An Atypical Presentation of Rheumatoid Arthritis as an Asymmetrical Arthropathy.

We report a rare entity of distinctly asymmetrical rheumatoid arthritis (RA) in a 71-year-old Chinese lady with a history of cervical radiculopathy secondary to trauma sustained during childhood. The joints on the side of the paresis were spared from severe clinical and radiological manifestations of RA. We review the plausible mechanisms that could explain the link between neurological impairment and rheumatoid joint involvement.

Population Segmentation Based on Healthcare Needs: Validation of a Brief Clinician-Administered Tool.

Background: As populations age with increasingly complex chronic conditions, segmenting populations into clinically meaningful categories of healthcare and related service needs can provide healthcare planners with crucial information to optimally meet needs. However, while conventional approaches typically involve electronic medical records (EMRs), such records do not always capture information reliably or accurately.

Objective: We describe the inter-rater reliability and predictive validity of a clinician-administered tool, the Simple Segmentation Tool (SST) for categorizing older individuals into one of six Global Impression (GI) segments and eight complicating factors (CFs) indicative of healthcare and related social needs.

Do healthcare needs-based population segments predict outcomes among the elderly? Findings from a prospective cohort study in an urbanized low-income community.

Background: A rapidly ageing population with increasing prevalence of chronic disease presents policymakers the urgent task of tailoring healthcare services to optimally meet changing needs. While healthcare needs-based segmentation is a promising approach to efficiently assessing and responding to healthcare needs at the population level, it is not clear how available schemes perform in the context of community-based surveys administered by non-medically trained personnel. The aim of this prospective cohort, community setting study is to evaluate 4 segmentation schemes in terms of practicality and predictive validity for future health outcomes and service utilization.

Population segmentation based on healthcare needs: a systematic review.

Background: Healthcare needs-based population segmentation is a promising approach for enabling the development and evaluation of integrated healthcare service models that meet healthcare needs. However, healthcare policymakers interested in understanding adult population healthcare needs may not be aware of suitable population segmentation tools available for use in the literature and barring better-known alternatives, may reinvent the wheel by creating and validating their own tools rather than adapting available tools in the literature. Therefore, we undertook a systematic review to identify all available tools which operationalize healthcare need-based population segmentation, to help inform policymakers developing population-level health service programmes.

Can we understand population healthcare needs using electronic medical records?

Introduction: The identification of population-level healthcare needs using hospital electronic medical records (EMRs) is a promising approach for the evaluation and development of tailored healthcare services. Population segmentation based on healthcare needs may be possible using information on health and social service needs from EMRs. However, it is currently unknown if EMRs from restructured hospitals in Singapore provide information of sufficient quality for this purpose.

Policy options for increasing the supply of transplantable kidneys in Singapore.

Kidney transplantation is the preferred treatment for eligible end-stage renal disease patients. However, the supply of donated kidneys has been consistently insufficient to meet the transplantation requirements of the population. In this paper, I discuss the feasibility of several policy options that engage potential donors or key individuals in a Singapore context, including financial and non-financial incentives for deceased/living organ donors and their families, improving actualisation rates of both donation after brain death, donation after cardiac death through quality improvement programmes and remuneration schemes, and a media platform for directed organ donation.

A semi-automated method for patient-specific computational flow modelling of left ventricles.

Patient-specific computational fluid dynamics (CFD) modelling of the left ventricle (LV) is a promising technique for the visualisation of ventricular flow patterns throughout a cardiac cycle. While significant progress has been made in improving the physiological quality of such simulations, the methodologies involved for several key steps remain significantly operator-dependent to this day. This dependency limits both the efficiency of the process as well as the consistency of CFD results due to the labour-intensive nature of current methods as well as operator introduced uncertainties in the modelling process.