Publications by authors named "Mark I Chen"

Background: Trust in governments has been decreasing in recent years, especially during the Covid-19 pandemic, where low-trust societies showed reduced compliance with disease control measures. Few studies have examined how trust in authorities changed over the pandemic. This study investigated the trajectory of public trust in the Singapore government's vaccine recommendations during this period.

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Article Synopsis
  • Multiple Omicron sub-lineages, particularly XBB and XBB.1.5, have become the global dominant variants, showcasing their ability to evade immunity despite minor genetic changes from previous variants.
  • Researchers conducted a pseudovirus neutralization test with convalescent sera from individuals who recovered from SARS-CoV infections, including various Omicron subvariants.
  • The findings showed no significant cross-neutralization among the different strains, suggesting that current SARS-related coronaviruses should be classified into three distinct serotypes.
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Introduction: Low-level HIV epidemic settings like Singapore face the challenge of reaching men at-risk who have less contact with programmes. We investigated patterns of meeting platform use by men seeking male sexual partners (MSM) as potential marker of risk to differentiate sub-groups for interventions.

Methods: Latent Class Analysis (LCA) was applied to a survey sample of MSM recruited from bars/clubs, saunas and a smartphone application, using purposive sampling.

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  • Cytosolic nucleic acids activate pattern recognition receptors like STING and RIG-I, which lead to the production of type I interferons (IFNs) essential for fighting viral infections but also linked to autoimmune diseases.
  • This study identifies the DUSP4 phosphatase as a key regulator in the signaling pathway for type I IFN production by affecting TBK1 and ERK1/2 activation in immune response.
  • Mice lacking DUSP4 show increased resistance to viral infections but are more vulnerable to malaria, highlighting DUSP4's significant role in regulating immune responses to different pathogens.
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Introduction: To curb transmission of COVID-19, Singapore has experienced multiple, ongoing community restrictions. Gaining the ability to adapt and thrive under pressure will be key to addressing effects of these restrictions on mental health. To inform this, we examine the following research questions, (1) What typifies adversity related to living with on-off COVID-19 restrictions? (2) Who are the resilient? (3) How are negative effects of adversity attenuated?

Methods: Participants were a part of the Strengthening Our Community's Resilience Against Threats from Emerging Infections (SOCRATES) cohort, invited to participate in this survey either via email or text message.

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Introduction: COVID-19 has a wide disease spectrum ranging from asymptomatic to severe. While humoral immune responses are critical in preventing infection, the immune mechanisms leading to severe disease, and the identification of biomarkers of disease progression and/or resolution of the infection remains to be determined.

Methods: Plasma samples were obtained from infections during the initial wave of ancestral wildtype SARS-CoV-2 and from vaccine breakthrough infections during the wave of Delta variant, up to six months post infection.

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Immunosenescence (age-related immune dysfunction) and inflamm-aging contribute to suboptimal immune responses in older adults to standard-dose influenza vaccines, which may be exacerbated in those with metabolic co-morbidities. We sought to investigate metabolic factors/predictors of influenza vaccine immune response in an older adult (age ≥65 years) cohort in Singapore, where influenza typically circulates year-round. The primary outcome for the DYNAMIC prospective cohort study was haemagglutination-inhibition titer (HAI) response to each of the trivalent inactivated influenza vaccine strains at day 28 (D28) compared to baseline (D0), as assessed by seroconversion and D28/D0 log2 HAI fold rise.

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In response to declining vaccine-induced immunity and the emergence of new COVID-19 variants, COVID-19 booster vaccination programmes have been widely launched in several high-income countries. However, public response has been slow, and scepticism about these programmes is rising in these settings. This study sought to identify the sociodemographic, emotional, and psychological factors associated with COVID-19 booster vaccine hesitancy in Singapore.

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Background: Gay, bisexual, and other men who have sex with men (GBMSM) are at disproportionately higher risk of acquiring HIV and other sexually transmitted infections (STI). While HIV/STI testing rates among GBMSM are increasing worldwide, they remain suboptimal in a variety of settings. While many studies have attempted to evaluate the efficacy of a variety of community-based campaigns, including peer and reminder-based interventions on HIV/STI testing, however few have attempted to do so for a web drama series.

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Background: In 2019, two clusters of measles cases were reported in migrant worker dormitories in Singapore. We conducted a seroprevalence study to measure the level of susceptibility to measles among migrant workers in Singapore.

Methods: Our study involved residual sera of migrant workers from seven Asian countries (Bangladesh, China, India, Indonesia, Malaysia, Myanmar and the Philippines) who had participated in a survey between 2016 and 2019.

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Background: Since the last local case of diphtheria in 1992, there had not been any case in Singapore until an autochthonous case was reported in 2017. This fatal diphtheria case of a migrant worker raised concerns about the potential re-emergence of locally transmitted toxigenic diphtheria in Singapore. We conducted a seroprevalence study to assess the immunity levels to diphtheria among migrant workers in Singapore.

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COVID-19 vaccines are crucial for achieving sufficient immunisation coverage to manage the pandemic, but vaccine hesitancy persists. This study aimed to investigate the prevalence and determinants of vaccine hesitancy in adults and in parents for vaccinating their children using an integrated social cognition model. A community-based cohort in Singapore [ = 1623] completed a survey (wave 25) between June and July 2021 which measured their risk perceptions, distress, trust, vaccination beliefs, and vaccine intentions/behaviours.

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Background: Impact of the Delta variant and vaccination on SARS-CoV-2 transmission remains unclear. In Singapore, quarantine of all close contacts, including entry and exit PCR testing, provided the opportunity to determine risk of infection by the Delta variant compared to other variants, vaccine efficacy against SARS-CoV-2 acquisition, symptomatic or severe COVID-19, and risk factors associated with SARS-CoV-2 acquisition and symptomatic disease.

Methods: This retrospective cohort study included all close contacts between September 1, 2020 and May 31, 2021.

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Article Synopsis
  • The study focuses on assessing T cell responses to SARS-CoV-2 through a new, simple test that measures cytokines after stimulating whole blood with spike protein peptides.
  • The test was evaluated in various groups, including vaccinated individuals and COVID-19 patients, and showed sensitivity comparable to traditional methods.
  • Results indicated that T cell responses were similar in vaccinated and convalescent individuals, but varied widely among individuals, highlighting the need to measure both antibody and T cell immunity for better understanding vaccine effectiveness.
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The novel coronavirus disease 2019 (COVID-19) presents with non-specific clinical features. This may result in misdiagnosis or delayed diagnosis, and lead to further transmission in the community. We aimed to derive early predictors to differentiate COVID-19 from influenza and dengue.

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We studied the performance of an algorithm combining multiplex polymerase chain reaction with phenotypic detection of extended-spectrum β-lactamases and carbapenemases directly from positive blood culture bottles in patients with gram-negative bacteremia and found good concordance with routine cultures. Such an algorithm may be a tool to improve time to optimal therapy in patients with gram-negative bacteremia.

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Emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern pose a challenge to the effectiveness of current vaccines. A vaccine that could prevent infection caused by known and future variants of concern as well as infection with pre-emergent sarbecoviruses (i.e.

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Objectives: We considered how decision making around human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among gay, bisexual, and other men who have sex with men (GBMSM) is made in the context of one's perceived risk of HIV acquisition and the availability of condoms.

Methods: We recruited 648 GBMSM aged 18 years old and residing in Singapore through Grindr. Participants were given information on PrEP and participated in a discrete choice experiment requiring them to choose between 2 baskets of PrEP attributes and compare the chosen "PrEP only" option to default options of "condoms only" or "PrEP with condoms.

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  • The study investigates how neutralising antibodies specific to SARS-CoV-2 change over time in recovered COVID-19 patients, exploring their impact on long-term immunity.
  • Researchers monitored 164 patients for up to 180 days post-symptom onset, analyzing serum samples to categorize the dynamics of antibody waning into five distinct patterns.
  • Key findings revealed that a significant portion of participants experienced varying rates of antibody decline, highlighting the complexity of immune responses post-infection and the need for further investigation into the longevity of immunity.
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  • - The study evaluated the accuracy of serological tests for diagnosing COVID-19, focusing on how sensitivity and specificity change over time after symptom onset, using data from 39 publications with over 11,500 samples.
  • - By Day 21, the IgM test showed a sensitivity of 87.2% and specificity of 97.3%, while the IgG test had a sensitivity of 91.3% and specificity of 96.0%, indicating that these tests are more reliable after two weeks of infection.
  • - The findings suggest that while serological tests can help determine past infections, their limitations in early diagnosis must be considered when assessing population seroprevalence during outbreaks.
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Objective: To evaluate how public perceptions and trust in government communications affected the adoption of protective behaviour in Singapore during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: We launched our community-based cohort to assess public perceptions of infectious disease outbreaks in mid-2019. After the first case of COVID-19 was reported in Singapore on 23 January, we launched a series of seven COVID-19 surveys to both existing and regularly enrolled new participants every 2 weeks.

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Early detection of infection is crucial to limit the spread of coronavirus disease 2019 (COVID-19). Here we develop a flow cytometry-based assay to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein antibodies in individuals with COVID-19. The assay detects specific immunoglobulin M (IgM), IgA, and IgG in individuals with COVID-19 and also acquisition of all IgG subclasses, with IgG1 being the most dominant.

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Objectives: Voluntary HIV testing rates are still low in several Asian countries including Singapore. HIV self-testing (HIVST) has the potential to increase testing, leading to earlier diagnosis and better prognosis. However, the views of at-risk individuals, especially heterosexual men (HSM), who are not coming forward for testing are still poorly understood.

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