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Fieldwork remains the mainstay in the study of geography and in the analysis of the environmental processes. However, an in-depth understanding of the environmental and geographical processes requires extensive as well as intensive fieldwork that involves time and substantial effort, both of which may pose a problem within a given curriculum time. One solution to this could be a collaborative data collection both on extensive temporal and spatial scales and subsequently sharing of this data by all for an in-depth analysis. Having a large data set from extensive areas helps in a more reliable analysis of the given problem, rather than one done with a limited data set for lack of time and scope. Results of such analysis have the potential of providing outcomes beyond mere course grades and may yield results that are useful in solving real life problems. Such an understanding was used for the development and use of an online data resource portal named G-Portal. The portal was used for uploading and later sharing of data collected from extensive, remote sites in a forest (Bukit Timah Nature Reserve, Singapore). Several groups of researchers collected the data within a short time, to be subsequently shared among the groups for a very in-depth analysis of the environmental problem of trail degradation. The article analyses the fieldwork-related issues addressed while developing this portal and also describes how the portal was used by several groups of researchers and subsequently how this data were used for analysis. Responses of users regarding the usefulness of this portal in research and analysis are also examined. The portal has been found to support field inquiry through data collection, data sharing, analysing data, synthesising data and presenting results. (Contains 4 tables and 5 figures.)

Background: The optimal treatment of BRCA wild-type patients with platinum-sensitive recurrent ovarian cancer remains unknown. Recently, there is an increase in the evidence to support the role of the combination of a poly(adenosine diphosphate-ribose) polymerase inhibitor, anti-angiogenic agents, and immunotherapy as maintenance therapy in BRCA wild-type patients with platinum-sensitive recurrence. We hypothesized that adding pembrolizumab and bevacizumab to olaparib maintenance can increase progression-free survival (PFS) in BRCA wild-type patients with platinum-sensitive recurrent ovarian cancer. Methods: BRCA wild-type patients who received two previous courses of platinum-containing therapy, achieved complete or partial response to last treatment, and the treatment-free interval is >6 months after the penultimate platinum-based chemotherapy offered olaparib maintenance with pembrolizumab and bevacizumab. Forty-four patients will be included from 4 sites across Singapore and Korea. The primary endpoint of the study is 6-month PFS rate. [ABSTRACT FROM AUTHOR]

Purpose: The novel coronavirus 2019 (COVID-19) outbreak which was first reported in Wuhan, China has been declared a pandemic by the World Health Organization on March 11, 2020. Otorhinolaryngologists deal intimately with pathologies of the head and neck region and upper respiratory tract and have been reported as a vulnerable group of healthcare workers who may be more susceptible to COVID-19 nosocomial infection. Methods: In this article, we provide a comprehensive overview of the adaptations of Singapore's largest tertiary Otorhinolaryngology department during the COVID-19 outbreak. This was undertaken via an evidence-based approach. The relevant medical literature and evidence underlying our adaptations are highlighted. Results: A four-pronged strategy including (1) personnel segregation, (2) triaging and decantment, (3) use of personal protective equipment and (4) changes in clinical practice was employed. The strategy was bolstered by drawing upon a collective learnt experience from the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak. Conclusion: A rigorous framework which can preserve operationality while navigating the heightened risks during this outbreak is critical for every Otorhinolaryngology department. As the pandemic continues to evolve and more scientific reports of this disease are made available, approaches will need to be morphed. [ABSTRACT FROM AUTHOR]

The number of electric vehicles (EVs) is expected to grow significantly, which calls for effective planning of charging infrastructures. While the planning of the charging infrastructure relies on an accurate charging demands, the behaviours of EVs charging are not always predictable and can be sensitive to many uncertain future environmental factors. Considering such uncertainties, this study aims to robustly and optimally determine the chargers and main switch board (MSB) capacities without violating queuing time constraints and load flow constraints. The non-parametric estimations of charging demands are derived with data-driven charging behaviour analysis considering diverse social factors, including travelling patterns, queuing, and changes of charging facilities. Then, the impacts of the EV integration are modeled by a stochastic load flow program. The samples of the stochastic load flow stipulate the conditional value-at-risk constraints for the planning of chargers and MSBs, which consider the probabilities and scenarios in a box of ambiguity with bounds. Afterwards, by limiting the frequency and severity of constraints violation, the total investment cost is minimized with a distributionally robust optimisation program. Simulation based on a real-world residential community in Singapore is carried out to testify the effectiveness of the proposed method. [ABSTRACT FROM AUTHOR]

Introduction: In Singapore, as strict laws are a strong deterrent against armed violence, little is known about the epidemiology of penetrating stab wound injuries. Our study aimed to investigate the epidemiology of stab wound injuries at a major trauma centre in Singapore and determine if there was a difference in severity between self-inflicted stab wound (SI) injuries and those inflicted by others (IO).Methods: We retrospectively reviewed all penetrating injuries at Tan Tock Seng Hospital, and identified and categorised all stab wound injuries as SI or IO. Basic demographic information, injury severity characteristics and outcome data were compared between these two groups. A review of all mortalities was performed, including recording the causes of death.Results: Between 2005 and 2010, there were a total of 149 stab wound injuries, of which 24 (16.1%) were SI and 125 (83.9%) were IO injuries. Patients tended to be young (mean age 34.1 ± 14.2 years). The mean Injury Severity Score was significantly different between the SI and IO groups (8.8 ± 6.5 vs. 12.3 ± 8.1; p = 0.03). In both groups, the majority underwent an operative procedure (83.3% vs. 85.6%) and had an average hospital stay of four days.Conclusion: The study confirms our hypothesis that SI injuries tend to be less severe than IO injuries and are more likely to occur at home rather than at a public area. This finding may be useful in the triage of patients with stab wound injuries. [ABSTRACT FROM AUTHOR]

Background: Dengue causes 50 million infections per year, posing a large disease and economic burden in tropical and subtropical regions. Only a proportion of dengue cases require hospitalization, and predictive tools to triage dengue patients at greater risk of complications may optimize usage of limited healthcare resources. For severe dengue (SD), proposed by the World Health Organization (WHO) 2009 dengue guidelines, predictive tools are lacking. Methods: We undertook a retrospective study of adult dengue patients in Tan Tock Seng Hospital, Singapore, from 2006 to 2008. Demographic, clinical and laboratory variables at presentation from dengue polymerase chain reaction-positive and serology-positive patients were used to predict the development of SD after hospitalization using generalized linear models (GLMs). Principal findings: Predictive tools compatible with well-resourced and resource-limited settings – not requiring laboratory measurements – performed acceptably with optimism-corrected specificities of 29% and 27% respectively for 90% sensitivity. Higher risk of severe dengue (SD) was associated with female gender, lower than normal hematocrit level, abdominal distension, vomiting and fever on admission. Lower risk of SD was associated with more years of age (in a cohort with an interquartile range of 27–47 years of age), leucopenia and fever duration on admission. Among the warning signs proposed by WHO 2009, we found support for abdominal pain or tenderness and vomiting as predictors of combined forms of SD. Conclusions: The application of these predictive tools in the clinical setting may reduce unnecessary admissions by 19% allowing the allocation of scarce public health resources to patients according to the severity of outcomes. Author Summary: Dengue is a mosquito-borne tropical disease that poses a large economic and health burden to 40% of the world's population. Some dengue patients can evolve into a more severe form of the illness (severe dengue) and ideally should be hospitalized when this occurs. However, while only a small proportion of patients have severe dengue, many other patients are unnecessarily hospitalized. Being able to identify those patients at the highest risk of developing severe dengue can be very useful to reduce costs to hospitals and patients. In this study, we develop predictive tools to identify those patients that should be hospitalized. We find that some common features such as age, gender, fever duration, fever on admission, vomiting or abdominal distension can be good predictors of severe dengue. This is important because these features are easy to identify even in resource-limited settings where laboratory tests are not widely available. [ABSTRACT FROM AUTHOR]

In Singapore, road traffic accidents (RTAs) are the second most common cause of deaths in trauma. Motorcycle casualties account for 54% of all fatalities. Studies have shown that the mean age of motorcycle casualties is significantly younger than that of other RTA victims. We reviewed the mortality of all motorcycle casualties ≥16 years admitted to an acute hospital as emergencies from January 2004 to December 2006. To determine the impact of age on mortality, we divided our patients into two groups, one ≤21 years (younger group) and another >21 years (older group). A subset analysis based on riding position (driver versus passenger) was performed to determine the inpatient mortality rate in these two groups. There were 96 (14%) patients in the younger group and 586 (86%) patients in the older group. The mortality rate for younger motorcycle casualties was significantly higher (14.6% versus 8%; p = 0.04). Also, there were significantly more passengers in the younger group (25% versus 8.4%; p = 0.0001). The mortality rate among young passengers was significantly higher than that among young drivers (29.2% versus 9.7%; p = 0.019). Likewise, the mortality rate of the young passengers was also significantly higher than that among older passengers (29.2% versus 10.2%; p = 0.04). Young motorcycle casualties have a significantly higher mortality rate than older motorcycle casualties. Young passengers have the highest mortality rate and contribute significantly to the death rate among young motorcycle casualties. [ABSTRACT FROM AUTHOR]

Abstract: Background: In Singapore, the first local outbreak of chikungunya was reported in January 2008, followed by a larger outbreak occurred in August 2008. During the initial outbreak period, a strict containment strategy was adopted and all chikungunya PCR-confirmed cases were isolated and hospitalised at the designated national outbreak management centre. Objectives: To detail daily clinical and laboratory features of chikungunya cases during acute illness, and determine factors associated with persistent arthralgia at week 6. Study design: Prospective cohort study of patients with PCR-confirmed chikungunya infection and hospitalised within 5 days of illness onset, from 1st August to 10th November 2008. Post-hospital discharge, patients were followed up at the specialist outpatient clinic, and assessed for arthralgia at week 6 of illness. Results: Of the 97 patients in the study, the most common presenting symptoms were fever (89.7%) and arthralgia (87.6%). Mean nadir leukocyte and platelet counts were 3.5(SD 1.9)×109/L and 165(SD 42)×109/L respectively. Of the 39 patients who were evaluated at week 6, 14 (35.9%) had persistent arthralgia. Those with persistent arthralgia tended to be females (p =0.003), and had a lower peak creatinine level (p =0.036) than those without. Peak viral load (p =0.664), and duration of fever (p =0.056) and viremia (p =0.55) respectively, were not significantly different between those with persistent arthralgia and those without. Conclusions: This study details the daily clinical and laboratory features of chikungunya patients during acute illness. Those with persistent arthralgia tended to be females, who had significantly lower peak creatinine level. [ABSTRACT FROM AUTHOR]