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1. Developing Intentional Learning Skills among E-Commerce Student--Action Research in Metacognition through Reflective Learning Log

Author

Kheng, Yeoh Khar

Abstract

Intentional learners are self-directed people who take charge of their education, whether in a setting or an informal setting. Learners who practice intentional learning skills choose their learning methodologies and organize their studies in accordance with their interests, preferences, and speed. This study embarks on the following objectives: (i) To look into ways how to scaffold intentional learning experiences among the student and ritualize the intentional learner's mindsets and best practice skills, (ii) To investigate the effects (through a reflective learning log) of intentional learning skill of student on their study habits and attitudes toward learning, and, (iii) To examine their critical reflection log while they are studying E-commerce module which is underpinned by the intentional learning paradigm and Hatton and Smith's framework. In this qualitative study, data from 140 students in three classes of E-Commerce were required to write reflections that would be used to determine final grades using the reflective learning log. In order to support students' purposeful learning development as they join the job market, the study's findings strongly imply that they urgently need to strengthen their reflective writing skills while enrolled in higher education. The undergraduate must also be given the fundamental tools necessary to shape them into purposeful learners through exercises in reflective learning. The Hatton and Smith reflective framework worked well for categorizing written reflections and making the reflective learning log evaluation less subjective. This study brought to light the fact that many business students were unfamiliar with the genre of reflective writing and that this genre needed to be explicitly taught in the relevant course. Hence, to support students' purposeful learning development as they join the job market, the study's findings strongly imply that they urgently need to strengthen their reflective writing skills while enrolled in higher education.

Published
2023

2. The Development of Reflective Undergraduate Students: Assessing the Educational Benefits of Reflective Learning Logs in Entrepreneurship Module

Author

Kheng, Yeoh Khar and Sethela, June

Abstract

The objective of this paper is to analyze written reflections on learning log of among the third and final year students undertaking an entrepreneurship module. Data was collected in the form of written reflection taken from the learning log of 140 students from 3 classes. At the end of the collection only 136 students' responses were managed to be collected given 4 students failed to hand in the learning log. A thematic approach was utilized to present the reflections of the students and all data was recorded in a verbatim format. Findings show that most students have never written a reflective log or essay in the formative assessment. As a consequence, they had difficulty in writing the reflection when being requested to do so. This has resulted in their reflection being written descriptively which lacks in critical analysis and deep thinking. The results of this investigation have strongly suggested the need to urgently develop among the students the skills in writing reflectively as they go through the process of higher education which be useful in molding their future professional and entrepreneurial behavior as when they entered the job market which requires a critical reasoning ability. The limitation and future were discussed.

Published
2015

3. EFFECT OF SERENE BUSINESS ENVIRONMENT ON THE PERFORMANCE OF SMALL AND MEDIUM ENTERPRISES IN MALAYSIA

Author

Yeoh Khar Kheng

Subjects
Serene business environment, performance, SMEs, Malaysia, Management. Industrial management, HD28-70, Business, HF5001-6182
Abstract

The effect of business environment on the performance of small and medium enterprises (SMEs) has been widely studied. Nevertheless, research on the effect of a serene business environment on the performance of SMEs is insufficient, notably in the context of Malaysia. Therefore, this study examined the effect of a serene business environment on SMEs’ performance in Malaysia. Related literature was critically reviewed, and five hypotheses on the effect of serene business environmental factors on performance were formulated. By adopting the cross-sectional survey design, the data of 148 respondents were collected and analyzed using descriptive and inferential statistical tools – Statistical Package for Social Sciences (SPSS) and Partial Least Square – Structural Equation Modeling (PLS-SEM). From the empirical findings, Malaysia’s serene business environment is critical in stimulating the performance of SMEs. Financial market environment, technological environment, and regulatory environment exerted a positive significant effect on SMEs’ performance. Nonetheless, economic environment and competitive environment indicated a strong, but negative significant effect on SMEs’ performance. These findings proposed new insights in this field of research by providing relevant research implications and suitable recommendations to business managers and policymakers in Malaysia.

Published
2023
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4. The Wood Dragon comes in for a landing

Author

Hoon, Yeoh Siew

Subjects
Lunar New Year -- Influence, Dragons -- Public opinion -- Influence -- Portrayals, Market trend/market analysis, Business, Travel industry
Abstract

Here we are, already into the final days of January, which means the Chinese community all over the world is preparing for their Lunar New Year, ushering in the Year [...]

Published
2024

5. SOAR: Smart Online Aggregated Reservation for Mobile Edge Computing Brokerage Services

Author

Phee Lep Yeoh, Shizhe Zang, Branka Vucetic, Yonghui Li, and Wei Bao

Subjects
Service (business), Operations research, Competitive analysis, Computer Networks and Communications, Computer science, business.industry, Reservation, Cloud computing, Service provider, Resource (project management), Soar, Electrical and Electronic Engineering, business, Software, Edge computing
Abstract

With the development of MEC services, MEC brokers will emerge to facilitate the purchase and management of resources for individual MEC users. Both data communication and computing resources offered by MEC service providers can be purchased by pay-as-you-go (PAYG) or reserved plans. Besides data and computing plans for each type of resource, we also consider combo plans specifically designed for MEC services covering both resources. In this paper, we propose a smart online aggregated reservation (SOAR) framework for MEC brokers to minimize their cost of reserving resources for multiple users without the knowledge of future demands. In our framework, a task aggregation algorithm is designed to aggregate the users' demands in each PAYG billing cycle to improve the plan utilization, and plan reservation algorithms are proposed to decide when to reserve which plans. The performance gap (competitive ratio) between SOAR and optimal solution which knows all future demands in advance, is analyzed and derived in closed-form. The performance gap is proved to be the minimum among all deterministic online algorithms. Trace-driven simulations verify the cost advantage of our SOAR framework, which can save nearly 40% of cost for users through the brokerage service.

Published
2023

6. Case of sodium-glucose cotransporter-2 inhibitor-associated euglycaemic diabetic ketoacidosis

Author

Woei Jack Pan, Huei Li Yeoh, Marilyn Lee, and Hean Yee Ong

Subjects
Male, Diabetic ketoacidosis, business.industry, Sodium, Anion gap, Metabolic acidosis, General Medicine, Middle Aged, medicine.disease, High anion gap metabolic acidosis, Diabetic Ketoacidosis, Bolus (medicine), Intravenous sodium bicarbonate, Glucose, Basal (medicine), Diabetes Mellitus, Type 2, Anesthesia, medicine, Empagliflozin, Humans, business, Sodium-Glucose Transporter 2 Inhibitors
Abstract

Following non-elective orthopaedic surgery, a 61-year-old man with poorly controlled type 2 diabetes mellitus on empagliflozin developed high anion gap metabolic acidosis in the high-dependency unit. Metabolic acidosis persisted despite intravenous sodium bicarbonate, contributing to tachycardia and a run of non-sustained ventricular tachycardia. He was euglycaemic throughout hospital admission. Investigations revealed elevated urine and capillary ketones, and a diagnosis of sodium–glucose cotransporter-2 inhibitor-associated euglycaemic diabetic ketoacidosis was made. He was treated with an intravenous sliding scale insulin infusion and concurrent dextrose 5% with potassium chloride. Within 24 hours of treatment, his arterial pH, anion gap and serum bicarbonate levels normalised. After a further 12 hours, the intravenous insulin infusion was converted to a basal/bolus regimen of subcutaneous insulin, and he was transferred to the general ward. He was discharged well on subcutaneous insulin 6 days postoperatively.

Published
2023

7. SINGAPORE'S SURVIVAL KIT: The city relies on the outside world to power its economy. And the extraordinary challenges to keep its tourism industry alive in a pandemic yielded remarkable innovations

Author

Hoon, Yeoh Siew

Subjects
Epidemics -- Economic aspects, Travel industry -- Economic aspects -- Officials and employees -- Innovations, Business, Travel industry
Abstract

What happens when the world shuts down and your entire existence is based on an open world? That's the dilemma that Singapore found itself in when the pandemic was declared. [...]

Published
2020

8. Satisfaction-Maximized Secure Computation Offloading in Multi-Eavesdropper MEC Networks

Author

Trung Q. Duong, Yao Yu, Lei Guo, Shumei Liu, Branka Vucetic, Phee Lep Yeoh, and Yonghui Li

Subjects
Mobile edge computing, Optimization problem, business.industry, Computer science, Applied Mathematics, Workload, Eavesdropping, Provisioning, Computer Science Applications, Reduction (complexity), Secrecy, Secure multi-party computation, Electrical and Electronic Engineering, business, Computer network
Abstract

In this paper, we consider a mobile edge computing (MEC)-based secure computation offloading system, and design a practical multi-eavesdropper model including two specific scenarios of non-colluding and colluding eavesdropping. Furthermore, we design a requirement satisfaction model by exploring practical variations in user request patterns for security provisioning, delay reduction and energy saving. Based on these, we propose a satisfaction-maximized secure computation offloading (SMax-SCO) scheme, and then formulate an optimization problem aiming at maximizing users’ requirement satisfactions subject to secrecy offloading rate, tolerable delay, task workload and maximum power constraints. Since the optimization problem is nonconvex, we present an efficient successive convex approximation (SCA)-based algorithm to obtain suboptimal solutions. We demonstrate that the proposed SMax-SCO scheme achieves a significant improvement in security performance and requirement satisfaction compared with existing schemes. Moreover, we conclude that SMax-SCO can resist eavesdropping attacks of multiple eavesdroppers and even colluding eavesdroppers.

Published
2022

9. Clinical guidance on endoscopic management of colonic polyps in Singapore

Author

Vikneswaran Namasivayam, James Weiquan Li, Chern Hao Chong, Christopher Khor, Tiing Leong Ang, Jit Fong Lim, Khay Guan Yeoh, Tju Siang Chua, Kok Ann Gwee, Kok Yang Tan, Lai Mun Wang, and Charles Vu

Subjects
Adenoma, Curative resection, Singapore, medicine.medical_specialty, medicine.diagnostic_test, Colorectal cancer, business.industry, General surgery, Perforation (oil well), Colonic Polyps, Colonoscopy, Review Article, General Medicine, Endoscopic management, medicine.disease, United States, Endoscopic polypectomy, Colonic Neoplasms, medicine, Humans, Endoscopic resection, Surveillance colonoscopy, Colorectal Neoplasms, business
Abstract

Colonoscopy with endoscopic resection of detected colonic adenomas interrupts the adenoma-carcinoma sequence and reduces the incidence of colorectal cancer and cancer-related mortality. In the past decade, there have been significant developments in instruments and techniques for endoscopic polypectomy. Guidelines have been formulated by various professional bodies in Europe, Japan and the United States, but some of the recommendations differ between the various bodies. An expert professional workgroup under the auspices of the Academy of Medicine, Singapore, was set up to provide guidance on the endoscopic management of colonic polyps in Singapore. A total of 23 recommendations addressed the following issues: accurate description and diagnostic evaluation of detected polyps; techniques to reduce the risk of post-polypectomy bleeding and delayed perforation; the role of specific endoscopic resection techniques; the histopathological criteria for defining endoscopic cure; and the role of surveillance colonoscopy following curative resection.

Published
2022

10. Sport and Recreational Physical Activities Attenuate the Predictive Association of Multimorbidity With Increased Geriatric Depressive Symptoms: A 14-Year Follow-Up Study of Community-Dwelling Older Adults

Author

Wai Chan, Francisco T. T. Lai, Eng-Kiong Yeoh, Joyce Lok Yin Kwan, and Yonglin Liang

Subjects
Gerontology, Physical Therapy, Sports Therapy and Rehabilitation, Physical exercise, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, 030212 general & internal medicine, Exercise, Depression (differential diagnoses), Aged, Depression, business.industry, Rehabilitation, Multimorbidity, medicine.disease, Mental health, Comorbidity, Confidence interval, Relative risk, Cohort, Geriatric Depression Scale, Independent Living, Geriatrics and Gerontology, business, human activities, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

Multimorbidity is associated with increased depression risks. Little research examines how physical exercise moderates this association. From an existing cohort of community-dwelling older adults in Hong Kong recruited in 2001–2003, the authors included participants who were successfully interviewed after 14 years (2015–2017). Geriatric depressive symptoms were used as the primary outcome and measured by the 15-item Geriatric Depression Scale, while multimorbidity was operationalized using a list of 19 conditions. Subscores of the Physical Activity Scale for the Elderly measuring light, moderate, and strenuous sport/recreational activities were included as moderators. In total, 1,056 participants were included, of whom 50.7% were multimorbid. Multimorbidity was associated with 12% more geriatric depressive symptoms, but strenuous physical activities were associated with a smaller risk elevation only among multimorbid patients (adjusted relative risk = 0.99, 95% confidence interval [0.98, 0.99]; p = .001). In conclusion, strenuous sport and recreational activities may attenuate the association between multimorbidity and geriatric depressive symptoms.

Published
2022

11. Effects of mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction patients with chronic obstructive pulmonary disease in EMPHASIS-HF and RALES

Author

Pardeep S. Jhund, Su E. Yeoh, Dirk J. van Veldhuisen, Bertram Pitt, Karl Swedberg, John J.V. McMurray, João Pedro Ferreira, Faiez Zannad, Matteo Serenelli, Pooja Dewan, and Cardiovascular Centre (CVC)

Subjects
Male, medicine.medical_specialty, COPD, Ejection fraction, business.industry, Chronic obstructive pulmonary disease, Hazard ratio, Stroke Volume, Heart failure, medicine.disease, Placebo, Sudden death, Confidence interval, Mineralocorticoid receptor antagonists, respiratory tract diseases, Pulmonary Disease, Chronic Obstructive, Internal medicine, Cardiology, medicine, Clinical endpoint, Humans, Cardiology and Cardiovascular Medicine, business, Respiratory Sounds
Abstract

Heart failure with reduced ejection fraction (HFrEF) and chronic obstructive pulmonary disease (COPD) individually cause significant morbidity and mortality. Their coexistence is associated with even worse outcomes, partly due to suboptimal heart failure therapy, especially underutilisation of beta-blockers. Our aim was to investigate outcomes in HFrEF patients with and without COPD, and the effects of mineralocorticoid receptor antagonists (MRAs) on outcomes.\ud \ud Methods and results:\ud \ud We studied the effect of MRA therapy in a post-hoc pooled analysis of 4397 HFrEF patients in the RALES and EMPHASIS-HF trials. The primary endpoint was the composite of heart failure hospitalisation or cardiovascular death. A total of 625 (14.2%) of the 4397 patients had COPD. Patients with COPD were older, more often male, and smokers, but less frequently treated with a beta-blocker. In patients with COPD, event rates (per 100 person-years) for the primary endpoint and for all-cause mortality were 25.2 (95% confidence interval 22.1–28.7) and 17.2 (14.9–19.9), respectively, compared with 19.9 (18.8–21.1) and 12.8 (12.0–13.7) in participants without COPD. The risks of all-cause hospitalisation and sudden death were also higher in patients with COPD. The benefit of MRA, compared with placebo, was consistent in patients with or without COPD for all outcomes, e.g. hazard ratio for the primary outcome 0.66 (0.50–0.85) for COPD and 0.65 (0.58–0.73) for no COPD (interaction p = 0.93). MRA-induced hyperkalaemia was less frequent in patients with COPD.\ud \ud Conclusions:\ud \ud In RALES and EMPHASIS-HF, one-in-seven patients with HFrEF had coexisting COPD. HFrEF patients with COPD had worse outcomes than those without. The benefits of MRAs were consistent, regardless of COPD status.

Published
2022

12. Analysis Survival of Breast Cancer with Brain Metastases Treated with Different Fraction Whole Brain Radiotherapy Concomitant with Capecitabine

Author

Rudiyo Yeoh, Jacub Pandelaki, Hendriyo Yeoh, Adang Bachtiar, Juli Jamnasi, William Omar, Suzy Indharty, Iskandar Japardi, Aznan Lelo, Sudibio Sudibio, and R. Susworo

Subjects
Oncology, Response rate (survey), medicine.medical_specialty, business.industry, medicine.medical_treatment, Whole brain radiotherapy, Cancer, COHORT ANALYTIC STUDY, General Medicine, medicine.disease, Capecitabine, Radiation therapy, Breast cancer, Internal medicine, Concomitant, Medicine, business, medicine.drug
Abstract

Introduction: Breast cancer is the second most frequent cancer worldwide. The main therapeutic modality for breast cancer with brain metastases is radiation. Whole Brain Radiotherapy (WBRT) is a treatment that provides moderate doses of radiotherapy to all brain tissue. Capecitabine was found to be effective for the treatment of breast cancer with metastases and its metabolites can cross the BBB in animal models. Objective: This study aims to determine the response and survival of breast cancer patient with brain metastases treated with different fractionation WBRT combined with capecitabine administration. Materials and methods: This is a prospective, randomized-blind cohort analytic study. Subjects were randomized into two groups by giving different fraction of WBRT (Group I WBRT 10x3Gy and Group II WBRT 20x2Gy) concomitant with capecitabine 850-1000mg/m2. OS was calculated from brain metastases diagnosis. Median follow-up was 5.6 months. Results: A total of 22 breast cancer patients with brain metastases participated in this study. Group I obtained results of 5 (45.5%) out of 11 are responding to therapy and median OS was 4.4 months. Whereas in group II found 11 (100%) out of 11 patients responded to therapy and median OS was 9.4 months. The results of statistical analysis showed that there were significant differences of response between the two groups with p value= 0.012. The differences of survival of each group also statistically significant with p value=0.004 Conclusions: WBRT with 20x2Gy concomitant with Capecitabine gives a better response rate and OS.

Published
2021

13. A chat with 'Mr. Asia'

Author

Hoon, Yeoh Siew

Subjects
Singapore -- Description and travel -- Public opinion, Travelers -- Interviews, Business, Travel industry
Abstract

Bob Guy first visited Singapore in 1971 when he was serving in the military in Vietnam and one of his tasks was to check out R&R spots. Back then, the [...]

Published
2023

14. Measurement of Plaque Characteristics Using Coronary Computed Tomography Angiography: Achieving High Interobserver Performance

Author

G.B. John Mancini, Eunice Yeoh, Craig Kamimura, C. David Mazer, and Arnold Ryomoto

Subjects
Reproducibility, Training set, Correlation coefficient, business.industry, Operating procedures, Coronary computed tomography angiography, medicine.anatomical_structure, Standard error, Observer performance, RC666-701, medicine, Diseases of the circulatory (Cardiovascular) system, Cardiology and Cardiovascular Medicine, business, Nuclear medicine, Artery
Abstract

Background: Coronary computed tomography angiography (CCTA) is used to assess plaque characteristics, remodelling, and progression and regression. Few papers address standard operating procedures that ensure achievement of high interobserver reproducibility. Moreover, assessment of coronary artery bypass grafts has not been reported. Methods: A training set of images was created of native coronary segments, spanning the full range of atheromatous disease from normal to severe, excluding totally occluded segments, and including segments with or without calcification (n = 24) and completely normal-appearing bypass grafts (n = 16). Three observers used a validated software program during a training phase to establish standard operating procedures and then to achieve high intraobserver performance based on Pearson’s correlation coefficient. Subsequently, interobserver variability for the laboratory as a whole was determined with a focus on measures of plaque volume, low- attenuation plaque (LAP), mixed plaque (MP), and calcified plaque (CP). Results: We found no substantive differences in analytical issues between grafts and native vessels and emphasize the aggregated data. The range of mean total plaque percent was approximately 55% of total vessel volume with maximal interobserver mean absolute differences of 2% or less. Percent of LAP, MP, and CP demonstrated interobserver standard errors of 1% to 2% and interobserver mean absolute differences of 0% to 1%. Pearson’s correlations were all highly significant and ranged from 0.969 to 0.999. Conclusions: CCTA provides a rich diversity of measures of atherosclerosis in coronary and bypass segments that are highly reproducible with experience and adherence to standard operating procedures. Résumé: Introduction: L’angiographie cardiaque par tomodensitométrie (TDM) est utilisée pour évaluer les caractéristiques, le remodelage, la progression et la régression de la plaque. Peu d’articles portent sur les procédures opérationnelles normalisées qui permettent d’atteindre une reproductibilité inter-observateurs élevée. De plus, les greffons de pontage aorto-coronarien n’ont pas fait l’objet d’évaluation. Méthodologie: Un ensemble de formation composé d’images de segments d’artères coronaires natives couvrant l’ensemble de la maladie athéromateuse, c’est-à-dire de normale à sérieuse, à l’exclusion des segments totalement obstrués, mais y compris les segments calcifiés ou non (n = 24) et les greffons de pontage qui apparaissent complètement normaux (n = 16) a été créé. Trois observateurs ont utilisé un programme informatique validé durant la phase de formation pour établir des procédures opérationnelles normalisées et ensuite pour atteindre une performance intra-observateurs élevée en fonction du coefficient de corrélation de Pearson. Subséquemment, la variabilité inter-observateurs du laboratoire dans son ensemble a été déterminée plus particulièrement par les mesures du volume de la plaque, la plaque de faible atténuation (PFA), la plaque mixte (PM) et la plaque calcifiée (PC). Résultats: Nous n’avons constaté aucune différence dans les difficultés analytiques entre les greffons et les vaisseaux natifs et faisons valoir les données regroupées. La fourchette du pourcentage total moyen de la plaque était approximativement de 55 % du volume total du vaisseau avec des différences inter-observateurs absolues moyennes maximales de 2 % ou moins. Le pourcentage de la PFA, de la PM et de la PC a démontré des erreurs types inter-observateurs de 1 % à 2 % et des différences absolues moyennes inter-observateurs de 0 % à 1 %. Les corrélations de Pearson étaient toutes hautement significatives et allaient de 0,969 à 0,999. Conclusions: La TDM offre une riche diversité de mesures de l’athérosclérose dans les segments d’artères coronaires et de pontage qui, avec l’expérience et le respect des procédures opérationnelles normalisées, sont très reproductibles.

Published
2022

15. A Multi-Cluster-Based Distributed CDD Scheme for Asynchronous Joint Transmissions in Local and Private Wireless Networks

Author

Philip Orlik, Yukimasa Nagai, Kyeong Jin Kim, Jianlin Guo, H. Vincent Poor, Phee Lep Yeoh, and Hongwu Liu

Subjects
Scheme (programming language), Wireless network, business.industry, Computer science, Applied Mathematics, Multi cluster, Computer Science Applications, Asynchronous communication, Electrical and Electronic Engineering, business, Joint (audio engineering), computer, Computer network, computer.programming_language
Published
2022

16. Wireless Secret Key Generation for Distributed Antenna Systems: A Joint Space-Time-Frequency Perspective

Author

Yan Zhang, Zunwen He, Branka Vucetic, Yonghui Li, Phee Lep Yeoh, Hao Yin, Zijie Ji, and Bin Li

Subjects
Key generation, Computer Networks and Communications, Computer science, business.industry, Orthogonal frequency-division multiplexing, Encryption, Multiplexing, Computer Science Applications, Hardware and Architecture, Channel state information, Signal Processing, Wireless, Randomness tests, business, Decorrelation, Information Systems, Computer network
Abstract

Wireless secret key generation has emerged as a promising technique for Internet of Things (IoT) systems to establish shared encryption keys between the server and legitimate mobile user. This paper focuses on the use of multi-domain joint information to achieve a high key generation rate (KGR) and the implementation of a reliable, low-complexity secret key generation mechanism for distributed antenna systems (DAS) with orthogonal-frequency division multiplexing (OFDM). We present a space-time-frequency channel state information (CSI)-based key generation scheme based on a two-step approach of adaptive link selection and stepwise decorrelation algorithms. The performance is evaluated in terms of KGR, key disagreement rate (KDR), randomness, and computational complexity by using both a standardized channel model and real-world measurements. Numerical results show that our proposed low-complexity algorithms effectively utilize the space-time-frequency CSI to multiply the KGR in both indoor and outdoor environments. Through adaptive link selection in DAS, the KDR is maintained within a correctable range, thereby ensuring the validity of generated keys in dynamic environments. Further applying stepwise decorrelation reduces the computational complexity by more than half while satisfying all eight key generation randomness tests in the NIST test suite.

Published
2022

17. Mucosal microbiome associates with progression to gastric cancer

Author

Shijia Joy Chua, Wei Jie Jonathan Lee, Chin Wen Png, Yong Liang Zhang, Feng Zhu, and Khay Guan Yeoh

Subjects
Helicobacter pylori, business.industry, gastric cancer, microbiome, Medicine (miscellaneous), Cancer, intestinal metaplasia, medicine.disease, Gastrointestinal Microbiome, Gastric Mucosa, Stomach Neoplasms, early gastric neoplasia, medicine, Cancer research, Dysbiosis, Humans, Longitudinal Studies, Prospective Studies, Microbiome, business, Pharmacology, Toxicology and Pharmaceutics (miscellaneous), Research Paper
Abstract

Background & Aims: Dysbiosis is associated with gastric cancer (GC) development. However, no longitudinal study was carried out to identify key bacteria that could predict for GC progression. Here, we aimed to investigate changes in bacterial metagenome prior to GC and develop a microbiome-based predictive model to accurately classify patients at risk of GC. Methods: Bacterial 16S rDNA was sequenced from 89 gastric antral biopsies obtained from 43 participants. This study was nested in a prospective, longitudinal study, whereby study participants underwent screening gastroscopy, with further 1-2 yearly surveillance gastroscopies for at least 5 years. Putative bacterial taxonomic and functional features associated with GC carcinogenesis were identified by comparing between controls, patients with gastric intestinal metaplasia (IM) and patients with early gastric neoplasia (EGN). Results: Patients with EGN had enrichment of Proteobacteria (in particular Proteus genus) and depletion of Bacteroidetes (in particular S24-7 family) in their gastric mucosa. Sequencing identified more patients with Helicobacter pylori compared to histopathological assessment, while H. pylori was also significantly enriched in EGN. Furthermore, a total of 261 functional features, attributing to 97 KEGG pathways were differentially abundant at baseline between patients who subsequent developed EGN (n = 13/39) and those who did not. At the same time, a constellation of six microbial taxonomic features present at baseline, provided the highest classifying power for subsequent EGN (AUC = 0.82). Conclusion: Our study highlights early microbial changes associated with GC carcinogenesis, suggesting a potential role for prospective microbiome surveillance for GC.

Published
2022

18. Distinct clinical characteristics ofDUX4-andPAX5-altered childhood B-lymphoblastic leukemia

Author

Shawn Hsien Ren Lee, Grace Shimin Koh, Evelyn Huizi Lim, Bernice Ling Zhi Oh, Yi Lu, Zhenhua Li, Thuan Chong Quah, Ah Moy Tan, Allen Eng Juh Yeoh, Hany Ariffin, Nan Jiang, Zhiwei Chen, Winnie Hui Ni Chin, Hai Peng Lin, Elaine Coustan-Smith, Jun J. Yang, Shirley Kow Yin Kham, and Kean Hui Chiew

Subjects
Vincristine, medicine.medical_specialty, Neoplasm, Residual, business.industry, B lymphoblastic leukemia, Lymphoma, Non-Hodgkin, Treatment intensification, PAX5 Transcription Factor, Hematology, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Prognosis, Gastroenterology, Peripheral blood, DUX4, Internal medicine, Prednisolone, Humans, Medicine, PAX5, Child, business, Intermediate risk, medicine.drug
Abstract

Among the recently described subtypes in childhood B-lymphoblastic leukemia (B-ALL) were DUX4- and PAX5-altered (PAX5alt). By using whole transcriptome RNA sequencing in 377 children with B-ALL from the Malaysia-Singapore ALL 2003 (MS2003) and Malaysia-Singapore ALL 2010 (MS2010) studies, we found that, after hyperdiploid and ETV6-RUNX1, the third and fourth most common subtypes were DUX4 (n = 51; 14%) and PAX5alt (n = 36; 10%). DUX4 also formed the largest genetic subtype among patients with poor day-33 minimal residual disease (MRD; n = 12 of 44). But despite the poor MRD, outcome of DUX4 B-ALL was excellent (5-year cumulative risk of relapse [CIR], 8.9%; 95% confidence interval [CI], 2.8%-19.5% and 5-year overall survival, 97.8%; 95% CI, 85.3%-99.7%). In MS2003, 21% of patients with DUX4 B-ALL had poor peripheral blood response to prednisolone at day 8, higher than other subtypes (8%; P = .03). In MS2010, with vincristine at day 1, no day-8 poor peripheral blood response was observed in the DUX4 subtype (P = .03). The PAX5alt group had an intermediate risk of relapse (5-year CIR, 18.1%) but when IKZF1 was not deleted, outcome was excellent with no relapse among 23 patients. Compared with MS2003, outcome of PAX5alt B-ALL with IKZF1 codeletion was improved by treatment intensification in MS2010 (5-year CIR, 80.0% vs 0%; P = .05). In conclusion, despite its poor initial response, DUX4 B-ALL had a favorable overall outcome, and the prognosis of PAX5alt was strongly dependent on IKZF1 codeletion.

Published
2021

19. A positive urine pregnancy test with haemoperitoneum: misdiagnosed postpartum choriocarcinoma with uterine rupture mimicking ruptured ectopic pregnancy

Author

Soon-Leong Yong, Marcus Kang, Shakti Yeoh, and Pak-Inn Teoh

Subjects
medicine.medical_specialty, Ectopic pregnancy, business.industry, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Choriocarcinoma, Perforation (oil well), Uterus, General Medicine, medicine.disease, Surgery, Uterine rupture, Endocrinology, medicine.anatomical_structure, Acute abdomen, Laparotomy, medicine, medicine.symptom, business, Molecular Biology, Postpartum period
Abstract

Objectives Choriocarcinoma after a term pregnancy is rare and can be life-threatening, especially when it perforates the uterus, resulting in massive haemoperitoneum. As uterine rupture due to choriocarcinoma is uncommonly encountered in the clinical practice, its diagnosis is often missed or delayed. Case presentation We present a case of a 41-year-old para 4 + 1 who had acute abdomen and hypovolaemic shock secondary to haemoperitoneum at three months postpartum period. The urine pregnancy test was positive, and, therefore, a provisional diagnosis of a ruptured ectopic pregnancy was made. She was managed aggressively with fluids and blood product transfusion at the emergency department to achieve haemodynamic stability. Subsequently, she underwent an emergency laparotomy where intraoperatively noted a perforation at the left posterior uterine cornu with purplish tissue spillage. A wedge resection was performed, and the histopathological examination (HPE) was reported as atypical trophoblastic cells, in which choriocarcinoma could not be ruled out. The patient then underwent a total abdominal hysterectomy three weeks later. The final HPE confirmed the diagnosis of choriocarcinoma. Conclusions The clinical presentation of postpartum choriocarcinoma can be indistinguishable from a ruptured ectopic pregnancy. A high index of suspicion is crucial to allow early diagnosis.

Published
2021

20. A Weighted Scoring System Based on Preoperative and Long-Term Patient-Reported Outcome Measures to Guide Timing of Knee Arthroplasty

Author

Ngai Nung Lo, Jerry Yongqiang Chen, Zhi Guang Felix Yeoh, Ming Han Lincoln Liow, Yong Zhi Khow, and Seng Jin Yeo

Subjects
musculoskeletal diseases, medicine.medical_specialty, Scoring system, Knee Joint, business.industry, Minimal clinically important difference, medicine.medical_treatment, Evidence-based medicine, Prom, Osteoarthritis, Knee, Arthroplasty, female genital diseases and pregnancy complications, humanities, Term (time), Treatment Outcome, Physical therapy, medicine, Humans, Orthopedics and Sports Medicine, Patient-reported outcome, Patient Reported Outcome Measures, Arthroplasty, Replacement, Knee, business, Oxford knee score
Abstract

Background There is currently no existing consensus regarding timing of knee arthroplasty. This study aimed to develop a weighted scoring system from patient-reported outcome measures (PROMs) to guide timing of knee arthroplasty based on preoperative severity and long-term effectiveness. Methods Prospectively collected data of 766 total knee arthroplasties (TKAs) and 382 unicompartmental knee arthroplasties (UKAs) at a single institution were analyzed. PROMs were assessed preoperatively and at 10 years using the Knee Society Score (KSS), Oxford Knee Score (OKS), and Short Form-36 physical component score (SF-36 PCS). Receiver operating characteristic analysis identified thresholds where preoperative PROMs predicted 10-year clinically meaningful improvements (minimal clinically important difference [MCID]). Threshold weights were assigned to PROMs based on their ability to predict MCID in isolation or in combination. Results Poorer baseline PROMs predicted 10-year MCID attainments. The threshold of 49.5 points for the KSS, 30.5 points for the OKS, and 40.7 points for the SF-36 PCS and 55.5 points for the KSS, 33.5 points for the OKS, and 40.5 points for the SF-36 PCS was weighted 1 point for predicting MCID in 1 PROM for TKA and UKA, respectively. The threshold of 33.4 and 33.9 points for the SF-36 PCS was weighted 2 points for predicting MCID in 2 PROMs, whereas 29.3 and 31.3 points for the SF-36 PCS were weighted 3 points for predicting MCID in 3 PROMs for TKA and UKA, respectively. The sum of weighted components from 0 (lowest) to 5 (highest) represented likelihood for long-term benefits at 10 years. Conclusion This scoring system is a useful clinical adjunct for deciding timing of knee arthroplasty and prioritizing patients in institutions with long waitlists. Level of Evidence II.

Published
2021

21. Frailty status, timely goals of care documentation and clinical outcomes in older hospitalised medical patients

Author

Ravindranath Tiruvoipati, Michael Bailey, Faisal Hussain, Ashwin Subramaniam, Cameron Green, Aun Chian Yeoh, Velandai Srikanth, David Pilcher, and Lionel Soh

Subjects
medicine.medical_specialty, Frail Elderly, Psychological intervention, MEDLINE, Documentation, 030204 cardiovascular system & hematology, Age and sex, Patient Care Planning, 03 medical and health sciences, 0302 clinical medicine, Older patients, Internal Medicine, Humans, Medicine, 030212 general & internal medicine, Geriatric Assessment, Rapid response, Aged, Retrospective Studies, Aged, 80 and over, Medical unit, Framingham Risk Score, Frailty, business.industry, Retrospective cohort study, Length of Stay, Emergency medicine, business, human activities
Abstract

OBJECTIVE Hospitalised frail older patients are at risk of clinical deterioration. Early goals of care documentation (GOC) is vital to avoid futile/unwarranted interventions in the event of deterioration. We aimed to investigate the impact of frailty on timely GOC and its association with clinical outcomes in hospitalised older patients. DESIGN, SETTING, PARTICIPANTS Single-centre retrospective study of all medical patients aged ≥80 years admitted to acute medical unit between 1/3/2015 and 31/8/2015, with GOC derived from electronic records. Frailty was measured using Hospital Frailty Risk Score (HFRS) derived from hospital coding data. MAIN OUTCOME MEASURES Primary outcome compared proportions timely GOC within 72-h between frail (HFRS≥5) and non-frail (HFRS

Published
2021

22. An Exploration of Cost Overrun in Building Construction Projects

Author

Keng, Tan Chin, Mansor, Norizzati, and Ching, Yeoh Kah

Subjects
Business
Abstract

Purpose: Within the context of promoting financial stability of Islamic countries, this study is focusing on the issue of cost overrun in building construction projects in Malaysia, the objectives of this study are to determine causes of cost overrun in building construction projects and to identify the strategies to overcome cost overrun problem in building construction projects.Design/methodology/approach: The data obtained from the questionnaires survey were analyzed by using Statistical Package for Social Science (SPSS) version 20.Findings: The study concludes that design changes and project delays are the major causes of cost overrun in building construction projects. The suggested strategies to reduce these problems are to ensure the project designs are detail, to ensure the design changes are with authorization of relevant project party, to get in-depth information on the complicated parts of a project, and to prepare a detailed material schedule planning in accordance with the scope of works to prevent premature material delivery to site.Research limitations/implications: The findings of the study are based on responses from thirty-two (32) respondents.Practical implications: The study has proposed several strategies to overcome cost overrun problem in building construction projects.Originality/value: The findings of this study have practical value towards the development of the construction industry.Keywords: Cost Overrun, Construction Projects, Causes, Strategies., IntroductionCost is one of the major considerations throughout the lifecycle of a construction project. Unfortunately, Hameed Memon, Rahman, Abdullah, Asmi and Azis (2014) stated that most of the construction projects [...]

Published
2018

23. Factors reducing inappropriate attendances to emergency departments before and during the COVID-19 pandemic: A multicentre study

Author

Lorraine Yong, Yi Song Terence Liew, Wei Ming Ng, Lawrence Siu-Chun Law, Ziwei Lin, Chew Kiat Yeoh, Win Sen Kuan, Lenard Cheng, Ian Mathews, and Wei Ping Daniel Chor

Subjects
Coronavirus disease 2019 (COVID-19), SARS-CoV-2, business.industry, COVID-19, General Medicine, medicine.disease, Communicable Disease Control, Pandemic, Humans, Medicine, Medical emergency, Emergency Service, Hospital, business, Pandemics, Retrospective Studies
Abstract

Introduction: Inappropriate attendances (IAs) to emergency departments (ED) create an unnecessary strain on healthcare systems. With decreased ED attendance during the COVID-19 pandemic, this study postulates that there are less IAs compared to before the pandemic and identifies factors associated with IAs. Methods: We performed a retrospective review of 29,267 patient presentations to a healthcare cluster in Singapore from 7 April 2020 to 1 June 2020, and 36,370 patients within a corresponding period in 2019. This time frame coincided with local COVID-19 lockdown measures. IAs were defined as patient presentations with no investigations required, with patients eventually discharged from the ED. IAs in the 2020 period during the pandemic were compared with 2019. Multivariable logistic regression was performed to identify factors associated with IAs. Results: There was a decrease in daily IAs in 2020 compared to 2019 (9.91±3.06 versus 24.96±5.92, P

Published
2021

24. One-year comparative assessment of retention of arch width increases between modified vacuum-formed and Hawley retainers

Author

Lew Xian, Sindhu Sinnasamy, Rohaya Megat Abdul Wahab, Yeoh Chiew Kit, Asma Ashari, Malathi Deva Tata, Elavarasi Kuppusamy, and Alizae Marny Fadzlin Syed Mohamed

Subjects
Molar, Orthodontics, Randomization, Vacuum, business.industry, Clinical effectiveness, Arch width, Original Articles, Data analyst, Treatment Outcome, Distobuccal cusp, Humans, Orthodontic Appliance Design, Medicine, Retention period, business, Orthodontic Retainers, Mesiobuccal cusp
Abstract

Objectives To compare the clinical effectiveness of Hawley retainers (HRs) and modified vacuum-formed retainers (mVFRs) with palatal coverage in maintaining transverse expansion during a 12-month retention period. Materials and Methods Data were collected from postorthodontic treatment patients who met the inclusion criteria. A total of 35 patients were randomly allocated using a centralized randomization technique into either mVFR (n = 18) or HR group (n = 17). The outcome assessor and data analyst were blinded to the retention method. Dental casts of patients were evaluated at debond, 3 months, 6 months, and 12 months of retention. Intercanine width (ICW), interpremolar width (IPMW), interfirst molar mesiobuccal cusp width 1 (IFMW1), and interfirst molar distobuccal cusp width 2 (IFMW2) were compared between groups over time using mixed analysis of variance. Results No statistically significant differences were found between the two groups for ICW (P = .76), IPMW (P = .63), IFMW1 (P = .16), and IFMW2 (P = .40) during the 12-month retention period. Conclusions The null hypothesis could not be rejected. HR and mVFR had similar clinical effectiveness in the retention of transverse expansion cases during a 12-month retention period.

Published
2021

25. Tensor Factorization-Based Prediction With an Application to Estimate the Risk of Chronic Diseases

Author

Haolin Wang, Qingpeng Zhang, Eng-Kiong Yeoh, Frank Y. Chen, Eman Yee Man Leung, and Eliza L.Y. Wong

Subjects
medicine.medical_specialty, Tensor factorization, Health management system, Computer Networks and Communications, business.industry, Computer science, Disease, medicine.disease, Comorbidity, Artificial Intelligence, Health care, medicine, High dimensionality, Intensive care medicine, business, One chronic disease, Risk assessment
Abstract

Tensor factorization has emerged as a powerful method to address the challenges of high dimensionality and sparsity regarding disease development and comorbidity. Chronic diseases have a high likelihood to co-occur, making patients suffering from one chronic disease to have an elevated risk for other diseases in the course of aging. Despite rich results of risk assessment models for chronic diseases, risk prediction considering the complex mechanisms of disease development and comorbidity remains to be under-researched. This research aims to develop tensor factorization-based methods to predict the onset of new chronic diseases through incorporating the comorbidity patterns with the clinical and sequential factors revealed in the electronic health records (EHRs). The efficacy of the proposed methods was validated through predicting the onset of new chronic diseases using the EHRs data for 23 years from a major hospital in Hong Kong. The proposed methods could inform proactive health management programs for at-risk patients with different chronic conditions.

Published
2021

26. Acceptance of pneumococcal vaccination in older adults: A general population-based survey

Author

Eliza L.Y. Wong, Eng-Kiong Yeoh, Hanyue Ding, Boyuan Wang, Chun Ho Ngai, Kin-On Kwok, Martin C.S. Wong, Yijun Bai, and Junjie Huang

Subjects
Health Knowledge, Attitudes, Practice, Population, Logistic regression, Pneumococcal Infections, Pneumococcal Vaccines, Surveys and Questionnaires, Humans, Medicine, Health belief model, education, Population based survey, Aged, education.field_of_study, General Veterinary, General Immunology and Microbiology, business.industry, Vaccination, Public Health, Environmental and Occupational Health, Odds ratio, Confidence interval, Cross-Sectional Studies, Infectious Diseases, Pneumococcal vaccination, Molecular Medicine, business, Demography
Abstract

BACKGROUND Pneumococcal infection is a leading cause of disability and death globally. The Hong Kong Government has launched two programmes for pneumococcal vaccination - The Vaccination Subsidy Scheme (VSS) and the Government Vaccination Programme (GVP). This study aimed to examine the enabling factors, obstacles and perception of pneumococcal vaccination, and their association with its uptake in a general Chinese population. METHODS We performed a population-based, telephone survey in the general public aged 65 or above via simple random sampling. A validated survey based on the Health Belief Model (HBM) was used. Their socio-demographic information; history of previous participation in the GVP or VSS; and self-perceived health status were captured. Binary logistic regression models were constructed to examine the factors independently associated with vaccination. RESULTS A total of 1,000 respondents were enrolled in the study, with 402 (40.2%) respondents having intention to join the GVP/VSS in 12 months. Respondents with long-term medical consultant and medication (adjusted odds ratios [aOR] = 1.541, 95% confidence interval (CI): 1.008-2.356, p = 0.046); high levels of perceived susceptibility of infections (aOR = 3.624, 95 %CI: 2.318-5.665, p

Published
2021

27. Using Consolidated Framework for Implementation Research to investigate facilitators and barriers of implementing alcohol screening and brief intervention among primary care health professionals: a systematic review

Author

Martin C.S. Wong, Junjie Huang, Zixin Wang, Paul Shing-fong Chan, Eng-Kiong Yeoh, and Yuan Fang

Subjects
Counseling, Medicine (General), Facilitators, Health Personnel, MEDLINE, Health Informatics, PsycINFO, Health informatics, Consolidated Framework for Implementation Research, Health administration, R5-920, Nursing, Humans, Mass Screening, Medicine, Health policy, Primary Health Care, business.industry, Health Policy, Alcohol screening, Public Health, Environmental and Occupational Health, Health services research, General Medicine, Primary care, Brief intervention, Crisis Intervention, Health professionals, Systematic Review, Implementation research, business, Barriers
Abstract

Background Alcohol screening and brief intervention (SBI) is recommended to be implemented in primary care settings to intervene against hazardous/harmful drinking. However, studies showed that the uptake rate was low in many regions/countries. This systematic review presented current findings on the facilitators and barriers of SBI implemented by health professionals in primary care settings using the Consolidated Framework for Implementation Research (CFIR). Methods We included qualitative, quantitative, and mixed-method studies identified through four electronic databases (PubMed, MEDLINE, PsycInfo, and Web of Science) from inception to June 2020. Included articles had to address barriers and facilitators of SBI implementation and provide sufficient details that the CFIR domains could be identified and data were abstracted using a standardized extraction form. Results A total of 74 studies published from 1985 to 2019 were finally analysed and summarized. The most common facilitators were knowledge and positive beliefs about SBI (characteristics of the individuals) and available resources (inner setting). In contrast, the most common barriers were cost related to implementing SBI (intervention characteristics), negative beliefs about SBI (characteristics of the individuals), and lack of self-efficacy in implementing SBI (characteristics of the individuals). It could be observed that factors related to the inner setting and characteristics of individuals were extensively studied whilst the process received the least attention. Conclusions Most of the facilitators and barriers are modifiable. Additionally, most literature focused on various kinds of available assets to implement SBI. To promote the spread of SBI implementation, more high-quality studies on the implementation process are needed. This systematic review could serve as a reference framework for health authorities to devise strategies for improving the implementation of SBI in primary care settings. Trial registration This systematic review was registered in PROSPERO (CRD42021258833).

Published
2021

28. Complicated Paediatric Bronchial Foreign Body: A Novel Extraction Technique

Author

Khairul Bariah Noh, Ng Siew Peng, Zaid Nailul Murad, Ong Fei Ming, Boon Chye Gan, Zakaria Zahirrudin, Yeoh Xing Yi, Goh Bee See, and Fathiyah Idris

Subjects
medicine.medical_specialty, business.industry, Mechanical Engineering, Extraction (chemistry), medicine, Energy Engineering and Power Technology, BRONCHIAL FOREIGN BODY, Radiology, Management Science and Operations Research, business
Abstract

A paediatric bronchoscopy procedure for foreign body inhalation is indeed a highly challenging procedure due to multiple risk factors such as lower physiological functional residual capacity and adverse pulmonary function effects by anaesthetic agents in addition to concurrent active lungs infection. Here we elucidate a novel technique of foreign body removal located at the distal airway in a paediatric patient and in a situation where a paediatric flexible bronchoscopy with built-in working channel is not available. A 1-year 7-months-old boy presented with acute respiratory distress syndrome following a one-week history of active respiratory infection. On examination, he was tachypnoeic with audible soft inspiratory stridor and intermittent barking cough despite being supplemented with 3 liters /minute oxygen mask. Chest x-ray showed right upper lobe collapse. He was referred to the otorhinolaryngology team after a suspicious history of foreign body aspiration obtained from his mother. Bedside flexible nasopharyngolaryngoscopy showed granulation tissue at the junction of laryngeal surface of epiglottis and anterior commissure. He underwent emergency direct laryngoscopy, tracheoscopy, bronchoscopy, excision of granulation tissue and removal of foreign body under general anaesthesia. Herein, some of complicated bronchoscopy demand critical thinking of alternative or modified techniques to achieve a successful and safe surgery. Bangladesh J Otorhinolaryngol 2021; 27(2): 177-183

Published
2021

29. Enhancing dam safety evaluation using dam digital twins

Author

Justin K. W. Yeoh, Ningxiao Jia, Tengfei Bao, Xi Zhu, and Hui Li

Subjects
business.industry, Computer science, Mechanical Engineering, Ocean Engineering, Building and Construction, Geotechnical Engineering and Engineering Geology, GeneralLiterature_MISCELLANEOUS, Construction engineering, Building information modeling, Long term monitoring, Industry Foundation Classes, Safety, Risk, Reliability and Quality, business, Civil and Structural Engineering
Abstract

Comprehensive evaluation of dams in a dynamic and proactive way is accepted as an effective strategy to improve dam safety. However, there is a lack of efficient and standardised approaches for man...

Published
2021

30. Practical Considerations for Using RNA Sequencing in Management of B-Lymphoblastic Leukemia

Author

Winnie Hui Ni Chin, Evelyn Huizi Lim, Joshua Yew Suang Lim, Bernice Ling Zhi Oh, Nan Jiang, Zhenhua Li, Kean Hui Chiew, Hany Ariffin, Allen Eng Juh Yeoh, Jun J. Yang, Shirley Kow Yin Kham, Yi Lu, and Ah Moy Tan

Subjects
Oncology, Sanger sequencing, medicine.medical_specialty, Thiopurine methyltransferase, biology, business.industry, Genetic heterogeneity, Disease, medicine.disease, Pathology and Forensic Medicine, symbols.namesake, Leukemia, Workflow, Internal medicine, medicine, symbols, biology.protein, Molecular Medicine, Immunoglobulin heavy chain, Oncogene Fusion, business
Abstract

Despite the immense genetic heterogeneity of B-lymphoblastic leukemia [or precursor B-cell acute lymphoblastic leukemia (B-ALL)], RNA sequencing (RNA-Seq) could comprehensively interrogate its genetic drivers, assigning a specific molecular subtype in >90% of patients. However, study groups have only started to use RNA-Seq. For broader clinical use, technical, quality control, and appropriate performance validation are needed. We describe the development and validation of an RNA-Seq workflow for subtype classification, TPMT/NUDT15/TP53 variant discovery, and immunoglobulin heavy chain (IGH) disease clone identification for Malaysia-Singapore acute lymphoblastic leukemia (ALL) 2020. We validated this workflow in 377 patients in our preceding Malaysia-Singapore ALL 2003/Malaysia-Singapore ALL 2010 studies and proposed the quality control measures for RNA quality, library size, sequencing, and data analysis using the International Organization for Standardization 15189 quality and competence standard for medical laboratories. Compared with conventional methods, we achieved >95% accuracy in oncogene fusion identification, digital karyotyping, and TPMT and NUDT15 variant discovery. We found seven pathogenic TP53 mutations, confirmed with Sanger sequencing, which conferred a poorer outcome. Applying this workflow prospectively to the first 21 patients in Malaysia-Singapore ALL 2020, we identified the genetic drivers and IGH disease clones in >90% of patients with concordant TPMT, NUDT15, and TP53 variants using PCR-based methods. The median turnaround time was 12 days, which was clinically actionable. In conclusion, RNA-Seq workflow could be used clinically in management of B-cell ALL patients.

Published
2021

31. In situ characterization of laser-generated melt pools using synchronized ultrasound and high-speed X-ray imaging

Author

Wei Yi Yeoh, Tao Sun, Niranjan D. Parab, Christopher M. Kube, Anthony D. Rollett, Jared Gillespie, Bo Lan, and Cang Zhao

Subjects
Materials science, Fabrication, Acoustics and Ultrasonics, business.industry, Laser, Thermal conduction, Characterization (materials science), law.invention, Optics, Arts and Humanities (miscellaneous), law, Metal powder, Ultrasonic sensor, business, Energy source, Keyhole
Abstract

Metal additive manufacturing is a fabrication method that forms a part by fusing layers of powder to one another. An energy source, such as a laser, is commonly used to heat the metal powder sufficiently to cause a molten pool to form, which is known as the melt pool. The melt pool can exist in the conduction or the keyhole mode where the material begins to rapidly evaporate. The interaction between the laser and the material is physically complex and difficult to predict or measure. In this article, high-speed X-ray imaging was combined with immersion ultrasound to obtain synchronized measurements of stationary laser-generated melt pools. Furthermore, two-dimensional and three-dimensional finite-element simulations were conducted to help explain the ultrasonic response in the experiments. In particular, the time-of-flight and amplitude in pulse-echo configuration were observed to have a linear relationship to the depth of the melt pool. These results are promising for the use of ultrasound to characterize the melt pool behavior and for finite-element simulations to aid in interpretation.

Published
2021

32. Gender-specific trends of educational inequality in diagnosed diabetes from 1999 to 2014 in Hong Kong: a serial cross-sectional study of 97,481 community-dwelling Chinese adults

Author

Francisco T. T. Lai, Eng-Kiong Yeoh, Roger Yat-Nork Chung, and Gary K K Chung

Subjects
Adult, Male, medicine.medical_specialty, Inequality, Epidemiology, Cross-sectional study, media_common.quotation_subject, Computer applications to medicine. Medical informatics, R858-859.7, Education, Diabetes Mellitus, Medicine, Humans, media_common, business.industry, Public health, Relative index of inequality, Research, Community trends, Diabetes, Public Health, Environmental and Occupational Health, Gender, Health Status Disparities, Educational inequality, Educational attainment, Cross-Sectional Studies, Socioeconomic Factors, Income, Household income, Educational Status, Hong Kong, Female, Independent Living, Inequalities, Public aspects of medicine, RA1-1270, business, Demography
Abstract

Background Gender differences in the trend of educational inequality in diabetes have been widely observed in the Western populations, indicating the increasing importance of educational attainment as a social determinant of diabetes among women. Nonetheless, relevant evidence is scarce in developed Asian settings for comparisons. This study examined the gender-specific trends of educational inequality in diagnosed diabetes in Hong Kong between 1999 and 2014. Methods A series of eight territory-wide population-representative samples of 97,481 community-dwelling Hong Kong Chinese adults aged 45 or above were surveyed between 1999 and 2014. Regression-based Relative Index of Inequality (RII) and age-standardized Slope Index of Inequality (SII) were adopted to examine the extent and trend of gender-specific educational inequality in self-reported physician-diagnosed diabetes. Results Age-standardized prevalence of diabetes increased in both genders over time, with a steeper surge among men. In addition, educational inequalities in diabetes, in both relative and absolute terms, significantly widened among women over the study period (annual RII change = 1.04; 95% CI = 1.02–1.07, annual SII change = 0.36%; 95% CI = 0.16–0.56%), with the peak in 2011 (RII = 2.44; 95% CI = 1.83–3.24, SII = 9.21%; 95% CI = 6.47–11.96%). However, no significant widening inequality was found among men. Further adjustment for household income level did not attenuate the observed educational inequality. Conclusions Despite a greater increase in diabetes prevalence among men, disparity in diabetes substantially widened across education levels among women in the past decade in Hong Kong. The gender perspective should be taken into considerations for policy making to alleviate the prevalence surge and rising educational inequality in diabetes.

Published
2021

33. Measuring health-related social deprivation in small areas: development of an index and examination of its association with cancer mortality

Author

Eng-Kiong Yeoh, Jiaying Zhao, Chi-Kin Law, Kailu Wang, Benjamin Hon Kei Yip, Alvin Yik-Kiu Hui, and Roger Yat-Nork Chung

Subjects
Adult, Male, medicine.medical_specialty, Chronic condition, Deprivation, Adolescent, Population, Chronic disease, Young Adult, Neoplasms, Poverty Areas, Health Status Indicators, Humans, Medicine, Small area indices, Mortality, Child, education, Health policy, Aged, Cancer, Aged, 80 and over, education.field_of_study, business.industry, Research, Health Policy, Public health, Infant, Newborn, Public Health, Environmental and Occupational Health, Health services research, Infant, Social environment, Health Status Disparities, Middle Aged, Social deprivation, Child, Preschool, Small-Area Analysis, Relative risk, Hong Kong, Female, Inequalities, Public aspects of medicine, RA1-1270, business, Demography
Abstract

Background The small-area deprivation indices are varied across countries due to different social context and data availability. Due to lack of chronic disease-related social deprivation index (SDI) in Hong Kong, China, this study aimed to develop a new SDI and examine its association with cancer mortality. Methods A total of 14 socio-economic variables of 154 large Tertiary Planning Unit groups (LTPUGs) in Hong Kong were obtained from 2016 population by-census. LTPUG-specific all-cause and chronic condition-related mortality and chronic condition inpatient episodes were calculated as health outcomes. Association of socio-economic variables with health outcomes was estimated for variable selection. Candidates for SDI were constructed with selected socio-economic variables and tested for criterion validity using health outcomes. Ecological association between the selected SDI and cancer mortality were examined using zero-inflated negative binomial regression. Results A chronic disease-related SDI constructed by six area-level socio-economic variables was selected based on its criterion validity with health outcomes in Hong Kong. It was found that social deprivation was associated with higher cancer mortality during 2011–2016 (most deprived areas: incidence relative risk [IRR] = 1.40, 95% confidence interval [CI]: 1.27–1.55; second most deprived areas: IRR = 1.34, 95%CI: 1.21–1.48; least deprived areas as reference), and the cancer mortality gap became larger in more recent years. Excess cancer death related to social deprivation was found to have increased through 2011–2016. Conclusions Our newly developed SDI is a valid and routinely available measurement of social deprivation in small areas and is useful in resource allocation and policy-making for public health purpose in communities. There is a potential large improvement in cancer mortality by offering relevant policies and interventions to reduce health-related deprivation. Further studies can be done to design strategies to reduce the expanding health inequalities between more and less deprived areas.

Published
2021

34. Rapid-stretch injury to peripheral nerves: comparison of injury models

Author

Wesley S Warner, Mark A. Mahan, Stewart Yeoh, and Ilyas M. Eli

Subjects
Stretch injury, business.industry, Axonal loss, General Medicine, Nerve injury, Neuroma, medicine.disease, Pathophysiology, Peripheral, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Anesthesia, medicine, Crush injury, medicine.symptom, Axon, business, 030217 neurology & neurosurgery
Abstract

OBJECTIVE Traditional animal models of nerve injury use controlled crush or transection injuries to investigate nerve regeneration; however, a more common and challenging clinical problem involves closed traction nerve injuries. The authors have produced a precise traction injury model and sought to examine how the pathophysiology of stretch injuries compares with that of crush and transection injuries. METHODS Ninety-five late-adolescent (8-week-old) male mice underwent 1 of 7 injury grades or a sham injury (n > 10 per group): elastic stretch, inelastic stretch, stretch rupture, crush, primary coaptation, secondary coaptation, and critical gap. Animals underwent serial neurological assessment with sciatic function index, tapered beam, and von Frey monofilament testing for 48 days after injury, followed by trichrome and immunofluorescent nerve histology and muscle weight evaluation. RESULTS The in-continuity injuries, crush and elastic stretch, demonstrated different recovery profiles, with more severe functional deficits after crush injury than after elastic stretch immediately following injury (p < 0.05). However, animals with either injury type returned to baseline performance in all neurological assessments, accompanied by minimal change in nerve histology. Inelastic stretch, a partial discontinuity injury, produced more severe neurological deficits, incomplete return of function, 47% ± 9.1% (mean ± SD) reduction of axon counts (p < 0.001), and partial neuroma formation within the nerve. Discontinuity injuries, including immediate and delayed nerve repair, stretch rupture, and critical gap, manifested severe, long-term neurological deficits and profound axonal loss, coupled with intraneural scar formation. Although repaired nerves demonstrated axon regeneration across the gap, rupture and critical gap injuries demonstrated negligible axon crossing, despite rupture injuries having healed into continuity. CONCLUSIONS Stretch-injured nerves present unique pathology and functional deficits compared with traditional nerve injury models. Because of the profound neuroma formation, stretch injuries represent an opportunity to study the pathophysiology associated with clinical injury mechanisms. Further validation for comparison with human injuries will require evaluation in a large-animal model.

Published
2021

35. Initial Invasive or Conservative Strategy for Stable Coronary Disease

Author

Maron D. J., Hochman J. S., Reynolds H. R., Bangalore S., O'Brien S. M., Boden W. E., Chaitman B. R., Senior R., Lopez-Sendon J., Alexander K. P., Lopes R. D., Shaw L. J., Berger J. S., Newman J. D., Sidhu M. S., Goodman S. G., Ruzyllo W., Gosselin G., Maggioni A. P., White H. D., Bhargava B., Min J. K., John Mancini G. B., Berman D. S., Picard M. H., Kwong R. Y., Ali Z. A., Mark D. B., Spertus J. A., Krishnan M. N., Elghamaz A., Moorthy N., Hueb W. A., Demkow M., Mavromatis K., Bockeria O., Peteiro J., Miller T. D., Szwed H., Doerr R., Keltai M., Selvanayagam J. B., Gabriel Steg P., Held C., Kohsaka S., Mavromichalis S., Kirby R., Jeffries N. O., Harrell F. E., Rockhold F. W., Broderick S., Bruce Ferguson T., Williams D. O., Harrington R. A., Stone G. W., Rosenberg Y, ISCHEMIA Research Group: Joseph Ricci, A Tello Montoliu, A I Robero Aniorte, Abbey Mulder, Abhay A Laddu, Abhinav Goyal, Abhishek Dubey, Abhishek Goyal, Abigail Knighton, Abraham Oomman, Adam J Jaskowiak, Adam Kolodziej, Adam Witkowski, Adnan Hameed, Adriana Anesini, Afshan Hussain, Agne Juceviciene, Agne Urboniene, Agnes Jakal, Agnieszka Szramowska, Ahmad Khairuddin, Ahmed Abdel-Latif, Ahmed Adel, Ahmed Aljzeeri, Ahmed Kamal, Ahmed Talaat, Aimee Mann, Aira Contreras, Ajit Kumar, V K Kumar, Akemi Furukawa, Akshay Bagai, Akvile Smigelskaite, Alain Furber, Alain Rheault, Alaine Melanie Loehr, Alan Rosen, Albert Varga, Albertina Qelaj, Alberto Barioli, Aldo Russo, Alec Moorman, Alejandro Gisbert, Aleksandra Fratczak, Aleksandras Laucevicius, Alena Kuleshova, Alessandro Sionis, Alexander A Sirker, Alexander M Chernyavskiy, Alexandra Craft, Alexandra Vazquez, Alexandre Ciappina Hueb, Alexandre S Colafranseschi, Alexandre Schaan de Quadros, Alexandre Tognon, Ali Alghamdi, Alice Manica Muller, Aline Nogueira Rabaça, Aline Peixoto Deiro, Alison Hallam, Allegra Stone, Allison Schley, Almudena Castro, Alvaro Rabelo Ales, Amanda Germann, Amanda O'Malley, Amar Uxa, Amarachi Ojajuni, Amarino C Oliveira Jr, Amber B Hull, Ambuj Roy, Amer Zarka, Amir Janmohamed, Ammani Brown, Ammy Malinay, Amparo Martinez Monzonis, Amy J Richards, Amy Iskandrian, Amy Ollinger, Ana D Djordjevic-Dikic, Ana Fernández Martínez, Ana Gomes Almeida, Ana Paula Batista, Ana Rita Francisco, Ana S Mladenovic, Ana Santana, Anam Siddiqui, Anastasia M Kuzmina-Krutetskaya, Andras Vertes, Andre S Sousa, Andre Gabriel, André Schmidt, Andrea M Lundeen, Andrea Bartykowszki, Andrea Lorimer, Andrea Mortara, Andrea Pascual, Andreia Coelho, Andreia Rocha, Andrés García-Rincón, Andrew G Howarth, Andrew J Moriarty, Andrew Docherty, Andrew Starovoytov, Andrew Zurick, Andrzej Łabyk, Andrzej Swiatkowski, Andy Lam, Anelise Kawakami, Angela Hoye, Angela Kim, Angelique Smit, Angelo Nobre, Anil V Shah, Anja Ljubez, Anjali Anand, Ankush Sachdeva, Ann Greenberg, Ann Luyten, Ann Ostrander, Anna Di Donato, Anna Cichocka-Radwan, Anna Fojt, Anna Plachcinska, Anna Proietti, Anna Teresinska, Anne Marie Webb, Anne Cartwright, Anne Heath, Anne Mackin, Anong Amaritakomol, Anong Chaiyasri, Anoop Chauhan, Anoop Mathew, Anthony Gemignani, Anto Luigi Andres, Antonia Vega, Antonietta Hansen, Antonino Ginel Iglesias, Antonio Carlos Carvalho, Antonio Di Chiara, Antonio Serra Peñaranda, Antonio Carvalho, Antonio Colombo, Antonio Fiarresga, Anupama Rao, Aquiles Valdespino-Estrada, Araceli Boan, Areef Ishani, Ariel Diaz, Arijit Ghosh, Arintaya Prommintikul, Arline Roberts, Arnold H Seto, Arnold P Good, Arshed Quyyumi, Arthur J Labovitz, Arthur Kerner, Arturo S Campos-Santaolalla, Arunima Misra, Ashok Mukherjee, Ashok Seth, Ashraf Seedhom, Asim N Cheema, Asker Ahmed, Atul Mathur, Atul Verma, Audrey W Leong, Axel Åkerblom, Axelle Fuentes, Aynun Naher, Badhma Valaiyapathi, Baljeet Kaur, Bandula Guruge, Barbara Brzezińska, Barbara Nardi, Bartosz Czarniak, Bebek Singh, Begoña Igual, Bela Merkely, Belen Cid Alvarez, Benjamin J Spooner, Benjamin J W Chow, Benjamin Cheong, Benoy N Shah, Bernard de Bruyne, Bernardas Valecka, Bernhard Jäger, Beth A Archer, Beth Abramson, Beth Jorgenson, Bethany Harvey, Betsy O'Neal, Bev Atkinson, Bev Bozek, Bevin Lang, Bijulal Sasidharan, Bin Yang, Bin Zhang, Binoy Mannekkattukudy Kurian, Bjoern Goebel, Bob Hu, Bogdan A Popescu, Bogdan Crnokrak, Bolin Zhu, Bonnie J Kirby, Brandi D Zimbelman, Brandy Starks, Branko D Beleslin, Brenda Hart, Brian P Shapiro, Brian McCandless, Brianna Wisniewski, Brigham R Smith, Brooks Mirrer, Bruce McManus, Bruce Rutkin, Bruna Edilena Paulino, Bruna Maria Ascoli, Bryn Smith, Byron J Allen, C Michael Gibson, C Noel Bairey Merz, Calin Pop, Cameron Hague, Camila Thais de Ormundo, Candace Gopaul, Candice P Edillo, Carísi A Polanczyk, Carita Krannila, Carla Vicente, Carl-Éric Gagné, Carlo Briguori, Carlos Peña Gil, Carlos Alvarez, Carly Ohmart, Carmen C Beladan, Carmen Ginghina, Carol M Kartje, Caroline Alsweiler, Caroline Brown, Caroline Callison, Caroline Pinheiro, Caroline Rodgers, Caroline Spindler, Carolyn Corbett, Carrie Drum, Casey Riedberger, Catherine Bone, Catherine Fleming, Catherine Gordon, Catherine Jahrsdorfer, Catherine Lemay, Catherine Weick, Cathrine Patten, Cecilia Goletto, Cezary Kepka, Chandini Suvarna, Chang Xu, Chantale Mercure, Charle A Viljoen, Charlene Wiyarand, Charles Jia-Yin Hou, Charles Y Lui, Charles Cannan, Charles Cornet, Charlotte Pirro, Chataroon Rimsukcharoenchai, Chen Wang, Cheng-Ting Tsai, Chen-Yen Chien, Cheryl A Allardyce, Chester M Hedgepeth, Chetan Patel, Chiara Attanasio, Chih-Hsuan Yen, Chi-Ming Chow, Ching Min Er, Ching-Ching Ong, Cholenahally Nanjappa Manjunath, Chris Beck, Chris Buller, Christel Vassaliere, Christian Hamm, Christiano Caldeira, Christie Ballantyne, Christina Björklund, Christine R Hinton, Christine Bergeron, Christine Masson, Christine Roraff, Christine Shelley, Christophe Laure, Christophe Thuaire, Christopher Kinsey, Christopher McFarren, Christopher Spizzieri, Christopher Travill, Chun-Chieh Liu, Chung-Lieh Hung, Chunguang Li, Chun-Ho Yun, Chunli Xia, Ciarra Heard, Cidney Schultz, Clare Venn-Edmonds, Claudia P Hochberg, Claudia Wegmayr, Claudia Cortés, Claudia Escobar, Cláudia Freixo, Claudio T Mesquita, Clemens T Kadalie, Colin Berry, Constance Philander, Corine Thobois, Costantino Costantini, Courtney Page, Craig Atkinson, Craig Barr, Craig Paterson, Cristina Bare, Cynthia Baumann, Cynthia Burman, Dalisa Espinosa, Damien Collison, Dan Deleanu, Dan Elian, Dan Gao, Dana Oliver, Daniel P Vezina, Daniel O'Rourke, Daniele Komar, Danielle Schade, Darrel P Francis, Dastan Malaev, David A Bull, David E Winchester, David P Faxon, David Booth, David Cohen, David DeMets, David Foo, David Schlichting, David Taggart, David Waters, David Wohns, Davis Vo, Dawid Teodorczyk, Dawn Shelstad, Dawn Turnbull, Dayuan Li, Dean Kereiakes, Deborah O'Neill, Deborah Yip, Debra K Johnson, Debra Dees, Deepak L Bhatt, Deepika Gopal, Deepti Kumar, Deirdre Mattina, Deirdre Murphy, Delano R Small, Delsa K Rose, Dengke Jiang, Denis Carl Phaneuf, Denise Braganza, Denise Fine, Derek Cyr, Desiree Tobin, Diana Cukali, Diana Parra, Diane Camara, Diane Minshall Liu, Diego Adrián Vences, Diego Franca de Cunha, Dimitrios Stournaras, Dipti Patel, Dongze Li, Donna Exley, Dorit Grahl, Dragana Stanojevic, Duarte Cacela, Dwayne S G Conway, E Pinar Bermudez, Eapen Punnoose, Edgar L Tay, Edgar Karanjah, Edoardo Verna, Eduardo Hernandez-Rangel, Edward D Nicol, Edward O McFalls, Edward T Martin, Edyta Kaczmarska, Ekaterina I Lubinskaya, Elena A Demchenko, Elena Refoyo Salicio, Eli Feen, Elihú Durán-Cortés, Elisabeth M Janzen, Elise L Hannemann, Elise van Dongen, Elissa Restelli Piloto, Eliza Kaplan, Elizabeta Srbinovska Kostovska, Elizabeth Capasso-Gulve, Elizabeth Congdon, Elizabeth Ferguson, Elizaveta V Zbyshevskaya, Ellen Magedanz, Ellie Fridell, Ellis W Lader, Elvin Kedhi, Emanuela Racca, Emilie Tachot, Emily DeRosa, Encarnación Alonso-Álvarez, Eric Nicollet, Eric Peterson, Erick Alexánderson Rosas, Erick Donato Morales, Erin Orvis, Ermina Moga, Estelle Montpetit, Estevao Figueiredo, Eugene Passamani, Eugenia Nikolsky, Eunice Yeoh, Evgeniy I Kretov, Ewa Szczerba, Ewelina Wojtala, Expedito Eustáquio Ribeiro Silva, F Marin Ortuño, Fabio R Farias, Fabio Fimiani, Fabrizio Rolfo, Fa-Chang Yu, Fadi Hage, Fadi Matar, Fahim Haider Jafary, Fang Feng, Fang Liu, Fatima Ranjbaran, Fatima Rodriguez, Fausto J Pinto, Fauzia Rashid, Federica Ramani, Fei Wang, Fernanda Igansi, Filipa Silva, Filippo Ottani, Fiona Haines, Firas Al Solaiman, Flávia Egydio, Flavio Lyra, Florian Egger, Fran Farquharson, Frances Laube, Francesc Carreras Costa, Francesca de Micco, Francesca Bianchini, Francesca Pezzetta, Francesca Pietrucci, Francesco Orso, Francesco Pisano, Francis Burt, Francisca Patuleia Figueiras, Francisco Fernandez-Aviles, Francois Pierre Mongeon, Frans Van de Werf, Franziska Guenther, Fraser N Witherow, Fred Mohr, Frederico Dall'Orto, Fumiyuki Otsuka, G De La Morena, G Karthikeyan, Gabor Dekany, Gabor Kerecsen, Gabriel Galeote, Gabriel Grossmann, Gabriel Vorobiof, Gabriela Sanchez de Souza, Gabriela Guzman, Gabriela Zeballos, Gabriele Gabrielli, Gabriele Jakl-Kotauschek, Gail A Shammas, Gail Brandt, Gang Chen, Gary E Lane, Gary J Luckasen, Gautam Sharma, Gelmina Mikolaitiene, Gennie Yee, Georg Nickenig, George E Revtyak, George J Juang, Gerald Fletcher, Gerald Leonard, Gerard Patrick Devlin, Gerard Esposito, Gergely Ágoston, Gervasio Lamas, Geza Fontos, Ghada Mikhail, Gia Cobb, Gian Piero Perna, Gianpiero Leone, Giles Roditi, Gilles Barone-Rochette, Girish Mishra, Giuseppe Tarantini, Glenda Wong, Glenn S Hamroff, Glenn Rayos, Gong Cheng, Gonzalo Barge-Caballero, Goran Davidović, Goran Stankovic, Gordana Stevanovic, Grace Jingyan Wang, Grace M Young, Graceanne Wayser, Graciela Scaro, Graham S Hillis, Graham Wong, Grazyna Anna Szulczyk, Gregor Simonis, Gregory Kumkumian, Gretchen Ann Peichel, Grzegorz Gajos, Gudrun Steinmaurer, Guilherme G Rucatti, Guilherme Portugal, Guilhermina Cantinho Lopes, Guillem Pons Lladó, Gunnar Frostfelt, Gurpreet S Wander, Gurpreet Gulati, Gustavo Pucci, Hafidz Abd Hadi, Haibo Zhang, Haitao Wang, Halina Marciniak, Han Chen, Hanan Kerr, Hani Najm, Hanna Douglas, Hannah Phillips, Hao Dai, Haojian Dong, Haqeel Jamil, Harikrishnan Sivadasanpillai, Harry Suryapranata, Hassan Reda, Hayley Pomeroy, Heather Barrentine, Heather Golden, Heather Hurlburt, Heidi Wilson, Helen C Tucker, Helene Abergel, Hemalata Siddaram, Hermine Osseni, Herwig Schuchlenz, Hesong Zeng, Hicham Skali, Hilda Solomon, Hollie Horton, Holly Hetrick, Holly Little, Holly Park, Hongjie Chi, Hossam Mahrous, Howard A Levite, Hristo Pejkov, Huajun Li, Hugo Bloise-Adames, Hugo Marques, Hui Zhong, Hui-Min Zhang, Humayrah Hashim, Hung-I Yeh, Hussien El Fishawy, Ian Webb, Iftikhar Kullo, Igor O Grazhdankin, Ihab Hamzeh, Ikraam Hassan, Ikuko Ueda, Ileana L Pina, Ilona Tamasauskiene, Ilse Bouwhuis, Imran Arif, Ina Wenzelburger, Inês Zimbarra Cabrita, Ines Rodrigues, Inga H Robbins, Inga Soveri, Ingela Schnittger, Iqbal Karimullah, Ira M Dauber, Iram Rehman, Irena Peovska Mitevska, Irene Marthe Lang, Irina Subbotina, Irma Kalibataite-Rutkauskiene, Irni Yusnida, Isabel Estela Carvajal, Isabella C Palazzo, Isabelle Hogan, Isabelle Roy, Ishba Syed, Ishita Tejani, Ivan A Naryshkin, Ivana Jankovic, Iwona Niedzwiecka, J David Knight, Jacek Kusmierek, Jackie M White, Jackie Chow, Jacob Udell, Jacqueline E Tamis-Holland, Jacqueline Fannon, Jacquelyn A Quin, Jacquelyn Do, Jaekyeong Heo, Jakub Maksym, James E Davies, James H O'Keefe Jr, James J Jang, James Cha, James Harrison, James Hirsch, James Stafford, James Tatoulis, Jamie Rankin, Jan Henzel, Jan Orga, Jana Tancredi, Janaina Oliveira, Jane Burton, Jane Eckstein, Jane Marucci, Janet P Knight, Janet Blount, Janet Halliday, Janetta Kourzenkova, Janitha Raj, Jan-Malte Sinning, Jaqueline Pozzibon, Jaroslaw Drozdz, Jaroslaw Karwowski, Jason D Glover, Jason Loh Kwok, Jason T Call, Jason Linefsky, Jassira Gomes, Jati Anumpa, Javier J Garcia, Javier Courtis, Jay Meisner, K Jayakumar, Jayne Scales, Jean E Denaro, Jean Michel Juliard, Jean Ho, Jeanette K Stansborough, Jean-Michel Juliard, Jeanne Russo, Jeannette J M Schoep, Jeet Thambyrajah, Jeff Leimberger, Jeffery A Breall, Jeffrey A Kohn, Jeffrey C Milliken, Jeffrey Anderson, Jeffrey Blume, Jeffrey Kanters, Jeffrey Lorin, Jeffrey Moses, Jelena J Stepanovic, Jelena Celutkiene, Jelena Djokic, Jelena Stojkovic, Jenne M Jose, Jenne Manchery, Jennifer A Mull, Jennifer H Czerniak, Jennifer L Stanford, Jennifer Gillis, Jennifer Horst, Jennifer Isaacs, Jennifer Langdon, Jennifer Thomson, Jennifer Tomfohr, Jennifer White, Jen-Yuan Kuo, Jeremy Rautureau, Jerome Fleg, Jessica Berg, Jessica Rodriguez, Jessica Waldron, Jhina Patro, Jia Li, Jiajia Mao, Jiamin Liu, Jian'an Wang, Jianhua Li, Jianxin Zhang, Jie Qi, Jihyun Lyo, Jill Marcus, Jim Blankenship, Jing Zhang, Jingjing Liu, Jing-Yao Fan, Jiun-Yi Li, Jiwan Pradhan, Jiyan Chen, J M Rivera Caravaca, Jo Evans, Joan Garcia Picart, Joan Hecht, Joanna Jaroch, Joanna Zalewska, Joanne Kelly, Joanne Taaffe, João Reynaldo Abbud, João V Vitola, Joaquín V Peñafiel, Jocelyne Benatar, Jody Bindeman, Joe Sabik, Joel Klitch, Johann Christopher, Johannes Aspberg, John D Friedman, John F Beltrame, John F Heitner, John Joseph Graham, John R Davies, John Doan, John Kotter, John Kurian, John Mukai, John Pownall, Jolanta Sobolewska, Jon Kobashigawa, Jonathan L Goldberg, Jonathan W Bazeley, Jonathan Byrne, Jonathan Himmelfarb, Jonathan Leipsic, Jonean Thorsen, Jorge F Trejo Gutierrez, Jorge Escobedo, Jorik Timmer, José A Ortega-Ramírez, José Antonio Marin-Neto, Jose D Salas, Jose Enrique Castillo, Jose Francisco Saraiva, José J Cuenca-Castillo, Jose L Diez, José Luis Narro Villanueva, José Luiz da Vieira, José M Flores-Palacios, Jose Ramon Gonzalez, Jose Seijas Amigo, Jose Fragata, Josep Maria Padró, Josheph F X McGarvey Jr, Joseph Hannan, Joseph Sacco, Joseph Sweeny, Joseph Wiesel, Josephine D Abraham, Joshua P Loh, Joy Burkhardt, Joyce R White, Joyce Riestenberg-Smith, Judit Sebo, Judith L Meadows, Judith Wright, Judy Mae Foltz, Judy Hung, Judy Otis, Juergen Stumpf, Jui-Peng Tsai, Julia S Dionne, Julia de Aveiro Morata, Julie Bunke, Julie Morrow, Julio César Figal, Jun Fujita, Jun Jiang, Junhua Li, Junqing Yang, Juntima Euathrongchit, Jyotsna Garg, K Manjula Rani, K Preethi, Kaatje Goetschalckx, Kai Eggers, Kamalakar Surineni, Kanae Hirase, T R Kapilamoorthy, Karen Calfas, Karen Gratrix, Karen Hallett, Karen Hultberg, Karen Nugent, Karen Petrosyan, Karen Swan, Karolina Kryczka, Karolina Wojtczak-Soska, Karolina Wojtera, Karsten Lenk, Karthik Ramasamy, Katarzyna Łuczak, Katarzyna Malinowska, Kate Pointon, Kate Robb, Katherine Martin, Kathleen Claes, Kathryn Carruthers, Kathy E Siegel, Katia Drouin, Katie Fowler-Lehman, Kavita Rawat, Kay Rowe, Keiichi Fukuda, Keith A A Fox, Ken Mahaffey, Kendra Unterbrink, Kenneth Giedd, Kerrie Van Loo, Kerry Lee, Kerstin Bonin, Kevin R Bainey, Kevin T Harley, Kevin Anstrom, Kevin Chan, Kevin Croce, Kevin Landolfo, Kevin Marzo, Keyur Patel, Khaled Abdul-Nour, Khaled Alfakih, Khaled Dajani, Khaled Ziada, Khaula Baloch, Khrystyna Kushniriuk, Kian-Keong Poh, Kim F Ireland, Kim Holland, Kimberly Ann Byrne, Kimberly E Halverson, Kimberly Elmore, Kimberly Miller-Cox, Kiran Reddy, Kirsten J Quiles, Kirsty Abercrombie, Klaus Matschke, Konrad Szymczyk, Koo Hui Chan, Kotiboinna Preethi, Kozhaya Sokhon, Krissada Meemuk, Kristian Thygesen, Kristin M Salmi, Kristin Newby, Kristina Wippler, Kristine Arges, Kristine Teoh, Krystal Etherington, Krystyna Łoboz-Grudzień, Krzysztof W Reczuch, Krzysztof Bury, Krzysztof Drzymalski, Krzysztof Kukuła, Kuo-Tzu Sung, Kurt Huber, Ladda Douangvila, Lance Sullenberger, Larissa Miranda Trama, Laszlone Matics, Laura Drew, Laura Flint, Laura Keinaite, Laura Sarti, Laurel Kolakaluri, Lawrence M Phillips, Lawrence Friedman, Lawrence Phillips, Lazar Velicki, Leah Howell, Leandro C Maranan, Leanne Cox, Ledjalem Daba, Lei Zhang, Lekshmi Dharmarajan, Leo Bockeria, Leonardo Pizzol Caetano, Leonardo Bridi, Leonid L Bershtein, Leszek Sokalski, Li Hai Yan, Li Li, Lia Nijmeijer, Lidia Sousa, Lihong Xu, Lihua Zhang, Lili Zhang, Lilia Schiavi, Lilian Mazza Barbosa, Lillian L Khor, Lina Felix-Stern, Linda L Hall, Linda M Hollenweger, Linda Arcand, Linda Davidson-Ray, Linda Schwarz, Lindsey N Sikora, Lingping Chi, Lino Patricio, Liping Zhang, Lisa Chaytor, Lisa Hatch, Lisa McCloy, Lisa Wong, Liselotte Persson, Lixin Jiang, Liz Low, Ljiljana Pupic, Loïc Bière, Lorenzo Monti, Lori Christensen, Lori Pritchard, Loriane Black, Lori-Ann Desimone, Lori-Ann Larmand, Lorraine McGregor, Louise Morby, Louise Thomson, Luc Harvey, Luciana de Pádua Baptista, Lucilla Garcia, Ludivine Eliahou, Ludmila Helmer, Luis F Smidt, Luis Bernanrdes, Luis Guzman, Luiz A Carvalho, Luyang Xiong, Lynette L Teo, Lynn M Neeson, Lynne Winstanley, M Barbara Srichai-Parsia, M Quintana Giner, M Sowjanya Reddy, M Valdés Chávarri, M Grazia Rossi, Maarten Simoons, Maayan Konigstein, Maciej Lesiak, Maciej Olsowka, Mafalda Selas, Magalie Corfias, Magdalena Madero Rovalo, Magdalena Łanocha, Magdalena Miller, Magdalena Misztal-Teodorczyk, Magdalena Rantinella, Magdy Abdelhamid, Magnolia Jimenez, Mahboob Alam, Mahevamma Mylarappa, Mahfouz El Shahawy, Mahmoud Mohamed, Mahmud Al-Bustami, Majo X Joseph, Malgorzata Frach, Małgorzta Celińska-Spodar, Malte Helm, Manas Chacko, Mandy Murphy, Manitha Vinod, Manjula Rani, Manu Dhawan, Manuela Mombelli, Marcel Weber, Marcello Galvani, Marcelo Jamus Rodrigues, Marcia F Dubin, Marcia F Werner Bayer, Marcin Szkopiak, Marco Antonio Monsalve, Marco Bizzaro Santos, Marco Magnoni, Marco Marini, Marco Sicuro, Marco Zenati, Marcos Valério Coimbra Resende, Marek Roik, Margalit Bentzvi, Margaret Gilsenan, Margaret Iraola, Margot C Quinn, Maria A Alfonso, Maria Antonieta Pereira Moraes, María Dolores Martínez-Ruíz, María Fernanda Canales, Maria Inês Caetano, Maria P Corral, Maria Pérez García, Maria Victoria Actis, Maria Aguirre, Maria Andreasson, Maria Aprile, Maria Colton, Maria Eugenia Martin, Maria Lasala, Maria Lorenzo, Maria Posada, Maria Shier, Maria Thottam, Mariana V Furtado, Mariana Yumi Okada, Marianna D A Dracoulakis, Marianne De Andrade, Mariano Rubio, Marie Essermark, Marielle Scherrer-Crosbie, Marija T Petrovic, Marija Zdravkovic, Marilyn Black, Marina Garcia, Mario J Garcia, Mariola Szulik, Marisa Orgera, Mark A de Belder, Mark Harbinson, Mark Hyun, Mark Peterson, Mark Xavier, Marlowe Mosley, Marta Capinha, Marta Marcinkiewicz-Siemion, Marta Swiderek, Martha Meyer, Martina Ceseri, Martina Tricoli, Marvin Kronenberg, Mary Williams, Mary Ann Champagne, Mary Colleen Rogge, Mary R Soltau, Mary Streif, Massimo Villella, Massoud Leesar, Matei Claudia, Mateusz Solecki, Matías Nicolás Mungo, Matthew Wall Jr, Matthew Budoff, Matthew Jezior, Matthew Luckie, Matthias Friedrich, Mauren P Haeffner, Maximilian Tscharre, Max-Paul Winter, Mayana Almeida, Mayil S Krishnam, Mayuri Patel, Meenakshi Mishra, Megan Manocchia, Meghana Kakade, Melanie J Munro, Melissa D Chaplin, Melissa LeFevre, Mervyn Andiapen, Michael A Gibson, Michael B Rubens, Michael C Turner, Michael D Shapiro, Michael W Lee, Michael Berlowitz, Michael Davidson, Michael Mack, Michael McDaniel, Michael Mumma, Michal Wlodarczyk, Michel G Khouri, Michel S Slama, Michele Rawlins, Michelle M Bonner, Michelle M Seib, Michelle Chang, Michelle Crowder, Michelle Dixon, Michelle Mayon, Michelle McEvoy, Michelle Yee, Miguel M Fernandes, Miguel Nobre Menezes, Miguel Souto Bayarri, Miguel Barrero, Mikhail T Torosoff, Milan R Dobric, Milan Dobric, Milica Nikola Dekleva, Milind Avdhoot Gadkari, Millie Gomez, Min Tun Kyaw, Miriam Brooks, Miroslav Stevo Martinovic, Mitchel B Lustre, Mohammad Tariq Vakani, Mohammad El-Hajjar, Mohammed Al-Amoodi, Mohammed Hussain, Mohammed Saleem, Moisés Blanco-Calvo, Moisés Jiménez-Santos, Mona Bhatia, Monica Rosca, Monika Laukyte, Montserrat Gracida Blanca, Montserrat Vila Perales, Mouaz H Al-Mallah, Moysés de Oliveira Filho, Mpiko Ntsekhe, Muhamed Saric, Mulei Chen, Myriam Brousseau, Myrthes Emy Takiuti, Nada Cemerlic-Adjic, Nadia Asif, Nadia Gakou, Nafisa Hussain, Nana O Katamadze, Nancy L Clapp, Nancy Aedy, Nandita Nataraj, Nanette K Wenger, Naomi Uchida, Nasrul Ismail, Natalia S Oliveira, Natalia de Carvalho Maffei, Natalie Spitzer, Natasha C Putnam, Naved Aslam, Neamat Mowafy, Neeraj Pandit, Neeraj Parakh, Nevena Garcevic, Ngaire Meadows, Nhi N Tran, Nicholas Danchin, Nicki Lakeman, Nicola Johnston, Nicolas W Shammas, Nicole Saint Vrestil, Nicole Deming, Nier Zhong, Niket Patel, Nikola N Boskovic, Nikolaos Karogiannis, Nikos Werner, Nina Johnston, Ning Zhang, Ning Zhou, Niree Hindoyan, Nirmal Kumar, Nitika Chadha, Nitish Naik, Nodira Aripova, Noloyiso Mtana, Nona A Eskelson, Noor Syamira 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Paula García-González, Paulo Cury Rezende, Paulo Ricardo Caramori, Pavel S Kozlov, Pedro Canas Silva, Pedro Gabriel Melo Barros E Silva, Pedro Píccaro de Oliveira, Pedro Carvalho, Pedro Modas, Pedro Rio, Peeyush Jain, Peiyu He, Peter A McCullough, Peter H Stone, Peter M Pollak, Peter Douglass, Peter Henriksen, Peter OKane, Peter Ong, Philip Jones, Philip Rogal, Philippe Généreux, Philippe Menasche, Philippe Rheault, Phoebe Goold, Pierre Gervais, Pierre Michaud, Pilar Calvillo, Ping Chai, Piotr Jakubowski, Piotr Pruszczyk, Piotr Slomka, Piyamitr Sritara, Poay-Huan Loh, Poonam Sonawane, Pouneh Samadi, Pragnesh P Parikh, Prakash Deedwania, Pranav M Patel, Praneeth Polamuri, Pratiksha Sharma, Precilia Vasquez, Preeti Kamath, Prince Thomas, Priyadarshani Arambam, Puja K Mehta, Purvez Grant, Pushpa Naik, Qi Zhong, Qian Zhao, Qiang Zhou, Qianqian Yuan, Qin Yu, Qingxian Li, Qiulan Xie, Qiutang Zeng, R J Vindhya, R James Gerlach, Rachel King, Rada Vučić, Radmila Lyubarova, Radoslaw Pracon, 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Bermudez, Eapen Punnoose, Edgar L Tay, Edgar Karanjah, Edoardo Verna, Eduardo Hernandez-Rangel, Edward D Nicol, Edward O McFalls, Edward T Martin, Edyta Kaczmarska, Ekaterina I Lubinskaya, Elena A Demchenko, Elena Refoyo Salicio, Eli Feen, Elihú Durán-Cortés, Elisabeth M Janzen, Elise L Hannemann, Elise van Dongen, Elissa Restelli Piloto, Eliza Kaplan, Elizabeta Srbinovska Kostovska, Elizabeth Capasso-Gulve, Elizabeth Congdon, Elizabeth Ferguson, Elizaveta V Zbyshevskaya, Ellen Magedanz, Ellie Fridell, Ellis W Lader, Elvin Kedhi, Emanuela Racca, Emilie Tachot, Emily DeRosa, Encarnación Alonso-Álvarez, Eric Nicollet, Eric Peterson, Erick Alexánderson Rosas, Erick Donato Morales, Erin Orvis, Ermina Moga, Estelle Montpetit, Estevao Figueiredo, Eugene Passamani, Eugenia Nikolsky, Eunice Yeoh, Evgeniy I Kretov, Ewa Szczerba, Ewelina Wojtala, Expedito Eustáquio Ribeiro Silva, F Marin Ortuño, Fabio R Farias, Fabio Fimiani, Fabrizio Rolfo, Fa-Chang Yu, Fadi Hage, Fadi Matar, Fahim Haider 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Hayley Pomeroy, Heather Barrentine, Heather Golden, Heather Hurlburt, Heidi Wilson, Helen C Tucker, Helene Abergel, Hemalata Siddaram, Hermine Osseni, Herwig Schuchlenz, Hesong Zeng, Hicham Skali, Hilda Solomon, Hollie Horton, Holly Hetrick, Holly Little, Holly Park, Hongjie Chi, Hossam Mahrous, Howard A Levite, Hristo Pejkov, Huajun Li, Hugo Bloise-Adames, Hugo Marques, Hui Zhong, Hui-Min Zhang, Humayrah Hashim, Hung-I Yeh, Hussien El Fishawy, Ian Webb, Iftikhar Kullo, Igor O Grazhdankin, Ihab Hamzeh, Ikraam Hassan, Ikuko Ueda, Ileana L Pina, Ilona Tamasauskiene, Ilse Bouwhuis, Imran Arif, Ina Wenzelburger, Inês Zimbarra Cabrita, Ines Rodrigues, Inga H Robbins, Inga Soveri, Ingela Schnittger, Iqbal Karimullah, Ira M Dauber, Iram Rehman, Irena Peovska Mitevska, Irene Marthe Lang, Irina Subbotina, Irma Kalibataite-Rutkauskiene, Irni Yusnida, Isabel Estela Carvajal, Isabella C Palazzo, Isabelle Hogan, Isabelle Roy, Ishba Syed, Ishita Tejani, Ivan A Naryshkin, Ivana Jankovic, Iwona Niedzwiecka, J David Knight, Jacek Kusmierek, Jackie M White, Jackie Chow, Jacob Udell, Jacqueline E Tamis-Holland, Jacqueline Fannon, Jacquelyn A Quin, Jacquelyn Do, Jaekyeong Heo, Jakub Maksym, James E Davies, James H O'Keefe Jr, James J Jang, James Cha, James Harrison, James Hirsch, James Stafford, James Tatoulis, Jamie Rankin, Jan Henzel, Jan Orga, Jana Tancredi, Janaina Oliveira, Jane Burton, Jane Eckstein, Jane Marucci, Janet P Knight, Janet Blount, Janet Halliday, Janetta Kourzenkova, Janitha Raj, Jan-Malte Sinning, Jaqueline Pozzibon, Jaroslaw Drozdz, Jaroslaw Karwowski, Jason D Glover, Jason Loh Kwok, Jason T Call, Jason Linefsky, Jassira Gomes, Jati Anumpa, Javier J Garcia, Javier Courtis, Jay Meisner, K Jayakumar, Jayne Scales, Jean E Denaro, Jean Michel Juliard, Jean Ho, Jeanette K Stansborough, Jean-Michel Juliard, Jeanne Russo, Jeannette J M Schoep, Jeet Thambyrajah, Jeff Leimberger, Jeffery A Breall, Jeffrey A Kohn, Jeffrey C Milliken, Jeffrey Anderson, Jeffrey Blume, 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John Doan, John Kotter, John Kurian, John Mukai, John Pownall, Jolanta Sobolewska, Jon Kobashigawa, Jonathan L Goldberg, Jonathan W Bazeley, Jonathan Byrne, Jonathan Himmelfarb, Jonathan Leipsic, Jonean Thorsen, Jorge F Trejo Gutierrez, Jorge Escobedo, Jorik Timmer, José A Ortega-Ramírez, José Antonio Marin-Neto, Jose D Salas, Jose Enrique Castillo, Jose Francisco Saraiva, José J Cuenca-Castillo, Jose L Diez, José Luis Narro Villanueva, José Luiz da Vieira, José M Flores-Palacios, Jose Ramon Gonzalez, Jose Seijas Amigo, Jose Fragata, Josep Maria Padró, Josheph F X McGarvey Jr, Joseph Hannan, Joseph Sacco, Joseph Sweeny, Joseph Wiesel, Josephine D Abraham, Joshua P Loh, Joy Burkhardt, Joyce R White, Joyce Riestenberg-Smith, Judit Sebo, Judith L Meadows, Judith Wright, Judy Mae Foltz, Judy Hung, Judy Otis, Juergen Stumpf, Jui-Peng Tsai, Julia S Dionne, Julia de Aveiro Morata, Julie Bunke, Julie Morrow, Julio César Figal, Jun Fujita, Jun Jiang, Junhua Li, Junqing Yang, Juntima Euathrongchit, Jyotsna Garg, K Manjula Rani, K Preethi, Kaatje Goetschalckx, Kai Eggers, Kamalakar Surineni, Kanae Hirase, T R Kapilamoorthy, Karen Calfas, Karen Gratrix, Karen Hallett, Karen Hultberg, Karen Nugent, Karen Petrosyan, Karen Swan, Karolina Kryczka, Karolina Wojtczak-Soska, Karolina Wojtera, Karsten Lenk, Karthik Ramasamy, Katarzyna Łuczak, Katarzyna Malinowska, Kate Pointon, Kate Robb, Katherine Martin, Kathleen Claes, Kathryn Carruthers, Kathy E Siegel, Katia Drouin, Katie Fowler-Lehman, Kavita Rawat, Kay Rowe, Keiichi Fukuda, Keith A A Fox, Ken Mahaffey, Kendra Unterbrink, Kenneth Giedd, Kerrie Van Loo, Kerry Lee, Kerstin Bonin, Kevin R Bainey, Kevin T Harley, Kevin Anstrom, Kevin Chan, Kevin Croce, Kevin Landolfo, Kevin Marzo, Keyur Patel, Khaled Abdul-Nour, Khaled Alfakih, Khaled Dajani, Khaled Ziada, Khaula Baloch, Khrystyna Kushniriuk, Kian-Keong Poh, Kim F Ireland, Kim Holland, Kimberly Ann Byrne, Kimberly E Halverson, Kimberly Elmore, Kimberly Miller-Cox, Kiran Reddy, Kirsten J Quiles, Kirsty Abercrombie, Klaus Matschke, Konrad Szymczyk, Koo Hui Chan, Kotiboinna Preethi, Kozhaya Sokhon, Krissada Meemuk, Kristian Thygesen, Kristin M Salmi, Kristin Newby, Kristina Wippler, Kristine Arges, Kristine Teoh, Krystal Etherington, Krystyna Łoboz-Grudzień, Krzysztof W Reczuch, Krzysztof Bury, Krzysztof Drzymalski, Krzysztof Kukuła, Kuo-Tzu Sung, Kurt Huber, Ladda Douangvila, Lance Sullenberger, Larissa Miranda Trama, Laszlone Matics, Laura Drew, Laura Flint, Laura Keinaite, Laura Sarti, Laurel Kolakaluri, Lawrence M Phillips, Lawrence Friedman, Lawrence Phillips, Lazar Velicki, Leah Howell, Leandro C Maranan, Leanne Cox, Ledjalem Daba, Lei Zhang, Lekshmi Dharmarajan, Leo Bockeria, Leonardo Pizzol Caetano, Leonardo Bridi, Leonid L Bershtein, Leszek Sokalski, Li Hai Yan, Li Li, Lia Nijmeijer, Lidia Sousa, Lihong Xu, Lihua Zhang, Lili Zhang, Lilia Schiavi, Lilian Mazza Barbosa, Lillian L Khor, Lina Felix-Stern, Linda L Hall, Linda M Hollenweger, Linda Arcand, Linda Davidson-Ray, Linda Schwarz, Lindsey N Sikora, Lingping Chi, Lino Patricio, Liping Zhang, Lisa Chaytor, Lisa Hatch, Lisa McCloy, Lisa Wong, Liselotte Persson, Lixin Jiang, Liz Low, Ljiljana Pupic, Loïc Bière, Lorenzo Monti, Lori Christensen, Lori Pritchard, Loriane Black, Lori-Ann Desimone, Lori-Ann Larmand, Lorraine McGregor, Louise Morby, Louise Thomson, Luc Harvey, Luciana de Pádua Baptista, Lucilla Garcia, Ludivine Eliahou, Ludmila Helmer, Luis F Smidt, Luis Bernanrdes, Luis Guzman, Luiz A Carvalho, Luyang Xiong, Lynette L Teo, Lynn M Neeson, Lynne Winstanley, M Barbara Srichai-Parsia, M Quintana Giner, M Sowjanya Reddy, M Valdés Chávarri, M Grazia Rossi, Maarten Simoons, Maayan Konigstein, Maciej Lesiak, Maciej Olsowka, Mafalda Selas, Magalie Corfias, Magdalena Madero Rovalo, Magdalena Łanocha, Magdalena Miller, Magdalena Misztal-Teodorczyk, Magdalena Rantinella, Magdy Abdelhamid, Magnolia Jimenez, Mahboob Alam, Mahevamma Mylarappa, Mahfouz El Shahawy, Mahmoud Mohamed, Mahmud Al-Bustami, Majo X Joseph, Malgorzata Frach, Małgorzta Celińska-Spodar, Malte Helm, Manas Chacko, Mandy Murphy, Manitha Vinod, Manjula Rani, Manu Dhawan, Manuela Mombelli, Marcel Weber, Marcello Galvani, Marcelo Jamus Rodrigues, Marcia F Dubin, Marcia F Werner Bayer, Marcin Szkopiak, Marco Antonio Monsalve, Marco Bizzaro Santos, Marco Magnoni, Marco Marini, Marco Sicuro, Marco Zenati, Marcos Valério Coimbra Resende, Marek Roik, Margalit Bentzvi, Margaret Gilsenan, Margaret Iraola, Margot C Quinn, Maria A Alfonso, Maria Antonieta Pereira Moraes, María Dolores Martínez-Ruíz, María Fernanda Canales, Maria Inês Caetano, Maria P Corral, Maria Pérez García, Maria Victoria Actis, Maria Aguirre, Maria Andreasson, Maria Aprile, Maria Colton, Maria Eugenia Martin, Maria Lasala, Maria Lorenzo, Maria Posada, Maria Shier, Maria Thottam, Mariana V Furtado, Mariana Yumi Okada, Marianna D A Dracoulakis, Marianne De Andrade, Mariano Rubio, Marie Essermark, Marielle Scherrer-Crosbie, Marija T Petrovic, Marija Zdravkovic, Marilyn Black, Marina Garcia, Mario J Garcia, Mariola Szulik, Marisa Orgera, Mark A de Belder, Mark Harbinson, Mark Hyun, Mark Peterson, Mark Xavier, Marlowe Mosley, Marta Capinha, Marta Marcinkiewicz-Siemion, Marta Swiderek, Martha Meyer, Martina Ceseri, Martina Tricoli, Marvin Kronenberg, Mary Williams, Mary Ann Champagne, Mary Colleen Rogge, Mary R Soltau, Mary Streif, Massimo Villella, Massoud Leesar, Matei Claudia, Mateusz Solecki, Matías Nicolás Mungo, Matthew Wall Jr, Matthew Budoff, Matthew Jezior, Matthew Luckie, Matthias Friedrich, Mauren P Haeffner, Maximilian Tscharre, Max-Paul Winter, Mayana Almeida, Mayil S Krishnam, Mayuri Patel, Meenakshi Mishra, Megan Manocchia, Meghana Kakade, Melanie J Munro, Melissa D Chaplin, Melissa LeFevre, Mervyn Andiapen, Michael A Gibson, Michael B Rubens, Michael C Turner, Michael D Shapiro, Michael W Lee, Michael Berlowitz, Michael Davidson, Michael Mack, Michael McDaniel, Michael Mumma, Michal Wlodarczyk, Michel G Khouri, Michel S Slama, Michele Rawlins, Michelle M Bonner, Michelle M Seib, Michelle Chang, Michelle Crowder, Michelle Dixon, Michelle Mayon, Michelle McEvoy, Michelle Yee, Miguel M Fernandes, Miguel Nobre Menezes, Miguel Souto Bayarri, Miguel Barrero, Mikhail T Torosoff, Milan R Dobric, Milan Dobric, Milica Nikola Dekleva, Milind Avdhoot Gadkari, Millie Gomez, Min Tun Kyaw, Miriam Brooks, Miroslav Stevo Martinovic, Mitchel B Lustre, Mohammad Tariq Vakani, Mohammad El-Hajjar, Mohammed Al-Amoodi, Mohammed Hussain, Mohammed Saleem, Moisés Blanco-Calvo, Moisés Jiménez-Santos, Mona Bhatia, Monica Rosca, Monika Laukyte, Montserrat Gracida Blanca, Montserrat Vila Perales, Mouaz H Al-Mallah, Moysés de Oliveira Filho, Mpiko Ntsekhe, Muhamed Saric, Mulei Chen, Myriam Brousseau, Myrthes Emy Takiuti, Nada Cemerlic-Adjic, Nadia Asif, Nadia Gakou, Nafisa Hussain, Nana O Katamadze, Nancy L Clapp, Nancy Aedy, Nandita Nataraj, Nanette K Wenger, Naomi Uchida, Nasrul Ismail, Natalia S Oliveira, Natalia de Carvalho Maffei, Natalie Spitzer, Natasha C Putnam, Naved Aslam, Neamat Mowafy, Neeraj Pandit, Neeraj Parakh, Nevena Garcevic, Ngaire Meadows, Nhi N Tran, Nicholas Danchin, Nicki Lakeman, Nicola Johnston, Nicolas W Shammas, Nicole Saint Vrestil, Nicole Deming, Nier Zhong, Niket Patel, Nikola N Boskovic, Nikolaos Karogiannis, Nikos Werner, Nina Johnston, Ning Zhang, Ning Zhou, Niree Hindoyan, Nirmal Kumar, Nitika Chadha, Nitish Naik, Nodira Aripova, Noloyiso Mtana, Nona A Eskelson, Noor Syamira Mokhtar, Noppon Taksaudom, Nor Asiah Basri, Nora Marchelletta, Norma Hogg, Nungshi Jungla, Nuno Ferreira, Oksana A Lubyanaya, Olga B Nikolaeva, Olga Cañavate, Olga Sobrino, Olga Walesiak, Olga Walter, Olga Zdończyk, Olivia J Lim, Olivia Anaya, Olivia Mancilla, Olivier Dubourg, Olugbenga Bello, Omar Almousalli, Omar Thompson, Oni Olurinde, Or Harel, Osama Raheem, Oscar Méndiz, Óscar Prada-Delgado, Oz Shapira, P Christian Schulze, Pachara Panpunuan, Pal Maurovich-Horvat, Pallav Garg, Paloma Moraga, Pam Singh, Pamela Julian, Pamela Ouyang, Pamela Sigel, Pamela Woodard, Panpan Zhou, Paola Emanuela Poggio, Paola Smanio, Paolo Calabro, Paramjit Jeetley, Pascal Goube, Patricia K Nguyen, Patricia Alarie, Patricia Arakelian, Patricia Arsenault, Patricia Blaise, Patricia Brito, Patricia Cowper, Patricia Endsley, Patricia Mieses, Patrick B Alexander, Patrick Donnelly, Patrick Wilmot, Patrycja Lebioda, Paul C Gordon, Paul Der Mesropian, Paul Galiwango, Paul Hauptman, Paul Kennedy, Paula Beardsley, Paula García-González, Paulo Cury Rezende, Paulo Ricardo Caramori, Pavel S Kozlov, Pedro Canas Silva, Pedro Gabriel Melo Barros E Silva, Pedro Píccaro de Oliveira, Pedro Carvalho, Pedro Modas, Pedro Rio, Peeyush Jain, Peiyu He, Peter A McCullough, Peter H Stone, Peter M Pollak, Peter Douglass, Peter Henriksen, Peter OKane, Peter Ong, Philip Jones, Philip Rogal, Philippe Généreux, Philippe Menasche, Philippe Rheault, Phoebe Goold, Pierre Gervais, Pierre Michaud, Pilar Calvillo, Ping Chai, Piotr Jakubowski, Piotr Pruszczyk, Piotr Slomka, Piyamitr Sritara, Poay-Huan Loh, Poonam Sonawane, Pouneh Samadi, Pragnesh P Parikh, Prakash Deedwania, Pranav M Patel, Praneeth Polamuri, Pratiksha Sharma, Precilia Vasquez, Preeti Kamath, Prince Thomas, Priyadarshani Arambam, Puja K Mehta, Purvez Grant, Pushpa Naik, Qi Zhong, Qian Zhao, Qiang Zhou, Qianqian Yuan, Qin Yu, Qingxian Li, Qiulan Xie, Qiutang Zeng, R J Vindhya, R James Gerlach, Rachel King, Rada Vučić, Radmila Lyubarova, Radoslaw Pracon, Raewyn Fisher, Rafael Beyar, Rafael Diaz, Rafael Selgas, Raffaele Bugiardini, Raffaele Fanelli, Raisa Kavalakkat, V S Rajalekshmi, Rajat S Barua, Rajeev Menon, Rajesh Gopalan Nair, Rajesh Francis, Rajiv Narang, Rakesh Yadav, Ralph Alan Huston, T Ramakrishnan, Ramesh de Silva, Rami El Mahmoud, Ramiro Carvalho, Ramon de Jesús-Pérez, Ramona Stevens, Ran Leng, Ranjan Kachru, Ranjit Kumar Nath, Raquel Sanchez, Raven R Dwyer, Raven Lee, Ray Wyman, Raymond C Wong, Raymond W Little, Raymundo Ocaranza Sanchez, Rebecca J Wimmer, Rebecca Bariciano, Rebecca Otis, Rebekah R Herrmann, Reem Yunis, Reinette Hampson, Renato Abdala Karam, Renee C Hessian, Renee Kaneshiro, Reshma Ravindran, Reto Andreas Gamma, Reyna Bhandari, Reza Arsanjani, Ricardo L Lopes, Ricardo Mendes Oliveira, Ricardo Costa, Richa Bhatt, Richard F Davies, Richard H J Trimlett, Richard Goldweit, Rik Hermanides, Rine Nakanishi, Rinu R Sidh, Risha Patel, Rita Coram, Rizwan A Siddiqui, Rob S Beanlands, Robert J Hamburger, Robert K Riezebos, Robert M Donnino, Robert Bojar, Robert Chilton, Robert Guyton, Robert Henderson, Robert Kornberg, Robert Leber, Robert Mao, Robert Stenberg, Roberta P Santos, Roberto René Favaloro, Roberto Amati, Rodolfo G S D Lima, Rodrigo J Cerci, Rogerio Tumelero, Rohit Tandon, Roma Tewari, Romalisa Miranda-Peats, Ron Wald, Ronald A Mastouri, Ronald G Morford, Ronald G Schwartz, Ronald P Pedalino, Rongrong Hu, Ronnell A Hansen, Ronny A Cohen, Rory Hachamovitch, Rosa Homem, Rosa Sandonato, Rosane Laimer, Rosann Gans, Roxanne Yost, Roy Mathew, Rubén Baleón-Espinosa, Ruben Ramos, Rubine Gevorgyan, Rui Ferreira, Rui Jing, Ruth Pérez-Fernández, S K Dwivedi, S Ramakrishnan, Saadat Khan, Sabahat Bokhari, Sabu Thomas, Sadath Lubna, Sajeeda Parveen Khan, Sajeev Chakanalil Govindan, Saket Girotra, Saleem Kassam, Sallie Canada, Salvador Cruz-Flores, Samaa Mohamed, Samantha Ly, Sameh El Kaffas, Samia Massalha, Sampoornima Setty, Samuel Nwosu, Sandeep Seth, Sandeep Singh, Sander R Niehe, Sandra M Rivest, Sandra S Zier, Sandra Ahoud, Sandy Carr, Sanjay Ganapathi, Sanjay Shetty, Sanjeev Sharma, Santa Jimenez, Santhosh Satheesh, Santiago A Garcia, Sara Fernandez, Sara Karlsson, Sara Salkind, Sara Temiyasathit, Sarah Medina Rodriguez, Sarah Beaudry, Sarah Hadjih, Sarah Williams, Sarah Zahrani, Sarju Ralhan, Sasa Hinic, Sasko Kedev, Satinder Singh, Satoshi Yasuda, Satvic Cholenahally Manjunath, Sau Lee, Scott M Kaczkowski, Scott Kinlay, Sean W Hayes, Sebastian Sobczak, Senait Asier, Sergey A Sayganov, Seth I Sokol, Shaheen Pandie, Shaiful Azmi Yahaya, Shamir Mehta, Shao-Ping Nie, Sharad Chandra, Sharder Islam, Sharon Tai, Sheetal Rupesh Karwa, Sheri Ussery, Sheromani Bajaj, Sherron C Crook, Shigeyuki Nishimura, Shintaro Nakano, Shirin Heydari, Shiv Kumar Choudhary, Shivali Patel, Shobana Ganesan, Shruti Pandey, Shuyang Zhang, Shweta Hande, Siddharth Gadage, Sik-Yin V Tan, Silvia Zottis Poletti, Silvia Riera, Silvia Valbuena, Simon Walsh, Simona Maspoli, Simone Savaris, Si-Ting Feng, So Yang Cho, Solomon Yakubov, Songlin Zhu, Songtao Wang, Sonia Guerrero, Sonika Gupta, Sonja Salinger Martinovic, Sonya Brons, Sorin Brener, Sothinathan Gurunathan, Souheil Saba, Soundarya Nayak, Sowjanya Reddy, Srinivasa Potluri, Sriram Sudarshan, Srun Kuanprasert, Stacie Van Oosterhout, Stamatios Lerakis, Stanley E Cobos, Stefan C Bertog, Stefan M Simović, Stefan Weikl, Stefano Di Marco, Stefano Provasoli, Stephanie A Tirado, Stephanie C Boer, Stephanie M Lane, Stephanie Ferket, Stephanie Kelly, Stephanie Wasmiller, Stephen H McKellar, Stephen P Hoole, Stephen Fremes, Stephen Preston, Steve Leung, Steven A Fein, Steven J Lindsay, Steven P Sedlis, Steven Giovannone, Steven Michael, Steven Weitz, Stijn van Vugt, Subhash Banerjee, Sudhir Naik, Suellen Hosino, Sukie Desire, Sukit Yamwong, Suku T Thambar, Sulagna Mookherjee, Suman Singh, Sundeep Mishra, Sunil Kumar Verma, Supap Kulthawong, Supatchara Khwakhong, Surendra Naik, Suresh Babu, Surin Woragidpoonpol, Suryaprakash Narayanappa, Susan Derbyshire, Susan Gent, Susan Mathus, Susan Milbrandt, Susan Moore, Susan Regan, Susan Stinson, Susan Webber, Susana Silva, Susanna Stevens, Susanne Gruensfelder, Suthara Aramcharoen, Suvarna Kolhe, Suzana Tavares, Suzanne Arnold, Suzanne Welsh, Svetlana Apostolovic, Swapna Kunhunny, Ta-Chuan Hung, Taissa Zappernick, Tali Sharir, Talita Silva, Tamara Colaiácovo Soares, Tapan Umesh Pillay, Tarun K Mittal, Tatiana Trifonova, Tauane Bello Duarte, Tauqir Huk, Téodora Dutoiu, Terrance Chua, Terry Weyand, Thabitha Charles, Theodoros Kofidis, Theresa McCreary, Thierry Lefevre, Thippeekaa Arumairajah, Thitipong Tepsuwan, Thomas J Mulhearn, Thomas M Meyer, Thomas P Rocco, Thomas R Downes, Thomas Crain, Thomas Haldis, Thomas Mathew, Thomas Redick, Thounaojam Indira Devi, Thuraia Nageh, Tia Cauthren, Tiago Silva, Tiffany Little, Tijana Andric, Tina Harding, Titus Lau, Tiziana Formisano, Tiziano Moccetti, Tomasz Ciurus, Tomasz Mazurek, Tomasz Tarchalski, Toshiyuki Nagai, Tri Tran, Tricia Youn, Trish Tucker, Trudie Milner, Tuhina Bose, Tushar Kotecha, Udo Sechtem, Uma S Valeti, Umberto Cucchini, Umesh Badami, Upendra Kaul, V K Bahl, V S Narain, Valentina Casali, Valeria Godoy, Valerie Robesyn, Vamshi P Priya, Vandana Yadav, Vera McKinney, Veronica De Lenges, Veronica Tinnirello, Vicente Miro, Victor Navarro, Victoria Gumerova, Victoria Hernandez, Vidya Seeratan, Vijay Kumar, Vikentiy Y Kozulin, Viktoria Bulkley, Vilmar Veiga Jr, Vincent Setang, C P Vineeth, Virginai Pubull Nuñez, Virginia Fernández-Figares, Vitor Gomes, Viviana Gabriel, Viviane Dos Santos, Viviane Almeida, Vlad A Iliescu, Vladan Mudrenovic, Vladimir Dzavik, Vojislav L Giga, Walter Enrique Mogrovejo, Wan Xian Chan, Wanda C Marfori, Wanda Parker, Warangkana Mekara, Wassim Nona, Wayne Old, Wayne Pennachi, Weerachai Nawarawong, Wei Chen, Wei Su, Weibing Xing, Wei-Ren Lan, Wenda Crawford, Wendy L Stewart, Wendy Drewes, Wenhua Lin, William B Abernethy, William D Salerno, William F Fearon, William Vergoni, William Weintraub, Winnie C Sia, Wlodzimierz J Musial, Xacobe Flores-Ríos, Xavier Garcia-Moll Marimon, Xi Su, Xiang Ma, Xiangqiong Gu, Xiao Wang, Xiaomei Li, Xiaowei Yao, Xin Fu, Xin Su, Xin Zeng, Xinchun Yang, Xiuhong Li, Xuehua Fang, Xutong Wang, Yaming Geng, Yan Yan, Yanek Pépin-Dubois, Yanfu Wang, Yang Wang, Yanmeng Tian, Yaping Huang, Yechen Han, Yesenia Zambrano, Yi-Hsuan Yang, Ying Tung Sia, Yining Yang, Yitong Ma, Yolayfi Peralta, Yongjian Wu, Yu Kunwu, Yu Zhao, Yudong Peng, Yueh-Hung Lin, Yulan Zhao, Yumei Dong, Yunhai Zhao, Yutthaphan Wannasopha, Yvonne Taul, Zakir Sahul, Zalina Kudzoeva, Zbigniew Kalarus, Zeljko Z Markovic, Zhen Huang, Zheng Ji, Zhenyu Liu, Zhou Yue, Zhulin Zhang, Zhuxi Li, Zile Singh Meharwal, Ziliang Bai, Zixiang Yu, Zohra Huda, Zoltan Davidovits

Subjects
Male, Cardiac Catheterization, Computed Tomography Angiography, medicine.medical_treatment, Myocardial Ischemia, Coronary Disease, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Coronary Angiography, ISCHEMIA Research Group, law.invention, Angina, Coronary artery disease, 0302 clinical medicine, Randomized controlled trial, law, Cardiovascular Disease, Myocardial Revascularization, 030212 general & internal medicine, Coronary Artery Bypass, 11 Medical and Health Sciences, Cardiac catheterization, General Medicine, Middle Aged, humanities, Cardiovascular Diseases, Cardiology, Female, Human, medicine.medical_specialty, Ischemia, Article, 03 medical and health sciences, Geriatric cardiology, Percutaneous Coronary Intervention, General & Internal Medicine, Internal medicine, medicine, Humans, Angina, Unstable, Aged, business.industry, Coronary Artery Bypa, Percutaneous coronary intervention, Bayes Theorem, medicine.disease, Heart failure, Quality of Life, business
Abstract

BACKGROUND: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS: We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS: Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, -1.8 percentage points; 95% CI, -4.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS: Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, NCT01471522.).

Published
2020

36. Multiphase CFD modelling for enclosure fires—A review on past studies and future perspectives

Author

Ivan Miguel De Cachinho Cordeiro, Qian Chen, Timothy Bo Yuan Chen, Anthony Chun Yin Yuen, Guan Heng Yeoh, and Hengrui Liu

Subjects
Fluid Flow and Transfer Processes, Nuclear and High Energy Physics, business.industry, Computer science, Mechanical Engineering, Context (language use), Computational fluid dynamics, Combustion, Fire protection engineering, Nuclear Energy and Engineering, Component (UML), Fire protection, Charring, Aerospace engineering, business, Large eddy simulation
Abstract

Modern buildings and structures are commonly equipped with fire safety detection and protection systems. Owing to the complexity in building architectures, performance-based fire engineering designs are often applied to achieve safety compliance criteria in stipulated fire events. With the uprising popularity of computer simulation fire predictive models benefited by the rapid improvement in computing speed and modelling techniques, the use of computational fluid dynamics (CFD) based fire field models has become an integrated component in fire tenability and assessment studies. This article delivers a comprehensive review on the history, past developments, and current state-of-the-art of CFD models for enclosure fires, as well as providing an in-depth review on the advancement in other sub-modelling components including turbulence, combustion, radiation, and soot models. Additionally, two types of multiphase modelling approaches involving solid-gas and liquid-gas phase models are reviewed. As for the preceding, the consideration of the solid phase combustibles is generally achieved via pyrolysis modelling under the context of CFD. Recent advancements in CFD-based pyrolysis studies are extensively discussed, including the consideration of porous media, charring layer formation, and kinetics search algorithms to describe the solid decomposition and charring processes. Meanwhile, fire suppression models involving the discrete phase model (DPM) approach are reviewed. This includes previous developments in simulation methods of water droplets, coupling approaches with the fire dynamics in the large eddy simulation (LES) framework. Finally, a future perspective regarding the need to develop a melting/dripping sub-model for building materials is discussed, whose reaction kinetics can be supported by molecular dynamics (MD).

Published
2021

38. Potential of Phage Display Antibody Technology for Cardiovascular Disease Immunotherapy

Author

Jia-Siang Sum, Theam Soon Lim, Jing Yi Lai, Soo Ghee Yeoh, and W Y Haniff W Isa

Subjects
Technology, Phage display, medicine.drug_class, medicine.medical_treatment, Pharmaceutical Science, Disease, Monoclonal antibody, Angina, chemistry.chemical_compound, Genetics, Humans, Medicine, Bacteriophages, cardiovascular diseases, Genetics (clinical), biology, business.industry, Cholesterol, Anticholesteremic Agents, Cholesterol, LDL, Immunotherapy, medicine.disease, chemistry, Cardiovascular Diseases, Lipid hypothesis, Immunology, biology.protein, Molecular Medicine, lipids (amino acids, peptides, and proteins), Proprotein Convertase 9, Antibody, Cardiology and Cardiovascular Medicine, business
Abstract

Cardiovascular disease (CVD) is one of the leading causes of death worldwide. CVD includes coronary artery diseases such as angina, myocardial infarction, and stroke. "Lipid hypothesis" which is also known as the cholesterol hypothesis proposes the linkage of plasma cholesterol level with the risk of developing CVD. Conventional management involves the use of statins to reduce the serum cholesterol levels as means for CVD prevention or treatment. The regulation of serum cholesterol levels can potentially be regulated with biological interventions like monoclonal antibodies. Phage display is a powerful tool for the development of therapeutic antibodies with successes over the recent decade. Although mainly for oncology, the application of monoclonal antibodies as immunotherapeutic agents could potentially be expanded to CVD. This review focuses on the concept of phage display for antibody development and discusses the potential target antigens that could potentially be beneficial for serum cholesterol management.

Published
2021

39. The influence of religious/spiritual beliefs on Malaysian hospital healthcare workers’ attitudes towards suicide and suicidal patients: a qualitative study

Author

Suzaily Wahab, Ching Sin Siau, Seen Heng Yeoh, Norhayati Ibrahim, Lei Hum Wee, Nur Atikah Abdul Halim, and Uma Visvalingam

Subjects
medicine.medical_specialty, Research and Theory, business.industry, Health care, Spirituality, medicine, Healthcare worker, Articles, Suicidal patients, Psychiatry, Psychology, business, Qualitative research
Abstract

Background There has been mixed findings on whether a healthcare workers’ religious beliefs contribute positively or negatively to their attitudes towards suicidal patients. Aims This study aims to explore qualitatively the influence of religious/spiritual beliefs on healthcare workers’ attitudes towards suicide and suicidal patients in the culturally heterogeneous Malaysian population. Methods Thirty-one healthcare workers from diverse religious backgrounds, professions and medical disciplines were interviewed. Thematic analysis revealed the centrality of religion in determining healthcare workers’ acceptability of suicide, specific religious beliefs that influenced their views on the right-to-die issue, perceptions of the suicidal patient’s religiousness/spirituality, and the aspects and extent of religious relevance in professional philosophy and practice. Results Healthcare workers who could perceive the multifactorial nature of suicide causation had a more empathetic response. There were high levels of paternalism in the care of suicidal patients, involving unsolicited religious/spiritual advice practised as a form of suicide deterrent and social support. Conclusions The formal integration of religious/spiritual practices into the professional care of suicidal patients was indicated.

Published
2021

40. Determinants of Participation and Outcomes in A Cause Marketing Event: A Laddering Approach

Author

Poh-Lin Yeoh

Subjects
Marketing, Customer engagement, Cause marketing, Laddering, Event (relativity), Perspective (graphical), Business, Customer identification, Event marketing
Abstract

While a rich stream of studies has emerged to understand customer identification at the brand level, this topic has not been addressed from an event marketing perspective. Secondly, although the co...

Published
2021

41. Shared spaces and 'throwntogetherness' in later life: A qualitative GIS study of non-migrant and migrant older adults in Singapore

Author

Elaine Lynn-Ee Ho, Guo Zhou, Jian An Liew, Shirlena Huang, Tuen Yi Chiu, and Brenda S. A. Yeoh

Subjects
Shared space, Geographic information system, Sociology and Political Science, business.industry, media_common.quotation_subject, 05 social sciences, 0211 other engineering and technologies, 0507 social and economic geography, 021107 urban & regional planning, Gender studies, 02 engineering and technology, Negotiation, Transnationalism, Sociology, Social differences, China, business, 050703 geography, Diversity (politics), media_common
Abstract

While there has been considerable academic interest in the topics of encounters and conviviality, including within the migration literature, little is known about how non-migrant and migrant older adults interact with one another in shared spaces, forming micro-publics that inflect the experiences of ageing for both groups. Using Qualitative Geographic Information Science (qualitative GIS), this paper identifies three types of spaces shared by non-migrant and migrant older adults from Singapore and the People’s Republic of China respectively. The first type of shared space is characterised by asynchronicity in that, despite co-located activities, intercultural interactions are less likely to be fostered between non-migrants and migrants. The second type of shared space features informal, spontaneous encounters that develop into more regular forms of interaction with ‘otherness’, but active negotiation of social difference could be limited. The third type of shared space is marked by formal, organised activities where non-migrants and migrants work towards a common goal, prompting productive negotiations with difference. Through juxtaposing these three types of shared spaces, we argue for the importance of drawing out how spatial attributes can deter or foster varying degrees of negotiations with difference, while acknowledging that the fluidity of such processes depend on the users and social contexts too. We also suggest that notions of ageing-in-place need to be analysed alongside ageing-across-borders, giving attention to how migration impacts ageing in later life—both for migrants who are adapting to life abroad temporarily as well as non-migrants who may experience “transnationalism by proxy”. (247 words; max 250 words)

Published
2021

42. Depression and anxiety among patients with psoriasis: A correlation with quality of life and associated factors

Author

Sharifah Zubaidiah Syed Jaapar, Raishan Shafini Bakar, Afiq F. Azmi, and Yeoh C. Aun

Subjects
Quality of life, Dyslipidaemia, Medicine (General), 020205 medical informatics, الصدفية, الاكتئاب, Population, 02 engineering and technology, Anxiety, نوعية الحياة, Hospital Anxiety and Depression Scale, 03 medical and health sciences, R5-920, 0302 clinical medicine, Psoriasis, 0202 electrical engineering, electronic engineering, information engineering, medicine, 030212 general & internal medicine, education, Depression (differential diagnoses), education.field_of_study, Depression, business.industry, القلق, General Medicine, Dermatology Life Quality Index, medicine.disease, Cohort, Original Article, medicine.symptom, business, خلل شحميات الدم, Clinical psychology
Abstract

الملخص: أهداف البحث: الصدفية هي مرض مزمن، بسبب المناعة يؤثر في المقام الأول على الجلد والأظافر والمفاصل. قد يجعل هذا المرض المرضى المصابين به عرضة للاضطرابات النفسية مثل الاكتئاب والقلق. تهدف هذه الدراسة إلى تحديد انتشار الاكتئاب والقلق في المرضى الذين يعانون من الصدفية وارتباط ذلك بجودة الحياة والعوامل المرتبطة به. طرق البحث: شملت هذه الدراسة المقطعية ١٧٤ مريضا بالصدفية في عيادة الأمراض الجلدية في مستشفى سلطانة بهية، آلور سيتار. وصدرت تعليمات إلى جميع المرضى بملء أربع مجموعات من الاستبانات؛ الملامح الاجتماعية الديموغرافية، والخصائص السريرية للمرض، والنسخة الماليزية المحققة من مقياس المستشفى للقلق والاكتئاب والنسخة الماليزية المحققة من مؤشر جودة الحياة للأمراض الجلدية. تم تحليل البيانات باستخدام تحليل وصفي وتحليل الترابط والتراجع اللوجستي المتعدد. نتائج: لقد وجدنا أن ٨.٥٪ من المرضى يعانون من الاكتئاب و١٦.٩٪ كان لديهم أعراض القلق. أظهر تحليل التحوف اللوجستي المتعدد أن ارتفاع درجات النسخة الماليزية المحققة من مؤشر جودة الحياة للأمراض الجلدية، ووجود آفات الأطراف السفلية، وكان خلل شحميات الدم مرتبط بالاكتئاب في العينة التي تم أخذ عينات منها. الاستنتاجات: أظهرت هذه الدراسة أن عينة الدراسة المصابة بالصدفية أظهرت أعراضا ملحوظة من الاكتئاب والقلق. تؤكد هذه النتيجة على الحاجة إلى تقييم القلق والاكتئاب بين المرضى الذين يعانون من الصدفية لأن هذه الأعراض تتوقع سوء نوعية الحياة. مثل هذا الارتباط بين الصدفية والقلق والاكتئاب يؤدي أساسا إلى عواقب نفسية. ويحتاج مرضى الصدفية المتضررين إلى التدخل المناسب. تمهد أبحاثنا الطريق لمزيد من البحث من خلال إشراك الثوابت الأساسية الأخرى مثل صورة الجسم المتصورة ووصمة العار. Abstract: Objectives: Psoriasis is a chronic, immune-mediated illness that primarily affects the skin, nails and joints. This illness may predispose people to mental disorders such as depression and anxiety. This study aims to determine the prevalence of depression and anxiety in patients with psoriasis and their correlation with quality of life and associated factors. Methods: This cross-sectional study involved 174 patients with psoriasis at the dermatology clinic of Hospital Sultanah Bahiyah, Alor Setar. All patients were instructed to complete four sets of questionnaires relating to: sociodemographic profile, clinical characteristics of illness, the validated Malay version of Hospital Anxiety and Depression Scale (HADS) and the Malay validated version of Dermatology Life Quality Index (DLQI). Data were analysed using a descriptive analysis and correlational and multiple logistic regression analyses. Results: We have found that 8.5% patients had depressive and 16.9% had anxiety symptoms. Multiple logistic regression analysis showed that higher DLQI scores, presence of lower limbs' lesions and dyslipidaemia were associated with depression in the sampled population. Conclusion: This study has shown that the cohort with psoriasis exhibited notable symptoms of depression and anxiety. This emphasises the need for the assessment of anxiety and depression among patients with psoriasis as these symptoms predict poor quality of life. Such correlation of psoriasis with anxiety and depression essentially leads to psychological sequelae. Affected psoriasis patients need appropriate intervention. Our study paves the way for further research by involving other underlying constructs such as perceived body image and stigma.

Published
2021

43. Numerical assessment of LES subgrid-scale turbulence models for expandable particles in fire suppression

Author

Ivan Miguel De Cachinho Cordeiro, Hengrui Liu, Anthony Chun Yin Yuen, Guan Heng Yeoh, Ao Li, and Timothy Bo Yuan Chen

Subjects
Physics::Fluid Dynamics, Materials science, Explosive material, business.industry, Turbulence, Flow (psychology), Fire protection, Particle, Mechanics, Computational fluid dynamics, business, Thermal diffusivity, Large eddy simulation
Abstract

Owing to the well-established Eulerian-Lagrangian framework on mixture fluids, computational fluid dynamics coupled with discrete element model (CFD-DEM) is an effective while appropriate tool to predict the complex interactive fire behaviours associate with suppression effects. Although suppression behaviours between hydrocarbon-fuelled fire and water-based suppression agents were extensively studied both numerically and experimentally, lack of numerical studies was conducted on fires involving water-reactive chemicals (i.e., Na, Li, and LiH), where extinguishment is barely performed by water-based active suppression system, as violent and explosive decomposition occurred between water and reactive fuel. In this research, a numerical investigation has been conducted on expandable graphite (EG) application for water-reactive fire suppression. Based on the discrete phase model (DPM) framework, a novel EG particle model is proposed to characterise the particle expansion that couples with superior thermal properties and chemical stability. A numerical assessment on large eddy simulation (LES) has been performed to study the temporal fire behaviours and the suppression effect of EG against the flame plume in various subgrid-scale (SGS) models. Four SGS models were adopted, which were namely Smagorinsky-Lilly, WALE, dynamic kinetic energy, and dynamic Smagorinsky-Lilly. As a result, the WALE SGS model was observed to be in a better agreement compared with the experimental data owing to its significant enhancement in flow diffusivity modelling. The WALE SGS model has achieved a more accurate temperature prediction and finer resolved turbulence compared with other SGS models.

Published
2021

44. Wet or dry multifunctional coating prepared by visible light polymerisation with fire retardant, thermal protective, and antimicrobial properties

Author

Cyrille Boyer, Ka Wai Fan, Susan Oliver, Lei Lei, Anthony Chun Yin Yuen, Guan Heng Yeoh, Juan-Carlos Baena, Phuong Pham, Imrana I. Kabir, Qianlan Lin, Cheng Wang, and Edgar H. H. Wong

Subjects
Textile, Materials science, Polymers and Plastics, Biocompatibility, business.industry, engineering.material, Limiting oxygen index, Combustibility, Coating, Thermal insulation, Cone calorimeter, engineering, Composite material, business, Fire retardant
Abstract

Cotton, the most popular textile fibre used today, suffers from high combustibility and a propensity for microbial growth. In this study, we used oxygen tolerant, visible light-activated free radical polymerisation to functionalise cotton with a biocompatible, fire retardant, antimicrobial coating that provided good fire retardancy when dry, and quickly absorbed water to provide exceptional fire retardancy and thermal insulation in more extreme fire conditions. The functionalised cotton, MF-cotton, had a limiting oxygen index (LOI) of 32% when dry and > 99% when wet. These exceptional fire retardancy results were confirmed by vertical burning tests and cone calorimeter testing. Wet MF-cotton was able to reduce exposure temperature by 140 °C under sustained heat exposure, displaying good thermal insulation. Good antimicrobial activity was demonstrated for MF-cotton against both gram-positive (Staphylococcus aureus) and gram-negative (Escherichia coli) bacteria with bacterial reductions of 98.1% and 99.998%, respectively, and in vitro testing confirmed its biocompatibility. Finally, MF-cotton had improved tensile properties compared with untreated cotton and maintained its softness and breathability. The coating could have potential applications for fabrics used in hospitals, household soft furnishings, fire blankets, and protective clothing.

Published
2021

45. Numerical study on using vortex flow to improve smoke exhaust efficiency in large-scale atrium fires

Author

Sherman Cp Cheung, Anthony Cy Yuen, Eric Wm Lee, Xiang Fang, and Guan Heng Yeoh

Subjects
Smoke, Scale (ratio), business.industry, Flow (psychology), 0211 other engineering and technologies, Public Health, Environmental and Occupational Health, 02 engineering and technology, Building and Construction, Computational fluid dynamics, Vortex, medicine.anatomical_structure, 020401 chemical engineering, medicine, Fire whirl, Environmental science, 021108 energy, 0204 chemical engineering, Atrium (heart), business, Marine engineering
Abstract

A high-performance smoke exhaust system is vital for maintaining a tenable environment during fire accidents evacuation. This study proposes a novel vortex flow driven smoke exhaust system to delay the smoke filling process during the atrium fire accident. The complex fluid movement and combustion reactions were predicted using Fire Dynamics Simulator, and the predicted smoke filling process was identified by the least-square method. Good agreements between numerical predictions and experimental measurements for vertical temperature, tangential velocity profile and smoke interface height were achieved. The numerical outcomes revealed that the amount of fresh air supplied, heat release rate and exhaust fan's rate determined the smoke interface's final height. A parametric study was also carried out to investigate the dominating factor in maintaining a stable vortex flow to maximize the smoke exhaust efficiency. Numerical results showed that the vortex flow smoke exhaust system could slow down the smoke filling, and the stability of the swirling fire is crucial for the system's performance.

Published
2021

46. LayerChain: A Hierarchical Edge-Cloud Blockchain for Large-Scale Low-Delay Industrial Internet of Things Applications

Author

Yao Yu, Branka Vucetic, Shumei Liu, Yonghui Li, and Phee Lep Yeoh

Subjects
Blockchain, business.industry, Computer science, Distributed computing, 020208 electrical & electronic engineering, Cloud computing, 02 engineering and technology, Computer Science Applications, Tree (data structure), Control and Systems Engineering, Node (computer science), Scalability, 0202 electrical engineering, electronic engineering, information engineering, Enhanced Data Rates for GSM Evolution, Electrical and Electronic Engineering, business, Edge computing, Information Systems, Block (data storage)
Abstract

The combination of pervasive edge computing and blockchain technologies opens up significant possibilities for industrial Internet of Things (IIoT) applications, but there are several critical limitations regarding efficient storage and rapid response for large-scale low-delay IIoT scenarios. To address these limitations, in this article we propose a hierarchical edge-cloud blockchain called LayerChain . Specifically, to promote scalability, we design a layered structure to hierarchically store the blockchain data in multiple distributed clouds and edge nodes. Next, we propose a node classification method to accommodate differences between the edge nodes when deploying the blockchain. Moreover, to mitigate lengthy delays during block propagation, we propose a tree-based clustering algorithm where blocks are propagated through different clusters with a compressed tree depth. Simulation results show that our LayerChain efficiently reduces the system's resource requirements and block propagation time, making it well-suited for large-scale low-delay IIoT applications.

Published
2021

47. A Life Cycle Assessment (LCA) Approach on the Production of Sago Sucker for Cultivation

Author

Chee Beng Yeoh, Najwa Sulaiman, Maizan Ismail, Farah Khuwailah Ahmad Bustamam, and Nik Sasha Khatrina Khairuddin

Subjects
business.industry, Applied Mathematics, General Mathematics, Sucker, Environmental science, Production (economics), business, Life-cycle assessment, Biotechnology
Abstract

Sago palm is one of the commodities being cultivated and traded in Malaysia for its high starch content. Sago seedling, or commonly referred to as sucker, is the planting material for sago cultivation. This paper discusses the life cycle assessment approach for the calculation of life cycle inventory for the production of one sago sucker. In this study, the functional unit is defined as one sago sucker. The process starts from the reception of suckers from suppliers, raft preparation, planting sago suckers in rafts, fertilization, and ends with transportation of the suckers to the plantation. Interviews and data verification were done on-site at the Crop Research and Application Unit (CRAUN) Sungai Talau Research Station. LCI data showed that water was the main input for the production of sago sucker, followed by diesel for transportation, pesticides, and fertilisers. The outcome of this study provides a basis or guideline to planters in implementing sago best agricultural practices for the production of sustainable sago.

Published
2021

48. Reliability of the ‘M-Line’ in the Prediction of the Facial Nerve Position in Patients with Parotid Neoplasms

Author

Aik Guan Yeoh, Liang Chye Goh, Mohamad Yunus Mohd Razif, Krishnan Punithamalar, Pei Fen Cheah, and Lawrence Sing Siong Kong

Subjects
Mastoid process, medicine.medical_specialty, business.industry, Mandible, Context (language use), Parotidectomy, Facial nerve, stomatognathic diseases, Retromandibular vein, stomatognathic system, Otorhinolaryngology, medicine, Paralysis, Surgery, Radiology, medicine.symptom, business
Abstract

Preoperative radiological assessment of parotid tumours represents a crucial step in the planning of a parotidectomy in order to avoid post-operative facial nerve paralysis. The purpose of this study is to determine the reliability of the novel ‘M-line’ in predicting the facial nerve position and compare it to various radiological methods in the same context. 66 patients whom had underwent parotidectomy for parotid tumours from January 2012 to February 2021 were analyzed. Parotid tumour location were identified using the retromandibular vein, facial nerve line, Conn’s arc, Utrecht line and the ‘M’-line were compared to the intraoperative location of parotid tumours.The ‘M’-line is a novel hypothetical line (drawn between the lateral surface of the mandible to the lateral border of the mastoid process) used to identify the location of the facial nerve radiologically. The ‘M-Line’ and other methods of radiological assessments were associated with statistical significance in predicting if the parotid tumours were superficial or deep to the facial nerve (p-value

Published
2021

49. Depression and Anxiety Predict Healthcare Workers’ Understanding of and Willingness to Help Suicide Attempt Patients

Author

Seen Heng Yeoh, Won Sun Chen, Jing Ni Tee, Norhayati Ibrahim, Caryn Mei Hsien Chan, Ching Sin Siau, Lena Lay Ling Yeap, Uma Visvalingam, Suzaily Wahab, and Lei Hum Wee

Subjects
Self-efficacy, Health (social science), Suicide attempt, business.industry, Burnout, Critical Care and Intensive Care Medicine, Health care, medicine, Anxiety, medicine.symptom, General hospital, Life-span and Life-course Studies, business, Psychology, Suicidal ideation, Depression (differential diagnoses), Clinical psychology
Abstract

We examined whether burnout, depression, anxiety, stress, lifetime suicidal ideation, self-efficacy in preventing suicide and demographic factors predicted the understanding of and willingness to help suicidal patients among hospital healthcare workers. A total of 368 healthcare workers from the major surgical and medical departments in a general hospital setting were recruited. Participants responded to the Depression Anxiety and Stress Scale-21, Self-efficacy in Suicide Prevention, and Understanding Suicide Attempt Patient Scale. Those from the psychiatric department, with higher suicide prevention self-efficacy, and lower personal accomplishment indicated more understanding and helpful attitudes; doctors, depressed and anxious healthcare workers reported less understanding and helpful attitudes. Suicide prevention efforts must be conducted in tandem with equipping and supporting the healthcare workers who manage suicidal patients.

Published
2021

50. Comparison of adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing potentially inappropriate medication use in Hong Kong older patients

Author

Francisco T. T. Lai, Eric K P Lee, Eliza L.Y. Wong, Patsy Y. K. Chau, Huanyu Zhang, Roger Yat-Nork Chung, Samuel Y. S. Wong, Eng-Kiong Yeoh, and Benjamin Hon Kei Yip

Subjects
Beers criteria, medicine.medical_specialty, Hong Kong-specific criteria, medicine.medical_treatment, Beers Criteria, Psychological intervention, Inappropriate Prescribing, Lower risk, Logistic regression, Older patients, hemic and lymphatic diseases, Prevalence, Humans, Medicine, Outpatient clinic, Medical diagnosis, Potentially Inappropriate Medication List, Aged, Rehabilitation, business.industry, Research, RC952-954.6, Cross-Sectional Studies, Geriatrics, Family medicine, Older adults, Hong Kong, Female, Potentially inappropriate medication, Geriatrics and Gerontology, business
Abstract

Background The Hong Kong-specific criteria have been established in 2019 to assess potentially inappropriate medication (PIM) use in older adults and improve the local prescribing quality. The aim of this study was to compare the adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing the prevalence and correlates of PIM use in Hong Kong older patients. Methods A cross-sectional study was performed from January 1, 2014 to December 31, 2014 using the Hospital Authority (HA) database. A total of 489,301 older patients aged 65 years and older visiting general outpatient clinics (GOPCs) during the study period were included in the study. Two categories of PIM use included in the Hong Kong-specific criteria and 2015 Beers criteria, i.e. PIMs independent of diagnoses and PIMs considering specific medical conditions, were adapted to assess the prevalence of PIM use among the study sample. Characteristics of PIM users and the most frequently prescribed PIMs were investigated for each set of the criteria. Factors associated with PIM use were identified using the stepwise multivariable logistic regression analysis. Results The adaptive Hong Kong-specific criteria could detect a higher prevalence of patients exposed to at least one PIM than that assessed by the adaptive Beers criteria (49.5% vs 47.5%). Meanwhile, the adaptive Hong Kong-specific criteria could identify a higher rate of patients exposed to PIMs independent of diagnoses (48.1% vs 46.8%) and PIMs considering specific medical conditions (7.3% vs 4.9%) compared with that of the adaptive Beers criteria. The most frequently prescribed PIMs detected by the adaptive Beers criteria were all included in the adaptive Hong Kong-specific criteria. The strongest factor associated with PIM use was number of different medications prescribed. Patients with female gender, aged 65 ~ 74 years, a larger number of GOPC visits, and more than six diagnoses were associated with greater risk of PIM use, whereas advancing age was associated with lower risk of PIM use. Conclusions The adaptive Hong Kong-specific criteria could detect a higher prevalence of PIM use than the adaptive Beers criteria in older adults visiting GOPCs in Hong Kong. It is necessary to update the prevalence and correlates of PIM use regularly in older adults to monitor the burden of PIM use and identify vulnerable patients who need further interventions.

Published
2021

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