Digital Commons Network^™

The New Era Of Arrhythmia Care: Innovation, Intervention & Issues, Chu-Pak Lau, Ngai-Yin Chan

Journal of the Hong Kong College of Cardiology

No abstract for this article type

Oral Anticoagulation In The Era Of Continuous Rhythm Monitoring, Chu-Pak Lau, Hung-Fat Tse

Journal of the Hong Kong College of Cardiology

Background

Primary prevention of stroke using oral anticoagulants (OACs) is indicated for clinical atrial fibrillation (AF) documented on standard electrocardiogram (ECG) in those patients with a high risk of stroke. The recent availability of both external ECG monitors (either using consumer electronic or medical devices) and implantable devices have enabled earlier AF episodes to be detected before clinical AF become manifest. These episodes, often termed subclinical AF (SCAF), represent an area of controversy for the application of OAC.

Objective

The present review summarises the management of SCAF, based on recent guidelines and publications in the following areas:

1. In the presence …

Will Conduction System Pacing Replace Biventricular Pacing For Treating Heart Failure In Patients With Wide Qrs Duration?, Chan Yat Sun Joseph

Journal of the Hong Kong College of Cardiology

Conduction system pacing CSP) is an emerging therapy for resynchronization of patients with heart failure and wide QRS duration. It has been proposed to replace cardiac resynchronization therapy with biventricular pacing (CRT with BVP) mainly because of shortcoming of CRT with BVP including failure to implant coronary sinus leads and unsatisfactory response in certain subset of heart failure patients. The current evidence for CSP in heart failure patients with wide QRS duration is reviewed and the gap in evidence in supporting CSP to replace CRT with BVP is discussed.

Associations Between Five-Year Blood Pressure Variability And Risk Of Cardiovascular Events And Mortality: A Territory-Wide Family Medicine Cohort Study, Jiandong Zhou, Sharen Lee, Wing Tak Wong, Keith Sai Kit Leung, Wai Kit Ming, Tong Liu, Kamalan Jeevaratnam, Bernard Man Yung Cheung, Gary Tse, Qingpeng Zhang

Journal of the Hong Kong College of Cardiology

Introduction: Blood pressure variability, in addition to blood pressure itself, has been used as a predictor for mortality. This study examined the predictive power of baseline/latest/mean/median blood pressure and blood pressure variability measures for all-cause mortality and adverse cardiovascular outcomes.

Methods: The retrospective observational study analyzed patients who presented to family medicine clinics between 1^st January, 2000 and 31^st December, 2001. Blood pressure measurements were obtained over a five-year period. Standard deviation (SD), root mean square (RMS), coefficient of variation (CV) and a variability score (number of >=5 mmHg blood pressure change) were used as measures of blood …

32nd Annual Scientific Congress Of Hong Kong College Of Cardiology Proceeding

Journal of the Hong Kong College of Cardiology

No abstract provided.

Challenges Faced In Managing The Hemodynamic Status Due To Recurrent Gastrointestinal Bleeding In Typhoid Fever With Uncorrected Double Outlet Right Ventricle Patient: A Case Report, Kellyn Trycia Zenjaya, Lindawati Wijoyo, Jovan Amadeo Muliyanto, Rizqi Rokhmadhoni Pikir, Dwi Putri Lestari, Esthy Poespitaningtyas

Journal of the Hong Kong College of Cardiology

Double Outlet Right Ventricle (DORV) is a rare cyanotic congenital heart defect often associated with polycythemia and bleeding risk. A 7-year-old boy with uncorrected DORV presented with fever, melena, and shock. He was cyanotic, tachypneic, and tachycardic, with SpO₂ of 68% and a harsh ejection systolic murmur. Labs showed anemia, thrombocytopenia, leukocytosis, and prolonged APTT. Tubex TF IgM was strongly positive. A diagnosis of typhoid fever with gastrointestinal bleeding and uncorrected DORV was made. Management included oxygen, inotropes, and fluid resuscitation. Propranolol was withheld. Severe infection with underlying cyanotic heart disease and coagulopathy presents a critical management dilemma.

Comparison Of Clinical Outcomes Between Provisional Stenting And Two-Stent Approach For True Left Main Bifurcation Lesions In The Era Of Imaging Guided Percutaneous Coronary Intervention, Ming Leo Lau, Ho Fai Daniel Fong, Nim Pong Kwong

Journal of the Hong Kong College of Cardiology

Background

Currently there are two strategies in Percutaneous Coronary Intervention (PCI) of the true left main (LM) bifurcation lesions: provisional stenting and two-stent technique. The optimal treatment strategy for true LM bifurcation lesions is undetermined. In addition, the percentage of use of imaging-guiding in these studies was low. We would like to undertake a retrospective cohort study to compare the clinical outcomes of provisional stenting versus two-stent technique in treating the true LM bifurcation lesions with the help of intravascular imaging.

Methods

Data of consecutive patients undergoing PCI of true LM bifurcation lesions in Yan Chai Hospital from January, 2018 …

10th Asian Preventive Cardiology And Cardiac Rehabilitation Conference

Journal of the Hong Kong College of Cardiology

No abstract provided.

27th Asc Of Icsm Proceedings

Journal of the Hong Kong College of Cardiology

No abstract provided.

An Unusual Cause Of Acute Constrictive Pericarditis, Yue Hin Tang, Raymond Chi Yan Fung

Journal of the Hong Kong College of Cardiology

Constrictive pericarditis, a condition where the pericardium thickens and constricts, has long been considered as a chronic sequela of prior insults to the pericardium such as heart surgery, repeated pericarditis, tuberculosis infection, radiation exposure, etc. Susceptible populations are thus expected to be middle-aged.

We present a case in which a young gentleman was diagnosed with acute constrictive pericarditis due to Adult-onset Still’s disease with macrophage activation syndrome. This case illustrated that constrictive pericarditis could happen in acute settings and thus the importance of cardiologists to maintain open-minded in search of a diagnosis

Bridging Awareness, Risk, And Innovation In Peripheral Arterial Disease, Guang-Ming Tan, Bryan P. Yan

Journal of the Hong Kong College of Cardiology

No abstract for this article type.

Machine Learning-Based Risk Stratification For Limb-Related Outcomes In Peripheral Artery Disease Patients Undergoing Percutaneous Transluminal Angioplasty, Yujia Zhang, Zhoudong Jing, Zhiqiang Liu, Angel Lai, Guangming Tan, Bryan P Yan

Journal of the Hong Kong College of Cardiology

Background: Patients with peripheral artery disease (PAD) remain at high risk of mortality and major adverse limb events (MALE) after endovascular revascularization, yet outcome prediction tools are limited. We apply machine learning (ML) to improve prognostic stratification in this population. Methods: PAD patients undergoing percutaneous transluminal angioplasty (PTA) between 2007 and 2024 were included. The primary endpoint was 1-year major adverse limb events (MALE) or all-cause death. Data were divided into training (70%) and testing (30%) sets. Six ML models were developed, and performance was evaluated using the area under the receiver operating characteristic curve (AUC). Feature importance and risk …

Machine Learning For Computer-Aided Diagnostics From Complex Medical Images, Afsah Saleem

Theses: Doctorates and Masters

Machine learning has significantly transformed medical image analysis in the current age of artificial intelligence offering vast potential in improving disease diagnosis and management. Cardiovascular diseases (CVDs) are among the leading cause of global mortality, emphasizing the need for early detection for effective intervention and prevention. Abdominal Aortic Calcification (AAC) is an early indicator and contributor to Atherosclerotic Cardiovascular Diseases (ASCVDs) and is commonly assessed through imaging modalities such as computed tomography (CT), X-rays, and Dual-energy X-ray Absorptiometry (DXA). Among these, lateral spine DXA scans, commonly used for osteoporosis screening, offer a cost-effective and low-radiation opportunity for opportunistic CVD risk …

The First International Study Into The Characteristics And Statistical Effectiveness Of Treatment For Indigenous And First Nations People Who Have Sexually Offended: A Meta-Analysis And Survey Of Routine Practice, James Finney

Theses: Doctorates and Masters

Psycho-criminological literature has continued to examine post-treatment recidivism outcomes homogeneously for people who have sexually offended. Because results indicate clear differences between Indigenous and non-Indigenous people who have sexually offended, this project set out to understand the characteristics and effectiveness of treatment for Indigenous and First Nations people from four jurisdictions: Australia, New Zealand, Canada and the United States. A strategic three study strategy was implemented and resulted in a systematic narrative synthesis, meta-analysis and survey of sexual offender treatment organisations in Australia. The systematic review used a comprehensive and scientifically rigorous approach to identify studies (k = 14) that …

The Interplay Between Injury And Body Composition With Performance In Police Recruits, Vanessa Sutton

Theses: Doctorates and Masters

The occupational demands of policing are challenging and potentially hazardous, with substantial rates of musculoskeletal injuries occurring during recruit training. Academy injury prevalence can be as high as one in five recruits. Injuries impact performance, result in lost training, and impose financial burdens on police agencies. However, limited research has explored pre-injury body composition or musculoskeletal characteristics in relation to police recruit performance. This thesis investigates injuries, body composition and musculoskeletal characteristics in physical performance and injury risk among law enforcement recruits.

Study One quantified prevalence and severity of pre-academy injuries and association with performance. Among 121 recruits, nearly half …

The Role Of Game-Based Learning Simulation To Enhance Leadership In Pandemic Preparedness For Nursing Students, Scott James Andrews

Theses: Doctorates and Masters

During the COVID-19 pandemic, nurses around the world suffered with the impact of resource scarcity on the provision of quality nursing care to patients. Nursing staff were at higher risk of infection than all other healthcare workers, with working conditions during the pandemic resulting in significant staffing pressures. The challenges faced by staff during the pandemic inevitably influenced the quality and delivery of clinical education, highlighting the need for innovative solutions such as digital learning to address emerging training needs. Further, the impact of COVID-19 restrictions on clinical education has highlighted the benefits of digital learning environments as alternatives to …

Resilience Among Undergraduate First-Year Students: The Differential Effects Of Gender, And Socioeconomic Status, Sahanowas Sk, Santoshi Halder

Journal of Educational and Psychological Studies

Resilience, as a multidimensional psychological construct, may vary with respect to personal characteristics such as gender and social context like socio-economic status, particularly in the Indian context. The researchers aim to explore the effects of gender (male and female) and socioeconomic status (low, moderate & high) on resilience and further investigate whether the effect of gender is independent of different levels of SES. The quantitative survey study included 490 first-year undergraduates (M = 18.97, SD = .83) from three districts of West Bengal. The questionnaire comprised socio-demographic data and the adapted Bengali version of the Connor-Davidson Resilience Scale (CD-RISC). The …

Developing Memory And Understanding Skills For Subject-Specific Knowledge Processing And To Face High-Stakes Exams: A Case Study, Jabbar Al Muzzamil Fareen

Journal of Educational and Psychological Studies

University students possess different levels of language and cognitive abilities in gaining their subject knowledge and face tremendous challenges to get through the exams in distinction. The present education system expects the students to possess excellent subject knowledge and outstanding results in their exams. In light of this context, this paper attempts to address how students are engrossed in learning difficulties while subject knowledge processing and facing their examinations. Qualitative case study approach has been undertaken to analyze the language and cognitive skills of the students in memory processing of their subject knowledge to face the exams. Their language learning …

Deep Brain Stimulation For Childhood Treatment-Resistant Obsessive-Compulsive Disorder: Mental Health Clinician Views On Candidacy Factors, Ilona Cenolli, Tiffany A Campbell, Natalie Dorfman, Meghan Hurley, Jared N Smith, Kristin Kostick-Quenet, Eric A Storch, Jennifer Blumenthal-Barby, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Deep brain stimulation (DBS) is approved under a humanitarian device exemption to manage treatment-resistant obsessive-compulsive disorder (TR-OCD) in adults. It is possible that DBS may be trialed or used clinically off-label in children and adolescents with TR-OCD in the future. DBS is already used to manage treatment-resistant childhood dystonia. Evidence suggests it is a safe and effective intervention for certain types of dystonia. Important questions remain unanswered about the use of DBS in children and adolescents with TR-OCD, including whether mental health clinicians would refer pediatric patients for DBS, and who would be a good candidate for DBS.

Objectives: …

The Mental Health Of Cardiology Fellows In Training, Juan Simon Rico-Mesa, Suman M Atluri, Maria Antonia Rico-Mesa

The Texas Heart Institute Journal

No abstract provided.

Sequelae And Surgical Management Of Giant Cardiac Myxoma, Norvin Hernandez, Michael Dileo, Christopher K Wong, Mahboob Alam

The Texas Heart Institute Journal

Cardiac myxomas are a rare phenomenon within the general population, and although there are reports of them, giant myxomas are not common in the medical literature. This report presents a case of a giant left atrial cardiac myxoma in a 57-year-old female patient who was largely asymptomatic until she presented with a diffuse thromboembolic stroke. This case report highlights the importance of surgical management of cardiac myxomas and discusses the difference in open vs minimally invasive surgical resection of giant cardiac myxomas.

The Infected Diabetic Foot: Risk Factors For Re-Infection After Treatment For Diabetic Foot Osteomyelitis, Lawrence A Lavery, Mario C Reyes, Bijan Najafi, Tyler L Coye, Matthew Sideman, Michael C Siah, Arthur N Tarricone

Center on Aging Staff Publications

Our objective was to evaluate risk factors for re-infection in patients after treatment for diabetic foot osteomyelitis (OM). We used pooled patient level data from two RTCs that evaluated patients with diabetic foot infections. We evaluated 171 patients with OM. OM was confirmed with bone culture or histopathology. Data from the 12-month follow-up were used to determine clinical outcomes. Re-infection occurred in 47 (27.5%) patients. Risk factors for re-infection were Toe Brachial Index < 0.40 (25.7% vs. 9.8%, p = 0.02), skin perfusion pressure < 40 mmHg (6.3% vs. 5.9%, p = 0.04), wound healing (55.3% vs. 75.0%, p = 0.01), time to heal (156.0, 69.5-365 vs. 91.5, 38.8-365, p = 0.001), and history of MI (14.9% vs. 3.2%, p = 0.005). During 12-month follow-up, patients with re-infections were 198.8 times more likely to require a foot related hospitalisation (81.8% vs. 0.0%, p = 0.001), 10.4 times more likely have an all-cause hospitalisation (70.2% vs. 18.5%, p = 0.001) and 9.4 times more likely to need an amputation (36.2% vs. 5.6%, p = 0.001). Patients with re-infection had a significantly longer median length of hospitalisation (20.0, 13.5-34.5 vs. 14.0, 10.0-22.0, p = 0.003) and median length of antibiotic duration (55.0, 35.0-87.0 vs. 46.0, 22.8-68.0, p = 0.03). Patients with re-infection are less likely to heal and have more foot-related hospitalizations and amputations.

Advancing Medical Applications Of Cancer Nanotechnology: Highlighting Two Decades Of The Nci's Nanotechnology Characterization Laboratory Service To The Research Community, Rachael M Crist, Yechezkel Barenholz, Ahuva Cern, Kate N Clark, Pieter R Cullis, Cheryl Dean, Neil Desai, Mauro Ferrari, Matthieu Germain, Carmen A Giacomantonio, Emma Grabarnik, Piotr Grodzinski, Atara Hod, Barry E Kennedy, Ruvanthi N Kularatne, Glen S Kwon, Emmanuel Loeb, Erin B Noftall, Len Pagliaro, Morteza Rasoulianboroujeni, Alexander Roth, Darren Rowles, Kulbir Singh, Nicole F Steinmetz, Zhanna Yehtina, Yao Zhang, Daniel Zilbersheid, Jeffrey D Clogston, Stephan T Stern, Marina A Dobrovolskaia

Center for Medical Ethics and Health Policy Staff Publications

The Nanotechnology Characterization Laboratory (NCL) is a US federally funded resource providing characterization and expertise to the cancer nanomedicine research community. Founded as a formal partnership among the US National Cancer Institute (NCI), the US Food and Drug Administration (FDA), and the US National Institute of Standards and Technology (NIST), the NCL has spent two decades developing a one-of-a-kind service with broad multidisciplinary expertise to meet the needs of a rapidly evolving drug development field. To mark the 20th anniversary of the lab's founding, the NCL hosted a symposium to highlight the achievements of the cancer nanomedicine field, showcase novel, …

The Pointer Imaging Baseline Cohort: Associations Between Multimodal Neuroimaging Biomarkers, Cardiovascular Health, And Cognition, Theresa M Harrison, Tyler Ward, Jacinda Taggett, Pauline Maillard, Samuel N Lockhart, Youngkyoo Jung, Laura C Lovato, Robert Koeppe, William J Jagust, Danielle Harvey, Joseph C Masdeu, Hwamee Oh, Darren R Gitelman, Neelum T Aggarwal, Mark A Espeland, Maryjo L Cleveland, Rachel Whitmer, Sarah Tomaszewski Farias, Stephen Salloway, Valory Pavlik, Melissa Yu, Christine Tangney, Heather Snyder, Maria Carrillo, Laura D Baker, Prashanthi Vemuri, Charles Decarli, Susan M Landau

Staff and Researcher Publications

Introduction: The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) is evaluating lifestyle interventions in older adults at risk for cognitive decline and dementia. Here we characterize the baseline data set of the POINTER Imaging ancillary study.

Methods: Participants underwent health and cognitive assessments and neuroimaging with multimodal positron emission tomography (PET) (beta-amyloid [Aβ] and tau) and magnetic resonance imaging (MRI). Framingham risk score (FRS) was used to quantify cardiovascular disease (CVD) risk.

Results: A total of 1052 participants (31% from underrepresented ethnoracial groups) were enrolled. Compared to Aβ-, Aβ+ (29%) participants were older, …

Flyphonedb2: A Computational Framework For Analyzing Cell-Cell Communication In Drosophila Scrna-Seq Data Integrating Alphafold-Multimer Predictions, Mujeeb Qadiri, Ying Liu, Ah-Ram Kim, Myeonghoon Han, Eric Zhou, Austin Veal, Tzu-Chiao Lu, Hongjie Li, Yanhui Hu, Norbert Perrimon

Center on Aging Staff Publications

Cell-cell communication (CCC) plays a critical role in the physiological regulation of organisms and has been implicated in numerous diseases. Previously, we introduced FlyPhoneDB, a tool designed to explore CCC in Drosophila single-cell RNA-sequencing datasets. The core algorithm of FlyPhoneDB infers tissue-specific signaling events between cell types by calculating cell-cell interaction scores based on curated ligand-receptor (L-R) expression across major signaling pathways. However, the utility of FlyPhoneDB was limited by the relatively small number of available L-R pairs.

Here, we present FlyPhoneDB2, a major upgrade featuring a significantly expanded knowledgebase that includes a greater number of L-R pairs, incorporating annotations …

The Human Spinothalamic Tract: Lessons From Cordotomy, Anthony K Allam, Michael Benjamin Larkin, Ishan A Patel, Mohammed Hasen, David Mears, Patrick Dougherty, Ashwin Viswanathan

Faculty, Staff and Student Publications

The spinothalamic tract has long been known as a primary conductor of nociceptive information, with its anatomical and physiological understanding evolving over centuries of research. This comprehensive review traces the history of the spinothalamic tract beginning with Brown-Sequard’s 1860 report of contralateral analgesia following a hemisection of the spinal cord. As clinical and surgical interventions, such as cordotomies have advanced, so did our understanding of the spinothalamic tract’s function and anatomy. The spinothalamic tract’s role as a crossed pathway conducting pain and temperature sensations was solidified by the mid-20th century. However, intricate details of its somatotopic arrangement, anatomical distributions and …

Characterizing Fermentable Carbohydrate Foods In The Diets Of Children With Abdominal Pain-Related Disorders Of Gut-Brain Interaction And Healthy Children, Vishnu Narayana, Jocelyn Chang, Ann R Mcmeans, Tasha Murphy, Rona L Levy, Robert J Shulman, Bruno P Chumpitazi

Children’s Nutrition Research Center Staff Publications

Objectives: Restricting dietary fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) can alleviate symptoms in children with disorders of gut-brain interaction (DGBI). Due to the restrictions of a low FODMAP diet (LFD), a less restrictive FODMAP Gentle diet (FGD) has been suggested. However, the types and amounts of high FODMAP foods and carbohydrates commonly consumed by children have not been studied. We aimed to identify the high FODMAP foods and proportions of FODMAP carbohydrates consumed by children with DGBI and healthy children (HC) and to determine which usually ingested FODMAPs would be restricted on the FGD.

Methods: Three-day diet records from …

The Impact Of Insurance On Adolescent Transition To Adult Care, Diane V Murrell, Cassandra J Enzler, Lauren Bretz, Beth H Garland, Albert C Hergenroeder, Christine Markham, Constance M Wiemann

Faculty, Staff and Student Publications

Background: This study sought to examine how adolescents and young adults with special health care needs (AYA) prepare for managing medical insurance (private and public) as an adult and the role of insurance in locating an adult provider and engaging in care.

Methods: Twenty-eight AYA aged 18-24 years with renal, inflammatory bowel, or rheumatologic diseases completed individual semi-structured interviews designed to evaluate the impact of insurance (private vs. public) on their health care transition experiences. An interdisciplinary team of coders analyzed transcripts using The Framework Method.

Results: Three themes emerged: continuum of accepting health insurance responsibility; the impact of insurance …

Long-Term Health-Related Quality Of Life In Kawasaki Disease-Related Coronary Artery Aneurysm: A Large Single-Center Assessment In Nanjing, China, Yun Zhou, Mei Chen, Wenting Gao, Yu Chen, Ying Meng

The Texas Heart Institute Journal

BACKGROUND: The impact of coronary artery aneurysms (CAAs) caused by Kawasaki disease (KD) on long-term health-related quality of life (HRQOL) in children has not been well documented.

METHODS: This study investigated long-term HRQOL in a large sample of children diagnosed with KD-related CAAs. A case-control, retrospective study included 66 patients with KD-related CAAs. A total of 98 hospitalized patients were matched as controls based on age and sex: 49 patients were allocated to a group with pneumonia and 49 patients were allocated to a group with arterio-arterial fistula. Both child-reported and parent-proxy-reported Pediatric Quality of Life Inventory surveys were collected. …

Double Atrial Septum With Interatrial Space In Patients Experiencing Ischemic Attack, Blerim Berisha, Fadhel Hamidani, Mathias Humm

The Texas Heart Institute Journal

No abstract provided.