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A new chemosensor 1 was synthesized by reacting rhodamine B hydrazide and 2,3,4-trihydroxybenzaldehyde, which was then characterized by spectroscopic techniques and single crystal X-ray crystallography. Sensor 1 has the ability to sense Co2+/Cu2+ ions by “naked-eye” with an apparent colour change from colourless to pink in different solvent system, MeCN and DMF respectively. Furthermore, it can selectively detect Co2+/Cu2+ among wide range of different metal ions, and it exhibits low detection limit of 4.425 × 10−8 M and 1.398 × 10−7 M respectively. Binding mode of the two complexes were determined to be 1:1 stoichiometry for Co2+ complex and 1:2 stoichiometry for Cu2+ complex through Job’s plot, IR spectroscopy, mass spectrometry and 1H NMR spectroscopy. Moreover, reversibility of the sensor 1 as copper (II) ion detector was determined by using EDTA and the results showed that sensor 1 can be reused for at least 6 cycles. Other than that, a low cost chemosensor test strips were fabricated for the convenient “naked-eye” detection of Co2+ and Cu2+ in pure aqueous media. The MTT assay was conducted in order to determine the cytotoxicity of sensor 1 towards human cell lines.

Summary Objective While cross-sectional and retrospective case–control studies suggest that gout is associated with knee osteoarthritis (KOA), no prospective study has evaluated the risk of total knee replacement (TKR) for KOA in association with gout. We prospectively evaluated the association between gout and the risk of TKR due to severe KOA. Design We used data from the Singapore Chinese Health Study (SCHS), a prospective cohort with 63,257 Chinese adults aged 45–74 years at recruitment (1993–1998). Self-report of physician-diagnosed gout was enquired at follow-up I interview (1999–2004) from 52,322 subjects. TKR cases for KOA after follow-up I were identified via linkage with nationwide hospital discharge database through 31 December 2011. Multivariable Cox proportional hazards regression model was applied with adjustment for potential risk factors of KOA. Results Among 51,858 subjects (22,180 men and 29,678 women) included in this analysis, after average 9.7 follow-up years, there were 1,435 cases of TKR. Gout was associated with 39% higher risk of TKR in women [hazard ratio (HR) 1.39; 95% confidence interval (CI) 1.08–1.79] but not in men (HR 0.78; 95% CI 0.49–1.23). The positive gout-TKR association in women remained after excluding participants with self-reported history of arthritis (HR 1.57; 95% CI 1.04–2.37). This association was stronger in women who were lean (body mass index [BMI] 2 ) (HR 2.17; 95% CI 1.30–3.64) compared to their heavier counterparts ( P interaction = 0.016). Conclusion Gout is associated with risk of severe KOA, especially in lean women, suggesting the crystal arthritis may play a role in the pathogenesis or progression of OA.

Aims: In Singapore, pneumococcal vaccination is recommended for the elderly (i.e. those ≥65 years of age) and people with chronic medical conditions. We investigated epidemiological characteristics associated with the uptake of pneumococcal vaccine based on a nationally representative cross-sectional sample of community-living adults aged ≥50 years. Methods: The data were obtained from the National Health Surveillance Survey (NHSS) 2013. Associations between pneumococcal vaccination and sociodemographic and health-related variables were analysed using univariable and multivariable logistic regression models. Results: Among 3672 respondents aged ≥50 years in the NHSS, 7.8% had taken the pneumococcal vaccination. A higher level of education and higher monthly household income were sociodemographic characteristics independently associated with pneumococcal vaccine uptake. Health-related characteristics predictive of pneumococcal vaccine uptake were better self-rated health and having a regular family doctor/general practitioner. Among those who responded to the two questions on vaccinations, 3.9% had been vaccinated against both seasonal influenza and pneumococcal infection, while 11.1% had taken only seasonal influenza vaccination in the past year. Conclusions: There is a need to boost pneumococcal vaccination coverage among community-dwelling older adults. These findings provide insights into reviewing and tailoring public-health strategies and programmes to increase vaccine uptake in at-risk population groups.

The objective of this work was to investigate the effect of calcined eggshell and montmorillonite (MMT) on the mechanical-physico properties and thermal characteristics of the polyvinyl alcohol (PVOH) blends. The increasing of calcined eggshell loading level up to 2 phr has gradually tensile strength of PVOH and PVOH/MMT blends. The MMT particles in PVOH matrix were observed to effectively intercalate into polymer matrix of 2 phr calcined eggshell added PVOH/MMT blends with the increasing of d-spacing of deflection peak (002). Scanning electron microscopy images showed that the greater dispersion of calcined eggshell particles in PVOH matrix for both PVOH blends and PVOH/MMT blends at low loading levels of calcined eggshell (

Introduction The Diabetes, Multidisciplinary, Experiential (DIAMANTE) program was established to enhance collaboration between retail pharmacists and the diabetes care team in the health institutions through interprofessional education. This article describes the program and reports on an evaluation of its impact on attitudes, knowledge, and confidence of the participants in managing diabetic patients. Methods This study utilized a mixed-method design with focus group (FG), exit assessment, and survey. Ten participants were approached to complete the 2-week DIAMANTE program with hands-on training from a multidisciplinary diabetes team. In addition to an exit assessment and a pre-post online survey to assess attitudes of participants toward diabetes care, diabetes knowledge, and confidence in managing diabetic patients, FG was used to obtain the qualitative feedback of pharmacists. Feedback of the preceptors related to the program and pharmacist performance was also sought through an online survey. Survey data and FGs were analyzed using Wilcoxon signed-rank test and thematic analysis, respectively. Results All participants completed the program successfully. The FGs revealed four themes: program design, participants' view on preceptors, participants' perceptions of program benefits, and program's outlook. Participants perceived the program content as comprehensive and relevant. With experiential learning, the pharmacists reported improved counseling skills and increased understanding of the roles of different healthcare members. Their knowledge and confidence in managing diabetic patients was improved (P = .008). All participants passed the exit assessment. In general, the preceptors were satisfied with the program design, assessment content, and participant performance. Discussion The overall view of DIAMANTE appeared positive. The program also improved knowledge and confidence of the participants in managing diabetic patients.

The discovery of graphene by Andre Geim and Konstantin Novoselov in 2004 contributed significantly to complementary metal-oxide-semiconductor (CMOS) technology, especially for electronic devices. Due to its outstanding properties, graphene has been used in many applications such as field-effect transistors (FETs), touch-sensitive screens, liquid-crystal displays, light-emitting diodes, dye-sensitised solar cells, and organic solar cells. Consequently, interface charge density in graphene field-effect transistors has become an important area of research in order to more accurately determine electronic characteristics such as capacitance-voltage (C-V). In this research, we developed a comprehensive simulation tool based on graphene FET called graphene field-effect transistor simulator (GFETSIM) of interface charge density, which functions as a graphical user interface (GUI) using MATLAB. This simulation represents the on-going development of a carbon-based device simulator begun in 2014 at Universiti Teknologi Malaysia (UTM). An automated selfconsistent approach is utilised to extract and compute the interface charge density. It is coded in MATLAB and the program was developed into an interactive MATLAB GUI simulation tool. The interface for GFETSIM is generated using the graphical user interface development environment (GUIDE) in MATLAB. This simulator allows users to import external C-V data into the GUI and carry out analysis based on the density of states plots. In addition, key parameter values can be varied to assess the outcome and changes in interface trapped density. In addition, a reset button is embedded into the simulator.

Objective: Dose-averaged linear energy transfer (LETD) is one of the factors which determines relative biological effectiveness (RBE) for treatment planning in proton therapy. It is usually determined from Monte Carlo (MC) simulation. However, no standard simulation protocols were established for sampling of LETD. Simulation parameters like maximum step length and range cut will affect secondary electrons production and have an impact on the accuracy of dose distribution and LETD. We aim to show how different combinations of step length and range cut in GEANT4 will affect the result in sampling of LETD using different MC scoring methods. Methods: In this work, different step length and range cut value in a clinically relevant voxel geometry were used for comparison. Different LETD scoring methods were established and the concept of covariance between energy deposition per step and step length is used to explain the differences between them. Results: We recommend a maximum step length of 0.05 mm and a range cut of 0.01 mm in MC simulation as this yields the most consistent LETD value across different scoring methods. Different LETD scoring methods are also compared and variation up to 200% can be observed at the plateau of 80 MeV proton beam. Scoring Method one has one of the lowest percentage differences compared across all simulation parameters. Conclusion: We have determined a set of maximum step length and range cut parameters to be used for LETD scoring in a 1 mm voxelized geometry. LETD scoring method should also be clearly defined and standardized to facilitate cross-institutional studies. Advances in knowledge: Establishing a standard simulation protocol for sampling LETD would reduce the discrepancy when comparing data across different centres, and this can improve the calculation for RBE.

Background Respiratory syncytial virus (RSV) is one of the leading causes of acute respiratory tract infections. To optimize control strategies, a better understanding of the global epidemiology of RSV is critical. To this end, we initiated the Global Epidemiology of RSV in Hospitalized and Community care study (GERi). Methods Focal points from 44 countries were approached to join GERi and share detailed RSV surveillance data. Countries completed a questionnaire on the characteristics of their surveillance system. Results Fifteen countries provided granular surveillance data and information on their surveillance system. A median (interquartile range) of 1641 (552–2415) RSV cases per season were reported from 2000 and 2020. The majority (55%) of RSV cases occurred in the Conclusions The high number of cases in the

Background: Host determinants of severe coronavirus disease 2019 include advanced age, comorbidities and male sex. Virologic factors may also be important in determining clinical outcome and transmission rates, but limited patient-level data is available. Methods: We conducted an observational cohort study at seven public hospitals in Singapore. Clinical and laboratory data were collected and compared between individuals infected with different SARS-CoV-2 clades. Firth’s logistic regression was used to examine the association between SARS-CoV-2 clade and development of hypoxia, and quasi-Poisson regression to compare transmission rates. Plasma samples were tested for immune mediator levels and the kinetics of viral replication in cell culture were compared. Findings: 319 patients with PCR-confirmed SARS-CoV-2 infection had clinical and virologic data available for analysis. 29 (9%) were infected with clade S, 90 (28%) with clade L/V, 96 (30%) with clade G (containing D614G variant), and 104 (33%) with other clades ‘O’ were assigned to lineage B.6. After adjusting for age and other covariates, infections with clade S (adjusted odds ratio (aOR) 0·030 (95% confidence intervals (CI): 0·0002-0·29)) or clade O (B·6) (aOR 0·26 (95% CI 0·064-0·93)) were associated with lower odds of developing hypoxia requiring supplemental oxygen compared with clade L/V. Patients infected with clade L/V had more pronounced systemic inflammation with higher concentrations of pro-inflammatory cytokines, chemokines and growth factors. No significant difference in the severity of clade G infections was observed (aOR 0·95 (95% CI: 0·35-2·52). Though viral loads were significantly higher, there was no evidence of increased transmissibility of clade G, and replicative fitness in cell culture was similar for all clades. Interpretation: Infection with clades L/V was associated with increased severity and more systemic release of pro-inflammatory cytokines. Infection with clade G was not associated with changes in severity, and despite higher viral loads there was no evidence of increased transmissibility. Funding Statement: This study was funded by grants from the Singapore National Medical Research Council (COVID19RF- 001, COVID19RF2-0001, COVID19RF-007, and COVID19RF-60) and Biomedical Research Council (project number H20/04/g1/006). Declaration of Interests: No conflicts of interest declared. Ethics Approval Statement: The epidemiological investigation was conducted under the Infectious Diseases Act (Singapore). Study protocols were approved by ethics committees of the National Healthcare Group and SingHealth. Written informed consent was obtained from participants for clinical data and biological sample collection as part of the PROTECT study (2012/00917; 2018/3045). A waiver of informed consent for retrospective data collection only was granted for individuals admitted to the National Centre of Infectious Diseases (2020/01122). Healthy donor samples were collected under study numbers 2017/2806 and NUS IRB 04-140.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, causing severe infections and death with hitherto no proven t

Recent development on various sensing techniques has made real-time traffic data readily available. The growing traffic data sources facilitate a shift to the data-driven prediction modelling paradigm to support real-time Intelligent Transportation System (ITS) applications, such as traffic forecast, prediction of congestion, bus arrival and so on. Both prediction accuracy and computational time are key factors in supporting real-time ITS applications, especially in such dynamic environment. In this paper, we propose two methods of data-driven traffic prediction for urban intersections. A time-based implementation can provide greater details and accuracy while an event-based implementation can complete prediction faster. Extensive experiments are conducted to study the tradeoff between prediction accuracy and processing time; different metrics, such as travelling delay and stops, are used to evaluate the prediction accuracy achieved between the two methods of implementation. Results show that both models can achieve good accuracy performance in predicting vehicles’ travelling delay. Specifically, the time-based prediction model can achieve 92% accuracy in predicting the in-queue state of a vehicle, while event-based prediction model can reduce 80% computation time compared to time-based prediction model.

Harvesting water from high humidity conditions is an attractive strategy toward strengthening water security due to its cost-effective and zero-energy mechanism. To facilitate this process, bio-inspired microstructures with heightened water accumulating ability are typically affixed onto atmospheric water harvesters. However, because of this surface morphology type harvester design, there is an inherent partition of regions with different water accumulating abilities: the active water harvesting region (AWHR) and passive water harvesting region (PWHR). Most of the water harvested by such water harvesters is usually attributed to the AWHR, while a large amount of uncollected water is present in the PWHR as numerous small water droplets that are prone to re-evaporation. This lack of PWHR utilization may be considered as the Achilles' heel toward optimal water harvesting. Hence, in this work, a cascading effect was proposed with a microstructure design to induce water harvesting from both AWHR and PWHR. The "clearing" of PWHR columns was demonstrated via a cascading effect, contributing to ca. 3 times more water harvested as compared to the unmodified water harvester. The successful demonstration of this cascading effect highlights the necessity of considering PWHR in the future water harvester designs so as to achieve efficient water harvesting.

Birth weight (BW) variation is influenced by fetal and maternal genetic and non-genetic factors, and has been reproducibly associated with future cardio-metabolic health outcomes. These associations have been proposed to reflect the lifelong consequences of an adverse intrauterine environment. In earlier work, we demonstrated that much of the negative correlation between BW and adult cardio-metabolic traits could instead be attributable to shared genetic effects. However, that work and other previous studies did not systematically distinguish the direct effects of an individual’s own genotype on BW and subsequent disease risk from indirect effects of their mother’s correlated genotype, mediated by the intrauterine environment. Here, we describe expanded genome-wide association analyses of own BW (n=321,223) and offspring BW (n=230,069 mothers), which identified 278 independent association signals influencing BW (214 novel). We used structural equation modelling to decompose the contributions of direct fetal and indirect maternal genetic influences on BW, implicating fetal- and maternal-specific mechanisms. We used Mendelian randomization to explore the causal relationships between factors influencing BW through fetal or maternal routes, for example, glycemic traits and blood pressure. Direct fetal genotype effects dominate the shared genetic contribution to the association between lower BW and higher type 2 diabetes risk, whereas the relationship between lower BW and higher later blood pressure (BP) is driven by a combination of indirect maternal and direct fetal genetic effects: indirect effects of maternal BP-raising genotypes act to reduce offspring BW, but only direct fetal genotype effects (once inherited) increase the offspring’s later BP. Instrumental variable analysis using maternal BW-lowering genotypes to proxy for an adverse intrauterine environment provided no evidence that it causally raises offspring BP. In successfully separating fetal from maternal genetic effects, this work represents an important advance in genetic studies of perinatal outcomes, and shows that the association between lower BW and higher adult BP is attributable to genetic effects, and not to intrauterine programming.

We investigated the temporal trends of short-term mortality (death within 1 year of diagnosis) and cause-specific deaths in human immunodeficiency virus (HIV)-infected persons by stage of HIV infection at diagnosis. We also assessed the impact of late diagnosis (LD) on short-term mortality.Epidemiological records of HIV-infected Singapore residents from the National HIV Registry were linked to death records from the Registry of Births and Deaths for observational analyses. Newly-diagnosed HIV cases with available cluster of differentiation 4 count at time of diagnosis in a 5-year period from 2012 to 2016 were included in the study. Hazard ratios (HRs) and 95% confidence interval (CI) of LD for all deaths excluding suicides and self-inflicted or accidental injuries, and HIV/ acquired immunodeficiency syndrome (AIDS)-related deaths occurring within 1 year post-diagnosis were calculated using Cox proportional hazards regression models with adjustment for age at HIV/AIDS diagnosis. Population attributable risk proportions (PARPs) were then calculated using the adjusted HRs.Of the 1990 newly-diagnosed HIV cases included in the study, 7.2% had died by end of 2017, giving an overall mortality rate of 2.16 per 100 person-years (PY) (95% CI 1.82-2.54). The mortality rate was 3.81 per 100 PY (95% CI 3.15-4.56) in HIV cases with LD, compared with 0.71 (95% CI 0.46-1.05) in non-LD (nLD) cases. Short-term mortality was significantly higher in LD (9.1%) than nLD cases (1.1%). Of the 143 deaths reported between 2012 and 2017, 58.0% were HIV/AIDS-related (nLD 28.0% vs LD 64.4%). HIV/AIDS-related causes represented 70.4% of all deaths which occurred during the first year of diagnosis (nLD 36.4% vs LD 74.7%). The PARP of short-term mortality due to LD was 77.8% for all deaths by natural causes, and 87.8% for HIV/AIDS-related deaths.The mortality rate of HIV-infected persons with LD was higher than nLD, especially within 1 year of diagnosis, and HIV/AIDS-related causes constituted majority of these deaths. To reduce short-term mortality, persons at high risk of late-stage HIV infection should be targeted in outreach efforts to promote health screening and remove barriers to HIV testing and treatment.

Background:Although fibre intake was inversely associated with the risk of symptomatic knee osteoarthritis (KOA) in a US study, this association was partially confounded by lower body mass index (BMI) in those with higher fibre intake.Objectives:We evaluated the association between fibre intake and its food sources, and the risk of total knee replacement (TKR) due to severe KOA.Methods:We used data from the Singapore Chinese Health Study, a prospective cohort study that recruited 63,257 participants aged 45-74 years from 1993 to 1998. At baseline, we assessed diet using a validated 165-item semi-quantitative food frequency questionnaire, together with BMI and lifestyle factors. Incident TKR cases were identified via record linkage with nationwide hospital discharge database through 2017. We used multivariable Cox regression models to compute hazard ratio (HR) and the corresponding 95% confidence interval (CI) for risk of TKR.Results:There were 2,816 cases of incident TKR due to severe KOA. Total fibre intake at baseline was not associated with risk of TKR after adjustment for confounders. Among the food sources of fibre, higher intake of legumes was associated with lower risk of TKR in dose-dependent manner; compared with those having the lowest quartile intake, HR (95% CI) was 0.86 (0.76, 0.96) for the highest quartile (p for trend = 0.004). This association was consistent after including BMI in the model, and homogenous across BMI categories. The consumption of other fibre sources, namely grain products, nuts and seeds, soy food, fruits and vegetables, was not associated with risk of TKR.Conclusion:Intake of legumes, but not total fibre, was associated with a reduced risk of TKR. Further research is needed to replicate our findings, and to evaluate possible biological mechanisms that could explain the effect of dietary legumes in pathogenesis or progression of KOA.Table 1.Hazard ratios (95% confidence intervals) for risk of total knee replacement according to intake of fibre (only shown total fibre and legumes): The Singapore Chinese Health Study (1993-2017).Quartiles of energy-adjusted food intakeQ1Q2Q3Q4p for trend 1Total fibreMedian, g/day8.559.4312.1917.70Cases/ person-years528/ 275,050712/ 280,456767/ 284,394809/ 287,955Multivariate Model 11.001.08 (0.96, 1.21)1.12 (1.00, 1.26)1.18 (1.05, 1.32)0.003Multivariate Model 21.001.06 (0.95, 1.19)1.09 (0.97, 1.22)1.11 (0.99, 1.24)0.088LegumesMedian, g/day0.110.432.117.01Cases/ person-years638/ 280,170754/ 278,001756/ 280,407668/ 289,275Multivariate Model 11.000.97 (0.87, 1.09)0.95 (0.84, 1.06)0.84 (0.76, 0.94)Multivariate Model 21.000.98 (0.87, 1.09)0.94 (0.84, 1.06)0.86 (0.77, 0.96)0.004Multivariate Model 31.000.98 (0.87, 1.09)0.95 (0.84, 1.06)0.86 (0.76, 0.96)0.0041Linear trend was tested by assigning to participants the median value of the quartile and treating this as a continuous variable. 2 The grain products included noodles and pasta, rice, bread and pancakes, breakfast cereals, biscuits and crackers.Multivariate model 1: adjusted for age at interview, sex, year of interview, total energy intake, dialect, education levelMultivariate model 2: model 1 plus BMI, sitting duration, sleep, physical activity, smoking, history of hypertension, diabetes, coronary artery disease and stroke.Multivariate model 3: model 2 plus grain products, legumes, nuts and seeds, soy food, fruits and vegetables.Q = quartileDisclosure of Interests:None declared.

A flexible and dendrite‐free Zn metal anode is prepared by inkjet printing silver nanoparticles on a 3D carbon matrix, boosting electrochemical performance of zinc metal batteries. The Ag nanoparticles as heterometallic seeds can promote reversible zinc stripping/plating via AgZn alloying/de‐alloying reactions and improve the zincophilicity and thermal conductivity of the carbon matrix.

Influenza is a major cause of mortality and morbidity. We aimed to examine the influenza-associated hospitalization rates and proportions for cardiovascular disease (CVD) in tropical Singapore. Hospital admissions for ischemic heart disease (IHD), congestive heart failure (CHF), and overall CVD were obtained from the national inpatient database for the period of 2010-2014. We used, as the key indicator of influenza virus activity, the overall proportion of specimens from outpatients with influenza-like illness in the community that tested positive for influenza as part of the national influenza surveillance program. The annual influenza-associated hospitalization rates per 100,000 person-years ranged from 9.5 to 12.2 for IHD, 7.7 to 9.1 for CHF, and 15.8 to 19.2 for overall CVD. The influenza-associated hospitalization rates increased with increasing age. Influenza was significantly associated with excess hospitalizations in elderly persons aged ≥80 years, with an excess hospitalization rate per 100,000 person-years of 242.7 for IHD (P = 0.02), 271.8 for CHF (P = 0.01), and 497.2 for overall CVD (P < 0.001). In the tropics, influenza accounts for excess cardiovascular-related hospitalizations, especially in the elderly.

The emergence of drug-resistant strains in recent years has fueled the epidemic of tuberculosis. This necessitates the development of new chemical scaffolds to curb resistant tuberculosis for effective control of this disease. In this study, we have designed and synthesized two series of benzimidazole derivatives. Their antimycobacterial activities were initially evaluated using Mycobacterium tuberculosis H37RV strains. The most potent analog (6h) was further assessed using various drug-resistant M. tuberculosis strains. This report described the importance of benzimidazoles as new antitmycobacterial agents targeting both the M. tuberculosis H37RV as well as the drug-resistant-tuberculosis strains. The trifluoromethyl group which was essential for antimycobacterial activity was also highlighted. Two series of benzimidazole derivatives and their antimycobacterial activities were evaluated using M. tuberculosis H37RV (MTB-H37RV) strains. Compound 6h was identified as the most potent among all synthesized compounds. The most potent analog was further assessed using various drug-resistant MTB strains. In addition, the trifluoromethyl was identified as an important substitution in giving good antimycobacterial effect.

We conducted a retrospective study of 40 case-patients and 58 controls as part of a nationwide investigation of a group B Streptococcus outbreak in Singapore in 2015. Eating a Chinese-style raw fish dish (yusheng) was a major risk factor for bacteremia, particularly caused by serotype III sequence type 283.

Singapore is situated in the tropics where the seasonality of influenza is not as well defined as that of temperate countries. We examined the circulation of influenza viruses in the community in terms of the characteristics of influenza activity. We reviewed laboratory-confirmed virological data collected between 2010 and 2014 under the national influenza surveillance programme. Influenza activity was measured by the proportion of specimens from outpatients with influenza-like illness tested positive for influenza virus based on 4-weekly moving interval. Seasonal epidemics occurred around the end of previous year or the beginning and middle of the year. Increases in influenza positivity were more pronounced when there was a change in the predominant circulating influenza virus type/subtype to influenza A(H3N2). Influenza epidemics lasted about 12 weeks on average, with longer duration when there was a change in the predominant influenza type/subtype and especially when it was associated with influenza A(H3N2). Continuous influenza surveillance is important as it could provide early warning of imminent surges in virus transmission, and allow for timely implementation of public health prevention and control interventions to minimize influenza-associated disease burden. J. Med. Virol. 88:2069-2077, 2016. © 2016 Wiley Periodicals, Inc.

Global flows and the inequalities they generate affect how fiction is published, marketed, read, and taught in universities; therefore, they embody important portraits of globalization's effects on social life. A novel like Shani Mootoo's When Cereus Blooms at Night illuminates how colonial notions of space have been carried over into the world under globalization, and how those notions organize experiences in racial, gendered, and sexual terms. The major themes in Cereus Blooms at Night are of spatiality, but space also plays an important part of the novel's revelations and it is this stylistic element that most obviously mirrors colonial notions of space. The development of the novel depends on the subversion of the rules governing how space can be thought of and used that are a legacy of colonial paternalism. Colonialism and globalization are not to be conflated, and globalization continues to rely on colonial logics of space. Keywords: Colonialism;colonial logics; globalization; globalization literature; Shani Mootoo; spatiality

Importance Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, in December 2019 and has spread globally with sustained human-to-human transmission outside China. Objective To report the initial experience in Singapore with the epidemiologic investigation of this outbreak, clinical features, and management. Design, Setting, and Participants Descriptive case series of the first 18 patients diagnosed with polymerase chain reaction (PCR)–confirmed SARS-CoV-2 infection at 4 hospitals in Singapore from January 23 to February 3, 2020; final follow-up date was February 25, 2020. Exposures Confirmed SARS-CoV-2 infection. Main Outcomes and Measures Clinical, laboratory, and radiologic data were collected, including PCR cycle threshold values from nasopharyngeal swabs and viral shedding in blood, urine, and stool. Clinical course was summarized, including requirement for supplemental oxygen and intensive care and use of empirical treatment with lopinavir-ritonavir. Results Among the 18 hospitalized patients with PCR-confirmed SARS-CoV-2 infection (median age, 47 years; 9 [50%] women), clinical presentation was an upper respiratory tract infection in 12 (67%), and viral shedding from the nasopharynx was prolonged for 7 days or longer among 15 (83%). Six individuals (33%) required supplemental oxygen; of these, 2 required intensive care. There were no deaths. Virus was detectable in the stool (4/8 [50%]) and blood (1/12 [8%]) by PCR but not in urine. Five individuals requiring supplemental oxygen were treated with lopinavir-ritonavir. For 3 of the 5 patients, fever resolved and supplemental oxygen requirement was reduced within 3 days, whereas 2 deteriorated with progressive respiratory failure. Four of the 5 patients treated with lopinavir-ritonavir developed nausea, vomiting, and/or diarrhea, and 3 developed abnormal liver function test results. Conclusions and Relevance Among the first 18 patients diagnosed with SARS-CoV-2 infection in Singapore, clinical presentation was frequently a mild respiratory tract infection. Some patients required supplemental oxygen and had variable clinical outcomes following treatment with an antiretroviral agent.

International audience; C-reactive protein (CRP) is a sensitive biomarker of chronic low-grade inflammation and is associated with multiple complex diseases. The genetic determinants of chronic inflammation remain largely unknown, and the causal role of CRP in several clinical outcomes is debated. We performed two genome-wide association studies (GWASs), on HapMap and 1000 Genomes imputed data, of circulating amounts of CRP by using data from 88 studies comprising 204,402 European individuals. Additionally, we performed in silico functional analyses and Mendelian randomization analyses with several clinical outcomes. The GWAS meta-analyses of CRP revealed 58 distinct genetic loci (p < 5 × 10-8). After adjustment for body mass index in the regression analysis, the associations at all except three loci remained. The lead variants at the distinct loci explained up to 7.0% of the variance in circulating amounts of CRP. We identified 66 gene sets that were organized in two substantially correlated clusters, one mainly composed of immune pathways and the other characterized by metabolic pathways in the liver. Mendelian randomization analyses revealed a causal protective effect of CRP on schizophrenia and a risk-increasing effect on bipolar disorder. Our findings provide further insights into the biology of inflammation and could lead to interventions for treating inflammation and its clinical consequences.Copyright © 2018 American Society of Human Genetics. All rights reserved.

OBJECTIVES. Knee osteoarthritis (OA) is more common in women, and may be related to reproductive or hormonal factors. We evaluated these factors with the risk of total knee replacement (TKR) for severe knee OA among women. METHODS. The Singapore Chinese Health Study recruited 63,257 Chinese aged 45–74 years from 1993 to 1998, and among them, 35,298 were women. Information on height, weight, lifestyle factors, number of biological children, ages at menarche and menopause, and use of hormonal therapies was collected through interviews. Incident cases of TKR were identified via linkage with nationwide database. RESULTS. There were 1,645 women with TKR after mean follow-up of 14.8 years. Higher parity was associated with increased TKR risk in a stepwise manner (P for trend

In anticipation of the new Proton Therapy Centre in Singapore at 2020, the medical physicists and physicists in NCCS and NUS have come together to do several preparation/preliminary works. Of which, one of the most important programme is to develop the Monte Carlo simulation capability using GEANT4 toolkit. We simulated the entire beam delivery and nozzle based on specifications given by Hitachi. The results of the Energy-Range curves in water phantom together with spot size in air agrees well with measurement data provided by Hitachi. We will show the complete methodology of simulation leading up to the comparison with measurement data. There were 3 main aspects we focused on—(1) The choice of physics models, (2) The determination of initial proton phase space based on Twiss parameters from beam profile measurement and (3) The choice of cut-off energy and step size. This simulation is important for the commissioning of the Proton Therapy System and the methodology presented will be helpful for other upcoming centers who are interested in doing the same.

Current Treatment Planning System uses advanced optimization algorithm with Dose Calculation Engine to optimize the dose delivered to the tumor to maximize the tumor-killing potential while limiting the side-effects to the normal tissues. Working in parallel, there are various radiobiology simulation programs being developed by different research groups to quantify biological endpoints such as Double Strand Breaks (DBSs) yield and Chromosome Aberration (CA) induced by different radiation types. In this paper, we conduct a novel preliminary work to combine these two areas to determine DSB yields in a 3D CT geometry. Our preliminary result shows that the position of the Bragg Peak determined from dose deposition differs from the position of maximal DSB yields. The difference can range from 0 to 1 mm, hence showing that dose is not entirely indicative of biological damage in tissue.

It is known that high energy protons in proton therapy generate secondary particles. Of which, secondary neutrons are a main concern as they deposit out-of-field doses and can have long-term health effects on cancer patients. In this paper, the energy, 3-D spatial and angular distribution of the production yield of neutrons is scored along the proton beam path in different types of tissue medium. The degree of biological damage is then quantified through factoring in the relative biological effectiveness of neutrons. This systematic study involved simulating 70, 150 and 200 MeV proton beam transport in various tissue compositions with the GEANT4 code. System specifications of the Hitachi proton therapy system were used in this study. Simulation results showed that the neutrons are forward facing and are generally emitted at a preferential angle. With considerations on the RBE variation with neutron’s energy, the spatial and angular distribution of the production of lethal neutrons were identified along the proton track. Non-trivial relations between biological damage in different tissue medium were observed. Such comprehensive simulation studies have not been reported and this input information can be useful for treatment planning in reducing out-of-field neutron dose in sensitive organs.

Purpose: To investigate the potential impact of anatomic change in the treatment of locally advanced oropharyngeal cancer with proton pencil beam scanning. Materials and Methods: Ten patients with locally advanced oropharyngeal cancer who previously received intensity-modulated radiation therapy (IMRT) and synchronous chemotherapy underwent replanning by using RapidArc IMRT and proton pencil beam scanning. Deformable image registration deformed the planning computed tomography (CT), target volumes, and organs at risk (OARs) contours onto each weekly cone-beam CT scan. Target and OARs volumes were reviewed and modified. Treatment plans were forward calculated onto each corrected cone-beam CT scan and dose-volume histograms produced for targets and OARs volumes. Results: Proton pencil beam scanning compared with RapidArc IMRT achieved lower mean doses to the contralateral parotid gland (14.8 Gy versus 20.6 Gy, P

The asymmetric synthesis of 3-alkyl-3-hydroxyindolin-2-ones via direct aldol reaction of isatin with ketones catalyzed by natural amino acid salts is described, in which the phenylalanine lithium salt was found to be the best catalyst. This strategy was then applied to a variety of isatin and ketone substrates and the corresponding aldol products were obtained in excellent yields (up to 97%) with good to excellent enantioselectivities (up to 90%).

A series of novel teraryl oxazolidinone compounds was designed, synthesized, and evaluated for their antimicrobial activity and toxicities. The compounds with aromatic N-heterocyclic substituents at the 4-position of pyrazolyl ring showed better antibacterial activity against the tested bacteria than other compounds with different patterns of substitution. Among all potent compounds, 10f exhibited promising safety profile in MTT assays and in hERG K(+) channel inhibition test. Furthermore, its phosphate was found to be highly soluble in water (47.1 mg/mL), which is beneficial for the subsequent in vivo test. In MRSA systemic infection mice models, 10f phosphate exerted significantly improved survival protection compared with linezolid. The compound also demonstrated high oral bioavailability (F = 99.1%). Moreover, from the results of in vivo toxicology experiments, 10f phosphate would be predicted to have less bone marrow suppression.

We conducted a pediatric seroprevalence study of dengue virus (DENV) infection in Singapore, a dengue endemic city-state. Residual sera from 1,200 Singapore residents aged 1-17 years seen in two hospitals between 2008 and 2010 were tested for anti-DENV IgG antibodies. The overall seroprevalence was 10.4% (95%CI: 8.7-12.1%). There had been a marked decline in seroprevalence in the 15-19-year age group over the last three decades, while the prevalence in the 1-5-year olds (12.6%) was significantly higher than that of the 1996-1997 pediatric survey (0.8%). The overall dengue seroprevalence in children and adolescents remained low.

A series of scutellarein-O-alkylamine derivatives were designed, synthesized and tested as multifunctional agents for the treatment of Alzheimer's disease (AD). The results showed that most of these compounds exhibited good multifunctional activities. Among them, compound 16d demonstrated significant metal chelating properties, moderate acetylcholinesterase (AChE) inhibitory and anti-oxidative activity, and excellent inhibitory effects on self-induced Aβ(1-42) aggregation, Cu(2+)-induced Aβ(1-42) aggregation, human AChE-induced Aβ(1-40) aggregation and disassembled Cu(2+)-induced aggregation of the well-structured Aβ(1-42) fibrils. Both kinetic analysis of AChE inhibition and molecular modeling study suggested that 16d binds simultaneously to the catalytic active site and peripheral anionic site of AChE. Moreover, compound 16d showed a good protective effect against H2O2-induced PC12 cell injury, with low toxicity in SH-SY5Y cells. Furthermore, the step-down passive avoidance test showed this compound significantly reversed scopolamine-induced memory deficit in mice. Thus, 16d was shown to be an interesting multifunctional lead compound worthy of further study.