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Article: Inpatient Rehabilitation Outcomes after Primary Severe Haemorrhagic Stroke: A Retrospective Study Comparing Surgical versus Non-Surgical Management.

Ong, Poo Lee / Seah, Justin Desheng / Chua, Karen Sui Geok

2023 Volume 13, Issue 8

Abstract: Background: Haemorrhagic stroke, accounting for 10-20% of all strokes, often requires decompressive surgery as a life-saving measure for cases with massive oedema and raised intracranial pressure. This study was conducted to compare the demographics, ... ...

Abstract	Background: Haemorrhagic stroke, accounting for 10-20% of all strokes, often requires decompressive surgery as a life-saving measure for cases with massive oedema and raised intracranial pressure. This study was conducted to compare the demographics, characteristics and rehabilitation profiles of patients with severe haemorrhagic stroke who were managed surgically versus those who were managed non-surgically. Methods: A single-centre retrospective study of electronic medical records was conducted over a 3-year period from 1 January 2018 to 31 December 2020. The inclusion criteria were first haemorrhagic stroke, age of >18 years and an admission Functional Independence Measure (FIM™) score of 18-40 upon admission to the rehabilitation centre. The primary outcome measure was discharge FIM™. Secondary outcome measures included modified Rankin Scale (mRS), rehabilitation length of stay (RLOS) and complication rates. Results: A total of 107 patients' records were analysed; 45 (42.1%) received surgical intervention and 62 (57.9%) patients underwent non-surgical management. Surgically managed patients were significantly younger than non-surgical patients, with a mean age of [surgical 53.1 (SD 12) vs. non-surgical 61.6 (SD 12.3), Conclusions: Our findings suggest that patients with surgically managed haemorrhagic stroke, while older and more dependent on admission to rehabilitation, achieved comparable FIM gains, discharge FIM and discharge home rates after ~8 weeks of rehabilitation. This highlights the importance of rehabilitation, especially for surgically managed haemorrhagic stroke patients.
Language	English
Publishing date	2023-08-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life13081766
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Article: Body morphometry did not affect the accuracy of a second-generation, miniature imageless navigation system for total hip arthroplasty (THA) using a posterior approach.

Ong, Justin / Ong, Christian B / Grubel, Jacqueline / Chiu, Yu-Fen / Lee, Gwo-Chin / Gonzalez Della Valle, Alejandro

Journal of clinical orthopaedics and trauma

2024 Volume 51, Page(s) 102404

Abstract: Introduction: Some modern imageless navigation platforms for total hip arthroplasty (THA) rely on virtual frontal and sagittal planes determined with the patient in the lateral decubitus position. Body morphometry that changes with gender, body mass ... ...

Abstract	Introduction: Some modern imageless navigation platforms for total hip arthroplasty (THA) rely on virtual frontal and sagittal planes determined with the patient in the lateral decubitus position. Body morphometry that changes with gender, body mass index, and other demographic factors may affect accuracy in patient positioning and consequently, navigation accuracy. The objective of this study was to analyze the influence of patient factors on the intraoperative accuracy of a second-generation imageless computer-assisted surgery platform. Methods: 325 consecutive patients undergoing posterior approach, navigated THA arthroplasty for primary osteoarthritis by a single surgeon were retrospectively reviewed. An optic-based imageless navigation system referenced off a generic sagittal and coronal plane was used to determine acetabular inclination and anteversion. Acetabular accuracy was determined by assessing differences between intraoperative values and those obtained from measuring standardized 6-week follow-up radiographs. The effect of age, gender, BMI, race, ethnicity, and laterality on acetabular accuracy was assessed via t-tests, Pearson correlation and ANOVA. Results: Gender had a significant impact on raw inclination accuracy (females and males had an average error of 1.41° and -1.03°, respectively - p < 0.001). There was a weak correlation between acetabular accuracy and patient age and BMI as a continuous variable (both absolute γ < 0.2). No difference was found between acetabular accuracy and BMI groups. Conclusion: This second-generation imageless computer assisted device provided accurate cup positioning regardless of patient's BMI. Gender was the only factor impacting inclination accuracy.
Language	English
Publishing date	2024-04-10
Publishing country	India
Document type	Journal Article
ZDB-ID	2596956-0
ISSN	2213-3445 ; 0976-5662
ISSN (online)	2213-3445
ISSN	0976-5662
DOI	10.1016/j.jcot.2024.102404
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Article ; Online: Improvised dual lumen nasojejunal feeding tube with gastric decompression.

Tan, Justin Ryan L / Tan, Jose A / Co, Arsenio / Ong, Evan G / Corral, Lord Byron

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy

2023 Volume 8, Issue 10, Page(s) 422–425

Abstract: Video 1Improvisation of the nasojejunal tube for gastric outlet obstruction. ...

Abstract	Video 1Improvisation of the nasojejunal tube for gastric outlet obstruction.
Language	English
Publishing date	2023-08-04
Publishing country	United States
Document type	Journal Article
ISSN	2468-4481
ISSN (online)	2468-4481
DOI	10.1016/j.vgie.2023.06.005
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Article ; Online: An international perspective of out-of-hospital cardiac arrest and cardiopulmonary resuscitation during the COVID-19 pandemic.

Ong, Justin / Pourmand, Ali / O'Connell, Francis

The American journal of emergency medicine

2021 Volume 48, Page(s) 340–341

MeSH term(s)	COVID-19 ; Cardiopulmonary Resuscitation ; Emergency Medical Services ; Humans ; Internationality ; Out-of-Hospital Cardiac Arrest/epidemiology ; Out-of-Hospital Cardiac Arrest/therapy ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-06-10
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2021.06.001
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Article ; Online: Development and validation of a deep learning system for detection of small bowel pathologies in capsule endoscopy: a pilot study in a Singapore institution.

Jiang, Bochao / Dorosan, Michael / Leong, Justin Wen Hao / Ong, Marcus Eng Hock / Lam, Sean Shao Wei / Ang, Tiing Leong

Singapore medical journal

2024 Volume 65, Issue 3, Page(s) 133–140

Abstract: Introduction: Deep learning models can assess the quality of images and discriminate among abnormalities in small bowel capsule endoscopy (CE), reducing fatigue and the time needed for diagnosis. They serve as a decision support system, partially ... ...

Abstract	Introduction: Deep learning models can assess the quality of images and discriminate among abnormalities in small bowel capsule endoscopy (CE), reducing fatigue and the time needed for diagnosis. They serve as a decision support system, partially automating the diagnosis process by providing probability predictions for abnormalities. Methods: We demonstrated the use of deep learning models in CE image analysis, specifically by piloting a bowel preparation model (BPM) and an abnormality detection model (ADM) to determine frame-level view quality and the presence of abnormal findings, respectively. We used convolutional neural network-based models pretrained on large-scale open-domain data to extract spatial features of CE images that were then used in a dense feed-forward neural network classifier. We then combined the open-source Kvasir-Capsule dataset (n = 43) and locally collected CE data (n = 29). Results: Model performance was compared using averaged five-fold and two-fold cross-validation for BPMs and ADMs, respectively. The best BPM model based on a pre-trained ResNet50 architecture had an area under the receiver operating characteristic and precision-recall curves of 0.969±0.008 and 0.843±0.041, respectively. The best ADM model, also based on ResNet50, had top-1 and top-2 accuracies of 84.03±0.051 and 94.78±0.028, respectively. The models could process approximately 200-250 images per second and showed good discrimination on time-critical abnormalities such as bleeding. Conclusion: Our pilot models showed the potential to improve time to diagnosis in CE workflows. To our knowledge, our approach is unique to the Singapore context. The value of our work can be further evaluated in a pragmatic manner that is sensitive to existing clinician workflow and resource constraints.
MeSH term(s)	Humans ; Deep Learning ; Capsule Endoscopy/methods ; Pilot Projects ; Singapore ; Neural Networks, Computer
Language	English
Publishing date	2024-03-26
Publishing country	India
Document type	Journal Article
ZDB-ID	604319-7
ISSN	2737-5935 ; 0037-5675
ISSN (online)	2737-5935
ISSN	0037-5675
DOI	10.4103/singaporemedj.SMJ-2023-187
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Article ; Online: Obesity Severity Does Not Associate With Rate, Timing, or Invasiveness of Early Reinterventions After Total Knee Arthroplasty.

Driscoll, Daniel A / Grubel, Jacqueline / Ong, Justin / Chiu, Yu-Fen / Mandl, Lisa A / Cushner, Fred / Parks, Michael L / Gonzalez Della Valle, Alejandro

The Journal of arthroplasty

2024

Abstract: Background: The use of body mass index (BMI) cutoff values has been suggested for proceeding with total knee arthroplasty (TKA) in obese patients. However, the relationship between obesity severity and early reoperations after TKA is poorly defined. ... ...

Abstract	Background: The use of body mass index (BMI) cutoff values has been suggested for proceeding with total knee arthroplasty (TKA) in obese patients. However, the relationship between obesity severity and early reoperations after TKA is poorly defined. This study evaluated whether increased World Health Organization (WHO) obesity class was associated with risk, severity, and timing of reintervention within one year after TKA. Methods: There were 8,674 patients from our institution who had a BMI ≥ 30 and underwent unilateral TKA for primary osteoarthritis between 2016 and 2021. Patients were grouped by WHO obesity class: 4,456 class I (51.5%), 2,527 class II (29.2%), and 1,677 class III (19.4%). A chart review was performed to determine patient characteristics and identify patients who underwent any closed or open reintervention requiring anesthesia within the first postoperative year. Regression analyses were performed to identify variables associated with increased odds ratios (ORs) for requiring a reintervention, its timing, and invasiveness. Results: There were 158 patients (1.8%) who required at least one reintervention, and 15 patients (0.2%) required at least 2 reinterventions. Reintervention rates for obesity classes I, II, and III were 1.8% (n = 81), 2.0% (n = 51), and 1.4% (n = 23), respectively. There were 65 closed procedures (41.1%), 47 minor procedures (29.7%), 34 open with or without liner exchange (21.5%), and 12 revisions with component exchange (7.6%). Obesity class was not associated with reintervention rate (P = .3), timing (P = .36), or invasiveness (P = .93). Diabetes (odds ratio [OR] = 2.47; P = .008) was associated with a need for reintervention. Non-Caucasian race (OR = 1.7; P = .01) and Charlson comorbidity index (OR = 2.1; P = .008) were associated with earlier reintervention. No factors were associated with the invasiveness of reintervention. Conclusions: The WHO obesity class did not associate with rate, timing, or invasiveness of reintervention after TKA in obese patients. These findings suggest that policies that restrict the indication for elective TKA based only on a BMI limit have limited efficacy in reducing early reintervention after TKA in obese patients. Level of evidence: III.
Language	English
Publishing date	2024-02-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2024.02.062
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Article: Defining the Learning Period of a Novel Imageless Navigation System for Posterior Approach Total Hip Arthroplasty: Analysis of Surgical Time and Accuracy.

Ong, Christian B / Ong, Justin M / Grubel, Jacqueline / Chiu, Yu-Fen / Premkumar, Ajay / Lee, Gwo-Chin / Della Valle, Alejandro Gonzalez

Indian journal of orthopaedics

2023 Volume 58, Issue 2, Page(s) 121–126

Abstract: Introduction: The use of imageless navigation in total hip arthroplasty (THA) is frequently associated with prolonged surgical times, predominantly during the learning period. The purpose of the present study was to characterize the learning period of a ...

Abstract	Introduction: The use of imageless navigation in total hip arthroplasty (THA) is frequently associated with prolonged surgical times, predominantly during the learning period. The purpose of the present study was to characterize the learning period of a novel imageless navigation system, specifically as it related to surgical time and acetabular navigation accuracy. Materials and methods: This was a retrospective observational study of a consecutive group of 158 patients who underwent primary unilateral THA for osteoarthritis by a team headed by a single surgeon. All procedures used an imageless navigation system to measure acetabular cup inclination and anteversion angles, referencing a generic sagittal and frontal plane. Navigation accuracy was determined by assessing differences between intraoperative inclination and anteversion values and those obtained from standardized 6-week follow-up radiographs. Operative time and navigation accuracy were assessed by plotting moving averages of 7 consecutive cases. The learning period was defined using Mann-Kendall trend analyses, student Results: The average surgical time was 67.3 min (SD:9.2) (range 45-95). The average navigation accuracy for inclination was 0.01° (SD:4.2) (range - 10 to 10), and that for anteversion was - 4.9° (SD:3.8) (range - 14 to 5). Average surgical time and navigation accuracy were similar between the first and final cases in the series with no learning period detected. Conclusions: There was no discernible learning period effect on surgical time or system measurement accuracy during the early phases of adoption for this imageless navigation system.
Language	English
Publishing date	2023-12-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	603194-8
ISSN	0019-5413
ISSN	0019-5413
DOI	10.1007/s43465-023-01060-9
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Article ; Online: STAGEs: A web-based tool that integrates data visualization and pathway enrichment analysis for gene expression studies.

Koh, Clara W T / Ooi, Justin S G / Ong, Eugenia Ziying / Chan, Kuan Rong

Scientific reports

2023 Volume 13, Issue 1, Page(s) 7135

Abstract: Gene expression profiling has helped tremendously in the understanding of biological processes and diseases. However, interpreting processed data to gain insights into biological mechanisms remain challenging, especially to the non-bioinformaticians, as ... ...

Abstract	Gene expression profiling has helped tremendously in the understanding of biological processes and diseases. However, interpreting processed data to gain insights into biological mechanisms remain challenging, especially to the non-bioinformaticians, as many of these data visualization and pathway analysis tools require extensive data formatting. To circumvent these challenges, we developed STAGEs (Static and Temporal Analysis of Gene Expression studies) that provides an interactive visualisation of omics analysis outputs. Users can directly upload data created from Excel spreadsheets and use STAGEs to render volcano plots, differentially expressed genes stacked bar charts, pathway enrichment analysis by Enrichr and Gene Set Enrichment Analysis (GSEA) against established pathway databases or customized gene sets, clustergrams and correlation matrices. Moreover, STAGEs takes care of Excel gene to date misconversions, ensuring that every gene is considered for pathway analysis. Output data tables and graphs can be exported, and users can easily customize individual graphs using widgets such as sliders, drop-down menus, text boxes and radio buttons. Collectively, STAGEs is an integrative platform for data analysis, data visualisation and pathway analysis, and is freely available at https://kuanrongchan-stages-stages-vpgh46.streamlitapp.com/ . In addition, developers can customise or modify the web tool locally based on our existing codes, which is publicly available at https://github.com/kuanrongchan/STAGES .
MeSH term(s)	Software ; Data Visualization ; Gene Expression Profiling ; Gene Expression ; Internet
Language	English
Publishing date	2023-05-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-34163-2
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Article ; Online: Complication rates following reverse and anatomic shoulder replacement in treatment of glenohumeral arthritis: a 10-year Medicare review study.

Givens, Justin M / Malkani, Arthur L / Ong, Kevin L / Watson, Heather N / Harreld, Kevin L

Journal of shoulder and elbow surgery

2023 Volume 33, Issue 2, Page(s) 273–280

Abstract: Background: We sought to compare the complication rates after anatomic total shoulder arthroplasty (aTSA) and reverse shoulder arthroplasty (RSA) for primary glenohumeral arthritis in a Medicare population.: Methods: Patients who underwent a shoulder ...

Abstract	Background: We sought to compare the complication rates after anatomic total shoulder arthroplasty (aTSA) and reverse shoulder arthroplasty (RSA) for primary glenohumeral arthritis in a Medicare population. Methods: Patients who underwent a shoulder arthroplasty were identified from the 5% subset of Medicare parts A/B between 2009 and 2019. Patients with less than 1-year follow-up were excluded. A total of 8846 patients with a diagnosis of glenohumeral arthritis were then subdivided into those who received aTSA (5935 patients) and RSA (2911 patients). A multivariate Cox regression analysis was then performed comparing complication rates at 3 months, 6 months, 1 year, 2 years, and 5 years. Results: Statistically significant increased rates of instability (hazard ratio [HR] = 1.46), fracture of the scapula (HR = 7.76), infections (HR = 1.45), early revision (HR = 1.79), and all complications (HR = 1.32) were seen in the RSA group. There was no significant difference in revision rate at 5 years between the 2 groups. There was no difference in patient characteristics or comorbid conditions (smoking status, diabetes, Charlson score, etc.) or hospital characteristics (location, teaching status, public vs. private, etc.) between the 2 groups. Conclusion: An increased rate of early complications was observed with the use of RSA compared with aTSA for the treatment of primary glenohumeral arthritis, including instability, scapula fracture, infection, and all cause complication. No difference in revision rate between RSA and aTSA at 5 years was observed.
MeSH term(s)	Aged ; Humans ; Arthritis/surgery ; Arthroplasty, Replacement, Shoulder/adverse effects ; Arthroplasty, Replacement, Shoulder/methods ; Medicare ; Range of Motion, Articular ; Shoulder Fractures/epidemiology ; Treatment Outcome ; United States/epidemiology ; Postoperative Complications/epidemiology
Language	English
Publishing date	2023-07-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1170782-3
ISSN	1532-6500 ; 1058-2746
ISSN (online)	1532-6500
ISSN	1058-2746
DOI	10.1016/j.jse.2023.06.017
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Article: The Incidence and Associated Risk Factors of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Emergency Setting: A Systematic Review.

Ong, Mei-Yi / Koh, Justin Jie-Hui / Kothan, Suchart / Lai, Christopher

Life (Basel, Switzerland)

2022 Volume 12, Issue 6

Abstract: Iodinated contrast media (ICM) during contrast-enhanced computed tomography (CECT) in the emergency department (ED) is essential to diagnose acute conditions, despite risks of contrast-induced nephropathy (CIN) development and its associated ... ...

Abstract	Iodinated contrast media (ICM) during contrast-enhanced computed tomography (CECT) in the emergency department (ED) is essential to diagnose acute conditions, despite risks of contrast-induced nephropathy (CIN) development and its associated complications. This systematic review aims to evaluate the incidence of CIN and CIN-induced complications, and to explore the relevance of classical risk factors for CIN among ED patients receiving ICM. PubMed, Cochrane, and Web of Science were used on 30 August 2021 to search for peer-reviewed English articles reporting on CIN incidence among ED patients aged ≥18 years who underwent an intravenous CECT. The inclusion criteria included studies that were in English, peer-reviewed, and involved ED patients aged ≥18 years who underwent single intravenous CECT. Studies on intra-arterial procedures and preventive strategies, meta-analyses, clinical guidelines, review articles, and case reports were excluded. The JBI critical appraisal checklist was applied to assess the risk of bias. In total, 18 studies were included wherein 15 were retrospective studies while three were prospective studies. We found a relatively higher CIN incidence in the ED, with variations owing to the CIN definitions. Several classical risk factors including acute hypotension remain linked to CIN onset in ED settings unlike factors such as age and diabetes. While risk of adverse renal events due to CIN is low, there is higher risk of CIN-induced mortality in the ED. Therefore, with the higher incidence of CIN and CIN-induced mortality rates in the ED, ICM administration during CECT in the ED should still be clinically justified after assessing both benefits and risks.
Language	English
Publishing date	2022-06-01
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life12060826
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