Insomnia during the COVID-19 pandemic: prevalence and correlates in a multi-ethnic population Singapore.

Background: Globally, the Coronavirus disease 2019 (COVID-19) pandemic had a significant impact on mental health. Sudden lifestyle changes, threatening information received through various sources, fear of infection and other stressors led to sleep disturbances such as insomnia. The current study aimed to assess the prevalence of insomnia and its associated risk factors during the first wave of COVID-19 pandemic among Singapore residents.

Prevalence and Outcomes of Orthostatic Hypotension in Hemorrhagic Stroke Patients During Hospitalization.

Background/objectives: Orthostatic hypotension (OH) is highly prevalent in hospitalized patients and can lead to major consequences. The prevalence of OH among patients with stroke has also been reported to be high in in-patient cohorts. However, no previous analysis has focused exclusively on patients with hemorrhagic stroke, a group that may have a different disease profile, including a greater need for blood pressure control and surgical intervention.

Development of BCMA-Targeted Bispecific Natural Killer Cell Engagers for Multiple Myeloma Treatment.

Background: B-cell maturation antigen (BCMA)-targeted T cell-redirecting immunotherapies, including Chimeric Antigen Receptor (CAR) T-cell therapy and T-cell engagers have demonstrated remarkable success in treating relapsed/refractory (RR) multiple myeloma (MM), a malignancy of plasma cells. However, a significant challenge is the severe side effects associated with T-cell overactivation, leading to cytokine release syndrome and neurotoxicity in MM patients undergoing such therapies. Bispecific NK cell engagers (NKCEs) may offer a promising alternative by redirecting NK cell cytotoxic activity towards tumor cells without triggering cytokine release syndrome.

Estimated potassium intake and major adverse cardiovascular events in individuals with type 2 diabetes: a prospective cohort study with trans-ethnic validation.

Background: Data on the relationship between potassium intake and major cardiovascular events (MACE) in patients with diabetes are scarce. We aim to study the association between estimated potassium intake and risk of MACE in individuals with type 2 diabetes.

Methods: The discovery cohort consisted of 1572 participants with type 2 diabetes from a secondary hospital.

Enhancing AI reliability: A foundation model with uncertainty estimation for optical coherence tomography-based retinal disease diagnosis.

Inability to express the confidence level and detect unseen disease classes limits the clinical implementation of artificial intelligence in the real world. We develop a foundation model with uncertainty estimation (FMUE) to detect 16 retinal conditions on optical coherence tomography (OCT). In the internal test set, FMUE achieves a higher F1 score of 95.

Deriving Accurate Nocturnal Heart Rate, rMSSD and Frequency HRV from the Oura Ring.

Cardiovascular diseases are a major cause of mortality worldwide. Long-term monitoring of nighttime heart rate (HR) and heart rate variability (HRV) may be useful in identifying latent cardiovascular risk. The Oura Ring has shown excellent correlation only with ECG-derived HR, but not HRV.

Plasma proteomic signatures of adiposity are associated with cardiovascular risk factors and type 2 diabetes risk in a multi-ethnic Asian population.

The biomarkers connecting obesity and cardiometabolic diseases are not fully understood. We aimed to (i) evaluate the associations between body mass index (BMI), waist circumference (WC), and ∼5,000 plasma proteins (SomaScan v4), (ii) identify protein signatures of BMI and WC, and (iii) evaluate the associations between the protein signatures and cardiometabolic health including metabolically unhealthy obesity and type 2 diabetes incidence in the Singapore Multi-Ethnic Cohort (MEC1). Among 410 BMI-associated and 385 WC-associated proteins, we identified protein signatures of BMI and WC and validated them in an independent dataset across two timepoints and externally in the Atherosclerosis Risk in Communities (ARIC) study.

Assessing the direct and spillover protective effectiveness of Wolbachia-mediated introgression to combat dengue.

Background: Dengue remains a global health challenge with limited treatment options, highlighting the need for effective vector control strategies. The introduction of Wolbachia pipientis into Aedes aegypti populations has shown success in reducing dengue transmission across global field trials. However, the spillover effectiveness of the technology on untreated areas is not well-known.

Patients and Spine Surgeons' Perspectives regarding Decision-Making and Outcomes in Lumbar Surgery: An Exploratory, Qualitative Study.

Background: Decision-making in lumbar surgery for degenerative conditions is influenced by various factors, including patient expectations and empowerment. The role of patient-reported outcomes (PROs) in guiding these decisions is underexplored. This study aims to understand the perspectives of patients and spine surgeons in decision-making for lumbar surgery and explore their perspectives on the relevance and influence of pre- and post-surgery PROs.

High-cost users still came to hospitals during the COVID-19 pandemic during first wave data in Thailand: secondary data analysis.

Background: The phenomenon of high-cost users (HCUs) in health care occurs when a small proportion of patients account for a large proportion of health care expenditures. By understanding this phenomenon during the COVID-19 pandemic, tailored interventions can be provided to ensure that patients receive the care they need and reduce the burden on the health system.

Objectives: This study aimed to determine (1) whether the HCUs phenomenon occurred during the pandemic in Thailand by exploring the pattern of inpatient health expenditures over time from 2016 to 2021; (2) the patient characteristics of HCUs; (3) the top 5 primary diagnoses of HCUs; and (4) the potential predictors associated with being an HCU.

Characterising global risk profiles of Mpox clade Ib importation.

The novel mpox clade Ib initially identified in the Domestic Republic of Congo has spread to its multiple neighbouring countries as well as countries beyond the African continent. We characterised the global risk of importation of mpox clade Ib, highlighting the need to ramp up surveillance capacity for early detection.

Adherence to COVID-19 measures and the associated factors: evidence from a two-wave longitudinal study in Singapore.

Background: At the onset of the Coronavirus disease (COVID-19) pandemic when pharmaceutical interventions were not readily available, governments relied on public health mandates and social distancing measures to counter rising infection rates. In order to address the dearth of longitudinal studies, this study sought to identify factors associated with continued adherence to COVID-19 preventive behaviours in Singapore.

Methods: Data were from a two-wave longitudinal cohort study; baseline study was conducted from May 2020 to June 2021 and follow-up study from October 2021 to September 2022.

Outcomes of implementing the International Code of Marketing of Breast-milk Substitutes as national laws: a systematic review.

Background: The International Code of Marketing of Breast-milk Substitutes, or 'the Code,' sets standards to regulate marketing of commercial milk formula (CMF) to protect breastfeeding. World Health Organization member states are advised to legislate the Code into national law, but understanding of its implementation outcomes is limited. This systematic review aimed to examine implementation outcomes in countries implementing the Code as national law.

Dietary pattern trajectories in early childhood and their associations with patterns of maternal feeding practices in a multi-ethnic Asian cohort.

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.