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With the ongoing evolution in technology, there is an increasing need to address participation in lifelong learning in Singapore's construction industry. It is necessary for employees and workers in the construction sector to acquire skillsets and knowledge to adapt to the ever-changing world. This study attempts to identify ways to increase participation in lifelong learning in the construction industry in Singapore by examining motivational theories for drivers and barriers. With the establishment of the conceptual framework, this study adopts a quantitative approach, using a questionnaire survey, the results of which are analysed using the SPSS and SmartPLS 3.0 software. The result of the analysis strongly supports the use of self-determination theory (SDT) and the fulfilment of three basic psychological needs -- competence, autonomy, and relatedness of individuals -- will produce a significant effect on the participation of lifelong learning within the construction industry. This means that the practical use of this theory in the construction industry will gradually increase individuals' participation in lifelong learning. This study examined theories of amotivation and barriers, and both were demonstrated to be insignificant affecting participation rates. This study also identified institutional barriers as a key factor within the barrier domain, suggesting that changes in the institutional situation may help individuals to fulfil their lifelong learning dream.

Background: Rare diseases pose immense challenges for healthcare systems due to their low prevalence, associated disabilities, and attendant treatment costs. Advancements in gene therapy, such as treatments for Spinal Muscular Atrophy (SMA), have introduced novel therapeutic options, but the high costs, exemplified by Zolgensma® at US$2.1 million, present significant financial barriers. This scoping review aimed to compare the funding approaches for rare disease treatments across high-performing health systems in Australia, Singapore, South Korea, the United Kingdom (UK), and the United States (US), aiming to identify best practices and areas for future research. Methods: In accordance with the PRISMA-ScR guidelines and the methodological framework by Arksey and O'Malley and ensuing recommendations, a comprehensive search of electronic databases (Medline, EMBASE, and Cochrane) and grey literature from health department websites and leading national organizations dedicated to rare diseases in these countries was conducted. Countries selected for comparison were high-income countries with advanced economies and high-performing health systems: Australia, Singapore, South Korea, the UK, and the US. The inclusion criteria focused on studies detailing drug approval processes, reimbursement decisions and funding mechanisms, and published from 2010 to 2024. Results: Based on a thorough review of 18 published papers and grey literature, various strategies are employed by countries to balance budgetary constraints and access to rare disease treatments. Australia utilizes the Life Saving Drugs Program and risk-sharing agreements. Singapore depends on the Rare Disease Fund, which matches public donations. South Korea's National Health Insurance Service covers specific orphan drugs through risk-sharing agreements. The UK relies on the National Institute for Health and Care Excellence (NICE) to evaluate treatments for cost-effectiveness, supported by the Innovative Medicines Fund. In the US, a combination of federal and state programs, private insurance and non-profit support is used. Conclusion: Outcome-based risk-sharing agreements present a practical solution for managing the financial strain of costly treatments. These agreements tie payment to actual treatment efficacy, thereby distributing financial risk and promoting ongoing data collection. Countries should consider adopting and expanding these agreements to balance immediate expenses with long-term benefits, ultimately ensuring equitable access to crucial treatments for patients afflicted by rare diseases. [ABSTRACT FROM AUTHOR]

Background: Despite the relative importance, the prevalence of workplace safety and health issues in hospital food service workers is not well studied. This study describes the epidemiology of work-related injuries and occupational diseases among hospital food service workers (FSWs) in a tertiary hospital in Singapore. Methods: Using a total population sampling approach, a cross-sectional self-administered questionnaire was distributed to all FSWs employed at a major tertiary hospital in Singapore. Results: The response rate was 98.4% (n = 125). The overall prevalence of workplace injuries and musculoskeletal symptoms was 35% (n = 43) and 53% (n = 65) respectively. The most common workplace injuries were cuts/lacerations (35.8%), muscle strain (25.4%) and burns (19.4%). The prevalence of workplace injuries among staff performing food preparation duties was higher at 56.3% as compared to 21.6% among staff with no food preparation duties (p < 0.01). The prevalence of workplace injuries among staff performing cooking duties was also higher at 47.5%, compared to 29.3% among staff with no cooking duties (p = 0.05). Staff performing food preparation duties had a higher prevalence of musculoskeletal symptoms at 66.7% as compared to 44.6% among staff with no food preparation duties (p = 0.02). Obese staff had a higher prevalence of musculoskeletal symptoms at 78.9%, compared to overweight staff at 53.8% and staff with normal weight at 43.1% (p = 0.03). Conclusion: FSWs with jobs involving cooking and preparation of food, and those with obesity, are at higher risk of sustaining workplace injuries or musculoskeletal symptoms. Targeted interventions should be implemented for injury prevention and to mitigate these risks. [ABSTRACT FROM AUTHOR]

The "coral gardening" approach has been effective in facilitating the recovery of degraded reefs but methodological variations can influence survivorship and growth of the coral material. In addition, the disproportionate use of certain corals, such as acroporids and pocilloporids, has contributed to a general lack of information on growth patterns and restoration strategies for species that are less common. To investigate how the yield of other species may be increased to support reef restoration efforts in Singapore, we assessed the effects of (1) environment (nursery, reef, and seawall) and (2) transplant orientation (horizontal and vertical) on the performance of Echinopora horrida (Dana, 1846) fragments. Fragments secured in the coral nursery grew significantly faster and survived better than those transplanted on the reef and seawall, highlighting the importance of a nursery‐rearing phase in optimizing the yield of this species. Additionally, survivorship and growth rates were not significantly different between vertically and horizontally transplanted corals, suggesting that modifying transplant orientation was less crucial toward enhancing coral yield. Our findings highlighted the need to optimize the propagation techniques of a wider range of understudied coral species in order to preserve their genetic diversity in the face of anthropogenic and climatic impacts. [ABSTRACT FROM AUTHOR]

Iridovirus poses a substantial threat to global aquaculture due to its high mortality rate; however, the molecular mechanisms underpinning its pathogenesis are not well elucidated. Here, a multi-omics approach was applied to groupers infected with Singapore grouper iridovirus (SGIV), focusing on the roles of key metabolites. Results showed that SGIV induced obvious histopathological damage and changes in metabolic enzymes within the liver. Furthermore, SGIV significantly reduced the contents of lipid droplets, triglycerides, cholesterol, and lipoproteins. Metabolomic analysis indicated that the altered metabolites were enriched in 19 pathways, with a notable down-regulation of lipid metabolites such as glycerophosphates and alpha-linolenic acid (ALA), consistent with disturbed lipid homeostasis in the liver. Integration of transcriptomic and metabolomic data revealed that the top enriched pathways were related to cell growth and death and nucleotide, carbohydrate, amino acid, and lipid metabolism, supporting the conclusion that SGIV infection induced liver metabolic reprogramming. Further integrative transcriptomic and proteomic analysis indicated that SGIV infection activated crucial molecular events in a phagosome-immune depression-metabolism dysregulation-necrosis signaling cascade. Of note, integrative multi-omics analysis demonstrated the consumption of ALA and linoleic acid (LA) metabolites, and the accumulation of L-glutamic acid (GA), accompanied by alterations in immune, inflammation, and cell death-related genes. Further experimental data showed that ALA, but not GA, suppressed SGIV replication by activating antioxidant and anti-inflammatory responses in the host. Collectively, these findings provide a comprehensive resource for understanding host response dynamics during fish iridovirus infection and highlight the antiviral potential of ALA in the prevention and treatment of iridoviral diseases. [ABSTRACT FROM AUTHOR]

Background: It is known that many surgeons encounter intraoperative adverse events which can result in Second Victim Syndrome (SVS), with significant detriment to their emotional and physical health. There is, however, a paucity of Asian studies in this space. The present study thus aimed to explore the degree to which the experience of an adverse event is common among surgeons in Singapore, as well as its impact, and factors affecting their responses and perceived support systems. Methods: A self-administered survey was sent to surgeons at four large tertiary hospitals. The 42-item questionnaire used a systematic closed and open approach, to assess: Personal experience with intraoperative adverse events, emotional, psychological and physical impact of these events and perceived support systems. Results: The response rate was 57.5% (n = 196). Most respondents were male (54.8%), between 35 and 44 years old, and holding the senior consultant position. In the past 12 months alone, 68.9% recalled an adverse event. The emotional impact was significant, including sadness (63.1%), guilt (53.1%) and anxiety (45.4%). Speaking to colleagues was the most helpful support source (66.7%) and almost all surgeons did not receive counselling (93.3%), with the majority deeming it unnecessary (72.2%). Notably, 68.1% of the surgeons had positive takeaways, gaining new insight and improving vigilance towards errors. Both gender and surgeon experience did not affect the likelihood of errors and emotional impact, but more experienced surgeons were less likely to have positive takeaways (p = 0.035). Individuals may become advocates for patient safety, while simultaneously championing the cause of psychological support for others. Conclusions: Intraoperative adverse events are prevalent and its emotional impact is significant, regardless of the surgeon's experience or gender. While colleagues and peer discussions are a pillar of support, healthcare institutions should do more to address the impact and ensuing consequences. [ABSTRACT FROM AUTHOR]

Introduction: Lockdowns, while limiting COVID-19 transmission, can affect provision of care by informal caregivers and their caregiving experience. We assessed, among informal caregivers in Singapore, (a) the perceived impact of a 2-month (April to May 2020) nationwide lockdown on their care provision, (b) correlates of different perceptions of the impact of the lockdown on care provision, and (c) association of different perceptions of the impact with negative and positive experiences of caregiving. Methods: In the August 2020 wave of the Singapore Life Panel (SLP; nationally representative, longitudinal monthly survey of Singapore citizens and permanent residents aged 50–70 years at baseline), 1,094 participants identified as informal caregivers reported whether their care provision became easier, remained the same, or became harder during the lockdown, compared to before the lockdown. We used multinomial logistic regression to assess the association of caregiver, care recipient, and caregiving context characteristics with their perceptions. Linear regression models examined the association of their perceptions with negative and positive experience domains of the modified Caregiver Reaction Assessment. Results: Just over one-third (36.1%) of the informal caregivers reported that their care provision became harder during the lockdown compared to before the lockdown. However, nearly one-fifth (18.0%) said that it became easier, and the rest (45.9%) said that it remained the same. Care provision was more likely to be perceived as having become harder among caregivers who were male, of Chinese ethnicity, in worse health, whose care recipients had functional limitations, who did not have caregiving support from cohabiting family members before the lockdown, and who had caregiving support from non-cohabiting family members before the lockdown. The perception that care provision became easier was less likely among caregivers who were of higher age, were unemployed, were socially isolated, and whose care recipients had functional limitations. Caregivers who perceived that care provision became harder during the lockdown were worse-off in negative experiences of caregiving. Conclusion: A nationwide lockdown did not make care provision harder for all informal caregivers. However, informal caregivers for whom it did were more likely to have greater negative experiences of caregiving. The heterogeneity of the impact of lockdowns and the possibility of offering flexibility to non-cohabiting family members who support caregiving should be important considerations when planning for such disruptions. [ABSTRACT FROM AUTHOR]

Introduction: Older patients on polypharmacy are predisposed to drug‐related problems (DRPs). While medication therapy management (MTM) with pharmacist involvement can reduce DRP occurrence, few have examined its impact on reducing unplanned admissions. This study was designed to determine whether a pharmacist‐provided MTM service can reduce unplanned admissions through the comparison with patients receiving usual care. Methods: A retrospective case–control study was conducted in Changi General Hospital. Patients enrolled to MTM service from January 2016 to December 2021 were included in the intervention arm (n = 96) while patients who were not enrolled were recruited as control (n = 96). Primary outcome was the incidence rate ratio (IRR) of unplanned admissions within 6 months postindex visit comparing between intervention arm and control arm. Secondary outcomes included number of DRPs identified, types of DRPs, and the potential risks avoided by resolving DRPs. The negative binomial mixed model was used to model the unplanned admissions data. Results: MTM with pharmacists' involvement was associated with a 39% (IRRs 0.61, 95% confidence interval [CI] 0.37–0.99, p = 0.047) lower rate of admissions in the intervention compared with the control group. There were higher number of DRPs (144 vs. 2) found in the intervention arm compared with control arm, respectively. The most prevalent types of DRPs were "Nonadherence" (80.1%), "Drug omission" (5.6%), and "Inappropriate dose" (2.8%). The most common potential risks avoided were increased cardiovascular risk, n = 29 (22.1%), increased fall risk, n = 18 (13.7%), and increased fracture risk, n = 17 (13.0%). Conclusion: The study suggests that pharmacist‐provided MTM service decreased unplanned admission. It has improved medication safety and quality of care by identifying and resolving more DRPs. [ABSTRACT FROM AUTHOR]

There is a dearth of research on the psychological processes that underlie the negative relation between impaired instrumental activities of daily living (IADL) and depressive symptoms in older adults. Drawing on the stress process model and the resilience framework, we investigated whether purpose in life and resilience serially mediate the relationship between impaired IADL and depressive symptoms. We recruited 111 cognitively healthy community-dwelling older adults (ages 54–85; M = 66.5) who scored a minimum of 25 points on the Mini-Mental State Examination. We found that purpose in life and resilience serially mediated the relationship between IADL and depressive symptomatology in older adults. This association held true when we controlled for covariates. Additional sensitivity analyses also supported these findings. This study extends our understanding of how IADL limitations contribute to depressive symptoms. Using a community-dwelling, cognitively healthy sample, we demonstrate that functional limitations indirectly influence older adults' depressive symptoms through a decreased sense of purpose in life and decreased resilience. Our findings have implications for intervention programs that aim to alleviate IADL limitations and mental health issues in an aging population and promote healthy aging by improving psychosocial resources (i.e., purpose in life and resilience). [ABSTRACT FROM AUTHOR]

The dual-specificity phosphatase (DUSP) family plays an important role in response to adverse external factors. In this study, the DUSP5 from Epinephelus coioides, an important marine fish in Southeast Asia and China, was isolated and characterized. As expected, E. coioides DUSP5 contained four conserved domains: a rhodanese homology domain (RHOD); a dual-specificity phosphatase catalytic domain (DSPc); and two regions of low compositional complexity, indicating that E. coioides DUSP5 belongs to the DUSP family. E. coioides DUSP5 mRNA could be detected in all of the examined tissues, and was mainly distributed in the nucleus. Infection with Singapore grouper iridovirus (SGIV), one of the most important pathogens of marine fish, could inhibit the expression of E. coioides DUSP5. The overexpression of DUSP5 could significantly downregulate the expression of the key SGIV genes (MCP, ICP18, VP19, and LITAF), viral titers, the activity of NF-κB and AP-I, and the expression of pro-inflammatory factors (IL-6, IL-8, and TNF-α) of E. coioides, but could upregulate the expressions of caspase3 and p53, as well as SGIV-induced apoptosis. The results demonstrate that E. coioides DUSP5 could inhibit SGIV infection by regulating E. coioides immune-related factors, indicating that DUSP5 might be involved in viral infection. [ABSTRACT FROM AUTHOR]

Singapore grouper iridovirus (SGIV) is a new ranavirus species in the Iridoviridae family, whose high lethality and rapid spread have resulted in enormous economic losses for the aquaculture industry. Curcumin, a polyphenolic compound, has been proven to possess multiple biological activities, including antibacterial, antioxidant, and antiviral properties. This study was conducted to determine whether curcumin protected orange-spotted grouper (Epinephelus coioides) from SGIV-induced intestinal damage by affecting the inflammatory response, cell apoptosis, oxidative stress, and intestinal microbiota. Random distribution of healthy orange-spotted groupers (8.0 ± 1.0 cm and 9.0 ± 1.0 g) into six experimental groups (each group with 90 groupers): Control, DMSO, curcumin, SGIV, DMSO + SGIV, and curcumin + SGIV. The fish administered gavage received DMSO dilution solution or 640 mg/L curcumin every day for 15 days and then were injected intraperitoneally with SGIV 24 h after the last gavage. When more than half of the groupers in the SGIV group perished, samples from each group were collected for intestinal health evaluation. Our results showed that curcumin significantly alleviated intestine damage and repaired intestinal barrier dysfunction, which was identified by decreased intestine permeability and serum diamine oxidase (DAO) activity and increased expressions of tight junction proteins during SGIV infection. Moreover, curcumin treatment suppressed intestinal cells apoptosis and inflammatory response caused by SGIV and protected intestinal cells from oxidative injury by enhancing the activity of antioxidant enzymes, which was related to the activation of nuclear factor erythroid 2-related factor 2 (Nrf2) signaling. Moreover, we found that curcumin treatment restored the disruption of the intestinal microbiota caused by SGIV infection. Our study provided a theoretical basis for the functional development of curcumin in aquaculture by highlighting the protective effect of curcumin against SGIV-induced intestinal injury. [ABSTRACT FROM AUTHOR]

Cells are important in the study of virus isolation and identification, viral pathogenic mechanisms and antiviral immunity. The spotted knifejaw (Oplegnathus punctatus) is a significant farmed fish in China that has been greatly affected by diseases in recent years. In this study, a new cell line derived from the spotted knifejaw brain (SKB) was established and characterized. SKB cells multiplied well in Leibovitz's L‐15 medium supplemented with 10% fetal bovine serum at 28°C. Chromosome analysis revealed that modal chromosome number was 48 for SKB. SKB cells exhibit susceptibility to several fish viruses, such as a largemouth bass virus, red grouper nervous necrosis virus (RGNNV), infectious spleen and kidney necrosis virus (ISKNV), Singapore grouper iridovirus (SGIV) and spotted knifejaw iridovirus isolate (SKIV‐TJ), as shown by cytopathic effect and increased viral titers. Electron microscopy results showed that the cytoplasm contained a large number of vacuoles, and many virus particles existed at the edge of the vacuoles in RGNNV‐infected cells and numerous viral particles were scattered throughout the cytoplasm in both ISKNV‐ and SKIV‐TJ‐infected cells. These results suggest that SKB is an ideal tool for studying host–virus interactions and potential vaccine development. [ABSTRACT FROM AUTHOR]

Coral restoration has largely focused on improving techniques and biological yield to hasten reef recovery. However, as socioeconomic considerations can affect restoration success, it is important to also consider inputs from various stakeholders in the design and execution of restoration projects. Through online questionnaires, the knowledge levels and attitudes of 142 participants toward coral ecology and restoration in Singapore, and their preferences toward species traits they felt were most beneficial for restoring reefs, were analyzed. Comprising varied sociodemographic profiles and stakeholder groups, participants fared better in general coral biology (up to 90% of answers correct) than local coastal resource management (35% of answers correct). More than 79% of participants agreed that Singapore's reefs were rapidly degrading and required restoration to slow the decline; however, over 63% of them disagreed that restoration was the sole domain of scientists or that the topic had been sufficiently communicated to the public. These knowledge scores and attitudes were most influenced by stakeholder group, educational level, and familiarity with local reefs, underscoring the need to improve environmental education and science communication to these groups. In the trait prioritization exercise involving 76 respondents, resilience and resistance to stress were regarded as most important for restoring reefs. Marine science professionals and nondivers preferred using species that could cope with stress, while nature enthusiasts and recreational divers considered habitat contribution by various coral growth forms as more important. The adaptable framework here facilitates integration of stakeholder inputs with the necessary strategies to boost restoration outcomes. [ABSTRACT FROM AUTHOR]

Urban complex is an achievement of enhancing the mixed function of buildings and the convenience of regions in the urbanization process. Since the independence of self-governance, Singapore has embarked on mixed-use development, first on community complexes, then launching numerous influential commercial complexes in the last fifty years, contributing to the city's economic and social benefits. This paper outlines the evolution of urban complexes in Singapore following an analytic discussion on the features of a gathered distribution in the CBD and green-aspects reorganization. The space features identified in multiexperiencing space are driven by economy from a sustainable life-cycle to experiential core consumption space, then to create an immersive themed scene and upward sky garden scenario. Considering Singapore's urban planning goals, which are to create a diverse and enjoyable city, this paper finally focuses on the interpretation of future-oriented complex space trends to provide a reference to meet the architecture and urban space problems of China's urbanization process. [ABSTRACT FROM AUTHOR]

Introduction: Receptor interacting protein 2 (RIP2), serves as a vital sensor of cell stress, is able to respond to cell survival or inflammation, and is involved in antiviral pathways. However, studies on the property of RIP2 in viral infections in fish have not been reported. Methods: In this paper, we cloned and characterized RIP2 homolog from orange-spotted grouper (Epinephelus coioides) (EcRIP2) and further discussed the relevance of EcRIP2 to EcASC, comparing the influences of EcRIP2 and EcASC on the modulation of inflammatory factors and the NF-kB activation to reveal the mechanism of EcRIP2 in fish DNA virus infection. Results: Encoded a 602 amino acid protein, EcRIP2 contained two structural domains: S-TKc and CARD. Subcellular localization signified that EcRIP2 existed in cytoplasmic filaments and dot aggregation patterns. After SGIV infection, the EcRIP2 filaments aggregated into larger clusters near the nucleus. The infection of SGIV could notably up-regulate the transcription level of the EcRIP2 gene compared with lipopolysaccharide (LPS) and red grouper nerve necrosis virus (RGNNV). Overexpression of EcRIP2 impeded SGIV replication. The elevated expression levels of inflammatory cytokines induced by SGIV were remarkably hindered by EcRIP2 treatment in a concentration-dependent manner. In contrast, EcASC treatment could up-regulate SGIV-induced cytokine expression in the presence of EcCaspase-1. Enhancing amounts of EcRIP2 could overcome the down regulatory effect of EcASC on NF-kB. Nevertheless, increasing doses of EcASC failed to restrain the NF-kB activation in the existence of EcRIP2. Subsequently, it was validated by a co-immunoprecipitation assay that EcRIP2 dose-dependently competed with EcASC binding to EcCaspase-1. With increasing time to SGIV infection, EcCaspase-1 gradually combined with more EcRIP2 than EcASC. Discussion: Collectively, this paper highlighted that EcRIP2 may impede SGIVinduced hyperinflammation by competing with EcASC for binding EcCaspase-1, thereby suppressing viral replication of SGIV. Our work supplies novel viewpoints into the modulatory mechanism of RIP2-associated pathway and offers a novel view of RIP2-mediated fish diseases. [ABSTRACT FROM AUTHOR]

Singapore grouper iridovirus (SGIV), one of the nucleocytoviricota viruses (NCVs), is a highly pathogenic iridovirid. SGIV infection results in massive economic losses to the aquaculture industry and significantly threatens global biodiversity. In recent years, high morbidity and mortality in aquatic animals have been caused by iridovirid infections worldwide. Effective control and prevention strategies are urgently needed. Here, we present a near-atomic architecture of the SGIV capsid and identify eight types of capsid proteins. The viral inner membrane-integrated anchor protein colocalizes with the endoplasmic reticulum (ER), supporting the hypothesis that the biogenesis of the inner membrane is associated with the ER. Additionally, immunofluorescence assays indicate minor capsid proteins (mCPs) could form various building blocks with major capsid proteins (MCPs) before the formation of a viral factory (VF). These results expand our understanding of the capsid assembly of NCVs and provide more targets for vaccine and drug design to fight iridovirid infections. High morbidity and mortality in aquatic have been caused by iridovirids worldwide. Here the authors present a near-atomic SGIV capsid structure. Functional assays further reveal the relationships between identified capsid proteins and viral assembly. [ABSTRACT FROM AUTHOR]

Gridded rainfall datasets based on various data sources and techniques have emerged to help describe the spatiotemporal features of rainfall patterns over large areas and have gained popularity in many regional/global climatic analyses. This study explored future variations of rainfall characteristics over peninsula Malaysia and Singapore region based on rainfall indices of PRCPTOT, Rx1day, Rx5day, R95pTOT, R1mm, and R20mm, under 9 CORDEX-SEA RCM datasets with RCP8.5 emission scenario. A monthly quantile delta mapping method (MQDM) was adopted for bias-correction of the RCM modelled data. It was indicated that all the studied rainfall indices have long-term variations both temporally and spatially. Generally, the further the future, the higher the variability and uncertainty of indices. For the study region, the relative increments of the medians from RCM models averaged over all climatic zones in the far future are 40.3%, 25.9%, and 4.7% for Rx1day, Rx5day and R95pTOT, respectively. The annual rainfall amount (PRCPTOT) in the long run would likely increase mainly in the northeast coastal zone and drop in most of other areas over the peninsula, with the median being -5.9% averaged over all zones. The frequency of wet days (R1mm) would generally drop over the whole peninsula, with the median averaged over all zones being -6.8% in the far future. The frequency of heavy rains (R20mm) would overall decrease (by -3.4% in average in the far future) but might still notably increase in the northeast zone (NE) at both annual and southwest monsoon. The extreme conditions implied from individual RCM models could be more alarming. The study result could be useful in revealing the essential spatiotemporal variations of rainfall over the peninsula from short- to long-term futures and supporting large-scale flood risk assessment and adaptation planning. [ABSTRACT FROM AUTHOR]

TRIM (tripartite motif) proteins have been demonstrated to exert critical roles in host defense against different microbial pathogens. Among them, TRIM23 acts as an important regulatory factor in antiviral immune and inflammatory responses, but the roles of fish TRIM23 against virus infection still remain largely unknown. Here, we investigated the characteristics of TRIM23 homolog from orange spotted grouper (Epinephelus coioides) (EcTRIM23). EcTRIM23 encoded a 580 amino acid peptide, which shared 93.1%, 89.73% and 86.36% identity with golden perch (Perca flavescens), zebrafish (Danio rerio) and human (Homo sapiens), respectively. The transcription levels of EcTRIM23 were significantly up-regulated in response to Singapore grouper iridovirus (SGIV) and red-spotted grouper nervous necrosis virus (RGNNV) infection. EcTRIM23 overexpression in vitro significantly inhibited RGNNV and SGIV replication, evidenced by the delayed cytopathic effect (CPE) progression and the decreased expression of viral core genes. EcTRIM23 significantly increased the expression levels of interferon (IFN) related signaling molecules and proinflammatory cytokines, as well as the promoter activities of IFN and NF-kB, suggesting that EcTRIM23 exerted antiviral function by positively regulating host IFN response. Exogenous EcTRIM23 exhibited either diffuse or aggregated localization in grouper cells. After co-transfection, TANK binding kinase 1 (TBK1), TNF receptor associated factor (TRAF) 3 and TRAF4, TRAF5 and TRAF6 were found to interact with EcTRIM23 in grouper cells. Moreover, these proteins could be recruited and co-localized with EcTRIM23 in vitro. Together, our results demonstrated that fish TRIM23 exerted antiviral activity against fish viruses by interacting with multiple host proteins to regulate immune responses. [ABSTRACT FROM AUTHOR]

Variations in the impact of the COVID-19 pandemic on out-of-hospital cardiac arrest (OHCA) have been reported. We aimed to, using population-based registries, compare community response, Emergency Medical Services (EMS) interventions and outcomes of adult, EMS-treated, non-traumatic OHCA in Singapore and metropolitan Atlanta, before and during the pandemic. Associations of OHCA characteristics, pre-hospital interventions and pandemic with survival to hospital discharge were analyzed using logistic regression. There were 2084 cases during the pandemic (17 weeks from the first confirmed COVID-19 case) and 1900 in the pre-pandemic period (corresponding weeks in 2019). Compared to Atlanta, OHCAs in Singapore were older, received more bystander interventions (cardiopulmonary resuscitation (CPR): 65.0% vs. 41.4%; automated external defibrillator application: 28.6% vs. 10.1%), yet had lower survival (5.6% vs. 8.1%). Compared to the pre-pandemic period, OHCAs in Singapore and Atlanta occurred more at home (adjusted odds ratio (aOR) 2.05 and 2.03, respectively) and were transported less to hospitals (aOR 0.59 and 0.36, respectively) during the pandemic. Singapore reported more witnessed OHCAs (aOR 1.96) yet less bystander CPR (aOR 0.81) during pandemic, but not Atlanta (p < 0.05). The impact of COVID-19 on OHCA outcomes did not differ between cities. Changes in OHCA characteristics and management during the pandemic, and differences between Singapore and Atlanta were likely the result of systemic and sociocultural factors. [ABSTRACT FROM AUTHOR]

Introduction: It is vital to diagnose and treat pulmonary tuberculosis (PTB) early, in the interests of the patient and public health. At the Singapore Tuberculosis Control Unit (TBCU), it was not uncommon to discover abnormal chest radiographs (CXRs) predating their PTB diagnosis by months to years in the electronic medical records (EMRs) of sputum acid-fast bacilli smear-positive patients. Our study explored this observation.Methods: The EMRs of sputum smear-positive PTB patients treated at the TBCU from January to July 2014 were viewed for abnormal CXRs preceding their PTB diagnosis. Information in the EMRs pertaining to the indication for the CXRs, radiological reports (including whether the possibility of PTB was stated) and action taken was captured.Results: Of the 254 sputum smear-positive patients, 108 had previous CXRs in their EMRs, of whom 39 (36.1%) had previous CXRs compatible with PTB. Most of these were performed in tertiary institutions and for reasons unrelated to PTB. No action was taken in response to these CXRs in 24 (61.5%) patients. 27 (69.2%) patients had abnormal CXRs dating back more than six months, with 12 (30.8%) dating back more than 30 months before the PTB diagnosis. Patients aged ≥ 55 years were significantly more likely to have previous CXRs that were compatible with PTB.Conclusion: PTB patients may be asymptomatic or have chronic indolent disease and remain undiagnosed for years. There is a need for vigilance within our healthcare system to seize opportunities for early diagnosis and treatment to prevent the spread of this infectious disease in Singapore. [ABSTRACT FROM AUTHOR]

Jonathan walked into your consultation room complaining of low back pain with pain running down his right leg for the past two weeks. He had been working from home since Singapore's circuit breaker measures were introduced in response to the COVID-19 pandemic. He recently started doing some home-based calisthenics workouts after getting restless from staying at home. He had tried self-medicating with some muscle rub pain relief creams, but the pain persisted. [ABSTRACT FROM AUTHOR]

(1) Background: Lysosomal aspartic protease Cathepsin D (CD) is a key regulator and signaling molecule in various biological processes including activation and degradation of intracellular proteins, the antigen process and programmed cell death. However, the function of fish CD in virus infection remains largely unknown. (2) Methods: The functions of the CD gene response to SGIV infection was determined with light microscopy, reverse transcription quantitative PCR, Western blot and flow cytometry. (3) Results: In this study, Ec-Cathepsin D (Ec-CD) was cloned and identified from the orange-spotted grouper, Epinephelus coioides. The open reading frame (ORF) of Ec-CD consisted of 1191 nucleotides encoding a 396 amino acid protein with a predicted molecular mass of 43.17 kDa. Ec-CD possessed typical CD structural features including an N-terminal signal peptide, a propeptide region and a mature domain including two glycosylation sites and two active sites, which were conserved in other CD sequences. Ec-CD was predominantly expressed in the spleen and kidneys of healthy groupers. A subcellular localization assay indicated that Ec-CD was mainly distributed in the cytoplasm. Ec-CD expression was suppressed by SGIV stimulation and Ec-CD-overexpressing inhibited SGIV replication, SGIV-induced apoptosis, caspase 3/8/9 activity and the activation of reporter gene p53 and activating protein-1 (AP-1) in vitro. Simultaneously, Ec-CD overexpression obviously restrained the activated mitogen-activated protein kinase (MAPK) pathways, including extracellular signal-regulated kinase (ERK) and c-Jun N-terminal kinase (JNK). In addition, Ec-CD overexpression negatively regulated the transcription level of pro-inflammatory cytokines and activation of the NF-κB promotor. (4) Conclusions: Our findings revealed that the Ec-CD possibly served a function during SGIV infection. [ABSTRACT FROM AUTHOR]

Singapore grouper iridovirus (SGIV) infection is associated with high mortality in mariculture, and effective treatments are urgently required. Given the wide‐ranging applications of metformin, we aimed to assess the effects of metformin against SGIV. The safe and effective concentration of metformin in grouper spleen cells was determined as 250 μg/mL. We detected the inhibitory activity of metformin against SGIV infection in grouper spleen cells using an aptamer‐based fluorescent molecular probe and reverse transcription‐quantitative real‐time polymerase chain reaction. Metformin effectively inhibited SGIV infection in a dose‐dependent manner and showed an excellent inhibitory effect against SGIV in vitro (70%). We further investigated metformin's possible antiviral mechanism and showed that metformin did not damage SGIV invading host cells, but could damage SGIV particles (59.57%) and interfere with SGIV binding (23.25%) and replication (29.48%) in host cells. Metformin mainly inhibited SGIV by damaging SGIV particles. Overall, these results suggested that metformin had direct and host‐mediated antiviral effects against SGIV and thus had great potential for the development of effective drugs to control SGIV infection in aquaculture. [ABSTRACT FROM AUTHOR]

• A comprehensive characterization is conducted for GFA. • GFA contained higher amounts of heavy metals than IFA. • GFA is a potential material for Zn recovery. • Low-graded lime could be recovered from GFA for industrial or civil application. • A reuse method combining civil engineering application and Zn recovery is advised. Slagging-gasification has received increasing attention as a municipal solid waste treatment technology. Compared with incineration, slagging-gasification can produce valuable syngas and generates by-products that can be easier reusable in different applications in some cases. Among these by-products, the gasification fly ash (GFA) is the only hazardous solid residue to be landfilled. To explore its potential recycling methods and maximize its recycling efficiency, the detailed physicochemical properties of GFA are crucial. This study conducted a comprehensive characterization of six GFA samples and the results were compared with one incineration fly ash (IFA) sample and available data of IFA collected in Singapore in literature. X-ray fluorescence (XRF), and microwave acid digestion (MAD) followed by inductively coupled plasma optical emission spectroscopy (ICP-OES) and inductively coupled plasma mass spectroscopy (ICP-MS) were carried out to determine the physicochemical composition of ashes. X-ray diffraction (XRD) and thermogravimetric analysis (TGA) were applied to identify their mineralogical composition. The hazard of the material was assessed through one-stage batch leaching tests. The results showed that the GFAs and IFA were both mainly composed of calcium compounds and chloride salts. However, GFA contained higher amounts of heavy metals especially lead (Pb) and zinc (Zn) than IFA. Zn contents in tested GFA samples were in a range of 1.4–3.0%, indicating the potential to recover Zn. The Ca(OH) 2 content in GFA samples was up to 24.1%, which could be recovered as a low-grade lime. Based on the characteristics of GFA, a reusing method combining civil engineering utilization and resource recovery was suggested. [ABSTRACT FROM AUTHOR]

Food security is one of the key global challenges in this century. In Singapore, our research team has been using novel aeroponic technology to produce fresh vegetables since 1997. Aeroponic systems allow for year-round production of not only tropical, but also sub-tropical and temperate fresh vegetables, by simply cooling the roots suspended in aeroponic systems while the aerial parts grow under tropical ambient environments. It has also been used to investigate the impacts of root-zone CO2 on vegetables by enriching root-zone CO2 while their aerial portions were subjected to constant atmospheric CO2. To compensate for the lack of available land, Singapore also needs to develop a farming system that can increase productivity per unit land area by many-fold. Over the past 10 years, my research team has established a commercially viable LED integrated vertical aeroponic farming system to grow different leafy vegetables under different LED spectra, intensities, and durations in the tropical greenhouse. The results demonstrate that it is possible to increase shoot production and rate of shoot production of leafy vegetables by increasing light intensity and extending the photoperiod under effective LED lighting. Furthermore, temperate vegetable crops such as lettuce were able to acclimate to high light intensity under supplementary LED lights to natural sunlight in the greenhouse. Supplementary LED lightings promote both leaf initiation and expansion with increased photosynthetic pigments, higher Cyt b6f and Rubisco protein contents on a per area basis and thus improve photosynthetic capacity and enhance productivity. Plants sense and respond to changes in their immediate environments (microclimate), manipulating the root zone temperature (RZT) and water supply will impact not only their growth and development but also their nutritional quality. Our on-going research aims to investigate if the nutritional quality of leafy vegetables could be improved under suboptimal RZT and mild water deficit through deficit irrigation. If substantial energy and water savings in urban farming can be achieved without substantial yield penalty but with higher nutritional quality, the amount of water and energy saved can bring substantial benefits to society. [ABSTRACT FROM AUTHOR]

The Beliefs about Medicines Questionnaire (BMQ) and Adherence Starts with Knowledge (ASK-12) questionnaire were originally developed and validated in Western populations to assess beliefs and barriers to medication adherence. The study aim is to validate the BMQ and ASK-12 questionnaire for use in a Singapore population with early stage breast cancer. English-speaking women on adjuvant endocrine therapy (n = 157) were recruited. The BMQ-Specific showed good internal consistency with structural validity. The internal consistency of BMQ-General and ASK-12 Behaviour scale improved with the new factor structure obtained from exploratory factor analysis. Further studies are needed to confirm these factor structures. [ABSTRACT FROM AUTHOR]

Singapore grouper iridovirus (SGIV), a member of the Iridoviridae family, is an important marine cultured fish pathogen worldwide. Our previous studies have demonstrated that lipid metabolism was essential for SGIV entry and replication, but the roles of glucose metabolism during SGIV infection still remains largely unknown. In this study, we found that the transcription levels of key enzymes involved in glycolysis were regulated in varying degrees during SGIV infection based on the transcriptomic analysis. Quantitative PCR and western blot analysis also indicated that the expression of both glucose transporters (GLUT1 and GLUT2) and the enzymes of glucose metabolism (hexokinase 2, HK2 and pyruvate dehydrogenase complex, PDHX) were upregulated during SGIV infection in vivo or in vitro , suggesting that glycolysis might be involved in SGIV infection. Exogenous glucose supplementation promoted the expression of viral genes and infectious virion production, while glutamine had no effect on SGIV infection, indicating that glucose was required for SGIV replication. Consistently, pharmacological inhibition of glycolysis dramatically reduced the protein synthesis of SGIV major capsid protein (MCP) and infectious virion production, and promotion of glycolysis significantly increased SGIV infection. Furthermore, knockdown of HK2, PDHX, or GLUT1 by siRNA decreased the transcription and protein synthesis of SGIV MCP and suppressed viral replication, indicating that those enzymes exerted essential roles in SGIV replication. In addition, inhibition of mTOR activity in SGIV-infected cells effectively reduced the expression of glycolysis key enzymes, including HK2, PDHX, GLUT1, and GLUT2, and finally inhibited SGIV replication, suggesting that mTOR was involved in SGIV-induced glycolysis. Thus, our results not only provided new insights into the mechanism of how SGIV infection affects host cell glycolysis, but also contributed to further understanding of the iridovirus pathogenesis. [ABSTRACT FROM AUTHOR]

Seasonal influenza A (H3N2) virus has been a concern since its first introduction in humans in 1968. Accumulating antigenic changes in viral hemagglutinin (HA), particularly recent cocirculations of multiple HA genetic clades, allow H3N2 virus evade into humans annually. From 2010, the binding of neuraminidase (NA) to sialic acid made the traditional assay for HA inhibition antibodies (Abs) unsuitable for antigenicity characterization. Here, we investigated the serum anti-NA response in a cohort with a seroconversion of microneutralizing (MN) Abs targeting the circulating strain, A/Singapore/INFIMH-16-0019/2016 (H3N2, 3C.2a1)-like, a virus during 2018/2019 flu seasons. We discovered that MN Ab titers show no difference between children and adults. Nevertheless, higher titers of Abs with NA activity inhibition (NI) activity of 129 and seroconversion rate of 68.42% are presented in children aged 7–17 years (n = 19) and 73.47 and 41.17% in adults aged 21–59 years (n = 17), respectively. The MN Abs generated in children display direct correlations with HA- and NA-binding Abs or NI Abs. The NI activity exhibited cross-reactivity to N2 of H3N2 viruses of 2007 and 2013, commonly with 329- N -glycosylation and E344 in N2, a characteristic of earlier 3C.2a H3N2 virus in 2014. The percentage of such viruses pronouncedly decreased and was even replaced by those dominant H3N2 viruses with E344K and 329 non-glycosylation, which have a significantly low activity to the tested antisera. Our findings suggest that NI assay is a testable assay applied in H3N2 infection in children, and the antigenic drift of current N2 should be considered for vaccine selection. [ABSTRACT FROM AUTHOR]

Biomarkers have important roles in various physiological functions and disease pathogenesis. As a nucleocytoplasmic DNA virus, Singapore grouper iridovirus (SGIV) causes high economic losses in the mariculture industry. Aptamer-Q5-complexed major capsid protein (MCP) in the membrane of SGIV-infected cells can be used as a specific molecular probe to investigate the crucial events of MCP endocytosis into SGIV-infected host cells during viral infection. Chlorpromazine blocks clathrin-mediated endocytosis, and MCP endocytosis into SGIV-infected cells decreased significantly when the cells were pretreated with chlorpromazine. The disruption of cellular cholesterol by methyl-β-cyclodextrin also significantly reduced MCP endocytosis. In contrast, inhibitors of key regulators of caveolae/raft-dependent endocytosis and macropinocytosis, including genistein, Na+/H+ exchanger, p21-activated kinase 1 (PAK1), myosin II, Rac1 GTPase, and protein kinase C (PKC), had no effect on MCP endocytosis. The endocytosis of the biomarker MCP is dependent on low pH and cytoskeletal actin filaments, as shown with various inhibitors (chloroquine, ammonia chloride, cytochalasin D). Therefore, MCP enters SGIV-infected host cells via clathrin-mediated endocytosis, which is dependent on dynamin, cholesterol, low pH, and cytoskeletal actin filaments. This is the first report of a specific aptamer-based probe used to analyze MCP endocytosis into SGIV-infected host cells during viral infection. This method provides a convenient strategy for exploring viral pathogenesis and facilitates the development of diagnostic tools for and therapeutic approaches to viral infection. [ABSTRACT FROM AUTHOR]

East Asian countries are often characterized as productivist welfare states whose social policies are subordinated to economic growth. However, in the past decade, public pressure for welfare expansion (or welfarism) has built up across all East Asian countries - including China, Japan, South Korea, Taiwan, and Singapore. Therefore, this paper asks: How has pro-welfare civil society influenced welfare expansion in East Asia over the past decade? Addressing this research question will help fill the theoretical gap on the relationship between contemporary pro-welfare civil society activism and welfare state expansion in East Asian countries. I address this theoretical gap by devising the New Power Approach which argues that pro-welfare civil society is the main driver of welfare expansions when the incumbent government is conservative. By implication, the stronger the pro-welfare civil society in generating political impetus for reforms, the greater the extent of welfare expansion in the country with a conservative government. [ABSTRACT FROM AUTHOR]

Viral infections seriously affect the health of organisms including humans. Now, more and more researchers believe that microRNAs (miRNAs), one of the members of the non-coding RNA family, play significant roles in cell biological function, disease occurrence, and immunotherapy. However, the roles of miRNAs in virus infection (entry and replication) and cellular immune response remain poorly understood, especially in low vertebrate fish. In this study, based on the established virus-cell infection model, Singapore grouper iridovirus (SGIV)-infected cells were used to explore the roles of miR-124 of Epinephelus coioides , an economically mariculture fish in southern China and Southeast Asia, in viral infection and host immune responses. The expression level of E. coioides miR-124 was significantly upregulated after SGIV infection; miR-124 cannot significantly affect the entry of SGIV, but the upregulated miR-124 could significantly promote the SGIV-induced cytopathic effects (CPEs), the viral titer, and the expressions of viral genes. The target genes of miR-124 were JNK3/p38α mitogen-activated protein kinase (MAPK). Overexpression of miR-124 could dramatically inhibit the activation of NF-κB/activating protein-1 (AP-1), the transcription of proinflammatory factors, caspase-9/3, and the cell apoptosis. And opposite results happen when the expression of miR-124 was inhibited. The results suggest that E. coioides miR-124 could promote viral replication and negatively regulate host immune response by targeting JNK3/p38α MAPK, which furthers our understanding of virus and host immune interactions. [ABSTRACT FROM AUTHOR]

Migrant domestic work is performed in precariously (im)mobile working conditions that mark the subaltern body in a state of constant lived experience with and in strife. In Singapore, the structural context of hire amplifies conditions of servitude, indebtedness, and subalternity that have implications for mental health. This study documents mental health narratives by migrant domestic workers during the COVID-19 pandemic, registering how mental health is negotiated amid dissension in the performance of precarious labor. While functional employment structures enabled and empowered well-being, dysfunctional structures disrupted mental health meanings, creating layers of constant contention for domestic workers to broker, limiting opportunities for mental health and well-being. Narratives gathered indicate systemic mental health precarities tied to workplace dysfunctions. [ABSTRACT FROM AUTHOR]

Western studies have highlighted alarmingly high rates of work-related violence experienced by emergency medical services (EMS) staff. As there is a paucity of Asian studies, we aimed to investigate the incidence of physical and verbal violence against the EMS crew in the Singapore Civil Defence Force (SCDF). This was a cross-sectional study, utilising an online survey made available to all active paramedics in the SCDF. Paramedics with at least one year of work experience were eligible to participate. All responses were kept anonymous. The response rate was 50.9% (n = 246), out of 483 paramedics in service at the time of the study. The respondents consisted of 144 males (58.5%) and 102 females (41.5%). They were between 18 and 55 years old; 160 (65.0%) of them had worked in EMS for less than 6 years. The paramedics experienced high levels of verbal and physical violence, but there was reticence in reporting these incidents. The main risk factor for violence appeared to be alcohol intoxication. Paramedics may benefit from security escort for clients with history of alcohol intoxication or violence and more teaching on self-defence and soft restraints. Current training and protocols should be revised to meet these needs. [ABSTRACT FROM AUTHOR]

Mesembryanthemum crystallinum (common ice plant), as a nutritious ready-to-eat salad in Singapore, has become popular in recent years. However, basic data about the impacts of NO3– supply on its NO3– accumulation and nutritional quality are lacking. In this study, all plants were first grown indoor hydroponically in 10% artificial seawater (ASW) with modified full-strength Netherlands Standard Composition nutrient solution for 11 days, before transferring them to different reduced NO3– solutions. All plants grew well and healthy after 7 days of treatment. However, plants grown with 3/4 N and 1/2 N were bigger with higher shoot and root fresh weight (FW), greater leaf number, and total leaf area (TLA) than those grown with full nitrogen (N), 1/4 N, and 0 N. Mesembryanthemum crystallinum grown with full N, 3/4 N, and 1/4 N had similar specific leaf area (SLA), while 0 N plants had significantly lower SLA. All plants had similar leaf succulence (LS). However, leaf water content (LWC) was lower, while leaf dry matter accumulation (LDMC) was higher in 0 N plants after 7 days of treatment. Compared with plants grown with full N, shoot NO3– concentrations in 3/4 N, 1/2 N, and 1/4 N plants were constant or slightly increased during the treatments. For 0 N plants, shoot NO3– concentration decreased significantly during the treatment compared with other plants. Shoot NO3– accumulation was associated with nitrate reductase activity (NRA). For instance, after 7 days of treatment, shoot NO3– concentration and NRA on a FW basis in 0 N plants were, respectively, 45 and 31% of full N plants. After transferring full N to 0 N for 7 days, all M. crystallinum had higher chlorophyll (Chl) content coupled with higher electron transport rate (ETR) and higher effective quantum yield of PSII, while full N plants had higher non-photochemical quenching (NPQ). The 0N plants had much higher concentrations of proline, total soluble sugar (TSS), and total ascorbic acid (ASC) than other plants. In conclusion, totally withdrawing NO3– from the growth media prior to harvest could be one of the strategies to reduce shoot NO3– concentration. Reduced NO3– supply further enhanced nutritional values as concentrations of proline, TSS, and ASC were enhanced markedly in M. crystallinum plants after transferring them from full N to 0 N. [ABSTRACT FROM AUTHOR]

• A point-process modelling and rainfall disaggregation framework is proposed. • PPMRD offers greater flexibility in having subdaily upper-level rainfall series. • The study method is successfully applied to the rainfall in the tropical region. Analyzing high-temporal-resolution rainfall data with disaggregation tools is vital for understanding precipitation variability, especially in climate change studies with limited access to such data. To facilitate such study for tropical region, we proposed a Point-Process Modelling and Rainfall Disaggregation (PPMRD) framework for rainfall disaggregation with flexible time scales. The framework was tested on two tropical sites in Singapore, using six point-process models and four disaggregation schemes (24 h to 5 min, 3 h to 5 min, 24 h to 1 h, and 6 h to 1 h). Most models excelled fundamental statistics and extreme value analysis. The Bartlett-Lewis Rectangular Pulse Seven parameter (BLRP7) model was found to be the best performer for simulating and disaggregating tropical rainfall. The study findings emphasized the utility of disaggregation models in generating fine-resolution time series for analyzing rainfall extremes. However, it is crucial to underscore the importance of employing ensembles to comprehensively address uncertainties arising from the stochastic nature of rainfall. The study also emphasized the importance of model selection in the proposed framework, as the disaggregation method depends on the generator's performance. The PPMRD surpasses traditional methods by handling subdaily upper-level series disaggregation to minute-level rainfall. This advancement offers greater capabilities and flexibility, promising benefits for generating high-temporal-resolution rainfall data in hydrological modeling and climate change impact studies. [ABSTRACT FROM AUTHOR]

The World Health Organization Surgical Safety Checklist (SSC) is a tool designed to enhance team communication and patient safety. When used properly, the SSC acts as a layer of defence against never events. In this study, we performed secondary qualitative analysis of operating theatres (OT) SSC observational notes to examine how the SSC was used after an intensive SSC re-implementation effort and drew on relevant theories to shed light on the observed patterns of behaviours. We aimed to go beyond assessing checklist compliance and to understand potential sociopsychological mechanisms of the variations in SSC practices. Direct observation notes of 109 surgical procedures across 13 surgical disciplines were made by two trained nurses in the OT of a large tertiary hospital in Singapore from February to April 2022, three months after SSC re-implementation. Only notes relevant to the use of SSC were extracted and analyzed using reflexive thematic analysis. Data were coded following an inductive process to identify themes or patterns of SSC practices. These patterns were subsequently interpreted against a relevant theory to appreciate the potential sociopsychological forces behind them. Two broad types of SSC practices and their respective sub-themes were identified. Type 1 (vs. Type 2) SSC practices are characterized by patience and thoroughness (vs. hurriedness and omission) in carrying out the SSC process, dedication and attention (vs. delegation and distraction) to the SSC safety checks, and frequent (vs. absence of) safety voices during the conduct of SSC. These patterns were conceptualized as safety-seeking action vs. ritualistic action using Merton's social deviance theory. Ritualistic practice of the SSC can undermine surgical safety by creating conditions conducive to never events. To fully realize the SSC's potential as an essential tool for communication and safety, a concerted effort is needed to balance thoroughness with efficiency. Additionally, fostering a culture of collaboration and collegiality is crucial to reinforce and enhance the culture of surgical safety. • The surgical safety checklist acts as a defensive layer to prevent never events. • Shift the focus from checklist compliance to its local sociocultural context. • Use sociopsychological theories to understand surgical safety checklist practices. • Conformity vs. ritualism checklist practices when viewed from social deviance lens. • Activate safety voices and safety listening, and prioritize safety and thoroughness. [ABSTRACT FROM AUTHOR]

Coral transplantation helps to reinstate coral cover in degraded reefs, but the general success of this approach is hampered by limited understanding of how coral-fragment size affects growth and survival of transplants of non-branching species. In this study, we compared the effects of three size classes of coral fragments (small: 2–4 cm, medium: 5–7 cm and large: 9–11 cm) on the post-transplantation survivorship and growth of Favites complanata (n = 51), Favites pentagona (n = 54) and Platygyra sinensis (n = 60) attached to granite rocks on a subtidal seawall in Singapore. After 18 months, transplants of all species showed high survivorship (all >64%) and up to 6.3-fold increase in live tissue area. Survivorship was not significantly different among the size classes of each species. Mean linear extension rates were fastest only for small F. complanata transplants compared to medium-sized ones. Our findings also suggested that the transplantation of only small fragments could generate better yield in live coral cover and present the most optimal use of the original amount of coral source material. Such information is critical for formulating management and conservation strategies in urbanized reef systems typically dominated by non-branching corals. [ABSTRACT FROM AUTHOR]

Interferon-induced transmembrane proteins (IFITMs) are novel viral restriction factors which inhibit numerous virus infections by impeding viral entry into target cells. To investigate the roles of IFITMs during fish virus infection, we cloned and characterized an IFITM1 homolog from orange spotted grouper (Epinephelus coioides) (EcIFITM1) in this study. EcIFITM1 encodes a 131-amino-acid polypeptide, which shares 64 and 43% identity with Seriola dumerili and Homo sapiens , respectively. The multiple sequence alignment showed that EcIFITM1 contained five domains, including NTD (aa 1–45), IMD (aa 46–67), CIL (aa 68–93), TMD (aa 94–119), and CTD (aa 120–131). In vitro , the level of EcIFITM1 mRNA expression was significantly up-regulated in response to Singapore grouper iridovirus (SGIV), or red-spotted grouper nervous necrosis virus (RGNNV) infection. EcIFITM1 encoded a cytoplasmic protein, which was partly colocalized with early endosomes, late endosomes, and lysosomes. The ectopic expression of EcIFITM1 significantly inhibited the replication of SGIV or RGNNV, which was demonstrated by the reduced virus production, as well as the levels of viral gene transcription and protein expression. In contrast, knockdown of EcIFITM1 using small interfering RNAs (siRNAs) promoted the replication of both viruses. Notably, EcIFITM1 exerted its antiviral activity in the step of viral entry into the host cells. Furthermore, the results of non-targeted lipometabolomics showed that EcIFITM1 overexpression induced lipid metabolism remodeling in vitro. All of the detected ceramides were significantly increased following EcIFITM1 overexpression, suggesting that EcIFITM1 may suppress SGIV entry by regulating the level of ceramide in the lysosomal system. In addition, EcIFITM1 overexpression positively regulated both interferon-related molecules and ceramide synthesis-related genes. Taken together, our results demonstrated that EcIFITM1 exerted a bi-functional role, including immune regulation and lipid metabolism in response to fish virus infections. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is a common malignancy worldwide. Despite being the most common cancer in Singapore, CRC screening rate remains low due to knowledge deficits, social reasons such as inconvenience and a lack of reminder or recommendation. A decision aid (DA) may facilitate an individual's decision-making to undertake CRC screening by addressing misconceptions and barriers. We postulate that a more person-centred and culturally adapted DA will better serve the local population. The views of the target users are thus needed to develop such a DA. A CRC screening DA prototype has been adapted from an American DA to cater to the Asian users. This study aimed to explore user perspectives on an adapted CRC screening DA-prototype in terms of the design, content and perceived utility.Methods: The study used in-depth interviews (IDIs) and focus group discussions (FGDs) to gather qualitative data from English-literate multi-ethnic Asian adults aged 50 years old and above. They had yet to screen for CRC before they were recruited from a public primary care clinic in Singapore. The interviews were audio-recorded, transcribed and analysed to identify emergent themes via thematic analysis.Results: This study included 27 participants involved in 5 IDI and 5 FGDs. Participants found the DA easily comprehensible and of appropriate length. They appreciated information about the options and proposed having multi-lingual DAs. The design, in terms of the layout, size and font, was well-accepted but there were suggestions to digitalize the DA. Participants felt that the visuals were useful but there were concerns about modesty due to the realism of the illustration. They would use the DA for information-sharing with their family and for discussion with their doctor for decision making. They preferred the doctor's recommendation for CRC screening and initiating the use of the DA.Conclusions: Participants generally had favourable perceptions of the DA-prototype. A revised DA will be developed based on their feedback. Further input from doctors on the revised DA will be obtained before assessing its effectiveness to increase CRC screening rate in a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Background and Aim: Singapore is a multi‐ethnic country that has undergone rapid development over the last few decades, with increasing influence of western culture, and faces an aging population. Previously, a varying prevalence of colonic diverticulosis (CD) was reported by a few small studies. This study aims to evaluate the prevalence of CD in Singapore and identify associations with common gastrointestinal symptoms and risk factors. Methods: We reviewed retrospective data of 20 395 consecutive colonoscopies performed from 2006 to 2016 for presence of CD and indications of screening, diarrhea, constipation, and abdominal pain. Results: The prevalence of CD progressively increased from 2006 to 2016 (14.9% vs 23.9%, adjusted trend < 0.001), with an overall prevalence of 19.6%. Patients with CD were older and had higher body mass index (BMI). CD was significantly more prevalent in Chinese compared with Malay and Indian races (20.5% vs 18.9% vs 15.5%, P < 0.05), and in male patients compared with female patients (21.5% vs 17.6%, P < 0.05). Right‐sided CD was more common than left‐sided or pan diverticulosis (16.2% vs 8.3% vs 4.8%, P < 0.05). Age [odds ratio (OR), 1.060; 95% confidence interval (CI), 1.052–1.068], BMI (OR, 1.051; 95% CI, 1.028–1.075), male gender (OR, 1.317; 95% CI, 1.084–1.600), and abdominal pain (OR, 1.409; 95% CI, 1.168–1.699) were positively associated, while constipation (OR, 0.566; 95% CI, 0.452–0.709) was negatively associated with CD. Conclusion: The prevalence of CD in Singapore has progressively increased over the last decade and is associated with older age, higher BMI, and abdominal pain. These findings may provide insights for healthcare resource planning in the region. [ABSTRACT FROM AUTHOR]

Singapore grouper iridovirus (SGIV) causes high mortality rates in mariculture, and effective treatments against SGIV infection are urgently required. Illicium verum Hook. f. (I. verum) is a well-known medicinal plant with a variety of biological activities. The natural ingredient quercetin isolated from I. verum could effectively inhibit SGIV infection in a dose-dependent manner. The possible antiviral mechanism of quercetin was further analyzed in this study. It showed that quercetin did obvious damages to SGIV particles. Furthermore, quercetin could interfere with SGIV binding to targets on host cells (by 76.14%), disturb SGIV invading into host cells (by 56.03%), and effect SGIV replication in host cells (by 52.73%), respectively. Quercetin had the best antiviral effects during the SGIV life cycle of binding to the receptors on host cells' membranes. Overall, the results suggest that quercetin has direct and host-mediated antiviral effects against SGIV and holds great potential for developing effective drugs to control SGIV infection in aquaculture. [ABSTRACT FROM AUTHOR]

Aim: To examine the perceived level of nursing teamwork and factors influencing teamwork among enrolled nurses (ENs) and registered nurses (RNs) in general ward settings. Background: The nursing care delivery model includes RNs, ENs and others who work as a team to deliver patient care. The potential impact of teamwork on nursing care highlights the need to explore the work of nursing teams. Design: A mixed‐methods exploratory study. Method: Quantitative and qualitative data were collected concurrently from ENs and RNs in 2018. Two hundred and forty‐eight (n = 248) nurses completed the Nursing Teamwork Survey. Sixteen nurses participated in focus group discussions. Qualitative data were reported following COREQ guidelines, while quantitative data followed the STROBE guidelines. Results: Both ENs and RNs scored highest for the shared mental model subscale but lowest for the team orientation subscale. Factors including qualification level, years of working experience, perceived job staffing adequacy and job satisfaction were found to influence teamwork. Three themes emerged from the qualitative findings: expectations of each other's role, delegation practices and interpersonal relationships. ENs and RNs differed in their expectations of their role in basic patient care activities and faced power struggles related to delegation practices. Open and structured communication was deemed essential in building interpersonal relationships. Conclusion: The ENs and RNs have clear understanding of their personal roles and responsibilities towards achieving a common goal. However, teamwork may be improved with a shared mental model in performing basic nursing care tasks, mutual support for workload management, better delegation practices, effective communication, enhanced interpersonal relationships and better team orientation. Relevance to clinical practice: Nurse managers and educators need to work collaboratively to foster positive delegation practices in clinical practice supported by applicable team training that enhances mutual trust, backup behaviours and collective orientation in nursing teams. [ABSTRACT FROM AUTHOR]

This paper presents the spatial distribution, variation and trend of 5-day antecedent rainfall in Singapore based on rainfall data from 22 meteorological stations. The effect of climate was analyzed by dividing the study period into three decades i.e. Decade 1: 1982–1991, Decade 2: 1992–2001 and Decade 3: 2002–2011. Kriging interpolation was used for rainfall mapping. The results show that spatial distribution of 5-day antecedent rainfall does not coincide with that of the annual rainfall. The maximum annual rainfall occurred in the northwestern side of Singapore. On the other hand, the maximum 5-day antecedent rainfall occurred in the north and northeastern sides. The results of this study suggest that the climate change has increased the amount of 5-day antecedent rainfall quite significantly, i.e. from 420.5 (1987) to 592.9 mm (2006), thus affecting the vulnerability of the area with respect to rainfall-induced slope failure. The analyses also showed that most of slope failures were located in the north and northeast of Singapore between December and earlier March. More slope failures were observed in Decade 3 as compared to Decades 1 and 2. In other words, the analysis confirmed that 5-day antecedent rainfall had affected the slope stability in Singapore. [ABSTRACT FROM AUTHOR]

Palmitic acid is the most common saturated fatty acid in animals, plants, and microorganisms. Studies highlighted that palmitic acid plays a significant role in diverse cellular processes and viral infections. Accumulation of palmitic acid was observed in fish cells (grouper spleen, GS) infected with Singapore grouper iridovirus (SGIV). The fluctuated content levels after viral infection suggested that palmitic acid was functional in virus-cell interactions. In order to investigate the roles of palmitic acid in SGIV infection, the effects of palmitic acid on SGIV induced cytopathic effect, expression levels of viral genes, viral proteins, as well as virus production were evaluated. The infection and replication of SGIV were increased after exogenous addition of palmitic acid but suppressed after knockdown of fatty acid synthase (FASN), of which the primary function was to catalyze palmitate synthesis. Besides, the promotion of virus replication was associated with the down-regulating of interferon-related molecules, and the reduction of IFN1 and ISRE promotor activities by palmitic acid. We also discovered that palmitic acid restricted TBK1, but not MDA5-induced interferon immune responses. On the other hand, palmitic acid decreased autophagy flux in GS cells via suppressing autophagic degradation, and subsequently enhanced viral replication. Together, our findings indicate that palmitic acid is not only a negative regulator of TBK1-IRF3/7 pathway, but also a suppressor of autophagic flux. Finally, palmitic acid promotes the replication of SGIV in fish cells. [ABSTRACT FROM AUTHOR]

Receptor interacting protein 1 (RIP1) is an essential sensor of cellular stress, which may respond to apoptosis or cell survival and participate in antiviral pathways. To investigate the roles of fish RIP1 in Singapore grouper iridovirus (SGIV) and red-spotted grouper nervous necrosis virus (RGNNV) infection, a RIP1 homolog from orange-spotted grouper (Epinephelus coioides) (EcRIP1) was cloned and characterized. EcRIP1 encoded a 679 amino acid protein that shares 83.28% identity with that of Perca flavescens and contained a homologous N-terminal kinase (S-TKc) domain, a RIP isotype interaction motif (RHIM), and a C-terminal domain (DD). EcRIP1 was predominantly detected in immune tissues, and its expression was induced by RGNNV or SGIV infection in vitro. Subcellular localization showed that EcRIP1 was distributed in the cytoplasm with point-like uniform and dot-like aggregation forms. Overexpression of EcRIP1 inhibited SGIV and RGNNV replication and positively regulated the expression levels of interferon (IFN) and IFN-stimulated genes and pro-inflammatory factors. EcRIP1 may interact with grouper tumor necrosis factor receptor type 1-associated DEATH domain protein (EcTRADD) to promote SGIV-induced apoptosis, and interact with grouper Toll/interleukin-1 receptor (TIR) domain containing adapter inducing interferon-β (EcTRIF) and participate in Myeloid Differentiation Factor 88 (MyD88)-independent toll-like receptor (TLR) signaling. EcRIP1 may also interact with grouper tumor necrosis factor receptor-associated factors (TRAFs) as intracellular linker proteins and mediate the signaling of various downstream signaling pathways, including NF-κB and IFN. These results suggest that EcRIP1 may inhibit SGIV and RGNNV infection by regulating apoptosis and various signaling molecules. Our study offers new insights into the regulatory mechanism of RIP1-related signaling, and provides a novel perspective on fish diseases mediated by RIP1. [ABSTRACT FROM AUTHOR]

Autophagy is a conserved catabolic process that occurs at basal levels to maintain cellular homeostasis. Most virus infections can alter the autophagy level, which functions as either a pro-viral or antiviral pathway, depending on the virus and host cells. Singapore grouper iridovirus (SGIV) is a novel fish DNA virus that has caused great economic losses for the marine aquaculture industry. In this study, we found that SGIV inhibited autophagy in grouper spleen (GS) cells which was evidenced by the changes of LC3-II, Beclin1 and p-mTOR levels. Further study showed that SGIV developed at least two strategies to inhibit autophagy: (1) increasing the cytoplasmic p53 level; and (2) encoding viral proteins (VP48, VP122, VP132) that competitively bind autophagy related gene 5 and mediately affect LC3 conversion. Moreover, activation of autophagy by rapamycin or overexpressing LC3 decreased SGIV replication. These results provide an antiviral strategy from the perspective of autophagy. [ABSTRACT FROM AUTHOR]

Skeletal density, a measure of a coral's investment in its structure and a known proxy for climate history, can potentially be used to enhance the precision of reef accretion models and benefit reef management strategies. However, trait data and an understanding of how it may vary are limited, especially for Southeast Asia's coral reefs where information is available for only a few species. To fill this knowledge gap, we quantified the skeletal densities of 11 common species from four reefs in Singapore. Skeletal density was best explained by a model that included species, depth, colony size, sedimentation rate, water motion, as well as an interaction between depth and colony size. Mean skeletal densities ranged from 0.99 to 2.01 g cm−3, and species with massive growth forms (e.g. Platygyra sinensis) were least dense, while a branching coral (Pocillopora acuta) was densest. Skeletal density was influenced positively by water motion and negatively by sedimentation and colony size. The depth–size interaction also indicated that large colonies in deeper areas were denser compared to shallow colonies. Our findings suggest that environmental conditions at local scales play important roles in affecting coral skeletal density and provide an indication of the relative vulnerability among taxa and locations to physical disturbances. The need for baseline information on the skeletal properties of more species is further underscored if habitat conservation is to be effective in a changing climate. [ABSTRACT FROM AUTHOR]

This paper reports about an effort to generate LoD3 models of buildings semi-automatically, with the highest possible level of automation. It is work in progress. We use multi-sensor data like aerial images from a 5-head camera with a GSD of 10 cm, UAV images, and aerial and mobile LiDAR point clouds. We distinguish two cases: LoD2 models are available and they are not. We apply Multi-Photo Geometrically Constrained Least Squares Matching for different kind of point measurements. The regularity of many building façades in Singapore leads us to the idea to generalize the measurement procedure towards using measurement macros (geometrical primitives, i.e. windows, doors, etc.) and combine reality-based with procedural modelling. In parallel we try to model these façade elements from LiDAR point cloud data. In another research line we do building detection by a novel approach to land-cover classification, incorporating features of the façades to improve the classification accuracy. To generate the semantic labels of the façades, we developed a spatially unrelated mean-shift clustering method to yield structurally confined segments. It is the characteristic of automated and even semi-automated procedures that the results need some amount of editing. We therefore work on interactive post-editing approaches on CityGML building models containing semantic information of each surface. Maintaining the semantic information throughout the editing process is essential but often lack the support from current tools. Accordingly, we implement a method to synchronize CityGML models. Overall this project consists of a great number of different algorithmic components, which can only be coarsely explained in this paper. [ABSTRACT FROM AUTHOR]