Global prevalence of depression and anxiety in patients with hepatocellular carcinoma: Systematic review and meta-analysis

Darren Jun Hao Tan,Sabrina Xin Zi Quek,Jie Ning Yong,Adithya Suresh,Kaiser Xuan Ming Koh,Wen Hui Lim,Jingxuan Quek,Ansel Tang,Caitlyn Tan,Benjamin Nah,Eunice Tan,Taisei Keitoku,Mark D. Muthiah,Nichola 대한간학회 2022 Clinical and Molecular Hepatology(대한간학회지) Vol.28 No.4

Background/Aims: Depression and anxiety are associated with poorer outcomes in patients with hepatocellular carcinoma (HCC). However, the prevalence of depression and anxiety in HCC are unclear. We aimed to establish the prevalence of depression and anxiety in patients with HCC. Methods: MEDLINE and Embase were searched and original articles reporting prevalence of anxiety or depression in patients with HCC were included. A generalized linear mixed model with Clopper-Pearson intervals was used to obtain the pooled prevalence of depression and anxiety in patients with HCC. Risk factors were analyzed via a fractional-logistic regression model. Results: Seventeen articles involving 64,247 patients with HCC were included. The pooled prevalence of depression and anxiety in patients with HCC was 24.04% (95% confidence interval [CI], 13.99–38.11%) and 22.20% (95% CI, 10.07–42.09%) respectively. Subgroup analysis determined that the prevalence of depression was lowest in studies where depression was diagnosed via clinician-administered scales (16.07%;95% CI, 4.42–44.20%) and highest in self-reported scales (30.03%; 95% CI, 17.19–47.01%). Depression in patients with HCC was lowest in the Americas (16.44%; 95% CI, 6.37–36.27%) and highest in South-East Asia (66.67%; 95% CI, 56.68–75.35%). Alcohol consumption, cirrhosis, and college education significantly increased risk of depression in patients with HCC. Conclusions: One in four patients with HCC have depression, while one in five have anxiety. Further studies are required to validate these findings, as seen from the wide CIs in certain subgroup analyses. Screening strategies for depression and anxiety should also be developed for patients with HCC.

Rediscovery of nylon upgraded by interactive biorenewable nano-fillers

Hao, Lam Tan,Eom, Youngho,Tran, Thang Hong,Koo, Jun Mo,Jegal, Jonggeon,Hwang, Sung Yeon,Oh, Dongyeop X.,Park, Jeyoung The Royal Society of Chemistry 2020 Nanoscale Vol.12 No.4

<P>Inorganic nanomaterials can only stiffen nylon with a significant loss of its toughness and ductility. Furthermore, they are not eco-friendly. In this study, the facile tuning of nylon's mechanical properties from stiff to tough was achieved, using cellulose nanocrystals (CNC) and chitosan nanowhiskers (CSW) as biorenewable fillers. The interaction between the matrix and filler was controlled by varying the types of fillers and the employed processing methods, including <I>in situ</I> interfacial polymerization and post-solution blending. Particularly with CSW, the <I>in situ</I>-incorporated filler with a 0.4 wt% loading strengthened nylon and led to a 1.9-fold increase in its Young's modulus (2.6 GPa) and a 1.7-fold increase in its ultimate tensile strength (106 MPa), whereas the solution-blended filler with a 0.3 wt% loading toughened the polymer with a 2.1-fold increase (104 MJ m<SUP>−3</SUP>). Compared with inorganic nanocomposites, these interactive biofiller-nanocomposites are unrivaled in their reinforcing performance when normalized by filler content. This stiff-to-tough tuning trend is more pronounced in the CSW system than in the CNC system. Covalent polymer grafts on the amine surface of CSW enhanced interfacial interactions in the <I>in situ</I> method, whereas its cationic surface charges plasticized the polymer matrix in the blending method. This proteinaceous composite-mimicking all-organic nylon nanocomposite opens new possibilities in the field of reinforced engineering plastics.</P>

Target-free vision-based approach for vibration measurement and damage identification of truss bridges

Jun LI,Dong Tan,Zhenghao Ding,Hong Hao 국제구조공학회 2023 Smart Structures and Systems, An International Jou Vol.31 No.4

This paper presents a vibration displacement measurement and damage identification method for a space truss structure from its vibration videos. Features from Accelerated Segment Test (FAST) algorithm is combined with adaptive threshold strategy to detect the feature points of high quality within the Region of Interest (ROI), around each node of the truss structure. Then these points are tracked by Kanade-Lucas-Tomasi (KLT) algorithm along the video frame sequences to obtain the vibration displacement time histories. For some cases with the image plane not parallel to the truss structural plane, the scale factors cannot be applied directly. Therefore, these videos are processed with homography transformation. After scale factor adaptation, tracking results are expressed in physical units and compared with ground truth data. The main operational frequencies and the corresponding mode shapes are identified by using Subspace Stochastic Identification (SSI) from the obtained vibration displacement responses and compared with ground truth data. Structural damages are quantified by elemental stiffness reductions. A Bayesian inference-based objective function is constructed based on natural frequencies to identify the damage by model updating. The Success-History based Adaptive Differential Evolution with Linear Population Size Reduction (L-SHADE) is applied to minimise the objective function by tuning the damage parameter of each element. The locations and severities of damage in each case are then identified. The accuracy and effectiveness are verified by comparison of the identified results with the ground truth data.

Neutronics analysis of JSI TRIGA Mark II reactor benchmark experiments with SuperMC3.3

Wanbin Tan,Pengcheng Long,Guangyao Sun,Jun Zou,Lijuan Hao 한국원자력학회 2019 Nuclear Engineering and Technology Vol.51 No.7

Jozef Stefan Institute (JSI), TRIGA Mark II reactor employs the homogeneous mixture of uranium and zirconium hydride fuel type. Since its upgrade, a series of fresh fuel steady state experimental benchmarks have been conducted. The benchmark results have provided data for testing computational neutronics codes which are important for reactor design and safety analysis. In this work, we investigated the JSI TRIGA Mark II reactor neutronics characteristics: the effective multiplication factor and two safety parameters, namely the control rod worth and the fuel temperature reactivity coefficient using SuperMC. The modeling and real-time cross section generation methods of SuperMC were evaluated in the investigation. The calculation analysis indicated the following: the effective multiplication factor was influenced by the different cross section data libraries; the control rod worth evaluation was better with Monte Carlo codes; the experimental fuel temperature reactivity coefficient was smaller than calculated results due to change in water temperature. All the results were in good agreement with the experimental values. Hence, SuperMC could be used for the designing and benchmarking of other TRIGA Mark II reactors.

A Computed Tomography Analysis of the Success of Spinal Fusion Using Ultra-Low Dose (0.7 mg per Facet) of Recombinant Human Bone Morphogenetic Protein 2 in Multilevel Adult Degenerative Spinal Deformity Surgery

Gabriel Liu,Jun Hao Tan,Changwei Yang,John Ruiz,Hee-Kit Wong 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.6

Study Design: Retrospective cohort study. Purpose: To report on spinal fusion assessment using computed tomography (CT) after adult spinal deformity (ASD) surgery using ultra-low dose recombinant human bone morphogenetic protein 2 (RhBMP-2). Overview of Literature: The reported dose of RhBMP-2 needed for successful spinal posterolateral fusion in ASD ranges from 10 to 20 mg per spinal level. This study reports the use of ultra-low dose of RhBMP-2 (0.07 mg per facet) to achieve spinal fusion in multilevel ASD surgery. Methods: Consecutive patients who underwent ASD surgery using ultra-low dose RhBMP-2 were recruited. Routine postoperative CT analysis for spinal fusion was performed by two spine surgeons. Inter-observer agreement was calculated for facet fusion (FF) and interbody fusion (IBF) at 6 and 12 months after the procedure. Results: Six consecutive ASD patients with a mean age of 62 years (28–72 years) were examined. Each patient received a total dose of 12 mg with an average dose of 0.69±0.2 mg (0.42–1 mg) per single FF and 1.38±0.44 mg (0.85–2 mg) for IBF. Total 131 FF and 15 IBF were examined in the study, with 88 FFs and nine IBFs being analyzed specifically at 6 months after the surgery. FF and IBF reported by surgeons A and B at 6 months were 97.7% vs. 91.9% FF, respectively (κ=0.95) and 100% vs. 100% IBF, respectively (κ=1). Two patients underwent longitudinal follow-up CT at 12 months, and the FF rates reported by surgeons A and B were 100% vs. 95.8%, respectively (κ=0.96). Five out of nine facet (56%) non-unions were identified at the cross-links. The remaining four facet pseudarthrosis were noted at 1–2 spinal levels caudal to the cross-links. At the final clinical follow-up, there was no rod breakage, deformity progression, neurological deficit, or symptom recurrence. The Oswestry Disability Index improved by an average of 32.8±6.3, while the mental component summary of the 36-item Short-Form Health Survey improved by an average of 4.7±2.1, and physical component summary improved by an average of 10.5±2.1. Conclusions: To our knowledge, this is the first study to report a CT that defined 92%–98% FF and 100% IBF using the lowest reported dose of RhBMP-2 in multilevel ASD surgery. The use of ultra-low dose RhBMP-2 reduces the RhBMP-2 related complications and healthcare costs.

Spinal Stenosis Presenting with Scrotal and Perianal Claudication

Jacob YL Oh,Jun-Hao Tan,Timothy WW Teo,Hwan-Tak Hee 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.1

A 63-year-old gentleman presented with a one-year duration of progressive neurogenic claudication. However, unlike most patients who presents with leg symptoms, his pain was felt in his scrotal and perianal region. This was exacerbated with walking and standing, but he had immediate relief with sitting. An magnetic resonance imaging (MRI) was performed which showed severe central canal stenosis. An L3/4 and L4/5 surgical decompression and a transforaminal lumbar interbody fusion was performed, and the patient made good recovery with immediate resolution of symptoms. Although rare, spinal stenosis should be considered a differential when approaching a patient with perianal and scrotal claudication, even in the absence of leg claudication. An MRI is useful to confirm the diagnosis. This rare symptom may be a sign of severe cauda equina compression and we recommend decompression with predictable good results.

Use of Paclitaxel Coated Drug Eluting Technology to Improve Central Vein Patency for Haemodialysis Access Circuits: Any Benefit?

Tze Tec Chong,Hao Yun Yap,Chieh Suai Tan,Qingwei Shaun Lee,Sze Ling Chan,Ian Jun Yan Wee,Tjun Yip Tang 대한혈관외과학회 2020 Vascular Specialist International Vol.36 No.1

Purpose: Central venous stenosis is a recurring problem affecting dialysis access patency. Increasing evidence suggests that the use of drug-coated balloons (DCBs) improves target lesion primary patency (TLPP) in dialysis access. However, few studies have investigated the use of DCBs specifically in central venous stenosis. Thus, this study presents our initial experience with DCBs in the central vein of a dialysis access circuit. Materials and Methods: This is a retrospective cohort study of all hemodialysis patients who underwent central vein angioplasty with DCB between February 2017 and March 2018 at Singapore General Hospital. We compared the primary patency post DCB angioplasty to the primary patency of the patient’s previous plain old balloon angioplasty (POBA). Results: We observed a 100% anatomic and procedural success rate with no complications. The median follow-up period was 151 days (interquartile range, 85.5- 234 days) and no patients were lost to follow-up. The 30- and 90-day TLPPs after DCB were 93.3% and 75.7%, respectively. The mean primary patency in our study group post-DCB during the follow-up period was 164 days (vs. 140 days in the POBA group). However, no statistically significant difference was detected. Conclusion: DCB showed a similar TLPP to that for POBA in treating central venous stenosis with a trend toward a longer re-intervention-free period for DCB. However, there were numerous confounding factors and a well-designed randomized controlled trial is warranted to assess the true utility of DCB in treating central venous stenosis.

Thoracolumbar Injury Classification and Severity Score Is Predictive of Perioperative Adverse Events in Operatively Treated Thoracic and Lumbar Fractures

Liu Gabriel Ka-Po,Tan Jiong Hao,Kong Jun Cheong,Tan Yong Hao Joel,Kumar Nishant,Liang Shen,Shawn Seah Jing Sheng,Ting Chiu Shi,Lim Lau Leok,Dennis Hey Hwee Weng,Kumar Naresh,Thambiah Joseph,Wong Hee-K 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.6

Study Design: A retrospective cohort study of patients with surgically treated thoracolumbar fractures.Purpose: This study aimed to describe the incidence of adverse events (AEs) after surgical stabilization of thoracolumbar spine injuries and to identify predictive factors for the occurrence of AEs. Overview of Literature: Thoracolumbar spine fractures are frequently present in patients with blunt trauma and are associated with significant morbidity. AEs can occur due to the initial spinal injury or secondary to surgical treatment. There is a lack of emphasis in the literature on the AEs that can occur after operative management of thoracolumbar fractures.Methods: We performed a retrospective review of 199 patients with surgically treated thoracolumbar fractures operated between January 2007 and January 2018. The potential risk factors for the development of AEs as well as the development of common complications were evaluated by univariate analysis, and a multivariate logistic regression analysis was performed to identify independent risk factors predictive of the above.Results: The overall rate of AEs was 46.7%; 83 patients (41.7%) had nonsurgical AEs, whereas 24 (12.1%) had surgical adverse events. The most common AEs were urinary tract infections in 43 patients (21.6%), and hospital-acquired pneumonia in 21 patients (10.6%). On multivariate logistic regression, a Thoracolumbar Injury Classification and Severity (TLICS) score of 8–10 (odds ratio [OR], 6.39; 95% confidence interval [CI], 2.33–17.51), the presence of polytrauma (OR, 2.64; 95% CI, 1.17–5.99), and undergoing open surgery (OR, 2.31; 95% CI, 1.09–4.88) were significant risk factors for AEs. The absence of neurological deficit was associated with a lower rate of AEs (OR, 0.47; 95% CI, 0.31–0.70).Conclusions: This study suggests the presence of polytrauma, preoperative American Spinal Injury Association score, and TLICS score are predictive of AEs in patients with surgically treated thoracolumbar fractures. The results might also suggest a role for minimally invasive surgical methods in reducing AEs in these patients.

Hepatocellular carcinoma surveillance in non-alcoholic fatty liver disease – who and how?

Margaret LP Teng,Darren Jun Hao Tan,Cheng Han Ng,Daniel Q. Huang 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.2

Making a Traditional Spine Surgery Clinic Telemedicine-Ready in the “New Normal” of Coronavirus Disease 2019

Liu Ka-Po Gabriel,Tan Wei Loong Barry,Yip Wei Luen James,Tan Jun-Hao,Wong Hee-Kit 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.2

Study Design: An original article describing a comprehensive methodology for making a traditional spine surgery clinic telemedicineready in terms of logistical considerations and workflow.Purpose: The aim of this study is to promote the use of telemedicine via videoconferencing to reduce human exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and reduce the risk of coronavirus disease 2019 (COVID-19) transmission at outpatient clinics.Overview of Literature: The COVID-19 pandemic is the biggest healthcare crisis in the 21st century. Until a vaccine is developed or herd immunity against SARS-CoV-2 is achieved, social distancing to avoid crowding is an important strategy to reduce disease transmission and resurgence. Telemedicine has already been applied in the field of orthopedics with encouraging results.Methods: We reviewed the evidence behind telemedicine and described our clinical protocol, patient selection criteria, and workflow for telemedicine. We discussed a simple methodology to convert pre-existing traditional clinic resources into telemedicine tools, along with future challenges.Results: Our methodology was successfully and easily applied in our clinical practice, with a streamlined workflow allowing our spine surgery service to implement telemedicine as a consultation modality in line with the national recommendations of social distancing.Conclusions: Telemedicine was well incorporated into our outpatient practice using the above workflow. We believe that the use of telemedicine via videoconferencing can become part of the new normal and a safe strategy for healthcare systems as both a medical and an economic countermeasure against COVID-19.