12,695 results match your criteria: "Duke-NUS Medical School; hu.jiancheng@nccs.com.sg.[Affiliation]"

Purpose: This study aimed to investigate the longitudinal associations between myopic optic disc features and optical coherence tomography (OCT) measurements of peripapillary retinal nerve fibre layer (RNFL) thickness in young myopic children in Singapore.

Methods: A prospective, single-site cohort study was conducted, involving children aged 7-16 years who participated in the PROM-Kids clinical cohort study from 2019 to 2022. Participants underwent annual assessments, including cycloplegic refraction, axial length measurements, fundus photography, and OCT imaging, with ocular magnification correction.

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  • The study compared changes in macular curvature after a spike in intraocular pressure (IOP) across various types of myopia, using 328 eyes from 184 participants.
  • Researchers utilized optical coherence tomography (OCT) to assess macular changes at baseline and during acute IOP elevation, specifically measuring the curvature of the sclera-choroid interface.
  • Results showed that individuals with pathological myopia and those with glaucoma exhibited significantly more curvature change compared to those with high myopia or emmetropic controls, suggesting increased sensitivity to IOP elevation in these groups.
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Background: Socioeconomic disadvantage is associated with greater risks of hospital readmission and mortality among patients with heart failure (HF). However, it is less clear whether socioeconomic disadvantage has an immediate and lasting impact on the risk of admissions after the diagnosis of HF.

Methods: We used electronic health record data of patients aged 65 years and older with newly diagnosed HF between January 2015 and July 2018 in the Duke University Health System, with up to 8 years of follow-up.

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Ki-67 proliferative index (PI) scoring is measured by estimating the proportion of the number of active cell nuclei in hotspot regions within immunohistochemical (IHC) stained slides. It provides valuable information about the rate of proliferation in a tumour. Manual scoring of Ki-67 PI is laborious, time-consuming and often the victim of interobserver variability between pathologists.

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Natural history of low-risk branch-duct intraductal papillary mucinous neoplasms and indeterminate pancreatic cysts: Implications on surveillance intervals by cyst size.

Pancreatology

December 2024

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital & National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-NUS Medical School Singapore, Singapore. Electronic address:

Background: The optimal surveillance strategy for low-risk branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) remains unclear. We aim to evaluate the natural history of low-risk BD-IPMN/indeterminate pancreatic cysts to determine optimal surveillance intervals.

Methods: We conducted a retrospective cohort study of patients with radiologically-diagnosed low-risk BD-IPMN/indeterminate pancreatic cysts from 1998 to 2021 at a tertiary referral center.

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  • - The study examines the impact of Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD) on cognitive function and the importance of early detection for better management and care.
  • - It presents a systematic review of 74 research papers that focus on using deep learning and electroencephalogram (EEG) signals for detecting MCI and AD, highlighting methods for distinguishing between these conditions.
  • - The findings identify current limitations in deep learning applications for MCI and AD detection and suggest future research directions to improve early diagnosis, while also proposing high-performing models as benchmarks for subsequent studies.
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Global burden of disease attributable to metabolic risk factors in adolescents and young adults aged 15-39, 1990-2021.

Clin Nutr

December 2024

MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China. Electronic address:

Background: Metabolic risk factors are a significant cause of global burden among adolescents and young adults, but there is a lack of attention to the burden attributable to these metabolic risk factors globally.

Aims: This study aims to provide comprehensive estimates of five important metabolic risk factors and the attributable disease burden in people aged 15-39 years from 1990 to 2021, based on the Global Burden of Disease Study (GBD) database.

Methods: Global total deaths and disability-adjusted life years (DALYs) were used to describe the burden attributable to five common metabolic risk factors, including high fasting plasma glucose (FPG), high low-density lipoprotein cholesterol (LDL-C), high systolic blood pressure (SBP), high body mass index (BMI), and kidney dysfunction, in adolescents and young adults.

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Use of Active Low Suction Pressure (Subgaleal) Drains in Chronic Subdural Hematoma Surgery.

World Neurosurg

December 2024

Department of Neurosurgery, Changi General Hospital, Singapore; Department of Neurosurgery, National Neuroscience Institute, Singapore; Duke-NUS Medical School, Singapore.

Background: Subdural drains are used to reduce recurrence after surgical evacuation of chronic subdural hematoma. There is a small risk of parenchymal injury. We hypothesize that using subgaleal drains with low active suction (-50 mm Hg to -100 mm Hg) may be a safer alternative and still maintain efficacy in preventing recurrence.

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Artificial intelligence in obstetric anaesthesiology - the future of patient care?

Int J Obstet Anesth

October 2024

Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore; Anaesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore.

The use of artificial intelligence (AI) in obstetric anaesthesiology shows great potential in enhancing our practice and delivery of care. In this narrative review, we summarise the current applications of AI in four key areas of obstetric anaesthesiology (perioperative care, neuraxial procedures, labour analgesia and obstetric critical care), where AI has been employed to varying degrees for decision support, event prediction, risk stratification and procedural assistance. We also identify gaps in current practice and propose areas for further research.

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  • Accurately measuring length in children under 18 months is crucial for monitoring their growth, but it can be challenging due to the need for proper equipment and cooperation from the kids.
  • The study developed a length artificial intelligence (LAI) algorithm that allows users to conveniently estimate a child's length using smartphone images and tested its effectiveness in a clinical setting.
  • The results showed that the LAI tool successfully predicted length for nearly all images analyzed, with a low mean absolute error, and both parents and investigators found it easy to use.
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Data-Driven Cutoff Selection for the Patient Health Questionnaire-9 Depression Screening Tool.

JAMA Netw Open

November 2024

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.

Article Synopsis
  • The study investigates how using small datasets to select an optimal cutoff score for the Patient Health Questionnaire-9 (PHQ-9) can lead to inaccurate results.
  • Researchers evaluated whether data-driven methods for cutoff selection resulted in scores that were significantly different from the true population optimal score and if these methods produced biased accuracy estimates.
  • Findings showed that many small studies frequently failed to identify the correct optimal cutoff score, particularly in smaller samples, leading to an overestimation of test sensitivity.
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Introduction: With technological advancements and the growing prevalence of smartphones, ophthalmology has opportunely harnessed medical technology for visual function assessment as a home monitoring tool for patients. Ophthalmology applications that offer these have likewise become more readily available in recent years, which may be used for early detection and monitoring of eye conditions. To date, no review has been done to evaluate and compare the utility of these apps.

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  • The DEGREE study explored the impact of chronic kidney disease of undetermined cause (CKDu) globally by analyzing the prevalence of low estimated glomerular filtration rate (eGFR) in adults aged 18-60, focusing on participants without known CKD causes.
  • The study included data from 60,964 participants across 43 areas in 14 countries collected from 2007 to 2023, revealing the highest CKDu prevalence in rural areas of Uddanam, India, and Northwest Nicaragua (14%).
  • The findings indicate that CKDu is notably prevalent in specific regions, especially within Central America and South Asia, prompting the need for global monitoring while acknowledging the potential existence of unidentified disease clusters elsewhere.
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Background: To identify the utilisation, type, and psychometric properties of patient-centered outcome measures (PCOMs) associated with the performance-based assessment of visual function (VF) in age-related macular degeneration (AMD) in clinical care and research.

Methods: A systematic literature search identified studies, available in English, that used PCOMs to assess VF in patients with any AMD severity, published from January 2015 to November 2023. Two researchers screened studies for quality using the Mixed Methods Appraisal Tool (MMAT) 2018 and assessed the psychometric properties of the PCOMs with the guidance of Consensus-based Standards for the selection of health Measurement Instruments (COSMIN).

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  • Parkinson's disease (PD) is a progressive movement disorder becoming more common due to an aging population, and researchers aimed to explore rare genetic variants that could help explain its development.
  • Whole-exome sequencing was conducted on a large group of PD cases and controls of Asian ancestry, revealing significant links between the genes GBA1 and SMPD1 and the risk of developing PD, confirmed in additional samples.
  • The research found that specific SMPD1 variants that reduced enzyme activity were particularly associated with PD risk, with a prominent Asian-specific variant being common among carriers.
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  • Natural killer (NK) cells are crucial for combating myeloid malignancies, and their function is linked to extended remission in chronic myeloid leukemia (CML), but they experience suppression during the disease.
  • Research using a CML mouse model revealed that NK cells have reduced numbers, an immature state, and decreased ability to kill cancer cells, which can improve when the BCR::ABL1 protein is inhibited.
  • The study found that inflammatory signals in the CML environment, particularly from TNFa, impair NK cell function, indicating that targeting inflammatory pathways could improve NK cell therapies for CML patients.
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The Chemistry of Phytoplankton.

Chem Rev

December 2024

Department of Pharmacy, Lanzhou University, Lanzhou 730000, Gansu China.

Article Synopsis
  • * Elevated CO levels, nutrients, and temperatures lead to harmful algal blooms (HABs), which can negatively impact water quality, ecosystems, and public health due to the production of toxins.
  • * The review discusses the dual role of algal blooms in carbon fixation and their complex metabolites, highlights advancements in understanding these structures, and examines strategies for managing and controlling HABs.
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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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Patient Preferences for Features Associated With Leadless Versus Conventional Transvenous Cardiac Pacemakers.

Circ Cardiovasc Qual Outcomes

December 2024

Duke Clinical Research Institute (S.D.R., J.-C.Y., M.J.W., J.S., F.R.J., S.O., S.M.A.-K.), Duke University School of Medicine, Durham, NC.

Article Synopsis
  • A study examined patient preferences for different types of pacemakers, including new dual-chamber leadless options and traditional transvenous ones, to identify which features are most important to them.
  • Surveying 117 patients, researchers found that half preferred leadless pacemakers while the other half favored conventional ones, highlighting a significant division in choices.
  • Key factors influencing patient decisions included preferred pacemaker type, acceptance of complication and infection risks, and the time since regulatory approval, with many willing to accept higher risks for their preferred options.
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The escalating integration of machine learning in high-stakes fields such as healthcare raises substantial concerns about model fairness. We propose an interpretable framework, fairness-aware interpretable modeling (FAIM), to improve model fairness without compromising performance, featuring an interactive interface to identify a "fairer" model from a set of high-performing models and promoting the integration of data-driven evidence and clinical expertise to enhance contextualized fairness. We demonstrate FAIM's value in reducing intersectional biases arising from race and sex by predicting hospital admission with two real-world databases, the Medical Information Mart for Intensive Care IV Emergency Department (MIMIC-IV-ED) and the database collected from Singapore General Hospital Emergency Department (SGH-ED).

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Background And Aim: The healing of diabetic foot ulcers (DFUs) can be hindered by the susceptibility of the surrounding intact skin to pro-inflammatory proteases. A conditioned media, known as PTT-6, derived from mesenchymal stem cells found in the lining of red deer umbilical cords, has been formulated to protect the intact peri-wound skin of DFUs. The aim is to evaluate the clinical effectiveness of PTT-6 in managing peri-wound intact skin in hard-to-heal DFUs.

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  • Transcatheter valve-in-valve (VIV) and valve-in-ring (VIR) therapies for failing mitral bioprosthetic valves are being researched to understand their effectiveness and safety over time.
  • A meta-analysis reviewed 34 studies involving 7,047 patients to assess short and long-term outcomes, focusing on complications like mortality, stroke, and procedural success rates.
  • Findings indicated high success rates of 94.8% for VIV and 80.5% for VIR, with varying short-term mortality and stroke risks across VIV, VIR, and traditional redo surgical mitral valve replacements (SMVR).
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Branched-chain amino acids promote hepatic Cyp7a1 expression and bile acid synthesis via suppressing FGF21-ERK pathway.

Acta Pharmacol Sin

November 2024

NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, 300134, China.

Branched-chain amino acids (BCAAs) including leucine, isoleucine and valine have been linked with metabolic and cardiovascular diseases. BCAAs homeostasis is tightly controlled by their catabolic pathway. BCKA dehydrogenase (BCKD) complex is the rate-limiting step for BCAA catabolism.

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