702 results on '"So, Ping Lam"'
Search Results
2. Applying the UTAUT2 framework to patients’ attitudes toward healthcare task shifting with artificial intelligence
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Weiting Huang, Wen Chong Ong, Mark Kei Fong Wong, Eddie Yin Kwee Ng, Tracy Koh, Chanchal Chandramouli, Choon Ta Ng, Yoran Hummel, Feiqiong Huang, Carolyn Su Ping Lam, and Jasper Tromp
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Healthcare artificial intelligence ,Machine learning ,Task shifting ,Point-of-care ultrasound ,Echocardiography ,Technology acceptance ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Increasing patient loads, healthcare inflation and ageing population have put pressure on the healthcare system. Artificial intelligence and machine learning innovations can aid in task shifting to help healthcare systems remain efficient and cost effective. To gain an understanding of patients’ acceptance toward such task shifting with the aid of AI, this study adapted the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), looking at performance and effort expectancy, facilitating conditions, social influence, hedonic motivation and behavioural intention. Methods This was a cross-sectional study which took place between September 2021 to June 2022 at the National Heart Centre, Singapore. One hundred patients, aged ≥ 21 years with at least one heart failure symptom (pedal oedema, New York Heart Association II-III effort limitation, orthopnoea, breathlessness), who presented to the cardiac imaging laboratory for physician-ordered clinical echocardiogram, underwent both echocardiogram by skilled sonographers and the experience of echocardiogram by a novice guided by AI technologies. They were then given a survey which looked at the above-mentioned constructs using the UTAUT2 framework. Results Significant, direct, and positive effects of all constructs on the behavioral intention of accepting the AI-novice combination were found. Facilitating conditions, hedonic motivation and performance expectancy were the top 3 constructs. The analysis of the moderating variables, age, gender and education levels, found no impact on behavioral intention. Conclusions These results are important for stakeholders and changemakers such as policymakers, governments, physicians, and insurance companies, as they design adoption strategies to ensure successful patient engagement by focusing on factors affecting the facilitating conditions, hedonic motivation and performance expectancy for AI technologies used in healthcare task shifting.
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- 2024
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3. Moving Beyond Abstracted Empiricism: Pursuing New Sociological Directions in Theorizing Male-to-Female Sexual Assault on University/College Campuses
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DeKeseredy, Walter S., Ip, Ping Lam, and DeKeseredy, Andrea
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- 2023
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4. Deep Learning-Based Prediction Model for the Cobb Angle in Adolescent Idiopathic Scoliosis Patients
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Chun-Sing (Elvis) Chui, Zhong He, Tsz-Ping Lam, Ka-Kwan (Kyle) Mak, Hin-Ting (Randy) Ng, Chun-Hai (Ericsson) Fung, Mei-Shuen Chan, Sheung-Wai Law, Yuk-Wai (Wayne) Lee, Lik-Hang (Alec) Hung, Chiu-Wing (Winnie) Chu, Sze-Yi (Sibyl) Mak, Wing-Fung (Edmond) Yau, Zhen Liu, Wu-Jun Li, Zezhang Zhu, Man Yeung (Ronald) Wong, Chun-Yiu (Jack) Cheng, Yong Qiu, and Shu-Hang (Patrick) Yung
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adolescent idiopathic scoliosis (AIS) ,Cobb angles ,Feedforward Neural Network (FNN) ,Medicine (General) ,R5-920 - Abstract
Scoliosis, characterized by spine deformity, is most common in adolescent idiopathic scoliosis (AIS). Manual Cobb angle measurement limitations underscore the need for automated tools. This study employed a vertebral landmark extraction method and Feedforward Neural Network (FNN) to predict scoliosis progression in 79 AIS patients. The novel intervertebral angles matrix format showcased results. The mean absolute error for the intervertebral angle progression was 1.5 degrees, while the Pearson correlation of the predicted Cobb angles was 0.86. The accuracy in classifying Cobb angles (45°) was 0.85, with 0.65 sensitivity and 0.91 specificity. The FNN demonstrated superior accuracy, sensitivity, and specificity, aiding in tailored treatments for potential scoliosis progression. Addressing FNNs’ over-fitting issue through strategies like “dropout” or regularization could further enhance their performance. This study presents a promising step towards automated scoliosis diagnosis and prognosis.
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- 2024
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5. Motion-Guided Dual-Camera Tracker for Low-Cost Skill Evaluation of Gastric Endoscopy.
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Yuelin Zhang, Wanquan Yan, Kim Yan, Chun Ping Lam, Yufu Qiu, Pengyu Zheng, Raymond Shing-Yan Tang, and Shing Shin Cheng
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- 2024
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6. Automatic Ultrasound Curve Angle Measurement via Affinity Clustering for Adolescent Idiopathic Scoliosis Evaluation.
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Yihao Zhou, Timothy Tin-Yan Lee, Kelly Ka-Lee Lai, Chonglin Wu, Hin Ting Lau, De Yang, Shing-Chow Chan, Winnie Chiu-Wing Chu, Jack Chun Yiu Cheng, Tsz-Ping Lam, and Yong-Ping Zheng
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- 2024
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7. Handgrip strength assessment at baseline in addition to bone parameters could potentially predict the risk of curve progression in adolescent idiopathic scoliosis
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Rufina Wing Lum Lau, Ka Yee Cheuk, Vivian Wing Yin Hung, Fiona Wai Ping Yu, Elisa Man Shan Tam, Lyn Lee Ning Wong, Jiajun Zhang, Wayne Yuk Wai Lee, Jack Chun Yiu Cheng, Tsz Ping Lam, and Adam Yiu Chung Lau
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adolescent idiopathic scoliosis ,handgrip ,strength ,bone ,curve progression ,Pediatrics ,RJ1-570 - Abstract
IntroductionAdolescent idiopathic scoliosis (AIS) is characterized by deranged bone and muscle qualities, which are important prognostic factors for curve progression. This retrospective case–control study aims to investigate whether the baseline muscle parameters, in addition to the bone parameters, could predict curve progression in AIS.MethodsThe study included a cohort of 126 female patients diagnosed with AIS who were between the ages of 12 and 14 years old at their initial clinical visit. These patients were longitudinally followed up every 6 months (average 4.08 years) until they reached skeletal maturity. The records of these patients were thoroughly reviewed as part of the study. The participants were categorized into two sub-groups: the progressive AIS group (increase in Cobb angle of ≥6°) and the stable AIS group (increase in Cobb angle
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- 2023
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8. A young man with rash and respiratory distress
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Wincy Wing‐Sze Ng, Luk‐Ping Lam, Tammy Sin‐Kwan Ma, and Kelvin Hei‐Yeung Chiu
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Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Published
- 2023
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9. Three‐dimensional ultrasonography could be a potential non‐ionizing tool to evaluate vertebral rotation of subjects with adolescent idiopathic scoliosis
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Tin Yan Lee, De Yang, Kelly Ka‐Lee Lai, Rene M. Castelein, Tom P. C. Schlosser, Winnie Chu, Tsz‐Ping Lam, and Yong‐Ping Zheng
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adolescent idiopathic scoliosis ,laminae ,nonionizing axial ,three‐dimensional ultrasonography ,vertebral rotation ,Orthopedic surgery ,RD701-811 - Abstract
Abstract Background Three‐dimensional (3D) ultrasonography is nonionizing and has been demonstrated to be a reliable tool for scoliosis assessment, including coronal and sagittal curvatures. It shows a great potential for axial vertebral rotation (AVR) evaluation, yet its validity and reliability need to be further demonstrated. Materials and Methods Twenty patients with adolescent idiopathic scoliosis (AIS) (coronal Cobb: 26.6 ± 9.1°) received 3D ultrasound scan for twice, 10 were scanned by the same operator, and the other 10 by different operators. EOS Bi‐planar x‐rays and 3D scan were conducted on another 29 patients on the same day. Two experienced 3D ultrasonographic researchers, with different experiences on AVR measurement, evaluated the 3D ultrasonographic AVR of the 29 patients (55 curves; coronal Cobb angle: 26.9 ± 11.3°). The gold standard AVR was determined from the 3D reconstruction of coronal and sagittal EOS radiographs. Intra‐class correlation coefficients (ICCs), mean absolute difference (MAD), standard error measurements (SEM), and Bland–Altman's bias were reported to evaluate the intra‐operator and inter‐operator/rater reliabilities of 3D ultrasonography. The reliability of 3D ultrasonographic AVR measurements was further validated using inter‐method with that of EOS. Results ICCs for intra‐operator and inter‐operator/rater reliability assessment were all greater than 0.95. MAD, SEM, and bias for the 3D ultrasonographic AVRs were no more than 2.2°, 2.0°, and 0.5°, respectively. AVRs between both modalities were strongly correlated (R2 = 0.901) and not significantly different (p = 0.205). Bland–Altman plot also shows that the bias was less than 1°, with no proportional bias between the difference and mean of expected and radiographic Cobb angles. Conclusion This study demonstrates that 3D ultrasonography is valid and reliable to evaluate AVR in AIS patients. 3D ultrasonography can be a potential tool for screening and following up subjects with AIS and evaluating the effectiveness of nonsurgical treatments.
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- 2023
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10. Clinical Outcomes of 111 Patients with Early Onset Idiopathic Scoliosis (EOIS) Receiving Brace Treatment: A Longitudinal Retrospective Cohort Study
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Rufina Wing-Lum Lau, Alec Lik-Hang Hung, Ho-Man Kee, Leo Chung-Hei Wong, Victor Kin-Wai Chan, Derek Wai-Yin Chung, Jerry Kwok-To Chan, Bosco Kin-Pok Chau, Stanley Ho-Fung Leung, Jack Chun-Yiu Cheng, Tsz-Ping Lam, and Adam Yiu-Chung Lau
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early onset ,idiopathic scoliosis ,curve progression ,in-brace correction ,bracing ,conservative treatment ,Medicine - Abstract
Introduction: Bracing is one of the first-line treatment for early-onset idiopathic scoliosis (EOIS) to control curves from progression. This study aimed to explore the determinants that govern bracing effectiveness in EOIS. Methods: One hundred and eleven patients with EOIS (mean age of 8.6 ± 1.25 at diagnosis) received bracing treatment and had a final follow-up beyond skeletal maturity were identified from records between 1988 and 2021. Demographic data and clinical features of spinal curvature were obtained for correlation analyses to determine the associations between curve outcomes and clinical features. Results: Most patients were female (85.6%) and had a major curve on the left side (67%). The mean baseline Cobb angle of major curves was 21.73 ± 7.92°, with a mean Cobb angle progression of 18.05 ± 19.11°. The average bracing duration was 5.3 ± 1.9 years. Only 26 (23.4%) of them underwent surgery. The final Cobb angle and curve progression at the final follow-up with a Cobb angle of ≥50° were positively correlated with the initial Cobb angle (r = 0.206 and r = 0.313, respectively) and negatively correlated with maturity parameters. The lumbar curve type was found to correlate with a smaller final Cobb angle. Conclusions: The majority of patients had a final Cobb angle < 50°, which was considered a successful bracing outcome. The final Cobb angle correlated with the initial Cobb angle and curve types observed in EOIS.
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- 2024
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11. Genetic insight into the putative causal proteins and druggable targets of osteoporosis: a large-scale proteome-wide mendelian randomization study
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Zhichong Wu, Kenneth Guangpu Yang, Tsz-Ping Lam, Jack Chun Yiu Cheng, Zezhang Zhu, and Wayne Yuk-Wai Lee
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mendelian randomization ,osteoporosis ,BMD ,genetic ,drug ,Genetics ,QH426-470 - Abstract
Background: Osteoporosis is a major causative factor of the global burden of disease and disability, characterized by low bone mineral density (BMD) and high risks of fracture. We aimed to identify putative causal proteins and druggable targets of osteoporosis.Methods: This study utilized the largest GWAS summary statistics on plasma proteins and estimated heel BMD (eBMD) to identify causal proteins of osteoporosis by mendelian randomization (MR) analysis. Different GWAS datasets were used to validate the results. Multiple sensitivity analyses were conducted to evaluate the robustness of primary MR findings. We have also performed an enrichment analysis for the identified causal proteins and evaluated their druggability.Results: After Bonferroni correction, 67 proteins were identified to be causally associated with estimated BMD (eBMD) (p < 4 × 10−5). We further replicated 38 of the 67 proteins to be associated with total body BMD, lumbar spine BMD, femoral neck BMD as well as fractures, such as RSPO3, IDUA, SMOC2, and LRP4. The findings were supported by sensitivity analyses. Enrichment analysis identified multiple Gene Ontology items, including collagen-containing extracellular matrix (GO:0062023, p = 1.6 × 10−10), collagen binding (GO:0005518, p = 8.6 × 10−5), and extracellular matrix structural constituent (GO:0005201, p = 2.7 × 10−5).Conclusion: The study identified novel putative causal proteins for osteoporosis which may serve as potential early screening biomarkers and druggable targets. Furthermore, the role of plasma proteins involved in collagen binding and extracellular matrix in the development of osteoporosis was highlighted. Further studies are warranted to validate our findings and investigate the underlying mechanism.
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- 2023
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12. Morphological changes of Intervertebral Disc detectable by T2-weighted MRI and its correlation with curve severity in Adolescent Idiopathic Scoliosis
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Kwong Hang Yeung, Gene Chi Wai Man, Min Deng, Tsz Ping Lam, Jack Chun Yiu Cheng, Ka Chi Chan, and Winnie Chiu Wing Chu
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Intervertebral disc ,Nucleus pulposus ,Volume ,Vertebral wedging ,Magnetic Resonance Imaging ,T2-weighted ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Our previous studies found disproportionate anteroposterior vertebral size is associated with severity of the scoliotic curves in adolescent idiopathic scoliosis (AIS) patients. Subsequent studies showed wedging of vertebral bodies (VB) had less contribution than intervertebral discs (IVD) to the anterior–posterior vertebral column length discrepancy in severe-AIS. However, the exact morphological changes of IVD were not clearly defined. This study aimed to evaluate the morphological and pathological changes of IVD and VB in AIS girls and healthy female controls. Methods This study included 33 age-matched female controls and 76 AIS girls with a right-sided thoracic curvature. Wedge angle, height ratio and distance ratio of VB and IVD were measured on the best midline coronal and sagittal planes from reformatted MRI spine. Volumes of VB, IVD and nucleus pulposus (NP) were also evaluated on volumetric images. One-way ANOVA with Bonferroni correction and Pearson correlation tests were used. Results There was significant difference in wedge angle and height ratio of VB and IVD between AIS and controls. In severe-AIS, the position of NP was significantly shifted to the convexity when compared with non-severe AIS and controls. Whereas, the volume of IVD and NP in severe-AIS was found to be significantly smaller. In addition, Cobb angle was significantly correlated with wedge angle and height ratio, and inversely correlated with the volume of NP. Conclusions In addition to wedging of VB and IVD, there was significantly reduced volume of IVD and NP in AIS patients with severe curve, insinuating the mechanical effect of scoliosis leads to a compression on both IVD and NP before significant disc desiccation occurs. We postulate that the compression of IVD and NP can contribute to curve progression in severe-AIS, these patients are more prone to disc degeneration in adulthood if no operative treatment is offered. Further longitudinal study on these parameters is still warranted.
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- 2022
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13. Upregulation of microRNA-96-5p is associated with adolescent idiopathic scoliosis and low bone mass phenotype
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Huanxiong Chen, Kenneth Guangpu Yang, Jiajun Zhang, Ka-yee Cheuk, Evguenia Nepotchatykh, Yujia Wang, Alec Lik-hang Hung, Tsz-ping Lam, Alain Moreau, and Wayne Yuk-wai Lee
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Medicine ,Science - Abstract
Abstract Bone densitometry revealed low bone mass in patients with adolescent idiopathic scoliosis (AIS) and its prognostic potential to predict curve progression. Recent studies showed differential circulating miRNAs in AIS but their diagnostic potential and links to low bone mass have not been well-documented. The present study aimed to compare miRNA profiles in bone tissues collected from AIS and non-scoliotic subjects, and to explore if the selected miRNA candidates could be useful diagnostic biomarkers for AIS. Microarray analysis identified miR-96-5p being the most upregulated among the candidates. miR-96-5p level was measured in plasma samples from 100 AIS and 52 healthy girls. Our results showed significantly higher plasma levels of miR-96-5p in AIS girls with an area under the curve (AUC) of 0.671 for diagnostic accuracy. A model that was composed of plasma miR-96-5p and patient-specific parameters (age, body weight and years since menarche) gave rise to an improved AUC of 0.752. Ingenuity Pathway Analysis (IPA) indicated functional links between bone metabolic pathways and miR-96-5p. In conclusion, differentially expressed miRNAs in AIS bone and plasma samples represented a new source of disease biomarkers and players in AIS etiopathogenesis, which required further validation study involving AIS patients of both genders with long-term follow-up.
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- 2022
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14. A Continuum Robotic Cannula With Tip Following Capability and Distal Dexterity for Intracerebral Hemorrhage Evacuation.
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Junyan Yan, Jibiao Chen, Junfan Chen, Wanquan Yan, Qingpeng Ding, Kim Yan, Jingxin Du, Chun Ping Lam, George Kwok Chu Wong, and Shing Shin Cheng
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- 2022
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15. Semi-automatic method for pre-surgery scoliosis classification on X-ray images using Bending Asymmetry Index.
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De Yang, Timothy Tin-Yan Lee, Kelly Ka-Lee Lai, Tsz-Ping Lam, René M. Castelein, Jack Chun Yiu Cheng, and Yong-Ping Zheng
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- 2022
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16. School-Based Sleep Education Program for Children: A Cluster Randomized Controlled Trial
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Si-Jing Chen, Shirley Xin Li, Ji-Hui Zhang, Siu Ping Lam, Mandy Wai Man Yu, Chi Ching Tsang, Alice Pik Shan Kong, Kate Ching Ching Chan, Albert Martin Li, Yun Kwok Wing, and Ngan Yin Chan
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sleep education ,children ,sleep pattern ,parent engagement ,behavioral outcome ,Medicine - Abstract
Insufficient sleep contributes negatively to child developmental processes and neurocognitive abilities, which argues the need for implementing interventions to promote sleep health in children. In this study, we evaluated the effectiveness of a multimodal and multilevel school-based sleep education program in primary school children using a cluster randomized controlled design. Twelve schools were randomly assigned to either the sleep education or nonactive control groups. The sleep education group included a town hall seminar, small class teaching, leaflets, brochures, and a painting competition for children. Parents and teachers were invited to participate in a one-off sleep health workshop. Parental/caregiver-reported questionnaires were collected at baseline and 1-month follow-up. A total of 3769 children were included in the final analysis. There were no significant improvements observed in the sleep-wake patterns, daytime functioning, and insomnia symptoms between the two groups at follow-up, whereas the intervention group had significantly improved parental sleep knowledge than the controls (paternal: adjusted mean difference: 0.95 [95% confidence interval (CI): 0.18 to 1.71]; maternal: adjusted mean difference: 0.87 [95% CI: 0.17 to 1.57]). In addition, children receiving the intervention had a lower persistence rate of excessive beverage intake (adjusted odds ratio: 0.49 [95% CI: 0.33 to 0.73]), and experienced greater reductions in conduct problems (adjusted mean difference: 0.12 [95% CI: 0.01 to 0.24]) compared with the controls at 1-month of follow-up. Moreover, a marginally significant reduction for emotional problems in the intervention group was also observed (adjusted mean difference: 0.16 [95% CI: −0.00 to 0.32]). These findings demonstrated that school-based sleep education was effective in enhancing parental sleep knowledge and improving behavioral outcomes in children, but not sufficient in altering the children’s sleep-wake patterns and sleep problems.
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- 2023
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17. Association of hip fractures with cardiometabolic‐renal risk factors in Southern Chinese patients with type 2 diabetes – the Hong Kong Diabetes Register
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Elaine Yun‐Ning Cheung, Alice Pik‐Shan Kong, Eric Siu‐Him Lau, Elaine Yee‐Kwan Chow, Andrea On‐Yan Luk, Ronald Ching‐Wan Ma, Tsz Ping Lam, Wayne Yuk‐Wai Lee, Jack Chun‐Yiu Cheng, Peter R Ebeling, and Juliana Chung‐Ngor Chan
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Cardiometabolic‐renal risk factors ,Hip fractures ,Type 2 diabetes ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Abstract Introduction Diabetes and bone health are closely related. We examined the incidence and risk factors of hip fractures in Chinese patients with type 2 diabetes (T2D). Materials and Methods In this prospective cohort, we consecutively enrolled 22,325 adults with T2D above the age of 40 years in the Hong Kong Diabetes Register between 1994 and 2015 with crude hip fracture incidence rate censored in 2017. Results At baseline, the mean age of this cohort was 60.9 ± 10.5 years (mean duration of diabetes 6 years, 52.4% male). During a mean ± standard deviation (SD) follow‐up period of 8.7 ± 5.2 years with 193,553 person‐years, 603 patients were hospitalized due to hip fractures with an incidence (95% confidence interval, CI) of 315.1 (290.4–341.3) per 100,000 person‐years. On multivariable analysis with competing death risk adjusted, the independent hazard ratios (95% CI) for hip fractures in T2D were 2.01 (1.61–2.51) for female sex, 1.08 (1.07–1.09) for age, 0.93 (0.90–0.95) for body mass index, 1.52 (1.25–1.85) for albuminuria and 1.12 (1.02–1.23) for low density lipoprotein‐cholesterol. In men, the 30‐day, 1‐year and 5‐year post‐hip fracture mortality rate (95% CI) were 5.8 (2.4–9.1) %, 29.2 (22.3–35.5) % and 65.9 (57.3–72.8) % respectively. The corresponding rates in women were 3.4 (1.6–5.1) %, 18.6 (14.7–22.4) %, and 46.8 (40.9–52.1) %. Conclusions Southern Chinese patients with T2D have a high risk of hip fracture associated with suboptimal cardiometabolic‐renal risk factors and a high post‐fracture mortality rate. The effects of improving modifiable risk factors on bone health warrants further evaluation.
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- 2021
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18. 3D ultrasound imaging provides reliable angle measurement with validity comparable to X-ray in patients with adolescent idiopathic scoliosis
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Timothy Tin-Yan Lee, Kelly Ka-Lee Lai, Jack Chun-Yiu Cheng, René Marten Castelein, Tsz-Ping Lam, and Yong-Ping Zheng
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Curve angles ,Reliability ,Validity ,Scoliosis ,Three-dimensional ultrasound imaging ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Background & Objective: The application of ultrasound imaging for spine evaluation could minimize radiation exposure for patients with adolescence idiopathic scoliosis (AIS). A customized three-dimensional (3D) ultrasound imaging system has been demonstrated to provide reliable and valid coronal curvature measurements. However, these measurements were using the spinous processes as anatomical reference, leading to a predictable underestimation of the traditionally used Cobb angles. An alternative 3D ultrasound image reconstruction method was applied to create coronal images with more lateral features for angle measurement. The objective of this study was to test the reliability and the validity of this angle, the ultrasound curve angle (UCA), and compare the UCA with the Cobb angles on X-ray images of patients with AIS. Materials and methods: This study was divided into: 1) Investigation of intra- and inter-reliability between two raters for measuring the UCA and two operators for acquiring ultrasound images; 2) Investigation of the validity between the radiographic Cobb angle and the UCA. Fifty patients and 164 patients with AIS, were included in the two stages, respectively. Patients underwent bi-planar X-ray and 3D ultrasound scanning on the same day. The proposed UCA was used to measure the coronal curvature from the ultrasound coronal images, which were formed using a newly customized volume projection imaging (VPI) method. The intra-rater/operator and inter-rater and operator reliability of the UCA were tested by intra-class correlation coefficient (ICC) (3,1) and (2,1), respectively. The validity of UCA measurements as compared to radiographic Cobb angles was tested by inter-method ICC (2,1), mean absolute difference (MAD), standard error of measurement (SEM), Pearson correlation coefficient and Bland–Altman statistics. The level of significance was set as 0.05. Results: Excellent intra-rater and intra-operator (ICC (3,1)≥0.973) and excellent inter-rater and inter-operator reliability (ICC (2,1)≥0.925) for UCA measurement, with overall MAD and SEM no more than 3.5° and 1.7° were demonstrated for both main thoracic and (thoraco)lumbar curvatures. Very good correlations were observed between UCA and Cobb angle for main thoracic (R2=0.893) and (thoraco)lumbar (R2=0.884) curves. The mean (SD) measurements in terms of radiographic Cobb and UCA were 27.2 ± 11.6° and 26.3 ± 11.4° for main thoracic curves; and 26.2 ± 11.4° and 24.8 ± 9.7° for (thoraco)lumbar curve respectively. One hundred sixty-four subjects (33 male and 131 female subjects; 11–18 years of age, mean of 15.1 ± 1.9 years) were included for the validity session. Excellent inter-method variations (ICC (2,K) ≥0.933) with overall MAD and SEM no more than 3.0° and 1.5° were demonstrated for both main thoracic and (thoraco)lumbar curvatures. In addition, Bland–Altman plots demonstrated an acceptable agreement between ultrasound and radiographic Cobb measurements. Conclusion: In this study, very good correlations and agreement were demonstrated between the ultrasound and X-ray measurements of the scoliotic curvature. Judging from the promising results of this study, patients with AIS with different severity of curves can be evaluated and monitored by ultrasound imaging, reducing the usage of radiation during follow-ups. This method could also be used for scoliosis screening.The Translational potential of this article: Ultrasound curve angle (UCA) obtained from 3D ultrasound imaging system can provide reliable and valid evaluation on coronal curvature for patients with AIS, without the need of radiation.
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- 2021
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19. More Prevalent and Severe Low Bone-Mineral Density in Boys with Severe Adolescent Idiopathic Scoliosis Than Girls: A Retrospective Study of 798 Surgical Patients
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Zhichong Wu, Xiufen Zhu, Leilei Xu, Zhen Liu, Zhenhua Feng, Vivian Wing Yin Hung, Jack Chun Yiu Cheng, Yong Qiu, Wayne Y. W. Lee, Tsz Ping Lam, and Zezhang Zhu
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adolescent idiopathic scoliosis ,sexual dimorphism ,bone mineral density ,risk factors ,Medicine - Abstract
Introduction: A total of 0.1–0.8% of AIS patients progress to severe stages without clear mechanisms, and AIS girls are more prone to curve progression than boys. Recent studies suggest that AIS girls have systemic and persistent low bone-mineral density (BMD), which has been shown to be a significant prognostic factor of curve progression in AIS. The present study aimed to (a) investigate the prevalence of low BMD in patients with severe AIS and (b) assess the sexual dimorphism and independent risk factors of low BMD in severe AIS patients. Materials and Methods: A total of 798 patients (140 boys vs. 658 girls) with AIS who reached surgical threshold (Cobb ≥ 40°) were recruited. BMD were assessed using BMD Z-scores from dual-energy X-ray absorptiometry (DXA). Demographic, clinical, and laboratory values of the subjects were collected from their medical records. Logistic regression analysis was performed to identify independent risk factors of low BMD. Results: The overall prevalence of BMD Z-score ≤ −2 and ≤ −1 were 8.1% and 37.5%, respectively. AIS boys had significantly lower BMD Z-scores (−1.2 ± 0.96 vs. −0.57 ± 0.92) and higher prevalence of low BMD (Z-score ≤ −2: 22.1% vs. 5.2%, p < 0.001; Z-score ≤ −1: 59.3% vs. 32.8%, p < 0.001) than girls. Sex, BMI, serum alkaline phosphatase, and potassium were independent factors of low BMD in the severe AIS patients. Conclusions: The present large cohort of surgical AIS patients revealed that low BMD is more prevalent and severe in boys than in girls with severe curves. Low BMD may serve as a more valuable predictive factor for curve progression to the surgical threshold in boys than girls with AIS.
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- 2023
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20. Towards a Wristed Percutaneous Robot With Variable Stiffness for Pericardiocentesis.
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Kim Yan, Wanquan Yan, Wenhui Zeng, Qingpeng Ding, Jianghua Chen, Junyan Yan, Chun Ping Lam, Song Wan, and Shing Shin Cheng
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- 2021
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21. Global sagittal alignment after surgery of right thoracic idiopathic scoliosis in adolescents and adults with and without thoracic hypokyphosis
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Kwong Hang Yeung, Gene Chi Wai Man, Wafa Skalli, Zongshan Hu, Vivian Wing Yin Hung, Alec Lik Hang Hung, Tsz Ping Lam, Bobby Kin Wah Ng, Jack Chun Yiu Cheng, Claudio Vergari, and Winnie Chiu Wing Chu
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Medicine ,Science - Abstract
Abstract This study aimed to characterize global sagittal alignment in adolescent idiopathic scoliosis (AIS) with normal kyphosis (NTK, kyphosis > 10°) and with thoracic hypokyphosis (THK, kyphosis 21). Biplanar radiographies were acquired at baseline, immediate post-operatively, 1-year and 2-year follow-up, and 3D reconstruction of the spine and pelvis was performed. NTK and THK showed different global sagittal alignment, as well as differences compared to controls. AIS with THK at baseline had higher SVA/SFD (2.0 ± 2.9 vs − 0.4 ± 1.9; P
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- 2021
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22. The Canadian Glomerulonephritis Registry (CGNR) and Translational Research Initiative: Rationale and Clinical Research Protocol
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Ainslie M. Hildebrand, Moumita Barua, Sean J. Barbour, Karthik K. Tennankore, Daniel C. Cattran, Tomoko Takano, Ping Lam, Sacha A. De Serres, Ratna Samanta, Michelle A. Hladunewich, Todd Fairhead, Penelope Poyah, D. Danielle Bush, Brian MacLaren, Dwight Sparkes, Philip Boll, Arenn Jauhal, Rohan John, Carmen Avila-Casado, and Heather N. Reich
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Background: Glomerulonephritis (GN) is a leading cause of kidney failure and accounts for 20% of incident cases of end-stage kidney disease (ESKD) in Canada annually. Reversal of kidney injury and prevention of progression to kidney failure is possible; however, limited knowledge of underlying disease mechanisms and lack of noninvasive biomarkers and therapeutic targets are major barriers to successful therapeutic intervention. Multicenter approaches that link longitudinal clinical and outcomes data with serial biologic specimen collection would help bridge this gap. Objective: To establish a national, patient-centered, multidimensional web-based clinical database and federated virtual biobank to conduct human-based molecular and clinical research in GN in Canada. Design: Multicenter, prospective observational registry, starting in 2019. Setting: Nine participating Canadian tertiary care centers. Patients: Adult patients with a histopathologic pattern of injury consistent with IgA nephropathy, focal and segmental glomerulosclerosis, minimal change disease, membranous nephropathy, C3 glomerulopathy, and membranoproliferative GN recruited within 24 months of biopsy. Measurements: Initial visits include detailed clinical, histopathological, and laboratory data collection, blood, urine, and tonsil swab biospecimen collection, and a self-administered quality of life questionnaire. Follow-up clinical and laboratory data collection, biospecimen collection, and questionnaires are obtained every 6 months thereafter. Methods: Patients receive care as defined by their physician, with study visits scheduled every 6 months. Patients are followed until death, dialysis, transplantation, or withdrawal from the study. Key outcomes include a composite of ESKD or a 40% decline in estimated glomerular filtration rate (eGFR) at 2 years, rate of kidney function decline, and remission of proteinuria. Clinical and molecular phenotypical data will be analyzed by GN subtype to identify disease predictors and discover therapeutic targets. Limitations: Given the relative rarity of individual glomerular diseases, one of the major challenges is patient recruitment. Initial registry studies may be underpowered to detect small differences in clinically meaningful outcomes such as ESKD or death due to small sample sizes and short duration of follow-up in the initial 2-year phase of the study. Conclusions: The Canadian Glomerulonephritis Registry (CGNR) supports national collaborative efforts to study glomerular disease patients and their outcomes. Trial registration: NCT03460054.
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- 2022
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23. Immunoglobulin A nephropathy is characterized by anticommensal humoral immune responses
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Elissa G. Currie, Bryan Coburn, Elisa A. Porfilio, Ping Lam, Olga L. Rojas, Jan Novak, Stuart Yang, Raad B. Chowdhury, Lesley A. Ward, Pauline W. Wang, Khashayar Khaleghi, James An, Sarah Q. Crome, Michelle A. Hladunewich, Sean J. Barbour, Daniel C. Cattran, Rulan S. Parekh, Christoph Licht, Rohan John, Rupert Kaul, Kenneth Croitoru, Scott D. Gray-Owen, David S. Guttman, Jennifer L. Gommerman, and Heather N. Reich
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Immunology ,Nephrology ,Medicine - Abstract
IgA nephropathy (IgAN) is a leading cause of kidney failure, yet little is known about the immunopathogenesis of this disease. IgAN is characterized by deposition of IgA in the kidney glomeruli, but the source and stimulus for IgA production are not known. Clinical and experimental data suggest a role for aberrant immune responses to mucosal microbiota in IgAN, and in some countries with high disease prevalence, tonsillectomy is regarded as standard-of-care therapy. To evaluate the relationship between microbiota and mucosal immune responses, we characterized the tonsil microbiota in patients with IgAN versus nonrelated household-matched control group participants and identified increased carriage of the genus Neisseria and elevated Neisseria-targeted serum IgA in IgAN patients. We reverse-translated these findings in experimental IgAN driven by BAFF overexpression in BAFF-transgenic mice rendered susceptible to Neisseria infection by introduction of a humanized CEACAM-1 transgene (B × hC-Tg). Colonization of B × hC-Tg mice with Neisseria yielded augmented levels of systemic Neisseria-specific IgA. Using a custom ELISPOT assay, we discovered anti-Neisseria–specific IgA-secreting cells within the kidneys of these mice. These findings suggest a role for cytokine-driven aberrant mucosal immune responses to oropharyngeal pathobionts, such as Neisseria, in the immunopathogenesis of IgAN. Furthermore, in the presence of excess BAFF, pathobiont-specific IgA can be produced in situ within the kidney.
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- 2022
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24. Civic localism, anti-mainland localism, and independence : The changing pattern of identity politics in Hong Kong special administrative region
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So, Alvin Y. and Ip, Ping Lam
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- 2020
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25. Patient‐reported outcomes in heart failure with preserved vs. reduced ejection fraction: focus on physical independence
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Weiting Huang, Tiew‐Hwa Katherine Teng, Wan Ting Tay, Arthur Mark Richards, Umesh Kadam, Claire A. Lawson, Wataru Shimizu, Seet Yoong Loh, Inder Anand, and Carolyn Su Ping Lam
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Quality of life ,Heart failure ,Patient‐reported outcomes ,Psychometric properties ,Kansas City Cardiomyopathy Questionnaire ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a widely used patient‐reported outcome measure in heart failure (HF). The KCCQ was validated in patients with HF with reduced ejection fraction (HFrEF), leaving knowledge gaps regarding its applicability in HF with preserved ejection fraction (HFpEF). This study addresses the psychometric properties of internal consistency and reliability, construct, and known‐group validity of KCCQ in both HFrEF and HFpEF. We aimed to evaluate the psychometric properties of the KCCQ and their prognostic significance in HFpEF and HFrEF, within a large prospective multinational HF cohort. Methods and results We examined the 23‐item KCCQ in the prospective multinational ASIAN‐HF study [4470 HFrEF (ejection fraction
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- 2020
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26. Which interventions may improve bracing compliance in adolescent idiopathic scoliosis? A systematic review and meta-analysis.
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Xue Li, Zhaohua Huo, Zongshan Hu, Tsz Ping Lam, Jack Chun Yiu Cheng, Vincent Chi-Ho Chung, and Benjamin Hon Kei Yip
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Medicine ,Science - Abstract
This review aimed to systematically review and meta-analyze the effects of interventions in improving bracing compliance among adolescent idiopathic scoliosis (AIS) patients. Eight databases were searched from their inception to April 2022. The eligibility criteria included controlled studies that used any type of intervention to enhance bracing compliance in braced AIS patients. Two researchers independently screened articles and extracted data based on the PICO (participant, intervention, comparator, and outcome) framework. Quality appraisal of included studies was performed using GRADE (overall assessment), and the risk of bias was assessed with Cochrane RoB Tool 2 for randomized controlled trials (RCT) and ROBINS-I for non-RCT studies. The primary outcome was bracing compliance and secondary outcomes included Cobb Angle and measurements for quality of life. Six eligible studies involving 523 participants were included. All studies were evaluated as low or very low quality with a high risk of bias. Four types of interventions were identified, including sensor monitoring (n = 2, RCTs), auto-adjusted brace (n = 1, RCT), more intensive or collaborated medical care (n = 2), and psychosocial intervention (n = 1). A meta-analysis of 215 patients from the three RCTs suggested that the compliance-enhancing intervention group had 2.92 more bracing hours per day than the usual care control (95%CI [1.12, 4.72], P = 0.001). In subgroup analysis, sensor monitoring significantly improved bracing wearing quantity compared to usual care (3.47 hours/day, 95%CI [1.48, 5.47], P = 0.001), while other aforementioned interventions did not show a significant superiority. Compliance-enhancing interventions may be favorable in preventing curve progression and promoting quality of life, but the improvements cannot be clarified according to limited evidence. In conclusion, although the results of this study suggested that sensor monitoring may be the most promising approach, limited high-quality evidence precludes reliable conclusions. Future well-designed RCTs are required to confirm the actual benefit of compliance-improving interventions in clinical practice.
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- 2022
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27. Accuracy on the preoperative assessment of patients with adolescent idiopathic scoliosis using biplanar low-dose stereoradiography: a comparison with computed tomography
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Kwong Hang Yeung, Gene Chi Wai Man, Tsz Ping Lam, Bobby Kin Wah Ng, Jack Chun Yiu Cheng, and Winnie Chiu Wing Chu
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Adolescent idiopathic scoliosis ,Three-dimensional analysis ,Intervertebral axial rotation ,Intervertebral wedging ,Kyphosis ,Lordosis ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Although computed tomography (CT) is commonly used to diagnose the scoliotic spine in patients with adolescent idiopathic scoliosis (AIS) preoperatively, it is limited by the high radiation and prone scanning position. Recently, a new biplanar stereoradiography (EOS) was used to image the scoliotic spine in an upright posture with significantly less radiation in non-severe AIS subjects. However, its reliability to assess preoperative AIS patients remains unreported. Hence, the purpose of this study is to compare the scoliotic curvature between prone (CT) and upright positions (EOS) in preoperative AIS patients. Methods Thirty-three pre-operative AIS patients (mean age:18.4 ± 4.2) were recruited. EOS was used to scan the whole thoracic spine at upright position. Whereas on the same day, a conventional CT scan was used to evaluate the spine in prone position. The three-dimensional reconstruction of EOS and CT of the spine were then generated. Using previous validated techniques, multiple scoliotic parameters in both modalities were determined. The agreement between the two modalities was compared using the Bland-Altman test, whereas the correlation was assessed by the intraclass correlation coefficient (ICC). Results The mean ICC (prone and upright) of intra-rater/inter-rater reliabilities for the measured parameters were 0.985,0.961/0.969,0.903, respectively. Thoracic Cobb angles, intervertebral wedging and lumbar lordosis correlated significantly between upright EOS imaging radiographs (62.9 ± 9.3°,6.4 ± 2.9° and 48.8 ± 12.4°) and prone CT (47.3 ± 10.0°,5.8 ± 2.7° and 27.9 ± 11.4°; P
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- 2020
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28. An unusual case of plasmablastic lymphoma presenting as dermatomyositis
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Ashlyn Rui Yin Chee, Teng Fong Ng, Stephanie Jin Ping Lam, Matthew Wright, and Michael F. Leahy
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autologous stem cell transplant ,bortezomib ,dermatomyositis ,plasmablastic lymphoma ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract We report a rare case of aggressive plasmablastic lymphoma with an initial presentation of dermatomyositis. The challenges associated with the diagnosis and treatment approach are also highlighted in this case report.
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- 2020
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29. Pharmacokinetic Characterization to Enable Medicine Use in Pregnancy, the Potential Role of Physiologically‐Based Pharmacokinetic Modeling: A Regulatory Perspective
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Susan Cole, Paola Coppola, Essam Kerwash, Janet Nooney, and Siu Ping Lam
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Therapeutics. Pharmacology ,RM1-950 - Published
- 2020
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30. Particulate air pollution on cardiovascular mortality in the tropics: impact on the elderly
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Jonathan Yap, Yixiang Ng, Khung Keong Yeo, Anders Sahlén, Carolyn Su Ping Lam, Vernon Lee, and Stefan Ma
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Air pollution ,Cardiovascular mortality ,Tropics ,Elderly ,Industrial medicine. Industrial hygiene ,RC963-969 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Air pollution has a significant health impact. Most data originate from temperate regions. We aim to study the health impact of air pollution, particularly among the elderly, in a tropical region. Methods A daily time-series analysis was performed to estimate excess risk (ER) of various air pollutants on daily death counts amongst the general population in Singapore from 2001 to 2013. Air pollutants included particulate matters smaller than 10 μm, and 2.5 μm (PM10, PM2.5), carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3) and sulphur dioxide (SO2). The studied outcomes were non-accidental and cardiovascular mortality. Single-day lag and distributed lag models were studied and adjusted for confounders. Results In single-day lag models, a 10 μg/m3 increase in particulate matter was associated with significant increases in non-accidental (PM10 ER: 0.627%; 95% confidence interval (CI): 0.260–0.995% and PM2.5 ER: 0.660%; 95% CI: 0.204–1.118%) and cardiovascular mortality (PM10 ER: 0.897; 95% CI: 0.283–1.516 and PM2.5 ER: 0.883%; 95% CI: 0.121–1.621%). This was significant in the elderly ≥ 65 years but not in those
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- 2019
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31. Effects of Mindfulness-Based Intervention to Improve Bracing Compliance in Adolescent Idiopathic Scoliosis Patients: a Randomized Controlled Trial
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Xue Li, Elsa Ngar Sze Lau, Stanley Kam Chung Chan, Tsz Ping Lam, Jack Chun Yiu Cheng, Eric Kam Pui Lee, Samuel Yeung Shan Wong, and Benjamin Hon Kei Yip
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Health (social science) ,Social Psychology ,Developmental and Educational Psychology ,Experimental and Cognitive Psychology ,Applied Psychology - Published
- 2023
32. Global alignment and proportion (GAP) score in asymptomatic subjects: is it universal?
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Zhen Liu, Hongru Ma, Zongshan Hu, Zezhang Zhu, Winnie Chiu Wing Chu, Tsz Ping Lam, Yong Qiu, and Jack Chun Yiu Cheng
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Neurology. Diseases of the nervous system ,RC346-429 - Published
- 2021
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33. School-Based Sleep Education Program for Children: A Cluster Randomized Controlled Trial
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Chan, Si-Jing Chen, Shirley Xin Li, Ji-Hui Zhang, Siu Ping Lam, Mandy Wai Man Yu, Chi Ching Tsang, Alice Pik Shan Kong, Kate Ching Ching Chan, Albert Martin Li, Yun Kwok Wing, and Ngan Yin
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sleep education ,children ,sleep pattern ,parent engagement ,behavioral outcome - Abstract
Insufficient sleep contributes negatively to child developmental processes and neurocognitive abilities, which argues the need for implementing interventions to promote sleep health in children. In this study, we evaluated the effectiveness of a multimodal and multilevel school-based sleep education program in primary school children using a cluster randomized controlled design. Twelve schools were randomly assigned to either the sleep education or nonactive control groups. The sleep education group included a town hall seminar, small class teaching, leaflets, brochures, and a painting competition for children. Parents and teachers were invited to participate in a one-off sleep health workshop. Parental/caregiver-reported questionnaires were collected at baseline and 1-month follow-up. A total of 3769 children were included in the final analysis. There were no significant improvements observed in the sleep-wake patterns, daytime functioning, and insomnia symptoms between the two groups at follow-up, whereas the intervention group had significantly improved parental sleep knowledge than the controls (paternal: adjusted mean difference: 0.95 [95% confidence interval (CI): 0.18 to 1.71]; maternal: adjusted mean difference: 0.87 [95% CI: 0.17 to 1.57]). In addition, children receiving the intervention had a lower persistence rate of excessive beverage intake (adjusted odds ratio: 0.49 [95% CI: 0.33 to 0.73]), and experienced greater reductions in conduct problems (adjusted mean difference: 0.12 [95% CI: 0.01 to 0.24]) compared with the controls at 1-month of follow-up. Moreover, a marginally significant reduction for emotional problems in the intervention group was also observed (adjusted mean difference: 0.16 [95% CI: −0.00 to 0.32]). These findings demonstrated that school-based sleep education was effective in enhancing parental sleep knowledge and improving behavioral outcomes in children, but not sufficient in altering the children’s sleep-wake patterns and sleep problems.
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- 2023
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34. Dim light melatonin patterns in unaffected offspring of parents with bipolar disorder: A case-control high-risk study
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Hongliang Feng, Amy Wing-Yin Ho, Binbin Lei, Joey Wing Yan Chan, Jing Wang, Yaping Liu, Jessie Chi Ching Tsang, Ngan Yin Chan, Siu Ping Lam, Kathleen Ries Merikangas, Chung Shun Ho, Jihui Zhang, and Yun Kwok Wing
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Male ,Parents ,Bipolar Disorder ,Adolescent ,Light ,Chronobiology Disorders ,Circadian Rhythm ,Psychiatry and Mental health ,Clinical Psychology ,Case-Control Studies ,Humans ,Saliva ,Sleep ,Melatonin - Abstract
Circadian dysregulation has long been thought to be a key component in the pathophysiology of bipolar disorder (BD). However, it remains unclear whether this dysregulation constitutes a risk factor, manifestation, or consequence of BD. This study aimed to compare dim light melatonin secretion patterns between unaffected offspring of parents with BD (OBD) and offspring of control parents (OCP).This case-control study included unaffected OBD (mean age 14.0 years; male 50.0 %) and age- and sex-matched OCP (mean age 13.0 years; male: 43.5 %). Seventeen saliva samples were collected in dim light conditions. Dim light melatonin onset (DLMO), phase angles, and area under the curve (AUC) were calculated.185 saliva samples from 12 OBD (n = 12) and 741 from OCP (n = 46) were collected. Unaffected OBD had a significant lower nocturnal melatonin level (14.8 ± 4.6 vs. 20.3 ± 11.7 pg/mL) and a smaller melatonin AUC within two hours after DLMO (35.5 ± 11.3 vs. 44.6 ± 18.1 pg/mL) but a significant larger phase angle between DLMO and sleep onset (2.2 ± 1.0 vs. 1.4 ± 1.2 h) than OCP. There was no significant between-group difference in DLMO. The graphic illustrations showed a considerably flattened melatonin secretion in unaffected OBD.The main limitations include lack of 24-h dim melatonin secretion measurement, large age range of participants, and small sample size.These findings suggest that unaffected OBD already presented with circadian rhythm dysregulations. Future investigations are needed to clarify the role of abnormal melatonin secretion in the onset of BD.
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- 2022
35. Biological effect of dysregulated LBX1 on adolescent idiopathic scoliosis through modulating muscle carbohydrate metabolism
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Yujia Wang, Mengheng Li, Chi-On Chan, Guangpu Yang, Jacky Chun-Kit Lam, Brian Chun-Sum Law, Tsz-ping Lam, Alec Lik-Hang Hung, Jack Chun-Yiu Cheng, Daniel Kam-Wah Mok, and Wayne Yuk-Wai Lee
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Homeodomain Proteins ,Proteomics ,Adolescent ,Body Weight ,Paraspinal Muscles ,Galactose ,Cross-Sectional Studies ,Scoliosis ,Carbohydrate Metabolism ,Humans ,Female ,Surgery ,Orthopedics and Sports Medicine ,Kyphosis ,Neurology (clinical) ,Transcription Factors - Abstract
Abnormal energy metabolism such as lower body weight and body mass index (BMI) and less fat mass is widely reported in patients with adolescent idiopathic scoliosis (AIS) and has been implicated in deformity development. However, the underlying mechanism is largely unclear. LBX1 is one of the promising AIS predisposing genes validated by multicenter studies.This study aimed to identify differentially expressed proteins (DEPs) relating to energy metabolism in AIS by using proteomic and metabolic analysis and to explore if the expression of these DEPs is associated with clinical parameters and modulated by LBX1.This is a cross-sectional study using clinical data and biological samples followed by basic study using a cellular model.Plasma samples were collected from Chinese girls with nonprogressive and progressive AIS (N=7 and 8, respectively) and age-matched healthy girls (N=50). Paraspinal muscle tissues were collected intraoperatively from concave and convex side of the apex of the major spinal curve in AIS (N=24) and either side from nonscoliosis patients (N=14).Radiological Cobb angle and basic anthropometric data of recruited subjects were measured. The DEPs and metabolites were compared in plasma using proteomics and metabolomics technique. The relative expression of selected genes was measured in muscles.Plasma samples from AIS were collected at first clinical visit and were further divided into nonprogressive or progressive groups according to Cobb angle changes in 6-year follow-up. Age-matched healthy girls were recruited as control. High-performance liquid chromatography-mass spectrometry based proteomic analysis was carried out in three groups to identify DEPs and their annotated metabolic pathways. An independent cohort was used for validation by gas chromatography-mass spectrometry based metabolomic analysis. Paraspinal muscles were subjected to quantitative polymerase chain reaction (qPCR) followed by correlation analysis. Human skeletal muscle myoblast (HSMM) was used as the cellular model.The likelihood of aberrant galactose metabolism and glycolysis was found to be associated with AIS curve progression as evidenced by the thirteen DEPs and seven related metabolites according to proteomic and metabolomic analysis. Some of the DEPs showed significantly altered expression in AIS concave and convex sides paraspinal muscles compared with those in nonscoliosis control. Four DEPs were found significantly and negatively correlated with LBX1 in AIS convex side paraspinal muscles. Overexpressing LBX1 in HSMM cells led to increased expression of three DEPs and decreased expression of three DEPs, respectively.This is the first integrated proteomic and metabolomic analysis on AIS. Our findings show dysregulated galactose metabolism and glycolysis pathways in progressive group of AIS, suggesting the presence of abnormal energy metabolism at early stage of this disease, and their association with higher risk of progressing into more severe curvature. Evidence from ex vivo study with human muscle biopsies and in vitro study with human myoblast cells propose the possible effect of LBX1 on these two pathways in skeletal muscles. The present study provides new evidence of LBX1 function in AIS via modulating effect on the expression of energy metabolism related genes. This study might provide new insights into etiopathogenesis and development of novel treatment strategy targeting on abnormal body weight and BMI in patients with AIS. Additionally, the plasma proteomic and metabolomic studies suggested new candidates as biomarkers for establishing predictive model for AIS onset/progression.
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- 2022
36. Global Alignment and Proportion (GAP) score in asymptomatic individuals: is it universal?
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Hongru Ma, Zongshan Hu, Benlong Shi, Zhen Liu, Zezhang Zhu, Winnie Chiu Wing Chu, Tsz Ping Lam, Jack Chun Yiu Cheng, and Yong Qiu
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Adult ,Male ,Sacrum ,Lumbar Vertebrae ,Middle Aged ,Radiography ,Young Adult ,Cross-Sectional Studies ,Lordosis ,Humans ,Female ,Surgery ,Orthopedics and Sports Medicine ,Prospective Studies ,Neurology (clinical) ,Aged - Abstract
The global alignment and proportion (GAP) score was established based on American and European subjects, which might limit its applicability to the Chinese population due to ethnicity-related difference of sagittal alignment.To analyze the applicability of GAP score in the Chinese population and to investigate the age- and gender-associated differences of spinopelvic and GAP score parameters.A prospective cross-sectional radiographic study.Of 692 asymptomatic Chinese volunteers aged between 20 and 79 prospectively recruited between January 2017 and June 2019, 490 subjects were eventually included in this study.The pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), L1-S1 lordosis, L4-S1 lordosis, sagittal vertical axis (SVA), T1 pelvic angle (TPA) and global tilt (GT) were measured on lateral X-rays. The GAP scores and its parameters including relative pelvic version (RPV), relative lumbar lordosis (RLL), lordosis distribution index (LDI) and relative spinopelvic alignment (RSA) were calculated for each subject.Subjects were divided into four groups: Group 1M: male subjects60 years old; Group 1F: female subjects60 years old; Group 2M: male subjects ≥60 years old and Group 2F: female subjects ≥60 years old. The GAP scores and categories were determined and compared between groups. The results of sagittal alignment were compared with the previous studies evaluating the normative sagittal alignment in other populations. Univariate linear regression analysis was carried out between pelvic incidence (PI) and sacral slope (SS), lumbar lordosis (LL) and global tilt (GT) in each group.The distributions of GAP categories and the updated Roussouly classification were statistically different from other populations. Significantly different distribution of GAP categories was observed between Group 1M and Group 2M, Group 1F and Group 2F, and Group 1M and Group 1F. Radiographic measurements and GAP parameters were significantly different between Group 1M and Group 2M, and Group 1F and Group 2F. Gender-related difference of parameters was more prominent between Group 1M and Group 1F. Linear relationship of PI with SS, LL and GT were different from the regression models of "ideal" sagittal alignment in GAP score.The GAP score might be inappropriate in Chinese population due to ethnicity-related alignment difference. Worse feasibility of GAP score was observed in female and old subjects.
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- 2022
37. The multifaceted role of protein kinase CK2 in high-risk acute lymphoblastic leukemia
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Yun Zhou, Haiwei Lian, Ning Shen, Sovannarith Korm, Andrew Kwok Ping Lam, Olivia Layton, Leah N. Huiting, Dun Li, Kelly Miao, Aozhuo Zeng, Esther Landesman-Bollag, David C. Seldin, Hui Fu, Li Hong, and Hui Feng
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2020
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38. A validated composite model to predict risk of curve progression in adolescent idiopathic scoliosis
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Jiajun Zhang, Ka-yee Cheuk, Leilei Xu, Yujia Wang, Zhenhua Feng, Tony Sit, Ka-lo Cheng, Evguenia Nepotchatykh, Tsz-ping Lam, Zhen Liu, Alec L.H. Hung, Zezhang Zhu, Alain Moreau, Jack C.Y. Cheng, Yong Qiu, and Wayne Y.W. Lee
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Medicine (General) ,R5-920 - Abstract
Background: In adolescent idiopathic scoliosis (AIS), the continuous search for effective prognostication of significant curve progression at the initial clinical consultation to inform decision for timely treatment and to avoid unnecessary overtreatment remains a big challenge as evidence of the multifactorial etiopathogenic nature is increasingly reported. This study aimed to formulate a composite model composed of clinical parameters and circulating markers in the prediction of curve progression. Method: This is a two-phase study consisting of an exploration cohort (120 AIS, mean Cobb angle of 25°± 8.5 at their first clinical visit) and a validation cohort (51 AIS, mean Cobb angle of 23° ± 5.0° at the first visit). Patients with AIS were followed-up for a minimum of six years to formulate a composite model for prediction. At the first visit, clinical parameters were collected from routine clinical practice, and circulating markers were assayed from blood. Finding: We constructed the composite predictive model for curve progression to severe Cobb angle > 40° with a high HR of 27.9 (95% CI of 6.55 to 119.16). The area under curve of the composite model is higher than that of individual parameters used in current clinical practice. The model was validated by an independent cohort and achieved a sensitivity of 72.7% and a specificity of 90%. Interpretation: This is the first study proposing and validating a prognostic composite model consisting of clinical and circulating parameters which could quantitatively evaluate the probability of curve progression to a severe curvature in AIS at the initial consultation. Further validation in clinic will facilitate application of composite model in assisting objective clinical decision. Keywords: Scoliosis, Adolescent, Clinical study, Hong Kong
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- 2020
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39. Twelve-year follow-up of a case of proximal femoral Unicameral Bone Cyst (UBC) treated by steroid injection using radiological and DXA scan data
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Bobby Kin-Wah Ng, Vivian Wing-Yin Hung, Wai-Wang Chau, Tsz-Ping Lam, and Jack Chun-Yiu Cheng
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Orthopedic surgery ,RD701-811 - Abstract
This report is of a proximal femoral unicameral bone cyst in a patient presented at 3 years. Intra-lesional steroid injection was used to treat this large active lesion. The response to treatment was monitored with the use of dual-energy X-ray absorptiometry (DXA) scan as an indirect method of monitoring the activity of the bone cyst. The patient had developed stress fracture during the course of treatment which had remodelled fully after successful treatment with multiple injections; at 12-year follow-up, the patient reached skeletal maturity. The affected femur had remodelled back to normal radiological appearance without avascular necrosis. This has demonstrated that steroid injection is a safe and effective procedure to achieve regression of a large active bone cyst in the proximal femur. It is a minimal invasive procedure resulting in no scar. DXA scan is a useful method combining clinical assessment to monitor status of the bone cyst to allow timing of injection. 中文摘要: 本報告為3歲患者的股骨近端骨囊腫,以用病灶內類固醇注射來治療這個巨大的活性病灶。 使用雙能X射線吸收測定法 (DXA) 掃描作為間接方法監測骨囊腫活性對治療的反應。 患者在治療過程中出現了應力性骨折,經多次注射成功治療後已完全改型,隨訪12年,患者達到骨骼成熟。 受影響的股骨已經重新恢復正常的放射學外觀及沒有缺血性壞死。 這證明了類固醇注射是一種安全有效的方法,以實現股骨近端巨大活躍骨囊腫的消退。 這是微創手術,沒有疤痕。 DXA掃描結合臨床評估以監測骨囊腫狀態是有效的方法以允許注射時機。 Keywords: DXA, steroid injection, Unicameral Bone Cyst
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- 2018
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40. Soft tissue release and osteotomies in the treatment of patients with spastic diplegic cerebral palsy
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Bobby Kin-Wah Ng, Wai-Wang Chau, Alec Lik-Hang Hung, Tsz-Ping Lam, and Jack Chun-Yiu Cheng
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Orthopedic surgery ,RD701-811 - Abstract
We aim to study the outcome of soft tissue releases by tendon elongations and osteotomies in fixed joint contractures by clinical examination and patient self-reported assessment on 20 patients (14 males and 6 females) with spastic diplegic cerebral palsy treated with single-event multilevel surgery (SEMLS) between 2000 and 2012. A questionnaire was used to collect information on problems encountered before and after surgery and decision on surgery. Comparing patients with Gross Motor Function Classification System class I/II, (N = 8), III (N = 8) and IV/V , patients of classes IV/V showed much slower mean recovery time than I/II group (14.00 vs. 4.38 months, p
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- 2018
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41. Potential Muscle-Related Biomarkers in Predicting Curve Progression to the Surgical Threshold in Adolescent Idiopathic Scoliosis—A Pilot Proteomic Study Comparing Four Non-Progressive vs. Four Progressive Patients vs. A Control Cohort
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Yujia Wang, Huanxiong Chen, Jiajun Zhang, Tsz-ping Lam, A.L.H. Hung, J.C.Y. Cheng, and W.Y.W. Lee
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scoliosis ,iTRAQ ,α-actin ,progressive ,differentially expressed proteins ,Medicine - Abstract
Previous studies have reported abnormal muscle morphology and functions in patients with adolescent idiopathic scoliosis (AIS). To answer whether such abnormalities could be reflected in their circulation and their clinical implication for predicting curve progression to the surgical threshold, this preliminary study explored the presence of baseline muscle-related proteins and their association with curve progression. Plasma samples were collected at the first clinical visit for AIS, with patients divided into non-progressive or progressive groups (N = four and four) according to their Cobb angle in six-year follow-ups, with age- and sex-matched healthy subjects (N = 50). Then, the samples were subjected to isobaric tags for relative and absolute quantitation (iTRAQ) for global comparison of untargeted protein expression. Seventy-one differentially expressed proteins (DEPs) were found elevated in progressive AIS. Functional analysis showed that 18 of these are expressed in muscles and play an essential role in muscle activities. Among the muscle-related DEPs, α-actin had the highest fold change in progressive/non-progressive groups. This preliminary study firstly suggested higher circulating levels of muscle structural proteins in progressive AIS, indicating the likelihood of structural damage at the microscopic level and its association with progression to the surgical threshold. Further studies with larger sample sizes are warranted to validate these novel candidates for early diagnosis and predicting progression.
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- 2021
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42. Statistical changes of lung morphology in patients with adolescent idiopathic scoliosis after spinal fusion surgery—a prospective nonrandomized study based on low-dose biplanar X-ray imaging
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Min, Deng, Qianyun, Chen, Qiao, Deng, Lin, Shi, Cherry Cheuk Nam, Cheng, Kwong Hang, Yeung, Rongli, Zhang, Wai Ping Fiona, Yu, Tsz Ping, Lam, Jack Chun Yiu, Cheng, and Winnie Chiu Wing, Chu
- Subjects
Original Article ,Radiology, Nuclear Medicine and imaging - Abstract
BACKGROUND: Adolescent idiopathic scoliosis (AIS) patients suffer from restrictive impairment of pulmonary function (PF) as a consequence of spinal and ribcage deformity. Statistic modelling of scoliotic geometry has been well-established based on low-dose biplanar X-ray device (EOS) imaging. However, the postoperative lung morphology change derived from EOS has not yet been studied adequately till now. METHODS: Twenty-five female AIS patients with severe right-sided major thoracic curve (aged 13–31 years; Cobb angle 45°–92°) underwent posterior spinal fusion (PSF) were prospectively recruited for standing EOS imaging at preoperative, postoperative, and 1-year follow-up (1Y-FU) stages. EOS-based lung morphology at frontal and lateral view was measured respectively to assess serial statistical changes in area and height. RESULTS: At frontal view, left lung area significantly increased postoperatively (104.7 vs. 125.1 cm(2); P0.05). At lateral view, the increase in left lung area was slight without statistically difference (median: 175.8, 178.4, 182.5 cm(2) at preoperative, postoperative, 1Y-FU stage, respectively; all P>0.05), while right lung area did not significantly change postoperatively (median: 209.9, 206.7, 212.4 cm(2) at preoperative, postoperative, 1Y-FU stage, respectively; all P>0.05). At both frontal and lateral view, left lung height significantly improved at both postoperative and 1Y-FU stage (all P0.05). CONCLUSIONS: EOS imaging demonstrates that left lung area in severe AIS may improve after PSF surgery. EOS may provide useful information about lung morphology change after PSF in severe AIS.
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- 2022
43. Familial α-synucleinopathy spectrum features in patients with psychiatric REM sleep behaviour disorder.
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Jing Wang, Siu Ping Lam, Bei Huang, Yaping Liu, Jihui Zhang, Yu, Mandy W. M., Tsang, Jessie C. C., Li Zhou, Chau, Steven W. H., Ngan Yin Chan, Chan, Joey W. Y., Schenck, Carlos H., Li, Shirley X., Mok, Vincent C. T., Ka Yan Ma, Karen, Yin Yan Chan, Anne, and Yun Kwok Wing
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BEHAVIOR disorders ,PEOPLE with mental illness ,SLEEP disorders ,RAPID eye movement sleep ,SMELL disorders ,DISEASE risk factors ,SMELL ,ANXIETY disorders - Published
- 2023
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44. Moving Beyond Abstracted Empiricism: Pursuing New Sociological Directions in Theorizing Male-to-Female Sexual Assault on University/College Campuses
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Walter S. DeKeseredy, Ping Lam Ip, and Andrea DeKeseredy
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Sociology and Political Science ,Law - Published
- 2023
45. Coordinated operation of a microgrid with a distribution network device.
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Thomas John, Yu Wang 0071, Kuan Tak Tan, and Ping Lam So
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- 2015
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46. Relationship between insomnia and quality of life: Mediating effects of psychological and somatic symptomatologies
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Jihui Zhang, Yaping Liu, Siu Ping Lam, Shirley Xin Li, Albert Martin Li, and Yun-Kwok Wing
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insomnia ,mediating effect ,psychological symptomatology ,quality of life ,somatic symptomatology ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objectives: We aimed to explore the potential mediating effects of neuroticism, depressive and anxiety symptoms, and somatic symptoms in the relationship between insomnia and health-related quality of life (HRQoL). Methods: This was a cross-sectional family study, which recruited a total of 297 adolescents (eighty insomniacs as determined by clinical interview) and 318 parents (93 insomniacs). HRQoL was measured by short form-36 (SF-36) health survey. A series of questionnaires were employed to measure insomnia severity, neuroticism personality, and depressive, anxiety and somatic symptoms. Results: Participants with insomnia had lower HRQoL than those without insomnia (71.9 vs. 77.1, P < 0.001). Insomnia severity (as measured byInsomnia Severity Index) was significantly associated with HRQoL (correlation coefficient = −0.451, P < 0.001). A total of 53% of the variance of SF-36 could be explained by the mediation model, which showed that a large proportion of the variances in the association between insomnia severity and HRQoL was mediated by depressive symptoms, somatic symptoms, and neuroticism personality trait. Conclusions: The close associations between insomnia severity and impaired HRQoL are largely mediated by psychological symptomatology and personality dimension. Further prospective study is warranted to investigate the long-term impact of insomnia symptoms on HRQoL and the roles of mood and somatic symptoms.
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- 2017
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47. Efficacy of Email-delivered Versus Face-to-face Group Cognitive Behavioral Therapy for Insomnia in Youths: A Randomized Controlled Trial
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Ngan Yan Chan, Siu Ping Lam, Jihui Zhang, Joey Wing Yan Chan, Mandy Man Wai Yu, Sooyeon Suh, Chien-Ming Yang, Isa Okajima, Albert Martin Li, Yun Kwok Wing, and Shirley Xin Li
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Adult ,Young Adult ,Psychiatry and Mental health ,Treatment Outcome ,Adolescent ,Cognitive Behavioral Therapy ,Electronic Mail ,Sleep Initiation and Maintenance Disorders ,Pediatrics, Perinatology and Child Health ,Public Health, Environmental and Occupational Health ,Humans ,Female ,Sleep Hygiene - Abstract
The purpose of the study was to compare the efficacy of group-based therapy (GT) and email-delivered self-help (ESH) cognitive behavioral therapy for insomnia (CBT-I) with the wait-list (WL) control group in youths.The study involved an assessor-blind, parallel group randomized controlled trial in youths meeting the diagnostic criteria for insomnia disorder. Participants were randomized to one of the three groups (8-week GT, 8-week ESH, or WL). Participants in all three groups were assessed at baseline and after treatment (week 9 for the WL group). The two treatment groups were additionally assessed at one month and six months after the intervention. Treatment effects were examined using linear mixed models.A total of 135 youths (mean age: 20.0 ± 2.5 years, female: 67.4%) were recruited. After treatment, both active treatment groups showed significant improvements in insomnia symptoms (GT vs. WL: Cohen's d = -1.03, ESH vs. WL: d = -.63), less presleep arousal (d = -.52 to -1.47), less sleep-related dysfunctional belief (d = -.88 to -1.78), better sleep hygiene practice (d = -.79 to -.84), and improved daytime functioning (d = -.56 to -.96) compared with the WL group. In addition, GT outperformed ESH in improving maladaptive sleep-related beliefs and mood symptoms at post-treatment and 6-month follow-up. A reduction of suicidality with moderate effect size favoring GT emerged at 6-month follow-up.Our findings suggested that both group-based and email-delivered CBT-I were effective in treating youth insomnia, but group-based CBT-I showed superior effects on reducing maladaptive beliefs and mood symptoms.
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- 2022
48. Sensitivity dependence of fiber loop mirror on the length of high birefringence fiber
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Zu, Peng, Chan, Chi Chiu, and So, Ping Lam
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- 2016
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49. The damping of inter-area oscillations in power systems with controllable phase shifters
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So, Ping Lam
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621.31042 ,Dynamic instability ,Power generators - Published
- 1997
50. Model Predictive Voltage Control for Single-Inductor Multiple-Output DC-DC Converter With Reduced Cross Regulation.
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Benfei Wang, Venkata Ravi Kishore Kanamarlapudi, Liang Xian, Xiaoyang Peng, Kuan Tak Tan, and Ping Lam So
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- 2016
- Full Text
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