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Improving outcomes in geriatric surgery:Is there more to the equation?

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World Journal of Clinical Cases 2022年第13期10卷 4321-4323页

作者： Serene Si Ning goh Clement LK Chia Department of General Surgery Khoo Teck Puat HospitalSingapore 768828Singapore

The era of geriatric surgery has arrived with increased global life *** need to optimize outcomes in this group of patients goes beyond traditional outcomes such as postoperative morbidity and mortality *** risk factors that impact adverse surgical outcomes such as frailty and sarcopenia,individualizing optimization strategies such as prehabilitation and a multidisciplinary geriatric surgical service have been shown to improve postoperative outcomes and help the older surgical patient regain premorbid function and maintain quality of *** needs to be a concerted effort to increase awareness of this increasingly important topic in practicing surgeons around the world to meet the challenges of the aging population.

关键词： Geriatric surgery Risk factors Prehabilitation Surgical outcomes Frailty

Redox catalysts for aprotic Li-O2 batteries: Toward a redox flow system

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Nano Materials Science 2019年第3期1卷 173-183页

作者： YunGuang Zhu F.W.Thomas goh Qing Wang Department of Materials Science and Engineering Faculty of Engineering National University of Singapore

Large-scale electrical energy storage with high energy density and round-trip efficiency is important to the resilience of power grids and the effective use of intermittent renewable energy such as solar and *** battery,due to its high energy density,is believed to be one of the most promising energy storage systems for the ***,large overpotentials,poor cycling stability,and degradation of electrolytes and cathodes have been hindering the development of lithium-oxygen *** heterogeneous oxygen electrocatalysts have been investigated to lower the overpotentials and enhance the cycling stability of lithium-oxygen ***,the prevailing issues of electrode passivation and clogging *** the past few years,redox mediators were explored as homogenous catalysts to address the issues,while only limited success has been achieved for these soluble *** conjunction with a flowing electrolyte system,a new redox flow lithium-oxygen battery(RFLOB)has been devised to tackle the aforementioned *** working mechanism and schematic processes will be elaborated in this *** addition,the performance gap of RFLOB with respect to practical requirements will be *** the above,we anticipate RFLOB would be a credible solution for the implementation of lithium-oxygen battery chemistry for the next generation energy storage.

关键词： Lithium-air battery Redox catalysis Oxygen reduction reaction Oxygen evolution reaction Redox flow cell

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Examining the practical limits of batch effect-correction algorithms:When should you care about batch effects?

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Journal of Genetics and Genomics 2019年第9期46卷 433-443页

作者： Longjian Zhou Andrew Chi-Hau Sue Wilson Wen Bin goh School of Pharmaceutical Science and Technology Tianjin UniversityTianjin30072China School of Biological Sciences Nanyang Technological University60 Nanyang Drive637551Singapore

Batch effects are technical sources of variation and can confound *** many performance ranking exercises have been conducted to establish the best batch effect-correction algorithm(BECA),we hold the viewpoint that the notion of best is ***,alternative questions beyond the simplistic notion of "best" are also interesting:are BECAs robust against various degrees of confounding and if so,what is the limit?Using two different methods for simulating class(phenotype) and batch effects and taking various representative datasets across both genomics(RNA-Seq) and proteomics platforms,we demonstrate that under situations where sample classes and batch factors are moderately confounded,most BECAs are remarkably robust and only weakly affected by upstream normalization *** observation is consistently supported across the multitude of test *** do have limits:When sample classes and batch factors are strongly confounded,BECA performance declines,with variable performance in precision,recall and also batch *** also report that while conventional normalization methods have minimal impact on batch effect correction,they do not affect downstream statistical feature selection,and in strongly confounded scenarios,may even outperform *** other words,removing batch effects is no guarantee of optimal functional ***,this study suggests that simplistic performance ranking exercises are quite trivial,and all BECAs are compromises in some context or another.

关键词： Batch effects Bioinformatics Feature selection Normalization Statistics

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Economic Analysis of Intravenous vs. Subcutaneously Administered Trastuzumab for the Treatment of HER2+ Early Breast Cancer in Malaysia

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Advances in Breast Cancer Research 2016年第1期5卷 1-13页

作者： wei Ching Lee Mohd Roslan Haron Kong Leong Yu Flora Li Tze Chong Adrian goh Soraya Azmi Radiotherapy and Oncology Department Penang General Hospital Georgetown Malaysia Radiotherapy and Oncology Department Sultan Ismail Hospital Johor Bahru Malaysia Oncology & Palliative Care Department Sarawak General Hospital Kuching Malaysia Radiotherapy & Oncology Department Likas Hospital Kota Kinabalu Malaysia Veras Research Petaling Jaya Malaysia

Human epidermal growth factor receptor-2 over expression has been reported in 23% - 37.3% of Malaysian breast cancer patients. Trastuzumab is a recommended adjuvant therapy for patients with early breast cancer. Currently, trastuzumab is administered intravenously but a new subcutaneous formulation could save time and costs. In Malaysia, the Ministry of Health funds most of the costs of secondary care, including cancer treatment. We performed a cost-minimisation analysis from the Ministry of Health and societal perspectives by adapting an excel-based mathematical model. Model inputs comprised of drug, consumables and personnel costs. Data sources were government statistics, price lists, government salary scales and estimated personnel time costs. Doctors, nurses and pharmacists at four hospitals estimated the time to perform necessary tasks following their usual practice. Results showed that subcutaneous trastuzumab could, on average, save an estimated 43.5 minutes of pharmacists’ time and 11.6 minutes and 4.9 minutes of nurses’ time administering loading dose and subsequent doses, respectively. Total cost savings were RM7561 (8.7%) per patient per year, consisting of RM6496 (7.6%) reduction in drug cost and RM1065 (66.2%) reduction in non-drug costs. Similarly, cost savings from the societal perspective were RM7820 per patient per year, comprising RM6496 (7.6%) and RM1325 (63.7%) of drug and non-drug costs savings, respectively. Sensitivity analyses showed that cost savings on subcutaneous formulation ranged from RM3715 to RM11408 to the Ministry of Health. Overall, subcutaneous trastuzumab is estimated to be cost-saving from Ministry of Health and societal perspectives. Other benefits from saving patients’ and carers’ time and convenience could not be taken into account. This study was a first to investigate cost-savings from subcutaneous trastuzumab in a middle-income Asian country and the findings were consistent with findings of earlier studies. Given the favou

关键词： Cost-Minimisation Analysis Trastuzumab Subcutaneous Intravenous Breast Cancer Malaysia

Does antiviral therapy reduce complications of cirrhosis?

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World Journal of Gastroenterology 2014年第23期20卷 7306-7311页

作者： goh Eun Chung Jeong-Hoon Lee Yoon Jun Kim Department of Internal Medicine Healthcare Research InstituteGangnam Healthcare CenterSeoul National University HospitalSeoul 135-984South Korea Department of Internal Medicine and Liver Research Institute Seoul National College of MedicineSeoul 110-744South Korea

Chronic hepatitis B infection is associated with the development of cirrhosis, hepatocellular carcinoma, and finally liver-related mortality. Each year, approximately, 2%-5% of patients with hepatitis B virus (HBV)-related compensated cirrhosis develop decompensation, with additional clinical manifestations, such as ascites, jaundice, hepatic encephalopathy, and gastrointestinal bleeding. The outcome of decompensated HBV-related cirrhosis is poor, with a 5-year survival of 14%-35% compared to 84% in patients with compensated cirrhosis. Because the risk of disease progression is closely linked to a patient’s serum HBV DNA level, antiviral therapy may suppress viral replication, stabilize liver function and improve survival. This article briefly reviews the role that antiviral therapy plays in cirrhosis complications, particularly, in decompensation and acute-on-chronic liver failure.

关键词： Antiviral therapy Cirrhosis Complication Hepatitis B Decompensation

Genotype 3 is the predominant hepatitis C genotype in a multi-ethnic Asian population in Malaysia

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Hepatobiliary & Pancreatic Diseases International 2015年第3期14卷 281-286页

作者： Shiaw-Hooi Ho Kee-Peng Ng Harvinder Kaur Khean-Lee goh Gastroenterology and Hepatology Unit Department of Internal MedicineUniversity of Malaya Department of Medical Microbiology University of Malaya

BACKGROUND： Genotypes of hepatitis C virus （HCV） are distributed differently across the world. There is a paucity of such data in a multi-ethnic Asian population like Malaysia. The objectives of this study were to determine the distribution of HCV genotypes between major ethnic groups and to ascer- tain their association with basic demographic variables like age and gender.

关键词： Asian genotype hepatitis C Malaysia multi-ethnic

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Intracellular interferon signalling pathways as potential regulators of covalently closed circular DNA in the treatment of chronic hepatitis B

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World Journal of Gastroenterology 2021年第14期27卷 1369-1391页

作者： Zhi Yi goh Ee Chee Ren Hui Ling Ko Singapore Immunology Network Agency for ScienceTechnology and ResearchSingapore 138648Singapore Integrative Sciences and Engineering Programme NUS Graduate SchoolNational University of SingaporeSingapore 119077Singapore Department of Microbiology and Immunology Yong Loo Lin School of MedicineNational University of SingaporeSingapore 119260Singapore

250 million people worldwide continue to be chronically infected with the *** patients may be treated with nucleoside/nucleotide analogues,this only suppresses HBV titre to sub-detection levels without eliminating the persistent HBV covalently closed circular DNA(cccDNA)*** a result,HBV infection cannot be cured,and the virus reactivates when conditions are ***(IFNs)are cytokines known to induce powerful antiviral mechanisms that clear viruses from infected *** have been shown to induce cccDNA clearance,but their use in the treatment of HBV infection is limited as HBVtargeting immune cells are exhausted and HBV has evolved multiple mechanisms to evade and suppress IFN ***,to fully utilize IFN-mediated intracellular mechanisms to effectively eliminate HBV,instead of direct IFN administration,novel strategies to sustain IFN-mediated anti-cccDNA and antiviral mechanisms need to be *** review will consolidate what is known about how IFNs act to achieve its intracellular antiviral effects and highlight the critical interferon-stimulated gene targets and effector mechanisms with potent anti-cccDNA *** include cccDNA degradation by APOBECs and cccDNA silencing and transcription repression by epigenetic *** addition,the mechanisms that HBV employs to disrupt IFN signalling will be *** that have been developed or are in the pipeline for components of the IFN signalling pathway and HBV targets that detract IFN signalling mechanisms will also be identified and discussed for utility in the treatment of HBV ***,these will provide useful insights into design strategies that specifically target cccDNA for the eradication of HBV.

关键词： Covalently closed circular DNA Interferons APOBECs Epigenetic modification Hepatitis B virus therapeutics

Detecting MoS2 and MoSe2 with optical contrast simulation

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Progress in Natural Science:Materials International 2019年第6期29卷 667-671页

作者： Xiaohe Zhang Hiroyo Kawai Jing Yang Kuan Eng Johnson goh Victoria Junior College Institute of Materials Research and Engineering A*STAR (Agency for Science Technology and Research) Department of Physics Faculty of Science National University of Singapore

Optical imaging is a promising method to identify and locate 2D materials efficiently and non-invasively. By putting a 2D material on a substrate, the nanolayer will add to an optical path and create a contrast to the case when the nanolayer is absent. This optical contrast imaging can be used to identify the 2D material and its number of layers. To make the optical imaging process in the laboratories an effective tool, Fresnel Law as a model was used to simulate the optical imaging results of 2D materials(graphene, Mo S2 and MoSe2) on top of different thickness of SiO2and Si wafer in the present investigation. The results provide the details of the optimal conditions(optimal light wavelength and optimal SiO2thickness) to identify and locate single to few 2D nanolayers, which can be used directly in laboratories. The optical contrasts of 1–5 layers of molybdenum disulfide(MoS2) and molybdenum diselenide(MoSe2) were simulated. To the best of our knowledge, it is the first time that the optical contrast results of MoSe2have been reported. In particular, this work highlights the sensitivity of the model on the accuracy of the refractive indices used. It is demonstrated that through computational modeling that optical contrast can allow effective determination of number of layers in few layer 2D materials.

关键词： 2D materials Optical imaging Substrate Fresnel law

Ulcerative colitis in a multiracial Asian country: Racial difference and clinical presentation among Malaysian patients

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World Journal of Gastroenterology 2005年第37期11卷 5859-5862页

作者： Khean-Lee goh Division of Gastroenterology Department of Medicine University of Malaya Kuala Lumpur 50603 Malaysia

AIM： To determine the prevalence of ulcerative colitis （UC） in Malaysian patients and to establish the spectrum of the disease seen in Malaysian patients. METHODS： Data were obtained retrospectively from a review of the medical records of in- and out-patients with a diagnosis of UC at the University Hospital, Kuala Lumpur between 1985 and 1998. RESULTS： There were 45 confirmed cases of UC, of which 3 were foreigners, who were excluded from analysis. Thirty new cases of UC were diagnosed during the study period. Their mean age at presentation was 33.0±10.0 years. The highest prevalence of UC was 17.9/100 000 hospital admissions in the Indians, followed by 11.2/100 000 hospital admissions in the Chinese. The lowest prevalence was 3.7/100 000 hospital admissions in the Malays. The prevalence of UC was significantly higher in the Indians and the Chinese when compared with the Malays with an OR of 4.89 （CI = 2.02-12.24; x^2 = 15.45, P〈0.001） and 3.06 （CI = 1.24-7.78; x^2= 6.30; P= 0.012） respectively. The extent of colonic disease Was similar in the Malay and Indian patients. In contrast, distal or left-sided colitis predominated in the Chinese with an OR of 8.17 （95%CI = 1.31-64.87; x^2 = 5.53, P = 0.02）. Extraintestinal manifestations were uncommon （11.9%）. CONCLUSION： UC is an uncommon disease in Malaysia, but racial differences exist. The Indians had the highest prevalence of UC with the Chinese demonstrating the least extensive disease.

关键词： Ulcerative colitis Asian races Racial differences