A safe-enhanced fully closed-loop artificial pancreas controller based on deep reinforcement learning.

Patients with type 1 diabetes and their physicians have long desired a fully closed-loop artificial pancreas (AP) system that can alleviate the burden of blood glucose regulation. Although deep reinforcement learning (DRL) methods theoretically enable adaptive insulin dosing control, they face numerous challenges, including safety and training efficiency, which have hindered their clinical application. This paper proposes a safe and efficient adaptive insulin delivery controller based on DRL.

Investigating the association between labor pain and cessation of breastfeeding.

Mothers encounter several challenges to sustain breastfeeding until the recommended 6 months of age. There is limited evidence on the impact of women's labor pain experiences upon cessation of breastfeeding. We aimed to investigate the association between women's labor pain experiences, intrapartum interventions, and pre-birth psychological vulnerabilities and cessation of breastfeeding.

Evaluation of Vocal and Pulmonary Health Through Acoustic Analysis of Voice and Respiratory Measurements in People With Long COVID-19 Symptoms.

Background/objectives: The coronavirus disease (COVID-19) pandemic has significantly impacted global health, with Malaysia reporting over 5 million cases as of May 2024. While symptoms like fatigue and breathlessness are commonly reported among COVID-19 patients, limited research exists on the vocal and pulmonary conditions of individuals with long COVID symptoms. This study aims to assess vocal impairments and pulmonary function differences between long COVID patients and healthy controls, addressing gaps in understanding how long COVID affects vocal and respiratory health.

Effectiveness of expressive writing therapy for postpartum women with psychological distress: Meta-analysis and narrative review.

Background: The increasing prevalence of psychological distress among mothers is outpacing the effectiveness of conventional coping methods like cognitive behavioral therapy. The efficacy of alternatives such as writing therapy for maternal psychological well-being remains uncertain due to a lack of extensive research and inconsistent findings.

Objective: The aim of this study was to evaluate the effectiveness of expressive writing therapy in comparison to standard postpartum care for alleviating psychological distress, encompassing symptoms of depression, anxiety, or stress, in postpartum women.

Maternal experiences and preference of maternity services in Singapore: A descriptive qualitative study.

Problem: Little is known about mothers' experiences and preferences for maternity services in Singapore. A more nuanced understanding would identify areas for improvement in perinatal care, reducing the burden on healthcare providers in supporting maternity services.

Background: Expecting mothers are typically referred to hospital-based antenatal and postnatal services in Singapore.

Predictors of functioning in treatment-resistant schizophrenia: the role of negative symptoms and neurocognition.

Introduction: Predictors of functioning are well-studied in schizophrenia, but much less so in treatment-resistant schizophrenia (TRS). In this study, we aim to investigate contributions of schizophrenia symptom domains and neurocognition to predict functioning in a TRS population (n = 146).

Methods: Participants were assessed on the Positive and Negative Syndrome Scale (PANSS), to calculate scores for five symptom factors (Positive, Negative, Cognitive, Depressive and Hostility) and two negative symptom constructs (Diminished Expressivity (DE), and Social Anhedonia (SA) as part of the Motivation and Pleasure-related dimension), based on a previously validated model, modified in accordance with EPA guidelines on negative symptoms assessment.

Underlying beliefs of preventive health behaviours among women with a history of gestational diabetes mellitus: A descriptive qualitative study.

Aims: To explore the underlying beliefs of preventive health behaviours among women with a history of GDM who had low levels of preventive health behaviours during their postpartum period in Singapore.

Methods: This paper reports on the qualitative arm of a mixed method study. The qualitative descriptive design was adopted.

Systematic literature review on reinforcement learning in non-communicable disease interventions.

There is evidence that reducing modifiable risk factors and strengthening medical and health interventions can reduce early mortality and economic losses from non-communicable diseases (NCDs). Machine learning (ML) algorithms have been successfully applied to preventing and controlling NCDs. Reinforcement learning (RL) is the most promising of these approaches because of its ability to dynamically adapt interventions to NCD disease progression and its commitment to achieving long-term intervention goals.

Semantic TRIZ feasibility in technology development, innovation, and production: A systematic review.

The study unfolds with an acknowledgment of the extensive exploration of TRIZ components, spanning a solid philosophy, quantitative and inductive methods, and practical tools, over the years. While the adoption of Semantic TRIZ (S-TRIZ) in high-tech industries for system development, innovation, and production has increased, the application of AI technologies to specific TRIZ components remains unexplored. This systematic literature review is conducted to delve into the detailed integration of AI with TRIZ, particularly S-TRIZ.

Longitudinal post-radiotherapy plasma Epstein-Barr virus DNA trends inform on optimal risk stratification in endemic nasopharyngeal carcinoma.

Objectives: To characterize longitudinal changes in Epstein-Barr virus (EBV) DNA post-radiotherapy in nasopharyngeal carcinoma (NPC) patients, and investigate whether an early (0-2 weeks) or delayed (8-12 weeks) EBV DNA result better predicts for disease-free survival (DFS).

Materials And Methods: Histologically-confirmed NPC patients with ≥1 EBV DNA test quantified using the harmonized BamHI-W polymerase chain reaction-based assay at 0-2 and 8-12 weeks post-radiotherapy were included.

Results: We identified 302 patients with EBV DNA measured at 0-2 weeks post-radiotherapy; of which, 110 (36.

Impact of negative symptoms on health-related quality of life in schizophrenia.

Evidence regarding the association of Negative Symptoms (NS) dimensions with Health-related Quality of Life (HRQoL) is limited and no prior study has looked into contributions of NS domains on HRQoL. This study bridges the gap by examining the associations of NS, its two dimensions (Motivation and Pleasure, and Emotional Expressivity) and five domains (Anhedonia, Avolition, Asociality, Blunted affect and Alogia) with HRQoL in schizophrenia. 274 individuals with schizophrenia were assessed on the Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptom Scale (BNSS).

A Randomized Phase 2 Trial of Nivolumab Versus Nivolumab-Ipilimumab Combination in EGFR-Mutant NSCLC.

Introduction: Although immune checkpoint inhibitors (ICIs) have dramatically improved outcomes for nononcogene-addicted NSCLC, monotherapy with programmed cell death protein-1 (PD1) inhibition has been associated with low efficacy in the EGFR-mutant setting. Given the potential for synergism with combination checkpoint blockade, we designed a trial to test the activity of combination nivolumab (N)-ipilimumab (NI) in EGFR-mutant NSCLC.

Methods: This is a randomized phase 2 study (NCT03091491) of N versus NI combination in EGFR tyrosine kinase inhibitor (TKI)-resistant NSCLC, with crossover permitted on disease progression.

Systematic Literature Review on Visual Analytics of Predictive Maintenance in the Manufacturing Industry.

The widespread adoption of cyber-physical systems and other cutting-edge digital technology in manufacturing industry production facilities may motivate stakeholders to embrace the idea of Industry 4.0. Some industrial companies already have different sensors installed on their machines; however, without proper analysis, the data collected is not useful.

Defining negative symptoms remission in schizophrenia using the Brief Negative Symptom Scale.

Introduction: This study aimed to propose criteria for negative symptoms remission (NSR) in schizophrenia using the Brief Negative Symptom Scale (BNSS).

Material And Methods: 274 participants were assessed on the Positive and Negative Syndrome Scale (PANSS), BNSS and Social and Occupational Functioning Assessment Scale (SOFAS). Two criteria for NSR on the BNSS were proposed - NSR based on the BNSS domains scores (NSR) and NSR based on 5 key items of the BNSS (NSR) A SOFAS score of 61 and above was considered as functional remission (FR).

Perceptions of physical activity during pregnancy among women: A descriptive qualitative study.

Objective: To explore the perceptions on physical activity during pregnancy among pregnant and postpartum women in Singapore.

Design: A descriptive qualitative study. Data were collected through in-depth semi-structured interviews.

Associations of living arrangements with symptoms and functioning in schizophrenia.

Background: Living arrangements and accommodation are closely related, but no study had concurrently investigated their associations with outcomes in schizophrenia. This study seeks to describe and compare socio-demographic, clinical and functioning profiles of people with schizophrenia in different living arrangements and accommodation, and to examine the associations of living arrangements and accommodation with symptomatic remission and functioning.

Methods: Community dwelling outpatients with schizophrenia (n = 276) were inquired on living arrangements, accommodation, socio-demographics and assessed on the Positive and Negative Syndrome Scale (PANSS) and the Social and Occupational Functioning Scale (SOFAS).

Complementary Sequential Circulating Tumor Cell (CTC) and Cell-Free Tumor DNA (ctDNA) Profiling Reveals Metastatic Heterogeneity and Genomic Changes in Lung Cancer and Breast Cancer.

Introduction: Circulating tumor cells (CTCs) and cell-free tumor DNA (ctDNA) are tumor components present in circulation. Due to the limited access to both CTC enrichment platforms and ctDNA sequencing in most laboratories, they are rarely analyzed together.

Methods: Concurrent isolation of ctDNA and single CTCs were isolated from lung cancer and breast cancer patients using the combination of size-based and CD45-negative selection method DropCell platform.

Integrative Profiling of T790M-Negative EGFR-Mutated NSCLC Reveals Pervasive Lineage Transition and Therapeutic Opportunities.

Purpose: Despite the established role of EGFR tyrosine kinase inhibitors (TKIs) in -mutated NSCLC, drug resistance inevitably ensues, with a paucity of treatment options especially in -negative resistance.

Experimental Design: We performed whole-exome and transcriptome analysis of 59 patients with first- and second-generation EGFR TKI-resistant metastatic -mutated NSCLC to characterize and compare molecular alterations mediating resistance in T790M-positive (T790M) and -negative (T790M) disease.

Results: Transcriptomic analysis revealed ubiquitous loss of adenocarcinoma lineage gene expression in T790M tumors, orthogonally validated using multiplex IHC.

Individualized Molecular Profiling for Allocation to Clinical Trials Singapore Study-An Asian Tertiary Cancer Center Experience.

Purpose: Precision oncology has transformed the management of advanced cancers through implementation of advanced molecular profiling technologies to identify increasingly defined subsets of patients and match them to appropriate therapy. We report outcomes of a prospective molecular profiling study in a high-volume Asian tertiary cancer center.

Patients And Methods: Patients with advanced cancer were enrolled onto a prospective protocol for genomic profiling, the Individualized Molecular Profiling for Allocation to Clinical Trials Singapore study, at the National Cancer Center Singapore.

Defining negative symptoms remission in schizophrenia using the Brief Negative Symptom Scale.

Introduction: This study aimed to propose criteria for negative symptoms remission (NSR) in schizophrenia using the Brief Negative Symptom Scale (BNSS).

Material And Methods: 274 participants were assessed on the Positive and Negative Syndrome Scale (PANSS), BNSS and Social and Occupational Functioning Assessment Scale (SOFAS). Two criteria for NSR on the BNSS were proposed - NSR based on the BNSS domains scores (NSR) and NSR based on 5 key items of the BNSS (NSR) A SOFAS score of 61 and above was considered as functional remission (FR).

Association between negative symptom domains and happiness in schizophrenia.

Objective: The study aimed to examine the association between levels of self-reported happiness and different domains and subdomains of negative symptoms (NS), as well as symptomatic remission in schizophrenia.

Methods: 274 individuals with schizophrenia were assessed on the Subjective Happiness Scale (SHS), Positive and Negative Syndrome Scale and Clinical Assessment Interview for Negative Symptoms (CAINS). Multiple linear regressions were used to examine the association between levels of happiness and increasingly specific CAINS NS domains and subdomains, as well as symptomatic remission.

Vocational Profile and Correlates of Employment in People With Schizophrenia: The Role of Avolition.

Objective: Employment was associated with recovery in individuals with schizophrenia. Our study aimed to delineate the vocational profile and investigate factors associated with likelihood of employment in individuals with schizophrenia.

Materials And Methods: 276 community dwelling outpatients with schizophrenia were recruited; 274 completed the Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptom Scale (BNSS).