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Very preterm infants are at risk for neurodevelopmental impairment because of postnatal morbidities. This study aims to (1) compare the outcomes of very-low-birth-weight (VLBW) infants in Singapore during two time periods over a decade; 2) compare performances among Singaporean neonatal intensive care units (NICUs); and 3) compare a Singapore national cohort with one from the Australian and New Zealand Neonatal Network (ANZNN). Singapore national data on VLBW infants born during two periods, 2007–2008 (SG2007, n = 286) and 2015–2017 (SG2017, n = 905) were extracted from patient medical records. The care practices and clinical outcomes among three Singapore NICUs were compared using SG2017 data. Third, using data from the ANZNN2017 annual report, infants with gestational age (GA) ≤29 weeks in SG2017 were compared with their Oceania counterparts. SG2017 had 9.9% higher usage of antenatal steroids (p < 0.001), 8% better survival for infants ≤26 weeks (p = 0.174), and used 12.7% lesser nonsteroidal anti-inflammatory drugs for patent ductus arteriosus closure (p < 0.001) than those of SG2007 cohort. Rate of late-onset sepsis (LOS) was almost halved (7.4% vs. 14.0%, p < 0.001), and exclusive human milk feeding after discharge increased threefold (p < 0.001). SG2017, in contrast, had a higher rate of chronic lung disease (CLD) (20.0% vs. 15.1%, p = 0.098). Within SG2017, the rates of LOS, CLD, and human milk feeding varied significantly between the three NICUs. When compared with ANZNN2017, SG2017 had significantly lower rates of LOS for infants ≤25 weeks (p = 0.001), less necrotizing enterocolitis for infants ≤27 weeks (p = 0.002), and less CLD across all GA groups. Postnatal morbidities and survival rates for VLBW infants in Singapore have improved over a decade. Outcomes for VLBW infants varied among three Singapore NICUs, which provide a rationale for collaboration to improve clinical quality. The outcomes of Singaporean VLBW infants were comparable to those of their ANZNN counterparts. [ABSTRACT FROM AUTHOR]

Takes the communicative intentions of the writer to a typical type of business letter as the basis for a genre-analysis and suggests that such a perspective will allow English-for-special-purpose practitioners to teach business writing more effectively and economically. Examples from a Singapore government project are used to illustrate this process. (JL)

Objective: Use next-generation sequencing (NGS) technology to improve our diagnostic yield in patients with suspected genetic disorders in the Asian setting.Design: A diagnostic study conducted between 2014 and 2019 (and ongoing) under the Singapore Undiagnosed Disease Program. Date of last analysis was 1 July 2019.Setting: Inpatient and outpatient genetics service at two large academic centres in Singapore.Patients: Inclusion criteria: patients suspected of genetic disorders, based on abnormal antenatal ultrasound, multiple congenital anomalies and developmental delay.Exclusion Criteria: patients with known genetic disorders, either after clinical assessment or investigations (such as karyotype or chromosomal microarray).Interventions: Use of NGS technology-whole exome sequencing (WES) or whole genome sequencing (WGS).Main Outcome Measures: (1) Diagnostic yield by sequencing type, (2) diagnostic yield by phenotypical categories, (3) reduction in time to diagnosis and (4) change in clinical outcomes and management.Results: We demonstrate a 37.8% diagnostic yield for WES (n=172) and a 33.3% yield for WGS (n=24). The yield was higher when sequencing was conducted on trios (40.2%), as well as for certain phenotypes (neuromuscular, 54%, and skeletal dysplasia, 50%). In addition to aiding genetic counselling in 100% of the families, a positive result led to a change in treatment in 27% of patients.Conclusion: Genomic sequencing is an effective method for diagnosing rare disease or previous 'undiagnosed' disease. The clinical utility of WES/WGS is seen in the shortened time to diagnosis and the discovery of novel variants. Additionally, reaching a diagnosis significantly impacts families and leads to alteration in management of these patients. [ABSTRACT FROM AUTHOR]

Introduction: Fetoscopic laser photocoagulation (FLP), a treatment option for twin-to-twin transfusion syndrome (TTTS) in monochorionic twin pregnancies, is currently the treatment of choice at our centre. We previously reported on our experience of FLP from June 2011 to March 2014. This paper audits our fetal surgery performance since then.Methods: 15 consecutive patients who underwent FLP for Stage II-III TTTS before 26 weeks of gestation from June 2011 to January 2017 were retrospectively reviewed, consisting of five cases from our initial experience and ten subsequent cases. Perioperative, perinatal and neonatal outcomes were analysed.Results: Of 15 pregnancies, 10 (66.7%) and 5 (33.3%) were for Stage II and III TTTS respectively, with FLP performed at an earlier Quintero stage in the later cohort. Overall mean gestational ages at presentation, laser and delivery were comparable between the cohorts at 19.7 (15.4-24.3) weeks, 20.3 (16.3-25.0) weeks and 31.2 (27.6-37.0) weeks, respectively. 2 (13.3%) cases had intra-amniotic bleeding and 1 (6.7%) had iatrogenic septostomy. 1 (6.7%) case had persistent TTTS requiring repeat FLP, and another (6.7%) had preterm premature rupture of membranes at seven weeks post procedure. The overall perinatal survival rate was 21 (75.0%) out of 28 infants. One mother underwent termination of pregnancy for social reasons at 1.4 weeks post procedure. Double survival occurred in 8 (57.1%) out of 14 pregnancies, while 13 (92.9%) had at least one survivor.Conclusion: FLP requires a highly specialised team and tertiary neonatal facility. Continual training improves maternal and perinatal outcomes, ensuring comparable standards with international centres. [ABSTRACT FROM AUTHOR]

In this study, we report the implementation of a comprehensive wastewater surveillance testing program at a university campus in Singapore to identify Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infected individuals and the usage of pharmaceuticals and personal care products (PPCPs) as well as other emerging contaminants (ECs). This unique co-monitoring program simultaneously measured SARS-CoV-2 with chemical markers/contaminants as the COVID-19 situation evolved from pandemic to endemic stages, following a nationwide mass vaccination drive. SARS-CoV-2 RNA concentrations in wastewater from campus dormitories were measured using real-time reverse transcription-polymerase chain reaction (RT-qPCR) and corroborated with the number of symptomatic COVID-19 cases confirmed with the antigen rapid test (ART). Consistent results were observed where the concentrations of SARS-CoV-2 RNA detected in wastewater increased proportionately with the number of COVID-19 infected individuals residing on campus. Similarly, a wide range of ECs, including disinfectants and antibiotics, were detected through sensitive liquid chromatography with tandem mass spectrometry (LC-MS/MS) techniques to establish PPCPs consumption patterns during various stages of the COVID-19 pandemic in Singapore. Statistical correlation of SARS-CoV-2 RNA was observed with few ECs belonging to disinfectants, PCPs and antibiotics. A high concentration of disinfectants and subsequent positive correlation with the number of reported cases on the university campus indicates that disinfectants could serve as a chemical marker during such unprecedented times. [Display omitted] • Campus-scale wastewater co-monitoring of SARS-CoV-2 and emerging contaminants reflects evolving COVID-19 pandemic. • Wastewater SARS-CoV-2 viral loads positively correlated with reported COVID-19 cases. • An increase in the use of quaternary ammonium compounds (QACs), and acetaminophen was seen. • Antibiotics (TET, LIN and AZT) consumption correlated with the total number of reported COVID-19 cases. • Being positively correlated with various pandemic markers, BAC-12 is suggested as a potential chemical marker. [ABSTRACT FROM AUTHOR]

• There is large but under-recognised potential for blue carbon in urban landscapes. • Singapore is used as a case study for urban blue carbon science and policy. • Singapore's blue carbon ecosystems store 577,227 tonnes of carbon. • Blue carbon is increasingly incorporated into urban planning and policy. The ability of vegetated coastal ecosystems to sequester high rates of "blue" carbon over millennial time scales has attracted the interest of national and international policy makers as a tool for climate change mitigation. Whereas focus on blue carbon conservation has been mostly on threatened rural seascapes, there is scope to consider blue carbon dynamics along highly fragmented and developed urban coastlines. The tropical city state of Singapore is used as a case study of urban blue carbon knowledge generation, how blue carbon changes over time with urban development, and how such knowledge can be integrated into urban planning alongside municipal and national climate change obligations. A systematic review of blue carbon studies in Singapore was used to support a qualitative review of Singapore's blue carbon ecosystems, carbon budget, changes through time and urban planning and policy. Habitat loss across all blue carbon ecosystems is coarsely estimated to have resulted in the release of ∼12.6 million tonnes of carbon dioxide since the beginning of the 20th century. However, Singapore's remaining blue carbon ecosystems still store an estimated 568,971 – 577,227 tonnes of carbon (equivalent to 2.1 million tonnes of carbon dioxide) nationally, with a small proportion of initial loss offset by habitat restoration. Carbon is now a key topic on the urban development and planning agenda, as well as nationally through Singapore's contributions to the Paris Agreement. The experiences of Singapore show that coastal ecosystems and their blue carbon stocks can be successfully managed along an urban coastline, and can help inform blue carbon science and management along other rapidly urbanizing coastlines throughout the tropics. [ABSTRACT FROM AUTHOR]

The India outbound market has grown slowly but steadily over the past few years. Intra-regional travel as in between the countries of South Asia is on the rise and at times economical too. In view of the intense competition in the Indian tourism sector with rapid corporatization of tourism services tourist satisfaction and services quality has been considered as essential requirement for survival. The present study examines the outbound Indian tourist's perception of Singapore Tourism from divergent angles. The study highlights the Indian tourist's perception and other factors, which can be used by Indian tourism sector for enhancement. 150 outbound Indian tourists were included in the study. The results of the analysis would enable Indian tourism sector to further recognize the tourist's preferences for better satisfaction which ultimately leads to tourist loyalty and portability. [ABSTRACT FROM AUTHOR]

Abstract: While how to improve the efficiency of solar cells is commonly researched, the effect of dust-fall on solar cell efficiency in the local Singapore weather has been largely neglected. In this work we investigated the conditions affecting dust-fall in Singapore and its effect on the optical transmission through glass modules. It was found that for bare glass samples, transmission reduces despite the heavy rains in Singapore over several months. After 33 days, transmission through plain glass slides reduced from 90.7% to 87.6%. Samples located nearer sources of dust and other contaminant particles such as heavy traffic, were more adversely affected compared to those which were situated in greenery. We also investigated the effect of substrate tilt in keeping them clean. Bare glass substrates were tilted at angles of 0, 10, 20, 30, 40, 50, 60, 70, 80 and 90 degrees during outdoor exposure. The transmission through the lower parts of the substrates tilted at a fixed angle, was generally worse than the upper part as dust is washed downwards. After 33 days, the average transmission through the upper part of sides was 88.7%, while through the lower part it was 87.9%. We also investigated the performance of TiO2 films as an outdoor self-cleaning coating for solar panels. TiO2 films of different thicknesses were deposited on glass substrate by hydrolysis method which is a low-cost and commercially viable process. We will present the outdoor performance of TiO2 films, and discuss the optimised film parameters for solar cell applications. [Copyright &y& Elsevier]

Purpose – The purpose of this paper is to examine the potential success and failure of small- and medium-sized enterprises (SMEs). Design/methodology/approach – An exploratory business success versus failure (S/F) prediction model is introduced, modeled after the Lussier prediction model, using data from Singapore. Using logistic regression analysis, it is found that the Lussier model (p=0.057) and the exploratory model (p=0.047) are significant predictors of business success and failure. Findings – The Lussier model accurately predicted 85.6 percent of the surveyed firms and explained 25 percent of the variance of contributing factors to S/F, and the exploratory model explained 86.3 and 38 percent of the same, respectively. SMEs regard the top four most important factors contributing to their business S/F as: employment, training, and the retainment of high-quality staff members; prevalence of good products, services, and optimum timing in introducing these in the marketplace; excellent relationships with customers and availability of top managers with good leadership qualities. Research limitations/implications – It is surprising that while pursuing their respective business activities, the SMEs surveyed in this study regarded government policy and the availability of business finance, amongst other factors, of lesser importance compared to the above-mentioned four broad variables. Originality/value – This paper establishes benchmarks that could be helpful to decision makers for improving future business-related policy formulation and research. Business leaders could pursue their goal of ensuring business successes with better personnel management and leadership training by, for example, taking more business management and leadership courses and personal development. Government public policy makers and others could utilize such a model to assess a firm's potential for success so that society could benefit via the allocation of limited resources toward higher potential firms. [ABSTRACT FROM AUTHOR]

Using a sample of 520 staff nurses employed by a large public hospital in Singapore, we examined whether psychological empowerment mediated the effects of transformational leadership on followers' organizational commitment. We also examined how structural distance (direct and indirect leadership) between leaders and followers moderated the relationship between transformational leadership and organizations commitment. Results from HLM analyses showed that psychological empowerment mediated the relationship between transformational leadership and organizational commitment. Similarly, structural distance between the leader and follower moderated the relationship between transformational leadership and organizational commitment. Implications for research and practice of our findings are discussed. [ABSTRACT FROM AUTHOR]

The article focuses on the results of research conducted at National University of Singapore (NUS) on therapeutic approaches for septic shock. The condition is caused by decreased tissue perfusion and oxygen delivery due to infection and sepsis. Researchers at NUS have focused on several therapeutic targets or mediators for septic shock, including an 11-amino acid neuropeptide called Substance P.

• Cultural ecosystem services are undervalued, particularly scientific value. • We created 11 novel indicators to quantify scientific value. • New indicators of scientific value tested on coastal ecosystems in Singapore. • Mangroves, reefs and open water have the highest scientific value in Singapore. • Scientific value is spatially explicit and differs between sites. Coastal ecosystems provide a broad range of ecosystem services, which can be used to justify habitat conservation. The cultural ecosystem services of coastal ecosystems are generally underappreciated, and this is particularly the case when quantifying their scientific value. We created a tiered set of indicators to quantify scientific value spatially, and tested them using the case study of the island nation of Singapore. We conducted a systematic review of research papers, book chapters, conference reports and academic theses produced across 10 coastal ecosystems in Singapore, including mangroves, seagrasses, coral reefs, beaches and artificial coastal structures. At least 656 articles have been produced on Singapore's coastal zone, with 2201 unique observations, showing that scientific value is spatially variable along Singapore's coastline. Novel indicators such as the Site Impact Factor are able to differentiate scientific value between sites. This method has shed light on an under-recognised, but important cultural ecosystem service, and is applicable to other spatially-bounded coastal, marine and terrestrial landscapes. [ABSTRACT FROM AUTHOR]