Publications by authors named "Yap Fabian"

Infants frequently experience sleep problems in early childhood. Poor infant sleep can impact not only infants' cognitive development but also maternal sleep and maternal mental health. Studies have reported associations between infant sleep and maternal sleep and between infant sleep and maternal depression.

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Introduction: Through the National Healthcare Group-Khoo Teck Puat Hospital Monogenic Diabetes Registry, we aimed to determine the prevalence and spectrum of maturity-onset diabetes of the young (MODY), describe the long-term renal trajectory of major MODY subtypes, and develop a diagnostic algorithm based on a combination of clinical parameters and biomarkers to refine selection of candidates for genetic testing.

Methods: A total of 373 study participants attending secondary care diabetes centres in Singapore were referred for genetic testing. Key inclusion criteria for genetic testing included onset age ≤35 years, body mass index <32.

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Background: Using longitudinal ultrasounds as an improved fetal growth marker, we aimed to investigate if increased postnatal growth following fetal abdominal circumference (AC) growth deceleration is associated with improved child cognition.

Methods: Among 797 term-born singletons in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort, we derived 2nd-3rd trimester fetal AC growth z-score, fetal AC growth deceleration, standardized height, weight, and body mass index (BMI) growth at early infancy (0-4 months), late infancy (4-15 months), toddlerhood (15-37 months), and early childhood (3-7 years), and investigated their associations with intelligence quotient (IQ) at ages 4.5 years (verbal, non-verbal) and 7 years (non-verbal-block design, matrix reasoning), adjusting for socio-demographic and biological confounders.

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Objective: There is an absence of a comprehensive clinical instrument to assess and track the development of non-ideal feeding practices and lifestyle behaviours in early childhood. Our primary aim was to develop and validate an assessment instrument, called Feeding, Lifestyle, Activity Goals (FLAGs), designed to serve as a feeding, lifestyle and activity behaviour checklist for children aged 0-2 years.

Methods: This study took place between January and May 2023.

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Introduction: Despite the global prevalence of low fertility rates, male contributions to fertility and reproductive health outcomes have been understudied. This study aims to investigate the male contribution to fertility and explore the underlying biological mechanisms. Specifically, we aim to (1) identify male factors associated with successful pregnancy, (2) develop a fertility index incorporating modifiable factors for both males and females to predict pregnancy rate and (3) explore the relationship of male modifiable factors with semen parameters and molecular characteristics.

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Article Synopsis
  • Accurately measuring length in children under 18 months is crucial for monitoring their growth, but it can be challenging due to the need for proper equipment and cooperation from the kids.
  • The study developed a length artificial intelligence (LAI) algorithm that allows users to conveniently estimate a child's length using smartphone images and tested its effectiveness in a clinical setting.
  • The results showed that the LAI tool successfully predicted length for nearly all images analyzed, with a low mean absolute error, and both parents and investigators found it easy to use.
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Background: Body mass index (BMI) trajectories have been used to assess the growth of children with respect to their peers, and to anticipate future obesity and disease risk. While retrospective BMI trajectories have been actively studied, models to prospectively predict continuous BMI trajectories have not been investigated.

Materials And Methods: Using longitudinal BMI measurements between birth and age 10 y from a mother-offspring cohort, we leveraged a multi-task Gaussian process approach to develop and evaluate a unified framework for modeling, clustering, and prospective prediction of BMI trajectories.

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  • This study explored how early gestational glucose levels, measured by continuous glucose monitoring (CGM), relate to the later development of insulin resistance (IR) and gestational diabetes mellitus (GDM) in pregnant women.
  • In a cohort of 167 pregnant women, 25% were found to have IR and 18% developed GDM, with higher early glucose levels and variability in glucose readings linked to increased risk of both conditions.
  • Results indicated that women with suboptimal glycemic control showed higher mean daily glucose and variability, which correlated with a significantly greater risk of developing IR and GDM as pregnancy progressed.
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Objective: The objective of this study is to evaluate the impact of using International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) (IG-21) growth standards compared with Fenton growth charts on birthweight classification in a multiethnic newborn cohort in Singapore.

Design: Cross-sectional study.

Setting: KK Women's and Children's Hospital, Singapore.

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  • Diazoxide (DZX) is the first-line treatment for hyperinsulinemic hypoglycemia (HH), but about 40%-50% of HH cases have unknown genetic causes.
  • A case study reports a neonate experiencing DZX hypersensitivity linked to a novel mutation inherited from the mother, requiring a very low DZX dosage for effective treatment.
  • Close monitoring is essential when starting DZX to prevent complications like diabetic ketoacidosis and hyperglycemic hyperosmolar state.
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  • Pediatricians in training need to understand the Developmental Origins of Health and Disease (DOHaD) to address the increasing issues of non-communicable diseases.
  • A survey conducted among 95 doctors revealed that only 23.2% were aware of DOHaD, with most believing their peers lacked knowledge on the topic.
  • Despite their limited knowledge, nearly all physicians expressed a desire to learn more about DOHaD and recognized the importance of guiding patients on healthy practices for better long-term health outcomes.
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  • Global fertility rates are declining due to metabolic and mental health issues among women, prompting the HELMS program in Singapore to create mHealth interventions to help address these challenges.
  • A validated evaluation questionnaire was developed through literature review and a two-step validation process, assessing its effectiveness with input from experts and participants.
  • The questionnaire demonstrated strong content validity and internal consistency, indicating its potential to effectively evaluate similar health intervention programs worldwide.
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Disorganized attachment is a risk for mental health problems, with increasing work focused on understanding biological mechanisms. Examining late childhood brain morphology may be informative - this stage coincides with the onset of many mental health problems. Past late childhood research reveals promising candidates, including frontal lobe cortical thickness and hippocampal volume.

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Article Synopsis
  • - The study investigates the link between evening-chronotype children, sleep issues, and socioemotional problems during preschool and later school age, emphasizing that evening-chronotype children experience more socioemotional challenges and sleep difficulties.
  • - Using data from 399 preschoolers, researchers looked at how sleep problems and duration influenced the relationship between chronotype and socioemotional issues, revealing that sleep problems, not duration, played a key mediating role as the children grew older.
  • - The findings suggest that addressing sleep problems early on can potentially mitigate socioemotional issues in school-aged children, particularly those with an evening chronotype.
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Background: Maternal feeding practices play a major role in children's dietary intakes. However, there is limited data on the associations between trajectories of dietary patterns (DPs) and patterns of maternal feeding practices during early childhood.

Methods: Using data from a multi-ethnic Asian cohort study, namely the Growing Up in Singapore Towards healthy Outcomes (GUSTO), dietary intakes were measured using Food Frequency Questionnaires in children at 18 months, 5 and 7 years of age.

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  • - Researchers studied how a mother's diet quality and eating habits during pregnancy affect her child's metabolic health, particularly focusing on weight and insulin resistance in children by age 6.
  • - They found that a better diet quality during pregnancy was linked to lower insulin resistance in children, while mothers who mainly ate at night tended to have offspring with higher insulin resistance, especially among boys.
  • - Overall, the study highlights the significance of maternal eating patterns and diet quality during pregnancy, suggesting both factors can influence a child’s metabolic health, with stronger effects observed in male children and in those exposed to lower diet quality.
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  • A study examined how physical activity, sedentary behavior, and sleep—collectively known as 24-h movement behaviors—affect cognitive development in children, specifically focusing on executive function and academic performance.
  • The research involved 432 children in Singapore aged 5.5 to 9 years, using wrist-worn accelerometers to accurately measure their movement behaviors and various cognitive assessments to gauge outcomes.
  • Findings revealed that while overall 24-h movement behaviors didn't link to cognitive performance, reallocating time from moderate-to-vigorous physical activity to sleep improved academic achievement scores.
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Objective: To characterise lifestyle patterns (comprising dietary and movement behaviour aspects) of children in Singapore and examine the correlates of these patterns.

Design: An observational study approach was used. Children recorded their diet and activities over two weekdays and two weekend days on a validated web-based assessment, My E-Diary for Activities and Lifestyle (MEDAL).

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  • Preconception is crucial for optimizing gamete function and placental development, but the lack of services has led to declining fertility rates and unhealthy pregnancies. A community-level preconception care program is urgently needed.* -
  • The proposed solution is a user-friendly mobile app that allows couples to assess their fecundability risks and receive personalized management plans, promoting better reproductive health.* -
  • This digital intervention aims to shift couples' perceptions about subfertility and facilitate ongoing behavior change, ultimately creating a framework for future preconception care delivery.*
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Studies examining preconception eating behaviours with longitudinal dietary patterns from preconception to late pregnancy as well as gestational weight gain (GWG) are limited. We derived dietary pattern trajectories from preconception to late-pregnancy, and related preconception eating behaviours to these trajectories and GWG. Preconception eating behaviours were assessed using the Three-Factor Eating Questionnaire measuring cognitive restraint (CR) - conscious restriction of food intake, emotional eating (EE) - overeating in response to negative emotions, and uncontrolled eating (UE) - overeating with a feeling of lack of control.

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Introduction: Pharmacogenetics currently supports clinical decision-making on the basis of a limited number of variants in a few genes and may benefit paediatric prescribing where there is a need for more precise dosing. Integrating genomic information such as methylation into pharmacogenetic models holds the potential to improve their accuracy and consequently prescribing decisions. Cytochrome P450 2D6 () is a highly polymorphic gene conventionally associated with the metabolism of commonly used drugs and endogenous substrates.

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Background: Parental practices and neighbourhood environmental factors may influence children's movement behaviours. We aimed to investigate the cross-sectional and prospective associations of parental practices and neighbourhood environmental factors with accelerometer-measured 24-hour movement behaviours (24 h-MBs) among school-aged children in Singapore.

Methods: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study collected information on dimensions of parental practices and neighbourhood environment at age 5.

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Background/objectives: Ostracism may lead to increased food intake, yet it is unclear whether greater reactivity to ostracism contributes to higher body mass index (BMI). We investigated whether children who exhibited greater stress to social exclusion subsequently consume more energy and whether this predicts BMI 6- and 18-months later.

Subjects/methods: Children (8.

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