Reducing economic burden through split-shared care model for people living with uncontrolled type 2 diabetes and polypharmacy: a multi-center randomized controlled trial.

Background: Interprofessional collaborative care such as a split-shared care model involving family physicians and community pharmacists can reduce the economic burden of diabetes management. This study aimed to evaluate the economic outcome of a split-shared care model between family physicians and community pharmacists within a pharmacy chain in managing people with uncontrolled type 2 diabetes and polypharmacy.

Method: This was a multi-center, parallel arm, open label, randomized controlled trial comparing the direct and indirect economic outcomes of people who received collaborative care involving community pharmacists (intervention) versus those who received usual care without community pharmacist involvement (control).

Sulfonamide Per- and Polyfluoroalkyl Substances Can Impact Microorganisms Used in Aromatic Hydrocarbon and Trichloroethene Bioremediation.

Per- and polyfluoroalkyl substances (PFASs) from aqueous film forming foams (AFFFs) can hinder bioremediation of co-contaminants such as trichloroethene (TCE) and benzene, toluene, ethylbenzene, and xylene (BTEX). Anaerobic dechlorination can require bioaugmentation of , and for BTEX, oxygen is often sparged to stimulate in situ aerobic biodegradation. We tested PFAS inhibition to TCE and BTEX bioremediation by exposing an anaerobic TCE-dechlorinating coculture, an aerobic BTEX-degrading enrichment culture, and an anaerobic toluene-degrading enrichment culture to -dimethyl perfluorohexane sulfonamido amine (AmPr-FHxSA), perfluorohexane sulfonamide (FHxSA), perfluorohexanesulfonic acid (PFHxS), or nonfluorinated surfactant sodium dodecyl sulfate (SDS).

Miniaturized inkjet-printed flexible ion-selective sensing electrodes with the addition of graphene in PVC layer for fast response real-time monitoring applications.

In this letter, we propose a miniaturization scheme of inkjet printed ionic sensing electrodes by adding graphene into the ion-selective PVC film not only to reduce the impedance of the ionic liquid layer of the electrode but also to increase the electrode capacitance for the reduction of the response time. Based on the scheme, we present a fully inkjet-printed electrochemical ion-selective sensor comprising a working electrode and reference electrode, which are inkjet-printed Ag NPs/PEDOT:PSS-graphene/PVC-graphene and Ag/AgCl/ionic liquid PVC-graphene layer structures, respectively. The printed ion-selective working electrode has been miniaturized to a size of 22,400 μm equivalent to a square shape of ∼150 × 150 μm comparable to the size of a human cell.

Impact of a rapid access chest pain clinic in Singapore to improve evaluation of new-onset chest pain.

Background: Chest pain (CP) accounts for 5% of emergency department (ED) visits, unplanned hospitalisations and costly admissions. Conversely, outpatient evaluation requires multiple hospital visits and longer time to complete testing. Rapid access chest pain clinics (RACPCS) are established in the UK for timely, cost-effective CP assessment.

Prevalence of IgE-mediated cow milk, egg, and peanut allergy in young Singapore children.

Background: The rising prevalence of food allergy reported in the United States, UK, and Australia may be attributable to the rise in peanut allergy prevalence. The food allergy prevalence in other parts of the world such as Asia is, however, less well documented.

Objective: This study aimed to evaluate the prevalence of cow's milk, egg, and peanut allergies in a general population of Singaporean children below 30 months of age.

Inkjet-printed flexible non-enzymatic lactate sensor with high sensitivity and low interference using a stacked NiO/NiO-Nafion nanocomposite electrode with clinical blood test verification.

In this paper, we present a flexible, inkjet-printed, non-enzymatic lactate sensor with high sensitivity and specificity, using a stacked nickel oxide-Nafion nanocomposite/nickel oxide working electrode. Instead of deploying a pure Nafion film on the top of the nickel oxide particles, the nickel oxide-Nafion nanocomposite layer in the new electrode scheme functions not only as an anti-interfering layer but also a reactive layer and the bottom pure nickel oxide layer free from interfering substances mainly participates in the redox reaction to enhance the sensing current. Experimental results show that the sensor with a working electrode printed using a 30 μL NiO ink and a mixture of 30 μL NiO and 4 μL Nafion ink can exhibit an anti-interference ability of >95%, a sensitivity of 20.

Primary Tumor Resection for Stage IV Non-small-cell Lung Cancer Without Progression After First-Line Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor Treatment: A Retrospective Case-Control Study.

Background: In studies of stage IV epidermal growth factor receptor (EGFR)-mutant nonsmall-cell lung cancer (NSCLC), <10% of patients underwent surgery; thus, the effect of surgery in these patients remains unclear. We investigated whether primary lung tumor resection could improve the survival of patients with stage IV EGFR-mutant NSCLC without progression after first-line EGFR-tyrosine kinase inhibitor (EGFR-TKI) treatment.

Methods: This retrospective case-control study included patients treated with first-line EGFR-TKIs without progression on follow-up imaging.

Enhancing diabetes care with community pharmacist-involved collaborative care model: A multi-centre randomised controlled trial.

Aim: To evaluate the clinical and humanistic outcomes of a community pharmacist-involved collaborative care model in diabetes management.

Methods: This was a parallel arm, open-label, multi-centre randomized controlled trial conducted over 6 months. Subjects with type 2 diabetes, HbA1c ≥ 7.

Long-term clinical and cost-effectiveness of collaborative care in people with uncontrolled type 2 diabetes mellitus and polypharmacy: A multicenter randomized controlled trial.

Aims: This study examined the effectiveness of a collaborative care model on clinical and humanistic outcomes, medical cost, productivity loss, and its cost-effectiveness in managing uncontrolled Type 2 Diabetes Mellitus (T2DM).

Methods: A randomized controlled study was conducted in two outpatient health institutions in Singapore. Patients aged above 21 years with HbA1c > 7% and polypharmacy were included.

Undiagnosed solitary caseating granulomas: Is lung resection surgery a feasible method for diagnosis and treatment?

Background: In many patients, low-dose computed tomography (CT) screening for lung cancer reveals asymptomatic pulmonary nodules. Lung resection surgery may be indicated in these patients; however, distinguishing malignancies from benign lesions preoperatively can be challenging.

Methods: From 2013 to 2018, 4181 patients undergoing surgery for pulmonary nodules were reviewed at National Taiwan University Hospital, and 837 were diagnosed with benign pathologies.

Previous Extrapulmonary Malignancies Impact Outcomes in Patients With Surgically Resected Lung Cancer.

As the overall survival of patients with cancer continues to improve, the incidence of second primary malignancies seems to be increasing. Previous studies have shown controversial results regarding the survival of patients with primary lung cancer with previous extrapulmonary malignancies. This study aimed to determine the clinical picture and outcomes of this particular subgroup of patients.

Risk-adjusted rates between hospitals for adverse outcomes of very-low-birth-weight infants.

Background/purpose: To analyze the amount of variation in these risk-adjusted adverse outcomes corresponding to the care of premature births. In addition, hospitals were ranked according to their unadjusted and adjusted rates, and we assessed the degree of concordance between these rankings. Finally, the correlations of hospital-adjusted adverse outcomes were also tested.

The Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) protocol: a non-randomised controlled trial of personalised care and support planning for persons living with diabetes.

Background: Personalised care and support planning (CSP) has been shown to improve diabetes outcomes, patient experience and provider morale in the care of persons living with diabetes. However, this has not been confirmed in controlled studies. Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) is a pragmatic controlled trial that evaluates the effectiveness of personalised CSP in persons living with diabetes in the public primary care setting in Singapore.

Efficacy and Safety of Use of the Fasting Algorithm for Singaporeans With Type 2 Diabetes (FAST) During Ramadan: A Prospective, Multicenter, Randomized Controlled Trial.

Purpose: We aimed to evaluate the efficacy and safety of use of the Fasting Algorithm for Singaporeans with Type 2 Diabetes (FAST) during Ramadan.

Methods: We performed a prospective, multicenter, randomized controlled trial. The inclusion criteria were age ≥21 years, baseline glycated hemoglobin (HbA) level ≤9.

The gestational effect of antenatal corticosteroids on respiratory distress syndrome in very low birth weight infants: A population-based study.

Background/purpose: The aim of this study was to evaluate the efficacy of antenatal corticosteroids for preventing very low birth weight (VLBW) infants with respiratory distress syndrome (RDS) from surfactant use at different gestational ages (GA).

Methods: We retrospectively analyzed the VLBW preterm infants registered in the Premature Baby Foundation of Taiwan from 1997 through 2014. Infants at 20-37 weeks' gestation were included, and infants with lethal congenital anomaly, chromosomal anomaly, and congenital infection were excluded.

Propensity-Matched Analysis Comparing Survival After Sublobar Resection and Lobectomy for cT1N0 Lung Adenocarcinoma.

Background: The optimal surgical method for cT1N0 lung adenocarcinoma remains controversial.

Objective: The aim of this study was to evaluate the differences in clinical outcomes of sublobar resection and lobectomy for cT1N0 lung adenocarcinoma patients.

Methods: We included 1035 consecutive patients with cT1N0 lung adenocarcinoma who underwent surgery at our institute from January 2011 to December 2016.

Association of Maternal Preeclampsia with Neonatal Respiratory Distress Syndrome in Very-Low-Birth-Weight Infants.

Preeclampsia is a common cause of preterm birth and neonatal morbidity, but its relationship with neonatal respiratory distress syndrome (RDS) remains controversial. We conducted a retrospective cohort study with data from very-low-birth-weight (VLBW) infants born in 1997-2014 from the database of the Premature Baby Foundation of Taiwan to evaluate the relationship between maternal preeclampsia and neonatal RDS. In total, 13,490 VLBW infants were enrolled, including 2200 (16.

Clinical outcome of subcentimeter non-small cell lung cancer after VATS resection: Single institute experience with 424 patients.

Background/purpose: Non-small cell lung cancer (NSCLC) presenting as subcentimeter lung tumor was increasing due to the popularity of low dose CT in recent years. However, the ideal surgical management is still controversial. We utilized our lung cancer surgery database to study the important issue, aiming to find the optimal treatment with VATS.

Computed tomography-guided dye localization for deeply situated pulmonary nodules in thoracoscopic surgery.

Background: Increased lung cancer screening of asymptomatic adults using low-dose computed tomography (CT) with high-resolution imaging modalities has increased the identification of small and deeply situated pulmonary nodules. This study aimed to evaluate the role of preoperative patient blue vital (PBV) dye localization for an undiagnosed nodule deeply situated in the lung parenchyma followed by minimally invasive lung resection.

Methods: From July 2013 to December 2016, 27 consecutive patients (16 women, median age: 62 years) with small undiagnosed pulmonary nodules at a depth of more than 30 mm underwent preoperative CT-guided PBV dye localization followed by thoracoscopic diagnostic resection of the nodule at National Taiwan University Hospital.

Correlation of tumor spread through air spaces and clinicopathological characteristics in surgically resected lung adenocarcinomas.

Objectives: Tumor spread through air spaces (STAS) has recently been reported as a novel invasive pattern in lung adenocarcinoma, but the correlation between other clinicopathological and genetic profiles has not been well studied. The aim of this study was to investigate these correlations in patients with surgically resected lung adenocarcinoma.

Materials And Methods: Five hundred consecutive patients with lung adenocarcinoma who underwent curative lung tumor resection and with available STAS profile were reviewed retrospectively from January to December 2016.

Preoperative Dye Localization for Thoracoscopic Lung Surgery: Hybrid Versus Computed Tomography Room.

Background: Preoperative computed tomography (CT)-guided dye localization is essential for the surgical treatment of small lung nodules and is mostly performed by radiologists in the CT room. Several studies reported their early experiences of preoperative localization in the hybrid operating room. A comparison between localization in the CT room and hybrid room has not been reported.