Publications by authors named "Wee L"

: Lung cancer (LC) is the leading cause of cancer mortality, making early diagnosis essential. While LC screening trials are underway globally, optimal prediction models and inclusion criteria are still lacking. This study aimed to develop and evaluate Bayesian Network (BN) models for LC risk prediction using a decade of data from Denmark.

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Background: Vaccination has been shown to attenuate the risk of post-acute sequelae following SARS-CoV-2 infection. However, no prior population-based studies have evaluated if updated bivalent boosters reduce risk of post-acute sequelae following Omicron-variant infection, versus ancestral vaccines.

Methods: National databases were utilised to construct a population-based cohort of adult individuals infected during Omicron-predominant transmission.

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Purpose: Research on rare diseases and atypical health care demographics is often slowed by high interparticipant heterogeneity and overall scarcity of data. Synthetic data (SD) have been proposed as means for data sharing, enlargement, and diversification, by artificially generating real phenomena while obscuring the real patient data. The utility of SD is actively scrutinized in health care research, but the role of sample size for actionability of SD is insufficiently explored.

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The use of artificial intelligence (AI) holds great promise for radiation oncology, with many applications being reported in the literature, including some of which are already in clinical use. These are mainly in areas where AI provides benefits in efficiency (such as automatic segmentation and treatment planning). Prediction models that directly impact patient decision-making are far less mature in terms of their application in clinical practice.

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Background: Patients with advanced-stage pancreatic ductal adenocarcinoma (PDAC) are regularly treated with FOLFIRINOX, a chemotherapy regimen based on 5-fluorouracil, irinotecan and oxaliplatin, which is associated with high toxicity. Dosing of FOLFIRINOX is based on body surface area, risking under- or overdosing caused by altered pharmacokinetics due to interindividual differences in body composition. This study aimed to investigate the relationship between body composition and treatment toxicity in advanced stage PDAC patients treated with FOLFIRINOX.

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Article Synopsis
  • Atopic dermatitis (AD) is a common chronic skin condition in children, and dupilumab is the first approved biologic treatment for moderate-to-severe cases; however, it can lead to ocular surface disease (DAOSD).
  • A study was conducted on Asian pediatric patients who developed DAOSD while being treated with dupilumab, analyzing their demographic information, eye symptoms, and treatment outcomes.
  • Among 216 patients, 16 (7.4%) experienced DAOSD, mainly presenting with symptoms like eye redness and conjunctivitis; however, the severity in children seemed lower than in adults, and prophylactic measures can help minimize complications.
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Shwachman-Diamond syndrome (SDS) is a rare inherited bone marrow failure syndrome characterized by the triad of exocrine pancreatic dysfunction, cytopenia, and skeletal abnormalities. We report a 5-month-old boy with SDS who presented with generalized ichthyosis in the neonatal period that evolved into more eczematous skin eruptions, accompanied by severe failure to thrive. This report highlights the importance of including SDS as a differential diagnosis in patients who present with early ichthyosis, failure-to-thrive, gastrointestinal symptoms and cytopenia.

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Background: Accurate prognostication of overall survival (OS) for non-small cell lung cancer (NSCLC) patients receiving definitive radiotherapy (RT) is crucial for developing personalized treatment strategies. This study aims to construct an interpretable prognostic model that combines radiomic features extracted from normal lung and from primary tumor with clinical parameters. Our model aimed to clarify the complex, nonlinear interactions between these variables and enhance prognostic accuracy.

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Introduction: Deficiencies in non-technical skills can severely impede the functioning of teams in high-intensity scenarios, such as in damage control surgery for the critically injured trauma patient. Truncated preoperative checklists, modified from the standard World Health Organization preoperative checklist, and situational reporting at intervals during surgery are long-established practices in the military, and are recommended in the National Health Service guidelines on major incidents. These tools allow the multiprofessional team to create a shared mental model of the anaesthetic and operative plan, thereby improving team efficiency.

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Background: Effective clinical education is essential for managing tracheostomy patients safely and efficiently. Simulation-based training has shown greater efficacy than traditional methods in various clinical settings. Our internal training programme, called the Tracheostomy Refresher Program (TRP) was used to enhance nurses' skills in tracheostomy care.

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  • The study assesses the population-wide risk-benefit ratio of COVID-19 vaccination during the Omicron variant phase, focusing on mortality and cardiovascular events post-vaccination and infection.
  • Conducted in Singapore from January to December 2022 with over 3 million participants, researchers utilized Cox regression to evaluate risks for various timeframes post-vaccination/infection.
  • Results showed no increased risk of mortality or cardiovascular events after vaccination, but older adults had elevated mortality risks after infection, particularly with vaccine-breakthrough infections, while cardiovascular risks were higher 1-2 months post-infection across all age groups.
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Objectives: Body composition assessment using CT images at the L3-level is increasingly applied in cancer research and has been shown to be strongly associated with long-term survival. Robust high-throughput automated segmentation is key to assess large patient cohorts and to support implementation of body composition analysis into routine clinical practice. We trained and externally validated a deep learning neural network (DLNN) to automatically segment L3-CT images.

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Background: Cancer-related fatigue (CRF) is common among patients with cancer. Various interventions have been reported to reduce fatigue, and some evidence suggests that nurse-led interventions may be effective in the management of CRF. A systematic review was conducted to assess the effectiveness of nurse-led interventions for CRF in patients with cancer and survivors.

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Objectives: Although neoadjuvant immunochemotherapy has been widely applied in non-small cell lung cancer (NSCLC), predicting treatment response remains a challenge. We used pretreatment multimodal CT to explore deep learning-based immunochemotherapy response image biomarkers.

Methods: This study retrospectively obtained non-contrast enhanced and contrast enhancedbubu CT scans of patients with NSCLC who underwent surgery after receiving neoadjuvant immunochemotherapy at multiple centers between August 2019 and February 2023.

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Objectives: Significant heterogeneity has been reported in cohort studies evaluating the impact of early oral antiviral treatment on preventing postacute sequelae after COVID-19. We evaluated the impact of early nirmatrelvir/ritonavir on risk of postacute cardiovascular, neurological, respiratory, and autoimmune diagnoses, as well as postacute symptoms amongst older Singaporeans.

Methods: National COVID-19 registries and healthcare claims databases were used to construct a retrospective population-based cohort enrolling all Singaporeans aged ≥60 years diagnosed with SARS-CoV-2 infection in primary care during Omicron transmission (18 March 2022-4 August 2023).

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Importance: Studies have reported increased risk of autoimmune sequelae after SARS-CoV-2 infection. However, risk may potentially be attenuated by milder Omicron (B.1.

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  • Urticaria multiforme is a rare form of acute urticaria mostly found in young children, often linked to viral infections as a trigger.
  • A study reviewed clinical data from 20 Asian children under 16 diagnosed with this condition, revealing that most were younger than 7 and experienced symptoms like fever and respiratory issues.
  • The condition is typically benign and self-limiting, with symptoms resolving within 6 weeks, and extensive medical investigations are usually unnecessary, focusing instead on supportive care.
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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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Heteromorphic sex chromosomes (XY or ZW) present problems of gene dosage imbalance between sexes and with autosomes. A need for dosage compensation has long been thought to be critical in vertebrates. However, this was questioned by findings of unequal mRNA abundance measurements in monotreme mammals and birds.

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There has been growing interest in the use of real-world data (RWD) to address clinically and policy-relevant (research) questions that cannot be answered with data from randomized controlled trials (RCTs) alone. This is, for example, the case in rare malignancies such as sarcomas as limited patient numbers pose challenges in conducting RCTs within feasible timeliness, a manageable number of collaborators, and statistical power. This narrative review explores the potential of RWD to generate real-world evidence (RWE) in sarcoma research, elucidating its application across different phases of the patient journey, from prediagnosis to the follow-up/survivorship phase.

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Background: Data on protection afforded by updated coronavirus disease 2019 (COVID-19) vaccines (bivalent/XBB 1.5 monovalent) against the emergent JN.1 variant remain limited.

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