Publications by authors named "Chia P"

Population aging has become a prevalent societal trend in the 21st century, giving rise to intricate challenges for healthcare systems. Taiwan is expected to become a "super-aging society" in 2025. In 2020, the Health Promotion Administration, referencing World Health Organization (WHO) guidelines on integrated care for older people (ICOPE), began promoting person-centered functional assessments for older adults to prevent and delay disability, reduce reliance on formal healthcare, and promote healthy aging, aging in place, and active aging.

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Mathematical models of viral dynamics are crucial in understanding infection trajectories. However, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load data often includes limited sparse observations with significant heterogeneity. This study aims to: (1) understand the impact of patient characteristics in shaping the temporal viral load trajectory and (2) establish a data collection protocol (DCP) to reliably reconstruct individual viral load trajectories.

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Objectives: Subclinical tuberculosis (TB) is challenging to diagnose due to the lack of a clear definition and symptoms. This study aimed to describe the subclinical disease spectrum among people with culture-confirmed pulmonary TB routinely diagnosed in Singapore, a country with moderate incidence, using different definitions. It also aimed to identify risk factors for subclinical TB and the current diagnostic approaches in detecting subclinical TB.

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Background: This systematic review and meta-analysis aimed to analyze the effects of transfusing "nonpacked red blood cell" blood products in patients with dengue and evaluate the effectiveness in reducing mean hospital stay, bleeding, mortality rate, and intensive care unit requirements.

Methods: Four databases were searched for relevant articles. Inclusion criteria were prospective or retrospective randomized or nonrandomized studies investigating the effects of transfusion of blood products in patients with dengue.

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  • Biomarker guided therapy can enhance treatment for COVID-19 patients, with a focus on evaluating the effectiveness of point-of-care (POC) antibody tests in this context.* -
  • Two POC tests, LumiraDX and RightSign, were assessed for their reliability and ease of use against a standard test, with both showing moderate agreement but differing in accuracy and usability.* -
  • The RightSign test was found to be easier to use and more effective at identifying patients without antibodies compared to the LumiraDX test, despite both tests being associated with clinical outcomes.*
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Background: BBV152 (Covaxin™) is a whole-virion inactivated SARS-CoV-2 vaccine mixed with an immune adjuvant. We aimed to compare immune responses after booster vaccination with heterologous BBV152 versus homologous mRNA vaccine.

Methods: We conducted a randomized, participant-blinded, controlled trial.

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  • - A study evaluated the immune responses from two types of booster vaccinations (homologous BNT162b2 and heterologous mRNA-1273) in individuals who had previously received BNT162b2 and had not been infected with SARS-CoV-2.
  • - The results showed that those who received the heterologous booster had significantly higher antibody levels against wild-type SARS-CoV-2 six months after vaccination, and many participants experienced Omicron breakthrough infections regardless of the booster type.
  • - The findings suggest that while booster shots are beneficial, the immune response decreases significantly over time, highlighting the need for timely booster administration before infection surges. !*
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  • A study was conducted in Singapore to explore whether having a prior dengue infection affects the risk and severity of getting COVID-19, particularly in a population where both diseases can overlap.
  • Researchers analyzed data from over 3 million individuals, looking at the relationship between prior dengue infections and subsequent SARS-CoV-2 cases during a time of increased COVID-19 transmission from Delta and Omicron variants.
  • The findings revealed that prior dengue infections slightly increase the risk of contracting SARS-CoV-2 and significantly heighten the likelihood of hospitalization and severe outcomes from COVID-19.
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Background: Patients with EGFR-mutated non-small-cell lung cancer (NSCLC) and MET amplification as a mechanism of resistance to first-line osimertinib have few treatment options. Here, we report the primary analysis of the phase 2 INSIGHT 2 study evaluating tepotinib, a highly selective MET inhibitor, combined with osimertinib in this population.

Methods: This open-label, phase 2 study was conducted at 179 academic centres and community clinics in 17 countries.

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  • Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a serious autoimmune disorder caused by the immune system attacking NMDA receptors in the brain, and there has been a lack of comprehensive studies on its prevalence and associated factors.
  • This study aimed to assess how common anti-NMDAR encephalitis is among patients with certain medical conditions and identify risk factors associated with it.
  • The results revealed that about 7% of patients with related medical conditions were affected, with those experiencing a first episode of psychosis or schizophrenia being significantly more at risk.
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Background: Door-to-balloon time (DTBT) for ST-elevation myocardial infarction (STEMI) is a performance metric by which primary percutaneous coronary intervention (PPCI) services are assessed.

Methods: Consecutive patients presenting with STEMI undergoing PPCI between January 2007 to December 2019 from the Singapore Myocardial Infarction Registry were included. Patients were stratified based on DTBT (≤60 min, 61-90 min, 91-180 min) and Killip status (I-III vs.

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Objectives: The emergence of new SARS-CoV-2 variants has led to the development of Omicron-targeting bivalent mRNA vaccines. It is crucial to understand how bivalent vaccines may improve antibody responses against new variants.

Methods: A total of 107 participants, who had three COVID-19 WT mRNA vaccine doses, were recruited, and given either a monovalent (WT) or a bivalent mRNA vaccination (Pfizer/BioNTech Bivalent (WT and BA.

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Background: While persistence of chronic symptoms following dengue infection has been documented in small prospective cohorts, population-based studies are limited. The post-acute risk of new-incident multi-systemic complications following dengue infection was contrasted against that following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a multi-ethnic adult Asian population.

Methods: National testing and healthcare claims that databases in Singapore were utilized to build a retrospective population-based adult cohort with laboratory-confirmed infection during overlapping waves of SARS-CoV-2 and dengue transmission (1 July 2021 to 31 October 2022).

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There is a lack of evidence on the optimal administration of intravenous (IV) fluids in hospitalized adult dengue patients without compensated and hypotensive shock. This study utilized a well-established cohort of dengue patients to compare risks of progressing to severe dengue (SD) over time for patients who were administered IV fluid versus others who were not. We included adult patients (n = 4781) who were hospitalized for dengue infection from 2005 to 2008.

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  • - The study aims to evaluate heart rate variability (HRV) as a tool for measuring job stress and sleep quality in nurses following the COVID-19 pandemic.
  • - It surveyed 403 nurses in Taiwan, revealing that 72.7% experienced poor sleep quality, with job stress being a significant factor influencing work frustration and decreased HRV.
  • - The findings suggest HRV can effectively monitor nurses' well-being, highlighting the need for targeted interventions to help those facing high job stress and sleep issues.
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Dengue is a mosquito-borne viral disease which causes significant morbidity and mortality each year. Previous research has proposed several mechanisms of pathogenicity that mainly involve the dengue virus and host humoral immunity. However, innate immune cells, such as neutrophils, may also play an important role in dengue, albeit a much less defined role.

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  • Limited research has examined how resistance exercise (RE) combined with whole body vibration (WBV) and blood flow restriction (BFR) affects working memory (WM) in older adults, particularly regarding molecular and neurophysiological mechanisms.
  • A study involving 66 participants found that while reaction times and P3 latencies were unaffected, accuracy rates and P3 amplitudes improved significantly in the WBV and WBV + BFR groups, with the latter showing the most improvement.
  • Additionally, both IGF-1 and norepinephrine levels increased across all groups after the exercise intervention, with only norepinephrine levels correlated with improvements in accuracy, suggesting that these combined exercises may help reduce cognitive decline in older individuals.
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The adrenal haemangioma, a rare benign vascular tumour, is increasingly detected through abdominal imaging. Just over 70 surgical cases have been reported since 1955. Their potential large size and overlapping imaging features with adrenocortical carcinoma poses a diagnostic challenge.

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Inadvertent dural puncture and post-dural puncture headache are complications of labour epidural analgesia and may result in acute and chronic morbidity. Identification of risk factors may enable pre-emptive management and reduce associated morbidity. In this retrospective cohort study, we aimed to identify factors associated with an inadvertent dural puncture or post-dural puncture headache by identifying parturients who received labour epidural analgesia from January 2017 to December 2021.

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Introduction: Several risk factors found to be associated with postoperative complications and cancer surgery, which carry a significant morbidity risk to cancer patients. Therefore, prehabilitation is necessary to improve the functional capability and nutritional status of a patient prior to surgery, so that the patient can withstand any postoperative activity and associated deterioration. Thus, this study aims to assess the effectiveness of prehabilitation interventions on the functional status of patients with gastric and oesophageal cancer who underwent esophagectomy and gastrectomy.

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Since 2020, the coronavirus disease 2019 (COVID-19) pandemic has seen many changes in our daily infection prevention behaviours so as to reduce healthcare-associated transmission of COVID-19 in patients and healthcare workers. In the early phases of the COVID-19 pandemic of 2020, there was much emphasis on compliant personal protective equipment utilization in the operating theatres (OTs) for COVID-19-positive patients. However, during this period, there was a lack of international validated protocols on the appropriate handling and subsequent storage of personal protective equipment in the context of aerosol-generating procedures in OTs for asymptomatic antigen rapid test (ART)-negative patients.

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Cardiac pacing has been an established therapy for bradyarrhythmia due to sinus or atrioventricular nodal disease since the 1950s. However, contemporary studies have shown that conventional right ventricular pacing (RVP) causes electromechanical dyssynchrony, which can lead to atrial fibrillation, heart failure and even death. Recently, the push for a more physiological cardiac pacing has seen a revival in the utilisation and development of conduction system pacing (CSP).

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Ambient sensors can continuously and unobtrusively monitor a person's health and well-being in everyday settings. Among various sensing modalities, wireless radio-frequency sensors offer exceptional sensitivity, immunity to lighting conditions, and privacy advantages. However, existing wireless sensors are susceptible to environmental interference and unable to capture detailed information from multiple body sites.

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