendations from Asia-Pacific experts on systemic therapy for HCC, addressing key questions about patient selection, effective treatments, and management strategies for immunotherapy.
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This study investigates the synergistic antitumor effect of PEG-BCT-100, an arginase, in clinical trials, with canavanine in pancreatic cancer, in vitro and in vivo. The treatment induces cancer cell apoptosis while sparing normal fibroblasts. Our findings suggest heightened susceptibility of pancreatic tumors deficient in arginine biosynthesis enzymes ASS1 and OTC.

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Background: The University of Pittsburgh School of Medicine collaborated with The Addis Clinic to create a global telemedicine elective for fourth-year medical students during the COVID-19 pandemic. The elective aimed to promote cross-cultural understanding by providing unique, hands-on telemedicine experience.

Aim: To assess the effectiveness of the telemedicine elective, four of five medical students and 11 of 12 Kenyan clinical officers completed one-on-one interviews and surveys.

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Social connections not only contribute to psychological and emotional well-being but also positively impact physical health, with social isolation and loneliness linked to early mortality and detrimental health outcomes. This study aims to evaluate an online Awareness, Courage, and Love (ACL) group intervention designed to enhance social connectedness and subjective well-being while reducing loneliness, depression, and anxiety among older adults. This randomised controlled trial (RCT) will involve an intervention group receiving a 2 h ACL session via videoconferencing.

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Background: Genomic screening uncovered interferon-gamma (IFNγ) pathway defects in tumours refractory to immune checkpoint blockade (ICB). However, its non-mutational regulation and reversibility for therapeutic development remain less understood.

Objective: We aimed to identify ICB resistance-associated druggable histone deacetylases (HDACs) and develop a readily translatable combination approach for patients with hepatocellular carcinoma (HCC).

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  • In the TOPAZ-1 trial, patients with biliary tract cancers (BTC) who had recurrence within 6 months of surgery were excluded, which often happens in practice. This study looked into the effectiveness of cisplatin-gemcitabine-durvalumab (CGD) in patients who did experience early recurrence.
  • The study enrolled 178 BTC patients who had surgery and then underwent treatment with CGD after experiencing either early or late disease recurrence. Key goals were to measure overall survival (OS) and progression-free survival (PFS).
  • Results showed no significant differences in OS and PFS between early and late relapse groups, suggesting CGD is effective regardless of when the cancer
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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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Pulmonary arterial hypertension (PAH) is a progressive disease driven by endothelial cell inflammation and dysfunction, resulting in the pathological remodeling of the pulmonary vasculature. Innate immune activation has been linked to PAH development; however, the regulation, propagation, and reversibility of the induction of inflammation in PAH is poorly understood. Here, we demonstrate a role for interferon inducible protein 16 (IFI16), an innate immune sensor, as a modulator of endothelial inflammation in pulmonary hypertension, utilizing human pulmonary artery endothelial cells (PAECs).

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  • Functional limitations are defined as the dependency on others to carry out everyday activities, and there's a growing connection between these limitations and cognitive abilities, although the specific reasons for this link are not fully understood.
  • A study with over 16,000 middle-aged and older adults analyzed data from the China Health and Retirement Longitudinal Study to explore how social participation affects the relationship between functional limitations and cognitive decline over eight years.
  • The findings suggest that social participation partially mediates the connection between functional limitations and cognitive decline, implying that staying socially active may help slow down the decline in cognitive functioning associated with increased dependency.
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  • - The study aimed to create and validate a prognostic model for assessing the risk of hepatocellular carcinoma (HCC) in noncirrhotic adults with chronic hepatitis B, focusing on those without significant alanine aminotransferase (ALT) elevation.
  • - Researchers analyzed data from over 13,000 patients across several cohorts in Taiwan, Korea, and Hong Kong, finding that baseline HBV DNA levels were key predictors of HCC risk, especially at moderate viral loads.
  • - The new model, called Revised REACH-B, showed strong predictive accuracy and was more beneficial compared to other strategies in predicting HCC risk, though its applicability to other racial groups remains a limitation.
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Introduction: There is a lack of data on the efficacy, effectiveness, and safety of lanreotide autogel in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) of Chinese ethnicity. This noninterventional, retrospective study evaluated the effectiveness and safety of lanreotide autogel in patients of Chinese ethnicity with GEP-NETs in clinical practice.

Methods: Patients' charts were abstracted from five hospitals in Hong Kong and Taiwan (July-September 2021), where lanreotide autogel is approved for treating GEP-NETs.

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  • Cell-free DNA (cfDNA) analysis, particularly through a method called FRAGMAXR, can detect and monitor diseases by examining nucleosomal patterns linked to DNA methylation around CpG sites.* -
  • The study found that patients with hepatocellular carcinoma (HCC) exhibited distinct cfDNA nucleosomal patterns that changed based on tumor stage, allowing for effective cancer detection using machine learning.* -
  • The research indicates that these cfDNA patterns could serve as valuable biomarkers for cancer detection and noninvasive prenatal testing, demonstrating strong correlation with established genetic measurements.*
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Lung endothelium resides at the interface between the circulation and the underlying tissue, where it senses biochemical and mechanical properties of both the blood as it flows through the vascular circuit and the vessel wall. The endothelium performs the bidirectional signaling between the blood and tissue compartments that is necessary to maintain homeostasis while physically separating both, facilitating a tightly regulated exchange of water, solutes, cells, and signals. Disruption in endothelial function contributes to vascular disease, which can manifest in discrete vascular locations along the artery-to-capillary-to-vein axis.

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  • The COVID-19 pandemic has created significant challenges for university students, impacting their mental well-being and prompting this study to explore how hope, self-esteem, and life satisfaction interconnect during crises.
  • A survey of 315 students in Hong Kong revealed that those with higher levels of hope and self-esteem also reported greater life satisfaction.
  • The findings suggest that self-esteem partially mediates the relationship, meaning that increased hope can enhance life satisfaction by boosting self-esteem, highlighting the importance of mental health interventions for students facing difficulties.
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Soft tissue aneurysmal bone cysts (STABCs) are rare neoplasms histopathologically identical to aneurysmal bone cysts. These benign lesions are characterized by thin, peripheral ossification and no skeletal continuity. STABC may be difficult to distinguish from myositis ossificans (MO) and malignant entities from imaging and fine needle aspiration, due to rarity and overlapping features.

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Background & Aims: In the global, phase III HIMALAYA study in unresectable hepatocellular carcinoma (uHCC), STRIDE (Single Tremelimumab Regular Interval Durvalumab) improved overall survival (OS) vs. sorafenib; durvalumab was non-inferior to sorafenib. HBV is the predominant HCC aetiology in most of Asia vs.

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KRAS gene mutations are common in pancreatic ductal adenocarcinoma (PDAC), but targeting mutant KRAS is still challenging. Here, an endoribonuclease-prepared small interfering RNA (esiRNA) library was used to screen new kinases that play critical roles in PDAC driven by KRAS gene mutations, and serine/threonine kinase 31 (STK31) was identified and characterized as a potential therapeutic target for KRAS-mutant PDAC. Our results showed that STK31 was upregulated in KRAS-mutant PDAC patients with poor survival and highly expressed in PDAC cell lines with KRAS mutation.

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Background: The TOPAZ-1 phase III trial showed a survival benefit with durvalumab plus gemcitabine and cisplatin in patients with advanced biliary tract cancer (BTC). To understand this combination's real-world efficacy and tolerability, we conducted a global multicenter retrospective analysis of its first-line treatment outcomes.

Methods: We included patients with unresectable, locally advanced, or metastatic BTC treated with durvalumab, gemcitabine, and cisplatin at 39 sites in 11 countries (Europe, the United States, and Asia).

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Background & Aims: Combined F-fluorodeoxyglucose (FDG) and C-acetate (dual-tracer) positron-emission tomography/computed tomography (PET/CT) is being increasingly performed for the management of hepatocellular carcinoma (HCC), although its role is not well defined. Therefore, we evaluated its effectiveness in (i) staging, (ii) characterization of indeterminate lesions on conventional imaging, and (iii) detection of HCC in patients with unexplained elevations in serum alpha-fetoprotein (AFP) levels.

Methods: We retrospectively assessed 525 consecutive patients from three tertiary centers between 2014 and 2020.

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Given the existing uncertainty regarding the effectiveness and safety of switching from low-molecular-weight heparin (LMWH) to direct oral anticoagulants (DOACs) in patients with cancer-associated venous thrombosis (CAT), we conducted a comprehensive population-based cohort study utilizing electronic health database in Hong Kong. A total of 4356 patients with CAT between 2010 and 2022 were included, with 1700 (39.0%) patients switching to DOAC treatment.

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