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Mailepessov D, Ong J, Nasir MZM, Aik J, Woo M, Zhao X, Tey HL, Yew YW. Association between exposure to ambient air pollution, meteorological factors and atopic dermatitis consultations in Singapore-a stratified nationwide time-series analysis. Sci Rep 2024; 14:10320. [PMID: 38710739 DOI: 10.1038/s41598-024-60712-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/26/2024] [Indexed: 05/08/2024] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting approximately 20% of children globally. While studies have been conducted elsewhere, air pollution and weather variability is not well studied in the tropics. This time-series study examines the association between air pollution and meteorological factors with the incidence of outpatient visits for AD obtained from the National Skin Centre (NSC) in Singapore. The total number of 1,440,844 consultation visits from the NSC from 2009 to 2019 was analysed. Using the distributed lag non-linear model and assuming a negative binomial distribution, the short-term temporal association between outpatient visits for AD and air quality and meteorological variability on a weekly time-scale were examined, while adjusting for long-term trends, seasonality and autocorrelation. The analysis was also stratified by gender and age to assess potential effect modification. The risk of AD consultation visits was 14% lower (RR10th percentile: 0.86, 95% CI 0.78-0.96) at the 10th percentile (11.9 µg/m3) of PM2.5 and 10% higher (RR90th percentile: 1.10, 95% CI 1.01-1.19) at the 90th percentile (24.4 µg/m3) compared to the median value (16.1 µg/m3). Similar results were observed for PM10 with lower risk at the 10th percentile and higher risk at the 90th percentile (RR10th percentile: 0.86, 95% CI 0.78-0.95, RR90th percentile: 1.10, 95% CI 1.01-1.19). For rainfall for values above the median, the risk of consultation visits was higher up to 7.4 mm in the PM2.5 model (RR74th percentile: 1.07, 95% CI 1.00-1.14) and up to 9 mm in the PM10 model (RR80th percentile: 1.12, 95% CI 1.00-1.25). This study found a close association between outpatient visits for AD with ambient particulate matter concentrations and rainfall. Seasonal variations in particulate matter and rainfall may be used to alert healthcare providers on the anticipated rise in AD cases and to time preventive measures to reduce the associated health burden.
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Affiliation(s)
- Diyar Mailepessov
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore, 138667, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore, 138667, Singapore
| | - Muhammad Zafir Mohamad Nasir
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore, 138667, Singapore
| | - Joel Aik
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way #06-05/08, Helios Block, Singapore, 138667, Singapore.
- Pre-Hospital and Emergency Research Centre, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - Maye Woo
- Environmental Quality Monitoring Department, Environmental Monitoring and Modelling Division, National Environment Agency, Singapore, 228231, Singapore
| | | | - Hong Liang Tey
- National Skin Centre, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yik Weng Yew
- National Skin Centre, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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2
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Waisberg E, Ong J, Zaman N, Tavakkoli A, Lee AG. The Impact of COVID-19 on Ophthalmology Clinic and Surgical Volume. Ir Med J 2023; 116:884. [PMID: 38259186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
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3
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Power L, Ong J, Ganeshan D, Bruzzi J, Soo A, Rutherford R. The breathless patient with a sore neck. Ir Med J 2023; 116:881. [PMID: 38258909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
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Ho SH, Lim JT, Ong J, Hapuarachchi HC, Sim S, Ng LC. Singapore's 5 decades of dengue prevention and control-Implications for global dengue control. PLoS Negl Trop Dis 2023; 17:e0011400. [PMID: 37347767 DOI: 10.1371/journal.pntd.0011400] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
This paper summarises the lessons learnt in dengue epidemiology, risk factors, and prevention in Singapore over the last half a century, during which Singapore evolved from a city of 1.9 million people to a highly urban globalised city-state with a population of 5.6 million. Set in a tropical climate, urbanisation among green foliage has created ideal conditions for the proliferation of Aedes aegypti and Aedes albopictus, the mosquito vectors that transmit dengue. A vector control programme, largely for malaria, was initiated as early as 1921, but it was only in 1966 that the Vector Control Unit (VCU) was established to additionally tackle dengue haemorrhagic fever (DHF) that was first documented in the 1960s. Centred on source reduction and public education, and based on research into the bionomics and ecology of the vectors, the programme successfully reduced the Aedes House Index (HI) from 48% in 1966 to <5% in the 1970s. Further enhancement of the programme, including through legislation, suppressed the Aedes HI to around 1% from the 1990s. The current programme is characterised by 4 key features: (i) proactive inter-epidemic surveillance and control that is stepped up during outbreaks; (ii) risk-based prevention and intervention strategies based on advanced data analytics; (iii) coordinated inter-sectoral cooperation between the public, private, and people sectors; and (iv) evidence-based adoption of new tools and strategies. Dengue seroprevalence and force of infection (FOI) among residents have substantially and continuously declined over the 5 decades. This is consistent with the observation that dengue incidence has been delayed to adulthood, with severity highest among the elderly. Paradoxically, the number of reported dengue cases and outbreaks has increased since the 1990s with record-breaking epidemics. We propose that Singapore's increased vulnerability to outbreaks is due to low levels of immunity in the population, constant introduction of new viral variants, expanding urban centres, and increasing human density. The growing magnitude of reported outbreaks could also be attributed to improved diagnostics and surveillance, which at least partially explains the discord between rising trend in cases and the continuous reduction in dengue seroprevalence. Changing global and local landscapes, including climate change, increasing urbanisation and global physical connectivity are expected to make dengue control even more challenging. The adoption of new vector surveillance and control tools, such as the Gravitrap and Wolbachia technology, is important to impede the growing threat of dengue and other Aedes-borne diseases.
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Affiliation(s)
- Soon Hoe Ho
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Jue Tao Lim
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University Novena Campus, Singapore, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | | | - Shuzhen Sim
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
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Wong WCW, Wong C, Ong J, Fairley C, Hocking J. Cost-effectiveness of screening and management strategies for chlamydia control in Hong Kong: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 1:27-31. [PMID: 36919216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Affiliation(s)
- W C W Wong
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C Wong
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - J Ong
- Central Clinical School, Monash University, Australia.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom.,Melbourne Sexual Health Centre, Alfred Health, Australia
| | - C Fairley
- Central Clinical School, Monash University, Australia.,Melbourne Sexual Health Centre, Alfred Health, Australia
| | - J Hocking
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
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Ong J, Ho SH, Soh SXH, Wong Y, Ng Y, Vasquez K, Lai YL, Setoh YX, Chong CS, Lee V, Wong JCC, Tan CH, Sim S, Ng LC, Lim JT. Assessing the efficacy of male Wolbachia-infected mosquito deployments to reduce dengue incidence in Singapore: study protocol for a cluster-randomized controlled trial. Trials 2022; 23:1023. [PMID: 36528590 PMCID: PMC9758775 DOI: 10.1186/s13063-022-06976-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Dengue is a severe environmental public health challenge in tropical and subtropical regions. In Singapore, decreasing seroprevalence and herd immunity due to successful vector control has paradoxically led to increased transmission potential of the dengue virus. We have previously demonstrated that incompatible insect technique coupled with sterile insect technique (IIT-SIT), which involves the release of X-ray-irradiated male Wolbachia-infected mosquitoes, reduced the Aedes aegypti population by 98% and dengue incidence by 88%. This novel vector control tool is expected to be able to complement current vector control to mitigate the increasing threat of dengue on a larger scale. We propose a multi-site protocol to study the efficacy of IIT-SIT at reducing dengue incidence. METHODS/DESIGN The study is designed as a parallel, two-arm, non-blinded cluster-randomized (CR) controlled trial to be conducted in high-rise public housing estates in Singapore, an equatorial city-state. The aim is to determine whether large-scale deployment of male Wolbachia-infected Ae. aegypti mosquitoes can significantly reduce dengue incidence in intervention clusters. We will use the CR design, with the study area comprising 15 clusters with a total area of 10.9 km2, covering approximately 722,204 residents in 1713 apartment blocks. Eight clusters will be randomly selected to receive the intervention, while the other seven will serve as non-intervention clusters. Intervention efficacy will be estimated through two primary endpoints: (1) odds ratio of Wolbachia exposure distribution (i.e., probability of living in an intervention cluster) among laboratory-confirmed reported dengue cases compared to test-negative controls and (2) laboratory-confirmed reported dengue counts normalized by population size in intervention versus non-intervention clusters. DISCUSSION This study will provide evidence from a multi-site, randomized controlled trial for the efficacy of IIT-SIT in reducing dengue incidence. The trial will provide valuable information to estimate intervention efficacy for this novel vector control approach and guide plans for integration into national vector control programs in dengue-endemic settings. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT05505682 . Registered on 16 August 2022. Retrospectively registered.
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Affiliation(s)
- Janet Ong
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Soon Hoe Ho
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Stacy Xin Hui Soh
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Yvonne Wong
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Youming Ng
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Kathryn Vasquez
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Yee Ling Lai
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Yin Xiang Setoh
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Chee-Seng Chong
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Vernon Lee
- grid.415698.70000 0004 0622 8735Communicable Diseases Division, Ministry of Health, Singapore, Singapore
| | - Judith Chui Ching Wong
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Cheong Huat Tan
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Shuzhen Sim
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Lee Ching Ng
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Jue Tao Lim
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore ,grid.59025.3b0000 0001 2224 0361Lee Kong Chian School of Medicine, Nanyang Technological University Novena Campus, Singapore, Singapore
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Turner A, Jones A, Ong J, Tu A, Crawford M. The effects of Cognitive Behaviour Therapy for insomnia and Continuous Positive Airway Pressure on neurocognitive functioning in individuals with comorbid insomnia and sleep apnea (COMISA). Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ho SH, Soh SXH, Wang MX, Ong J, Seah A, Wong Y, Fang Z, Sim S, Lim JT. Perfluoroalkyl substances and lipid concentrations in the blood: A systematic review of epidemiological studies. Sci Total Environ 2022; 850:158036. [PMID: 35973530 DOI: 10.1016/j.scitotenv.2022.158036] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/19/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFAS) are widely used synthetic aliphatic compounds. This systematic review aims to assess PFAS associations with low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), total cholesterol (TC) and total triglyceride (TG) concentrations in human populations. METHOD We systematically searched four online databases, PubMed, Scopus, Embase, and Cochrane Library for relevant peer-reviewed English language articles published until July 2021. Additional relevant articles identified were also included in the search results. We categorised populations into adults (≥18 years old) and children. Primary findings were the associations between PFAS concentrations and LDL, HDL, TC, and TG concentrations in the serum, plasma, or whole blood; secondary findings were the associations between PFAS concentrations and the odds of lipid-related health outcomes. Quantitative synthesis was done by vote counting of the effect directions between concentrations of PFAS and lipids/health outcomes, repeated on articles with sample size >1000. Sign tests were performed to assess the statistical significance of the differences between positive and negative associations. Sensitivity analysis was performed by separating out articles with populations having high concentrations of perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS). Quality was assessed with the STROBE checklist and NHBLI Study Quality Assessment Tool. RESULTS A total of 58 articles were included for review. There was evidence that PFAS exposure is associated with higher concentrations of LDL, HDL, and TC, particularly for PFOA-LDL, PFOA-TC, PFOS-TC, and PFNA-LDL. Associations between PFAS and TG tended to be negative, especially for perfluoroundecanoic acid (PFUnDA). Associations between PFAS concentration and the odds of secondary outcomes generally supported a positive association between PFAS and cholesterol concentrations. CONCLUSION We found evidence of associations between the concentrations of some PFAS-lipid pairs in human populations. Future research should be conducted on the less well-studied PFAS to explore their effects on human health and in regions where such studies are currently lacking. (300 words).
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Affiliation(s)
- Soon Hoe Ho
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore.
| | - Stacy Xin Hui Soh
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Min Xian Wang
- Saw Swee Hock School of Public Health, Tahir Foundation Building, National University of Singapore, 12 Science Drive 2, #10-01, Singapore 117549, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Annabel Seah
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Yvonne Wong
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Zhanxiong Fang
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Shuzhen Sim
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore
| | - Jue Tao Lim
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08 Helios Block, Singapore 138667, Singapore; Saw Swee Hock School of Public Health, Tahir Foundation Building, National University of Singapore, 12 Science Drive 2, #10-01, Singapore 117549, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University Novena Campus, 11 Mandalay Road, Singapore 308232, Singapore
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Soh S, Ho SH, Seah A, Ong J, Richards DR, Gaw LYF, Dickens BS, Tan KW, Koo JR, Cook AR, Lim JT. Spatial Methods for Inferring Extremes in Dengue Outbreak Risk in Singapore. Viruses 2022; 14:v14112450. [PMID: 36366548 PMCID: PMC9695662 DOI: 10.3390/v14112450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
Dengue is a major vector-borne disease worldwide. Here, we examined the spatial distribution of extreme weekly dengue outbreak risk in Singapore from 2007 to 2020. We divided Singapore into equal-sized hexagons with a circumradius of 165 m and obtained the weekly number of dengue cases and the surface characteristics of each hexagon. We accounted for spatial heterogeneity using max-stable processes. The 5-, 10-, 20-, and 30-year return levels, or the weekly dengue case counts expected to be exceeded once every 5, 10, 20, and 30 years, respectively, were determined for each hexagon conditional on their surface characteristics remaining constant over time. The return levels were higher in the country's east, with the maximum weekly dengue cases per hexagon expected to exceed 51 at least once in 30 years in many areas. The surface characteristics with the largest impact on outbreak risk were the age of public apartments and the percentage of impervious surfaces, where a 3-year and 10% increase in each characteristic resulted in a 3.8% and 3.3% increase in risk, respectively. Vector control efforts should be prioritized in older residential estates and places with large contiguous masses of built-up environments. Our findings indicate the likely scale of outbreaks in the long term.
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Affiliation(s)
- Stacy Soh
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore
| | - Soon Hoe Ho
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore
- Correspondence:
| | - Annabel Seah
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore
| | | | - Leon Yan-Feng Gaw
- Department of Architecture, College of Design and Engineering, National University of Singapore, Singapore 117566, Singapore
| | - Borame Sue Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore
| | - Ken Wei Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore
| | - Joel Ruihan Koo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore
| | - Alex R. Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore
| | - Jue Tao Lim
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University Novena Campus, Singapore 639798, Singapore
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Huang L, Xiao G, Chen H, Niu X, Fu X, Xu H, Xu G, Ma S, Ong J, Ng LC. Geographical clusters of dengue outbreak in Singapore during the Covid-19 nationwide lockdown of 2020. Sci Data 2022; 9:547. [PMID: 36071062 PMCID: PMC9451123 DOI: 10.1038/s41597-022-01666-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/26/2022] [Indexed: 11/14/2022] Open
Abstract
Dengue, a mosquito-transmitted viral disease, has posed a public health challenge to Singaporean residents over the years. In 2020, Singapore experienced an unprecedented dengue outbreak. We collected a dataset of geographical dengue clusters reported by the National Environment Agency (NEA) from 15 February to 9 July in 2020, covering the nationwide lockdown associated with Covid-19 during the period from 7 April to 1 June. NEA regularly updates the dengue clusters during which an infected person may be tagged to one cluster based on the most probable infection location (residential apartment or workplace address), which is further matched to fine-grained spatial units with an average coverage of about 1.35 km2. Such dengue cluster dataset helps not only reveal the dengue transmission patterns, but also reflect the effects of lockdown on dengue spreading dynamics. The resulting data records are released in simple formats for easy access to facilitate studies on dengue epidemics. Measurement(s) | dengue infection locations | Technology Type(s) | NEA’s disclosured report | Factor Type(s) | Singapore’s dengue in in 2020 |
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Affiliation(s)
- Liping Huang
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Gaoxi Xiao
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore.
| | - Hechang Chen
- School of Artificial Intelligence, Jilin University, Changchun, China
| | - Xuetong Niu
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Xiuju Fu
- Institute of High Performance Computing, Singapore, Singapore
| | - Haiyan Xu
- Institute of High Performance Computing, Singapore, Singapore
| | - George Xu
- Institute of High Performance Computing, Singapore, Singapore
| | - Stefan Ma
- Ministry of Health, Singapore, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
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Soh S, Ho SH, Ong J, Seah A, Dickens BS, Tan KW, Koo JR, Cook AR, Sim S, Tan CH, Ng LC, Lim JT. Strategies to Mitigate Establishment Using the Wolbachia Incompatible Insect Technique. Viruses 2022; 14:v14061132. [PMID: 35746601 PMCID: PMC9229438 DOI: 10.3390/v14061132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022] Open
Abstract
The Incompatible Insect Technique (IIT) strategy involves the release of male mosquitoes infected with the bacterium Wolbachia. Regular releases of male Wolbachia-infected mosquitoes can lead to the suppression of mosquito populations, thereby reducing the risk of transmission of vector-borne diseases such as dengue. However, due to imperfect sex-sorting under IIT, fertile Wolbachia-infected female mosquitoes may potentially be unintentionally released into the environment, which may result in replacement and failure to suppress the mosquito populations. As such, mitigating Wolbachia establishment requires a combination of IIT with other strategies. We introduced a simple compartmental model to simulate ex-ante mosquito population dynamics subjected to a Wolbachia-IIT programme. In silico, we explored the risk of replacement, and strategies that could mitigate the establishment of the released Wolbachia strain in the mosquito population. Our results suggest that mitigation may be achieved through the application of a sterile insect technique. Our simulations indicate that these interventions do not override the intended wild type suppression of the IIT approach. These findings will inform policy makers of possible ways to mitigate the potential establishment of Wolbachia using the IIT population control strategy.
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Affiliation(s)
- Stacy Soh
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore; (S.S.); (S.H.H.); (J.O.); (A.S.); (S.S.); (C.H.T.); (L.C.N.)
| | - Soon Hoe Ho
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore; (S.S.); (S.H.H.); (J.O.); (A.S.); (S.S.); (C.H.T.); (L.C.N.)
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore; (S.S.); (S.H.H.); (J.O.); (A.S.); (S.S.); (C.H.T.); (L.C.N.)
| | - Annabel Seah
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore; (S.S.); (S.H.H.); (J.O.); (A.S.); (S.S.); (C.H.T.); (L.C.N.)
| | - Borame Sue Dickens
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore; (B.S.D.); (K.W.T.); (J.R.K.); (A.R.C.)
| | - Ken Wei Tan
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore; (B.S.D.); (K.W.T.); (J.R.K.); (A.R.C.)
| | - Joel Ruihan Koo
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore; (B.S.D.); (K.W.T.); (J.R.K.); (A.R.C.)
| | - Alex R. Cook
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore; (B.S.D.); (K.W.T.); (J.R.K.); (A.R.C.)
| | - Shuzhen Sim
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore; (S.S.); (S.H.H.); (J.O.); (A.S.); (S.S.); (C.H.T.); (L.C.N.)
| | - Cheong Huat Tan
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore; (S.S.); (S.H.H.); (J.O.); (A.S.); (S.S.); (C.H.T.); (L.C.N.)
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore; (S.S.); (S.H.H.); (J.O.); (A.S.); (S.S.); (C.H.T.); (L.C.N.)
- School of Biological Sciences, Nanyang Technological University, Singapore 637551, Singapore
| | - Jue Tao Lim
- Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore; (S.S.); (S.H.H.); (J.O.); (A.S.); (S.S.); (C.H.T.); (L.C.N.)
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore; (B.S.D.); (K.W.T.); (J.R.K.); (A.R.C.)
- Correspondence:
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Khera B, van de Lande L, Sidpra J, Knoops P, Borghi A, Ong J, James G, Hayward R, Schievano S, Mankad K, Dunaway D, Jeelani N, Breakey W. 73 Computed Tomography Imaging to Determine Reduction in Intracrainal Pressure Before & After Posterior Vault Expansion in Apert Syndrome. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Apert syndrome is an autosomal dominant malformation syndrome, accounting for 4.5% of all craniosynostoses. Raised intracranial pressure (ICP) in Apert syndrome has a multifactorial aetiology, with an incidence of up to 45% if left untreated [1, 2]. Raised ICP can be determined clinically, with non-invasive and invasive methods. In this study, we want to assess whether the use of CT scans is reliable in identifying changes in ICP.
Method
Pre and postoperative CT scans for 13 Apert syndrome patients who had posterior vault expansion were assessed and graded for severity of intracranial pressure (ICP). The grading system used was departmental specific and the assessment was carried out by a single clinician on different brain structures. This process was repeated on the same patients, using the same CT scans, 4 months later to determine consistency and repeatability. The relationship between the pre and postoperative scans was explored using the chi squared test. Intra-observer variability was assessed using Kappa statistics [SS1].
Results
There was no statistically significant difference between the pre and postoperative CT scan grading. Across instances, only one assessed structure had a p-value <0.05. The Kappa interobserver reliability test did not identify a strong agreement in the comparison of the two instances of data analysis.
Conclusions
Assessment of CT scans is not a reliable method to determine changes in intracranial pressure in Apert syndrome patients who have had a posterior vault expansion.
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Affiliation(s)
- B. Khera
- Department of Plastic Surgery, Oxford, United Kingdom
| | - L. van de Lande
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
| | - J. Sidpra
- Department of Plastic, Great Ormond Street, London, United Kingdom
| | - P. Knoops
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
| | - A. Borghi
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
| | - J. Ong
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
| | - G. James
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
| | - R. Hayward
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
| | - S. Schievano
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
| | - K. Mankad
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
| | - D. Dunaway
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
| | - N.u.O. Jeelani
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
| | - W. Breakey
- Department of Plastic & Craniofacial Surgery, Great Ormond Street, London, United Kingdom
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13
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Ong J, Soh S, Ho SH, Seah A, Dickens BS, Tan KW, Koo JR, Cook AR, Richards DR, Gaw LYF, Ng LC, Lim JT. Fine-scale estimation of effective reproduction numbers for dengue surveillance. PLoS Comput Biol 2022; 18:e1009791. [PMID: 35051176 PMCID: PMC8836367 DOI: 10.1371/journal.pcbi.1009791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/11/2022] [Accepted: 12/29/2021] [Indexed: 12/25/2022] Open
Abstract
The effective reproduction number Rt is an epidemiological quantity that provides an instantaneous measure of transmission potential of an infectious disease. While dengue is an increasingly important vector-borne disease, few have used Rt as a measure to inform public health operations and policy for dengue. This study demonstrates the utility of Rt for real time dengue surveillance. Using nationally representative, geo-located dengue case data from Singapore over 2010–2020, we estimated Rt by modifying methods from Bayesian (EpiEstim) and filtering (EpiFilter) approaches, at both the national and local levels. We conducted model assessment of Rt from each proposed method and determined exogenous temporal and spatial drivers for Rt in relation to a wide range of environmental and anthropogenic factors. At the national level, both methods achieved satisfactory model performance (R2EpiEstim = 0.95, R2EpiFilter = 0.97), but disparities in performance were large at finer spatial scales when case counts are low (MASE EpiEstim = 1.23, MASEEpiFilter = 0.59). Impervious surfaces and vegetation with structure dominated by human management (without tree canopy) were positively associated with increased transmission intensity. Vegetation with structure dominated by human management (with tree canopy), on the other hand, was associated with lower dengue transmission intensity. We showed that dengue outbreaks were preceded by sustained periods of high transmissibility, demonstrating the potential of Rt as a dengue surveillance tool for detecting large rises in dengue cases. Real time estimation of Rt at the fine scale can assist public health agencies in identifying high transmission risk areas and facilitating localised outbreak preparedness and response. The effective reproduction number Rt is an epidemiological quantity that provides an instantaneous measure of transmission potential of an infectious disease. While dengue is an increasingly important vector-borne disease, few have used Rt as a measure to inform public health operations and policy for dengue. This study demonstrates the utility of Rt for real time dengue surveillance. Using nationally representative, geo-located dengue case data from Singapore over 2010–2020, we estimated Rt by modifying methods from Bayesian (EpiEstim) and filtering (EpiFilter) approaches, at both the national and local levels. We conducted model assessment of Rt from each proposed method and determined exogenous temporal and spatial drivers for Rt in relation to a wide range of environmental and anthropogenic factors. At the national level, both methods achieved high accuracy, but disparities in performance were large at finer spatial scales when case counts are low. This study demonstrates the potential of Rt as a dengue surveillance tool for detecting large rises in dengue cases. Real time estimation of Rt at the fine scale can assist public health agencies in identifying high transmission risk areas and facilitating localised outbreak preparedness and response.
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Affiliation(s)
- Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore
| | - Stacy Soh
- Environmental Health Institute, National Environment Agency, Singapore
| | - Soon Hoe Ho
- Environmental Health Institute, National Environment Agency, Singapore
| | - Annabel Seah
- Environmental Health Institute, National Environment Agency, Singapore
| | - Borame Sue Dickens
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ken Wei Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Joel Ruihan Koo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Alex R. Cook
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Leon Yan-Feng Gaw
- School of Design and Environment, National University of Singapore, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
| | - Jue Tao Lim
- Environmental Health Institute, National Environment Agency, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- * E-mail:
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14
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Ramjeeawon A, van der Plas P, van de Lande L, Ong J, Wyatt M, Abel F, Kangesu L, Sommerlad B, Navaratnarajah J, Wolvius E, Laverty A, Bulstrode N. 1173 Airway and Breathing Problems in Pierre Robin Sequence: A Systematic Review Protocol. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
The primary aim is to systematically review the specific airway and/or breathing problems which have been reported in Pierre Robin Sequence (PRS). Secondary aims are to understand the prevalence and severity of these airway and breathing problems, and options for screening, assessment, and monitoring.
Method
A search strategy will be designed to search the following databases: MEDLINE, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials(CENTRAL) including a grey literature search, to identify publications on airway and/or breathing problems in Pierre Robin Sequence patients. Airway or breathing problems to be included are defined upper airway conditions (e.g., sleep apnoea) or clinically or objectively defined airway/breathing problems (e.g., increased respiratory rate, polysomnography). Screening will exclude non-English articles, abstracts, letters, editorials, expert opinions and breathing problems not anatomically related to craniofacial underdevelopment.
Results
This systematic review has been successfully registered on the PROSPERO International Prospective Register of Systematic Reviews (CRD42020210572)
Conclusions
PRS is a rare craniofacial condition which presents at birth, consisting of micrognathia, glossoptosis and airway problems, and is usually, but not always, associated with a cleft palate. There is no consensus on the type of airway problems that affect patients with PRS. The findings of this systematic review will help to develop a consensus on the airway and breathing problems in PRS and options for assessment and monitoring of the airway and breathing problem. This data may also contribute to development of a standardized guideline for management of airway and breathing problems in PRS.
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Affiliation(s)
- A Ramjeeawon
- University College London, London, United Kingdom
| | | | | | - J Ong
- Great Ormond Street Hospital, London, United Kingdom
| | - M Wyatt
- Great Ormond Street Hospital, London, United Kingdom
| | - F Abel
- Great Ormond Street Hospital, London, United Kingdom
| | - L Kangesu
- Great Ormond Street Hospital, London, United Kingdom
| | - B Sommerlad
- Great Ormond Street Hospital, London, United Kingdom
| | | | | | - A Laverty
- Great Ormond Street Hospital, London, United Kingdom
| | - N Bulstrode
- Great Ormond Street Hospital, London, United Kingdom
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15
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Ruggiero F, Badiali G, Bevini M, Marchetti C, Ong J, Bolognesi F, Schievano S, Dunaway D, Bianchi A, Borghi A. Parametrizing the genioplasty: a biomechanical virtual study on soft tissue behavior. Int J Comput Assist Radiol Surg 2021; 17:55-64. [PMID: 34533757 PMCID: PMC8739543 DOI: 10.1007/s11548-021-02489-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/30/2021] [Indexed: 12/04/2022]
Abstract
Purpose Sliding genioplasty is used to surgically correct a retruded or misaligned chin: in this procedure, an osteotomy is performed and the bony segment is repositioned. In this study we investigate the effect of surgical parameters (bony segment movement, osteotomy design) on postop soft tissue changes in a patient cohort. Methods Seven patients were retrospectively recruited. Cone beam computed tomography data were obtained and soft tissue and bone shape reconstructions were performed. 3D models were created and surgical cuts were replicated according to postop scans. Each model was imported in ANSYS 2019R1 (Ansys Inc, USA) for simulation: the effect of variation in osteotomy plane as well as extent of bony segment movement were assessed by means of design of experiment: surgical parameters were varied in a surgically acceptable range and the soft tissue predictions were evaluated as displacement output of five craniometric landmarks. Results Simulation results show the overall changes of the lower third of the face are sensitive to changes in horizontal and vertical displacement of the bony segment as well as segment rotation. No significant changes in the soft tissue response were to attribute to the osteotomy design. Conclusions Our results are consistent with experimental findings reported in the literature: when planning genioplasty in orthognathic surgery, particular focus on the segment movement (horizontal translation, vertical translation and rotation), rather than on the design of the osteotomy itself, should be considered.
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Affiliation(s)
- F Ruggiero
- DIBINEM Alma Mater Studiorum Bologna, Bologna, Italy.,Craniofacial Group, UCL Great Ormond Street Institute of Child Health-The Zayed Centre for Research, 20 Guilford Street, London, WC1N 1DZ, UK
| | - G Badiali
- DIBINEM Alma Mater Studiorum Bologna, Bologna, Italy
| | - M Bevini
- DIBINEM Alma Mater Studiorum Bologna, Bologna, Italy
| | - C Marchetti
- DIBINEM Alma Mater Studiorum Bologna, Bologna, Italy
| | - J Ong
- Division of Craniofacial and Plastic Surgery, Great Ormond Street Hospital for Children, London, UK
| | - F Bolognesi
- DIBINEM Alma Mater Studiorum Bologna, Bologna, Italy
| | - S Schievano
- Craniofacial Group, UCL Great Ormond Street Institute of Child Health-The Zayed Centre for Research, 20 Guilford Street, London, WC1N 1DZ, UK
| | - D Dunaway
- Craniofacial Group, UCL Great Ormond Street Institute of Child Health-The Zayed Centre for Research, 20 Guilford Street, London, WC1N 1DZ, UK.,Division of Craniofacial and Plastic Surgery, Great Ormond Street Hospital for Children, London, UK
| | - A Bianchi
- Oral and Maxillo-facial Unit, University of Catania, Catania, Italy
| | - A Borghi
- Craniofacial Group, UCL Great Ormond Street Institute of Child Health-The Zayed Centre for Research, 20 Guilford Street, London, WC1N 1DZ, UK.
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16
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Lim JT, Dickens BS, Tan KW, Koo JR, Seah A, Ho SH, Ong J, Rajarethinam J, Soh S, Cook AR, Ng LC. Hyperendemicity associated with increased dengue burden. J R Soc Interface 2021; 18:20210565. [PMID: 34520691 PMCID: PMC8440027 DOI: 10.1098/rsif.2021.0565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Over 105 million dengue infections are estimated to occur annually. Understanding the disease dynamics of dengue is often difficult due to multiple strains circulating within a population. Interactions between dengue serotype dynamics may result in complex cross-immunity dynamics at the population level and create difficulties in terms of formulating intervention strategies for the disease. In this study, a nationally representative 16-year time series with over 43 000 serotyped dengue infections was used to infer the long-run effects of between and within strain interactions and their impacts on past outbreaks. We used a novel identification strategy incorporating sign-identified Bayesian vector autoregressions, using structural impulse responses, historical decompositions and counterfactual analysis to conduct inference on dengue dynamics post-estimation. We found that on the population level: (i) across-serotype interactions on the population level were highly persistent, with a one time increase in any other serotype associated with long run decreases in the serotype of interest (range: 0.5–2.5 years) and (ii) over 38.7% of dengue cases of any serotype were associated with across-serotype interactions. The findings in this paper will substantially impact public health policy interventions with respect to dengue.
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Affiliation(s)
- Jue Tao Lim
- Environmental Health Institute, National Environmental Agency, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Borame Sue Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Ken Wei Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Joel Ruihan Koo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Annabel Seah
- Environmental Health Institute, National Environmental Agency, Singapore
| | - Soon Hoe Ho
- Environmental Health Institute, National Environmental Agency, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environmental Agency, Singapore
| | | | - Stacy Soh
- Environmental Health Institute, National Environmental Agency, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environmental Agency, Singapore.,School of Biological Sciences, Nanyang Technological University, Singapore
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17
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Pang A, Ho F, Camelia N, Ng Y, Yao Y, Said NM, Chun M, Eng W, Chen W, Chien J, Loy Y, Ong J, Luah V, Soh T, Wong W, Lim S, Chen M. 1699P Introduction of the GOLDEN (Geriatric Oncology LongituDinal End to eNd) programme in a tertiary cancer centre. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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18
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Ong J, Aik J, Ng LC. Short Report: Adult Aedes abundance and risk of dengue transmission. PLoS Negl Trop Dis 2021; 15:e0009475. [PMID: 34081695 PMCID: PMC8205144 DOI: 10.1371/journal.pntd.0009475] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 06/15/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Dengue is transmitted mainly by the adult female Aedes aegypti mosquito. However, little is known about the impact of adult Aedes abundance on the risk of dengue transmission. Here we analysed nationally representative dengue case and vector surveillance data collected from Singapore, to determine the effect of adult Aedes abundance on the risk of dengue transmission. A case was an area with active dengue transmission as indicated by the presence of dengue cluster. A control was an area where no dengue cluster was reported. Using multivariate logistic regression, we analysed 88 cases and 602 controls and estimated the odds of dengue cluster formation at various adult Aedes abundance levels, estimated by the mean number of adult female Aedes per Gravitrap per week and categorised into Low, Moderate, High and Very High abundance level. We found that the risk of dengue cluster formation was positively associated with adult Ae. aegypti abundance. We observed a three to four-fold increase in the odds of dengue clusters forming in areas with High (AOR: 3.40, 95% CI: 2.09, 5.52) and Very High (AOR: 3.99, 95% CI: 2.46, 6.46) adult Aedes aegypti abundance level compared to those with low Ae. aegypti abundance level. Our study strengthens the evidence for the use of adult Aedes indices for dengue risk assessment and early warning for dengue outbreaks. Entomological indicators of adult Ae. aegypti could be used to anticipate and prioritize areas for dengue control.
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Affiliation(s)
- Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Joel Aik
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
- * E-mail:
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19
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Lim JT, Dickens BL, Ong J, Aik J, Lee VJ, Cook AR, Ng LC. Decreased dengue transmission in migrant worker populations in Singapore attributable to SARS-CoV-2 quarantine measures. J Travel Med 2021; 28:taaa228. [PMID: 33274384 PMCID: PMC7798931 DOI: 10.1093/jtm/taaa228] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 11/24/2020] [Accepted: 12/01/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND We examined the impact of SARS-CoV-2 social distancing and quarantine policies on dengue transmission in the general and migrant worker populations in Singapore. METHODS We utilized all nationally reported dengue cases in the general and migrant worker populations from 1 January 2013 to 31 May 2020. A difference-in-difference identification strategy was used to determine the effects of social distancing and quarantine policies on reported dengue case counts over time, whilst controlling for weather patterns, seasonality, age and population size. RESULTS A reduction of 4.8 dengue cases per age band among migrant workers was attributable to quarantine policies, corresponding to a total reduction of around 432 reported dengue cases over 10 weeks. In the general working population, an increase of 14.5 dengue cases per age band was observed, which corresponds to a total increase of around 1450 reported dengue cases in the same time period. There is an expected relative risk reduction in dengue transmission for the migrant worker population at 0.635 due to quarantine policy and a relative risk increase for the general working population due to social distancing policies at 0.685. CONCLUSIONS Migrant workers experienced a reduced risk of dengue when they were confined to their dormitories as part of the COVID-19 social distancing measures. Our study highlights the vulnerability of migrant workers under normal working conditions.
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Affiliation(s)
- Jue Tao Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Borame Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environmental Agency, Singapore
| | - Joel Aik
- Environmental Health Institute, National Environmental Agency, Singapore
| | - Vernon J Lee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Ministry of Health, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environmental Agency, Singapore
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20
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Lim JT, Chew LZX, Choo ELW, Dickens BSL, Ong J, Aik J, Ng LC, Cook AR. Increased Dengue Transmissions in Singapore Attributable to SARS-CoV-2 Social Distancing Measures. J Infect Dis 2021; 223:399-402. [PMID: 33000172 PMCID: PMC7543616 DOI: 10.1093/infdis/jiaa619] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/28/2020] [Indexed: 12/02/2022] Open
Abstract
Social distancing (SD) measures aimed at curbing the spread of SARS-CoV-2 remain an important public health intervention. Little is known about the collateral impact of reduced mobility on the risk of other communicable diseases. We used differences in dengue case counts pre- and post implementation of SD measures and exploited heterogeneity in SD treatment effects among different age groups in Singapore to identify the spillover effects of SD measures. SD policy caused an increase of over 37.2% in dengue cases from baseline. Additional measures to preemptively mitigate the risk of other communicable diseases must be considered before the implementation/reimplementation of SARS-CoV-2 SD measures.
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Affiliation(s)
- Jue Tao Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Lawrence Zheng Xiong Chew
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Geography, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Esther Li Wen Choo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Borame Sue Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environmental Agency, Singapore, Singapore
| | - Joel Aik
- Environmental Health Institute, National Environmental Agency, Singapore, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environmental Agency, Singapore, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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21
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Sun H, Dickens BL, Richards D, Ong J, Rajarethinam J, Hassim MEE, Lim JT, Carrasco LR, Aik J, Yap G, Cook AR, Ng LC. Spatio-temporal analysis of the main dengue vector populations in Singapore. Parasit Vectors 2021; 14:41. [PMID: 33430945 PMCID: PMC7802191 DOI: 10.1186/s13071-020-04554-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the licensure of the world's first dengue vaccine and the current development of additional vaccine candidates, successful Aedes control remains critical to the reduction of dengue virus transmission. To date, there is still limited literature that attempts to explain the spatio-temporal population dynamics of Aedes mosquitoes within a single city, which hinders the development of more effective citywide vector control strategies. Narrowing this knowledge gap requires consistent and longitudinal measurement of Aedes abundance across the city as well as examination of relationships between variables on a much finer scale. METHODS We utilized a high-resolution longitudinal dataset generated from Singapore's islandwide Gravitrap surveillance system over a 2-year period and built a Bayesian hierarchical model to explain the spatio-temporal dynamics of Aedes aegypti and Aedes albopictus in relation to a wide range of environmental and anthropogenic variables. We also created a baseline during our model assessment to serve as a benchmark to be compared with the model's out-of-sample prediction/forecast accuracy as measured by the mean absolute error. RESULTS For both Aedes species, building age and nearby managed vegetation cover were found to have a significant positive association with the mean mosquito abundance, with the former being the strongest predictor. We also observed substantial evidence of a nonlinear effect of weekly maximum temperature on the Aedes abundance. Our models generally yielded modest but statistically significant reductions in the out-of-sample prediction/forecast error relative to the baseline. CONCLUSIONS Our findings suggest that public residential estates with older buildings and more nearby managed vegetation should be prioritized for vector control inspections and community advocacy to reduce the abundance of Aedes mosquitoes and the risk of dengue transmission.
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Affiliation(s)
- Haoyang Sun
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore, 117549, Republic of Singapore.
| | - Borame L Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore, 117549, Republic of Singapore
| | - Daniel Richards
- Natural Capital Singapore, Singapore-ETH Centre, ETH Zurich, Singapore, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | | | - Muhammad E E Hassim
- Centre for Climate Research Singapore, Meteorological Service Singapore, National Environment Agency, Singapore, Singapore
| | - Jue Tao Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore, 117549, Republic of Singapore
| | - L Roman Carrasco
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Joel Aik
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Grace Yap
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore, 117549, Republic of Singapore.
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore, Singapore.,School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
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22
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Soh S, Ho SH, Seah A, Ong J, Dickens BS, Tan KW, Koo JR, Cook AR, Tan KB, Sim S, Ng LC, Lim JT. Economic impact of dengue in Singapore from 2010 to 2020 and the cost-effectiveness of Wolbachia interventions. PLOS Glob Public Health 2021; 1:e0000024. [PMID: 36962069 PMCID: PMC10021432 DOI: 10.1371/journal.pgph.0000024] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/15/2021] [Indexed: 05/01/2023]
Abstract
The release of Wolbachia-infected mosquitoes is a promising disease intervention strategy that aims to control dengue and other arboviral infections. While early field trials and modelling studies suggest promising epidemiological and entomological outcomes, the overall cost effectiveness of the technology is not well studied in a resource rich setting nor under the suppression approach that aims to suppress the wild-type mosquito population through the release of Wolbachia-infected males. We used economical and epidemiological data from 2010 to 2020 to first ascertain the economic and health costs of dengue in Singapore, a high income nation where dengue is hyper-endemic. The hypothetical cost effectiveness of a national Wolbachia suppression program was then evaluated historically from 2010 to 2020. We estimated that the average economic impact of dengue in Singapore from 2010 to 2020 in constant 2010US$ ranged from $1.014 to $2.265 Billion. Using empirically derived disability weights, we estimated a disease burden of 7,645-21,262 DALYs from 2010-2020. Under an assumed steady-state running cost of a national Wolbachia suppression program in Singapore, we conservatively estimate that Wolbachia would cost an estimated $50,453-$100,907 per DALYs averted and would lead to an estimated $329.40 Million saved in economic costs over 2010 to 2020 under 40% intervention efficacy. Wolbachia releases in Singapore are expected to be highly cost-effective and its rollout must be prioritised to reduce the onward spread of dengue.
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Affiliation(s)
- Stacy Soh
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Soon Hoe Ho
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Annabel Seah
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Borame Sue Dickens
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Ken Wei Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Joel Ruihan Koo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Alex R. Cook
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Shuzhen Sim
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Jue Tao Lim
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- * E-mail:
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Ong J, Chong CS, Yap G, Lee C, Abdul Razak MA, Chiang S, Ng LC. Gravitrap deployment for adult Aedes aegypti surveillance and its impact on dengue cases. PLoS Negl Trop Dis 2020; 14:e0008528. [PMID: 32764763 PMCID: PMC7439811 DOI: 10.1371/journal.pntd.0008528] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 08/19/2020] [Accepted: 06/26/2020] [Indexed: 01/13/2023] Open
Abstract
House Index, Container Index, and Breteau Index are the most commonly used indices for dengue vector surveillance. However, these larval indices are a poor proxy for measuring the adult population—which is responsible for disease transmission. Information on the adult distribution and density are important for assessing transmission risk as well as for developing effective control strategies. This study introduces a new entomological index, Gravitrap aegypti index (GAI), which estimates the adult female Aedes aegypti population in the community and presents its association with dengue cases. Gravitraps were deployed across 34 treatment sites in Singapore from September 2013 to September 2016. The GAI, derived from the Gravitrap surveillance data, was analysed to investigate the spatio-temporal patterns of the Ae. aegypti population in Singapore. The index was further categorised into low, moderate, and high-risk groups and its association with dengue cases were examined. A Before-After Control Impact analysis was performed to evaluate the epidemiology impact of Gravitrap system on dengue transmission. The Ae. aegypti population exhibits a seasonal pattern, and spatial heterogeneity in Ae. aegypti abundance was observed among treatment sites. The Ae. aegypti population was also found to be unevenly distributed among floors of an apartment block, with low floors (floors 1–4) having a higher abundance of mosquitoes trapped than mid (floors 5–8) and high (floors ≥9) floors. Areas with high GAI were shown to have higher dengue case count. Gravitrap has also demonstrated to be a good dengue control tool. The contribution of cases by treatment sites to the national numbers was lower after Gravitraps deployment. The GAI, which is of better relevance to dengue transmission risk, could be recommended as an indicator for decision making in vector control efforts, and to monitor the spatio-temporal variability of the adult Aedes population in the country. In addition, findings from this study indicate that Gravitraps can be used as a dengue control tool to reduce dengue transmission. In the absence of an effective vaccine: vector surveillance and control remain the key strategy for dengue prevention and control. The collection of the adult female Aedes mosquito is thus important to understand disease transmission dynamics. Information on its distribution and density are also essential for assessing transmission risk as well as for devising an effective control strategy. Here, we described a new approach to dengue vector surveillance based on adult female Aedes trapping using Gravitraps. Using the Gravitrap surveillance data, we derived a new entomological index, Gravitrap aegypti index (GAI), which estimates the adult female Ae. aegypti population in the community and presents its association with dengue cases. When analysed, the index can provide useful information on the spatio-temporal distribution of the Ae. aegypti population in the country and hence, assist planning of vector control. The GAI, which is of better relevance to dengue transmission risk, could be used as an indicator for decision making in vector control efforts, and to monitor the spatio-temporal variability of the adult Aedes population. In addition, findings from this study indicate that Gravitraps can be used as a dengue control tool to reduce dengue transmission.
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Affiliation(s)
- Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore
| | - Chee-Seng Chong
- Environmental Health Institute, National Environment Agency, Singapore
| | - Grace Yap
- Environmental Public Health Operations, National Environment Agency, Singapore
| | - Caleb Lee
- Environmental Health Institute, National Environment Agency, Singapore
| | | | - Suzanna Chiang
- Environmental Health Institute, National Environment Agency, Singapore
| | - Lee-Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
- * E-mail:
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng JCK, Atkin G, Azizi A, Cargill Z, China Z, Elliot J, Jebakumar R, Lam J, Mudalige G, Onyerindu C, Renju M, Babu VS, Hussain M, Joji N, Lovett B, Mownah H, Ali B, Cresswell B, Dhillon AK, Dupaguntla YS, Hungwe C, Lowe-Zinola JD, Tsang JCH, Bevan K, Cardus C, Duggal A, Hossain S, McHugh M, Scott M, Chan F, Evans R, Gurung E, Haughey B, Jacob-Ramsdale B, Kerr M, Lee J, McCann E, O'Boyle K, Reid N, Hayat F, Hodgson S, Johnston R, Jones W, Khan M, Linn T, Long S, Seetharam P, Shaman S, Smart B, Anilkumar A, Davies J, Griffith J, Hughes B, Islam Y, Kidanu D, Mushaini N, Qamar I, Robinson H, Schramm M, Tan CY, Apperley H, Billyard C, Blazeby JM, Cannon SP, Carse S, Göpfert A, Loizidou A, Parkin J, Sanders E, Sharma S, Slade G, Telfer R, Huppatz IW, Worley E, Chandramoorthy L, Friend C, Harris L, Jain P, Karim MJ, Killington K, McGillicuddy J, Rafferty C, Rahunathan N, Rayne T, Varathan Y, Verma N, Zanichelli D, Arneill M, Brown F, Campbell B, Crozier L, Henry J, McCusker C, Prabakaran P, Wilson R, Asif U, Connor M, Dindyal S, Math N, Pagarkar A, Saleem H, Seth I, Sharma S, Standfield N, Swartbol T, Adamson R, Choi JE, El Tokhy O, Ho W, Javaid NR, Kelly M, Mehdi AS, Menon D, Plumptre I, Sturrock S, Turner J, Warren O, Crane E, Ferris B, Gadsby C, Smallwood J, Vipond M, Wilson V, Amarnath T, Doshi A, Gregory C, Kandiah K, Powell B, Spoor H, Toh C, Vizor R, Common M, Dunleavy K, Harris S, Luo C, Mesbah Z, Kumar AP, Redmond A, Skulsky S, Walsh T, Daly D, Deery L, Epanomeritakis E, Harty M, Kane D, Khan K, Mackey R, McConville J, McGinnity K, Nixon G, Ang A, Kee JY, Leung E, Norman S, Palaniappan SV, Sarathy PP, Yeoh T, Frost J, Hazeldine P, Jones L, Karbowiak M, Macdonald C, Mutarambirwa A, Omotade A, Runkel M, Ryan G, Sawers N, Searle C, Suresh S, Vig S, Ahmad A, McGartland R, Sim R, Song A, Wayman J, Brown R, Chang LH, Concannon K, Crilly C, Arnold TJ, Burgin A, Cadden F, Choy CH, Coleman M, Lim D, Luk J, Mahankali-Rao P, Prudence-Taylor AJ, Ramakrishnan D, Russell J, Fawole A, Gohil J, Green B, Hussain A, McMenamin L, McMenamin L, Tang M, Azmi F, Benchetrit S, Cope T, Haque A, Harlinska A, Holdsworth R, Ivo T, Martin J, Nisar T, Patel A, Sasapu K, Trevett J, Vernet G, Aamir A, Bird C, Durham-Hall A, Gibson W, Hartley J, May N, Maynard V, Johnson S, Wood CM, O'Brien M, Orbell J, Stringfellow TD, Tenters F, Tresidder S, Cheung W, Grant A, Tod N, Bews-Hair M, Lim ZH, Lim SW, Vella-Baldacchino M, Auckburally S, Chopada A, Easdon S, Goodson R, McCurdie F, Narouz M, Radford A, Rea E, Taylor O, Yu T, Alfa-Wali M, Amani L, Auluck I, Bruce P, Emberton J, Kumar R, Lagzouli N, Mehta A, Murtaza A, Raja M, Dennahy IS, Frew K, Given A, He YY, Karim MA, MacDonald E, McDonald E, McVinnie D, Ng SK, Pettit A, Sim DPY, Berthaume-Hawkins SD, Charnley R, Fenton K, Jones D, Murphy C, Ng JQ, Reehal R, Robinson H, Seraj SS, Shang E, Tonks A, White P, Yeo A, Chong P, Gabriel R, Patel N, Richardson E, Symons L, Aubrey-Jones D, Dawood S, Dobrzynska M, Faulkner S, Griffiths H, Mahmood F, Patel P, Perry M, Power A, Simpson R, Ali A, Brobbey P, Burrows A, Elder P, Ganyani R, Horseman C, Hurst P, Mann H, Marimuthu K, McBride S, Pilsworth E, Powers N, Stanier P, Innes R, Kersey T, Kopczynska M, Langasco N, Patel N, Rajagopal R, Atkins B, Beasley W, Lim ZC, Gill A, Ang HL, Williams H, Yogeswara T, Carter R, Fam M, Fong J, Latter J, Long M, Mackinnon S, McKenzie C, Osmanska J, Raghuvir V, Shafi A, Tsang K, Walker L, Bountra K, Coldicutt O, Fletcher D, Hudson S, Iqbal S, Bernal TL, Martin JWB, Moss-Lawton F, Smallwood J, Vipond M, Cardwell A, Edgerton K, Laws J, Rai A, Robinson K, Waite K, Ward J, Youssef H, Knight C, Koo PY, Lazarou A, Stanger S, Thorn C, Triniman MC, Botha A, Boyles L, Cumming S, Deepak S, Ezzat A, Fowler AJ, Gwozdz AM, Hussain SF, Khan S, Li H, Morrell BL, Neville J, Nitiahpapand R, Pickering O, Sagoo H, Sharma E, Welsh K, Denley S, Khan S, Agarwal M, Al-Saadi N, Bhambra R, Gupta A, Jawad ZAR, Jiao LR, Khan K, Mahir G, Singagireson S, Thoms BL, Tseu B, Wei R, Yang N, Britton N, Leinhardt D, Mahfooz M, Palkhi A, Price M, Sheikh S, Barker M, Bowley D, Cant M, Datta U, Farooqi M, Lee A, Morley G, Amin MN, Parry A, Patel S, Strang S, Yoganayagam N, Adlan A, Chandramoorthy S, Choudhary Y, Das K, Feldman M, France B, Grace R, Puddy H, Soor P, Ali M, Dhillon P, Faraj A, Gerard L, Glover M, Imran H, Kim S, Patrick Y, Peto J, Prabhudesai A, Smith R, Tang A, Vadgama N, Dhaliwal R, Ecclestone T, Harris A, Ong D, Patel D, Philp C, Stewart E, Wang L, Wong E, Xu Y, Ashaye T, Fozard T, Galloway F, Kaptanis S, Mistry P, Nguyen T, Olagbaiye F, Osman M, Philip Z, Rembacken R, Tayeh S, Theodoropoulou K, Herman A, Lau J, Saha A, Trotter M, Adeleye O, Cave D, Gunwa T, Magalhães J, Makwana S, Mason R, Parish M, Regan H, Renwick P, Roberts G, Salekin D, Sivakumar C, Tariq A, Liew I, McDade A, Stewart D, Hague M, Hudson-Peacock N, Jackson CES, James F, Pitt J, Walker EY, Aftab R, Ang JJ, Anwar S, Battle J, Budd E, Chui J, Crook H, Davies P, Easby S, Hackney E, Ho B, Imam SZ, Rammell J, Andrews H, Perry C, Schinle P, Ahmed P, Aquilina T, Balai E, Church M, Cumber E, Curtis A, Davies G, Dennis Y, Dumann E, Greenhalgh S, Kim P, King S, Metcalfe KHM, Passby L, Redgrave N, Soonawalla Z, Waters S, Zornoza A, Gulzar I, Hole J, Hull K, Ishaq H, Karaj J, Kelkar A, Love E, Patel S, Thakrar D, Vine M, Waterman A, Dib NP, Francis N, Hanson M, Ingleton R, Sadanand KS, Sukirthan N, Arnell S, Ball M, Bassam N, Beghal G, Chang A, Dawe V, George A, Huq T, Hussain A, Ikram B, Kanapeckaite L, Khan M, Ramjas D, Rushd A, Sait S, Serry M, Yardimci E, Capella S, Chenciner L, Episkopos C, Karam E, McCarthy C, Moore-Kelly W, Watson N, Ahluwalia V, Barnfield J, Ben-Gal O, Bloom I, Gharatya A, Khodatars K, Merchant N, Moonan A, Moore M, Patel K, Spiers H, Sundaram K, Turner J, Bath MF, Black J, Chadwick H, Huisman L, Ingram H, Khan S, Martin L, Metcalfe M, Sangal P, Seehra J, Thatcher A, Venturini S, Whitcroft I, Afzal Z, Brown S, Gani A, Gomaa A, Hussein N, Oh SY, Pazhaniappan N, Sharkey E, Sivagnanasithiyar T, Williams C, Yeung J, Cruddas L, Gurjar S, Pau A, Prakash R, Randhawa R, Chen L, Eiben I, Naylor M, Osei-Bordom D, Trenear R, Bannard-Smith J, Griffiths N, Patel BY, Saeed F, Abdikadir H, Bennett M, Church R, Clements SE, Court J, Delvi A, Hubert J, Macdonald B, Mansour F, Patel RR, Perris R, Small S, Betts A, Brown N, Chong A, Croitoru C, Grey A, Hickland P, Ho C, Hollington D, McKie L, Nelson AR, Stewart H, Eiben P, Nedham M, Ali I, Brown T, Cumming S, Hunt C, Joyner C, McAlinden C, Roberts J, Rogers D, Thachettu A, Tyson N, Vaughan R, Verma N, Yasin T, Andrew K, Bhamra N, Leong S, Mistry R, Noble H, Rashed F, Walker NR, Watson L, Worsfold M, Yarham E, Abdikadir H, Arshad A, Barmayehvar B, Cato L, Chan-lam N, Do V, Leong A, Sheikh Z, Zheleniakova T, Coppel J, Hussain ST, Mahmood R, Nourzaie R, Prowle J, Sheik-Ali S, Thomas A, Alagappan A, Ashour R, Bains H, Diamond J, Gordon J, Ibrahim B, Khalil M, Mittapalli D, Neo YN, Patil P, Peck FS, Reza N, Swan I, Whyte M, Chaudhry S, Hernon J, Khawar H, O'Brien J, Pullinger M, Rothnie K, Ujjal S, Bhatte S, Curtis J, Green S, Mayer A, Watkinson G, Chapple K, Hawthorne T, Khaliq M, Majkowski L, Malik TAM, Mclauchlan K, En BNW, Parton S, Robinson SD, Saat MI, Shurovi BN, Varatharasasingam K, Ward AE, Behranwala K, Bertelli M, Cohen J, Duff F, Fafemi O, Gupta R, Manimaran M, Mayhew J, Peprah D, Wong MHY, Farmer N, Houghton C, Kandhari N, Khan K, Ladha D, Mayes J, McLennan F, Panahi P, Seehra H, Agrawal R, Ahmed I, Ali S, Birkinshaw F, Choudhry M, Gokani S, Harrogate S, Jamal S, Nawrozzadeh F, Swaray A, Szczap A, Warusavitarne J, Abdalla M, Asemota N, Cullum R, Hartley M, Maxwell-Armstrong C, Mulvenna C, Phillips J, Yule A, Ahmed L, Clement KD, Craig N, Elseedawy E, Gorman D, Kane L, Livie J, Livie V, Moss E, Naasan A, Ravi F, Shields P, Zhu Y, Archer M, Cobley H, Dennis R, Downes C, Guevel B, Lamptey E, Murray H, Radhakrishnan A, Saravanabavan S, Sardar M, Shaw C, Tilliridou V, Wright R, Ye W, Alturki N, Helliwell R, Jones E, Kelly D, Lambotharan S, Scott K, Sivakumar R, Victor L, Boraluwe-Rallage H, Froggatt P, Haynes S, Hung YMA, Keyte A, Matthews L, Evans E, Haray P, John I, Mathivanan A, Morgan L, Oji O, Okorocha C, Rutherford A, Spiers H, Stageman N, Tsui A, Whitham R, Amoah-Arko A, Cecil E, Dietrich A, Fitzpatrick H, Guy C, Hair J, Hilton J, Jawad L, McAleer E, Taylor Z, Yap J, Akhbari M, Debnath D, Dhir T, Elbuzidi M, Elsaddig M, Glace S, Khawaja H, Koshy R, Lal K, Lobo L, McDermott A, Meredith J, Qamar MA, Vaidya A, Acquaah F, Barfi L, Carter N, Gnanappiragasam D, Ji C, Kaminski F, Lawday S, Mackay K, Sulaiman SK, Webb R, Ananthavarathan P, Dalal F, Farrar E, Hashemi R, Hossain M, Jiang J, Kiandee M, Lex J, Mason L, Matthews JH, McGeorge E, Modhwadia S, Pinkney T, Radotra A, Rickard L, Rodman L, Sales A, Tan KL, Bachi A, Bajwa DS, Battle J, Brown LR, Butler A, Calciu A, Davies E, Gardner I, Girdlestone T, Ikogho O, Keelan G, O'Loughlin P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Teng J, Ong J, Patanaik A, Zhou J, Chee M, Lim J. 0143 Vigilance Declines Following Sleep Deprivation are Associated with Two Previously Identified Dynamic Connectivity States. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Dynamic functional connectivity (DFC) analysis of resting-state fMRI data has been successfully used to track fluctuations in arousal in the human brain. Changes in DFC have also been reported with acute sleep deprivation. Here, we demonstrate that dynamic connectivity states (DCS) previously related to arousal are reproducible, and are associated with individual differences in sustained attention declines after one night of total sleep deprivation.
Methods
32 participants underwent two counterbalanced resting-state fMRI scans: during rested wakefulness (RW) and following total sleep deprivation (SD). They also completed the Psychomotor Vigilance Test (PVT), a sustained attention task that is highly sensitive to the effects of sleep loss. SD vulnerability was computed as the decrease in response speed (∆RS) and increase in lapses (∆lapse) in SD compared with RW.
Dynamic functional connectivity analysis was conducted on rs-fMRI data. Connectivity matrices were clustered to obtain 5 prototypical DCS. We calculated the proportion of time participants spent in each of these DCS, as well as how often participants transitioned between DCSs. Relationships between SD vulnerability and connectivity metrics were then correlated.
Results
We recovered two DCS that were highly similar (ρ = .89-.91) to arousal-related DCS observed in previous work (high arousal state (HAS); low arousal state (LAS)).
After sleep deprivation, the proportion of time spent in the LAS increased significantly (t29=3.16, p=.0039), while there was no significant change in HAS (t29=-1.43, p=.16). We observed significantly more state transitions in RW compared with SD. Change in LAS and HAS across sleep conditions correlated significantly with SD vulnerability (ΔLASxΔRS: r=-0.64, p<.0001; ΔLASxΔlapse: r=0.43, p=.018; ΔHASxΔRS; r=0.43, p=.019; ΔHASxΔlapse; r=-0.39, p=.033). Finally, Δ%transitions was correlated with ΔRS but not Δlapse.
Conclusion
This study adds to the evidence that two specific reproducible DCS are robust markers of arousal and attention, and may be useful indicators of SD vulnerability.
Support
This work was supported by the National Medical Research Council, Singapore (STaR/0015/2013), and the National Research Foundation Science of Learning (NRF2016-SOL002-001).
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Affiliation(s)
- J Teng
- Duke-NUS Medical School, Singapore, SINGAPORE
| | - J Ong
- Duke-NUS Medical School, Singapore, SINGAPORE
| | - A Patanaik
- Duke-NUS Medical School, Singapore, SINGAPORE
| | - J Zhou
- Duke-NUS Medical School, Singapore, SINGAPORE
| | - M Chee
- Duke-NUS Medical School, Singapore, SINGAPORE
| | - J Lim
- Duke-NUS Medical School, Singapore, SINGAPORE
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Abstract
Abstract
Introduction
Daytime naps have been shown to improve learning outcomes. One theory underlying enhanced encoding following a nap is via the synaptic downscaling of neurons potentiated during wake - a process facilitated by slow oscillations. In this study, we sought to investigate neural mechanisms underlying enhanced encoding following a nap compared to a waking period using a combination of PSG and fMRI methods.
Methods
40 healthy undergraduates (M=23.3y, SD=2.96y; 10 males) who slept normally the previous night encoded word pair lists across 2 runs in an MRI scanner at 1PM and 4.30PM. In between encoding sessions, participants either stayed awake and watched a documentary (Wake group; N=20), or napped for 90-min while undergoing polysomnography (Nap group; N=20). Approximately 40min after each encoding session, memory of these word lists were assessed in a cued-recall fashion. Performance in each session was measured by percentage of correct responses.
Results
There were no baseline differences in encoding performance. However, a Session x Group interaction effect (p<0.001) was observed whereby performance significantly improved only in the Nap group in the second encoding session (Nap:20±19% vs. Wake:-1±13%). Concurrent to this, fMRI analyses revealed a Session x Run x Group interaction effect in the hippocampus (p=0.002) whereby hippocampal activation during encoding of the word lists increased only in the Nap group. In addition, although there was no association between degree of performance improvement in the nap group with duration of sleep or the various sleep stages (N1,N2,N3,REM), spindle count (12-15Hz) in the Nap group correlated significantly with both performance improvement (rs=0.46) and increase in hippocampal activation (rs=0.46).
Conclusion
These results confirm the benefit of a nap on encoding processes. Hippocampal activation also increased following the nap, which could indicate renewed hippocampal capacity to store new information. While we hypothesized that slow wave sleep would aid in this transfer, we instead found a relationship between spindle count and both degree of performance improvement and increase in hippocampal activation. The interplay between NREM sleep oscillations, hippocampal downscaling and encoding performance could be more complex than originally thought.
Support
National Medical Research Council, Singapore (NMRC/STaR/015/2013) and the Far East Organization.
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Affiliation(s)
- J Ong
- National University of Singapore, Singapore, SINGAPORE
| | - T Lau
- National University of Singapore, Singapore, SINGAPORE
| | - X Lee
- National University of Singapore, Singapore, SINGAPORE
| | - E van Rijn
- Duke-NUS Medical School, Singapore, SINGAPORE
| | - M W Chee
- National University of Singapore, Singapore, SINGAPORE
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Wong KF, Perini F, Henderson SL, Teng J, Hassirim Z, Lin J, Leow Z, Fan Q, Ong J, Lo J, Ong JC, Doshi K, Lim J. 0519 Mindfulness Based Therapy for Insomnia Improves Objective Markers of Sleep in the Elderly: Preliminary Data from the Mindfulness Sleep Therapy (MIST) Study. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Mindfulness-based treatment for insomnia (MBTI) is a viable intervention for improving poor sleep. We report preliminary data from an ongoing pre-registered, randomized controlled trial which investigates the effect of MBTI on elderly adults.
Methods
Participants above 50 years old with PSQI ≥ 5 were recruited and randomised into either MBTI or an active control group (Sleep hygiene education and exercise program, SHEEP) in sequential cohorts with about 20 participants per cohort (10 per group). Before and after the intervention, 1 night of portable polysomnography (PSG) and 1 week of actigraphy (ACT) and sleep diary (DIARY) data were collected. We report the ACT and DIARY results of the first 3 cohorts (n = 46, male = 23, mean age = 62.3, std = 6.3) and PSG data of the first 2 cohorts (n = 29, male = 12, mean age = 62.5, std = 5.7). Time in bed (TIB), total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE) were analysed with mixed-model repeated-measures ANOVA.
Results
We observed increases in TIBDIARY (F1,44 = 5.151, p < .05) and SEDIARY (F1,44 = 22.633, p < .0001), and significant reductions in SOLDIARY (F1,44 = 7.031, p < .05) and WASODIARY (F1,39 = 7.411, p < .05). In the actigraphy data, we found a significant interaction in SOLACT (F1,39 = 4.273, p < .05) with an increase in SHEEP SOLACT (t18= 2.36, p < .05). Significant reductions were also observed in WASOACT (F1,44 = 16.459, p < .0001) Finally, we observed a reduction in SOLPSG (F1,26 = 5.037, p <. 05). All other tests were non-significant.
Conclusion
Preliminary results suggest that both interventions lead to improvements in sleep with more pronounced effects in subjective sleep reports. Objective sleep data suggest that improvements in sleep is a result of improved sleep quality and not simply extending sleep opportunity. These preliminary data shows that MBTI may be a promising intervention for elderly individuals with sleep difficulties.
Support
This study was supported by an award from the 7th grant call of the Singapore Millennium Foundation Research Grant Programme
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Affiliation(s)
- K F Wong
- Duke NUS Medical School, Singapore, SINGAPORE
| | - F Perini
- Duke NUS Medical School, Singapore, SINGAPORE
| | | | - J Teng
- Duke NUS Medical School, Singapore, SINGAPORE
| | - Z Hassirim
- Duke NUS Medical School, Singapore, SINGAPORE
| | - J Lin
- Duke NUS Medical School, Singapore, SINGAPORE
| | - Z Leow
- Duke NUS Medical School, Singapore, SINGAPORE
| | - Q Fan
- Singapore General Hospital, Singapore, SINGAPORE
| | - J Ong
- Duke NUS Medical School, Singapore, SINGAPORE
| | - J Lo
- National University of Singapore, Singapore, SINGAPORE
| | - J C Ong
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - K Doshi
- Singapore General Hospital, Singapore, SINGAPORE
| | - J Lim
- Duke NUS Medical School, Singapore, SINGAPORE
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Simpson P, McCart Reed A, Kutasovic J, Coorey C, Kuo L, Nguyen H, Pei W, Ong J, Sokolova A, Evans E, Porter A, Lakhani S. 52P Characterising clinicopathological and biological parameters predictive of outcome for patients diagnosed with invasive lobular carcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Rajarethinam J, Ong J, Neo ZW, Ng LC, Aik J. Distribution and seasonal fluctuations of Ae. aegypti and Ae. albopictus larval and pupae in residential areas in an urban landscape. PLoS Negl Trop Dis 2020; 14:e0008209. [PMID: 32310960 PMCID: PMC7192508 DOI: 10.1371/journal.pntd.0008209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 04/30/2020] [Accepted: 03/11/2020] [Indexed: 01/21/2023] Open
Abstract
Dengue, a vector-borne disease spread by Aedes mosquitoes, is a global threat. In the absence of an efficacious dengue vaccine, vector control is the key intervention tool in Singapore. A good understanding of vector habitats is essential to formulate operational strategies. We examined the distribution, long-term trend and seasonality of Aedes data collected during regulatory inspections in residences and public areas from 2008 to 2017. We also studied the seasonality of climate factors to understand their influence on the detection of Aedes-positive containers. The most frequently reported Aedes-positive containers were domestic containers, drains, discarded receptacles, ornamental containers, flower pot plates/trays, plants, gully traps, canvas/plastic sheet, bins, ground puddle, inspection chambers and roof tops/gutters. We found more Ae. aegypti and Ae. albopictus-positive containers per inspection in residences and public areas, respectively. The seasonality of Ae. aegypti-positive containers in residences and public areas coincided with that of mean temperature. However, the seasonality of Ae. albopictus-positive containers lagged by one month compared to that of mean temperature. Our study demonstrates the seasonal fluctuations of Aedes-positive containers in an urban environment. Understanding the distribution and seasonality of Aedes breeding helps to facilitate resource planning and community awareness to moderate dengue transmission.
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Affiliation(s)
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Zhi-Wei Neo
- Environmental Public Health Operations, National Environment Agency, Singapore, Singapore
| | - Lee-Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
- * E-mail:
| | - Joel Aik
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Level 3, Samuels Building, Botany Road, Keningston, New South Wales, Australia
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Aik J, Ong J, Ng LC. The effects of climate variability and seasonal influence on diarrhoeal disease in the tropical city-state of Singapore - A time-series analysis. Int J Hyg Environ Health 2020; 227:113517. [PMID: 32272437 DOI: 10.1016/j.ijheh.2020.113517] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/18/2020] [Accepted: 03/20/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Diarrhoeal disease is common and imposes substantial health and economic burdens across the globe, especially in the African and Southeast Asian regions. Besides causing high mortality and morbidity, diarrhoeal disease has also been associated with growth and cognitive shortfalls in children in low-resource settings. Extreme weather events brought about by climate change may increase diarrhoeal disease and impact vulnerable populations in countries regardless of levels of development. We examined the seasonal and climatic influences of acute diarrhoeal disease reports in Singapore, a city-state located in Southeast Asia. METHODS We used a time-series analysis, adjusting for time-varying potential confounders in a negative binomial regression model and fitting fractional polynomials to investigate the relationship between climatic factors (temperature, relative humidity and rainfall) and reported diarrhoeal disease. RESULTS We included 1,798,198 reports of diarrhoeal disease from 2005 to 2018. We observed annual trimodal peaks in the number of reports. Every 10% increase in relative humidity in the present week was positively associated with an increase in reports one week later [Incidence Rate Ratio (IRR): 1.030, 95% CI 1.004-1.057] and negatively associated with a decrease in reports six weeks later (IRR: 0.979, 95% CI 0.961-0.997). We observed effect modification of relative humidity on the risk of diarrhoeal disease in the first calendar quarter (January to March). There was weak evidence of a delayed effect of ambient air temperature on reports of diarrhoeal disease one week later (IRR: 1.013, 95% CI 0.998-1.027). No threshold effects of climatic factors were observed. Each week of school holidays was associated with a 14.4% reduction in diarrhoeal disease reports (IRR: 0.856, 95% CI: 0.840 to 0.871). Public holidays were associated with a reduction in reports in the same week and an increase a week later. CONCLUSIONS Diarrhoeal disease is highly seasonal and is associated with climate variability. Food safety and primary healthcare resource mitigation could be timed in anticipation of seasonal and climate driven increases in disease reports.
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Affiliation(s)
- Joel Aik
- Environmental Health Institute, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, 228231, Singapore; School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, New South Wales, Australia.
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, 228231, Singapore.
| | - Lee-Ching Ng
- Environmental Health Institute, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, 228231, Singapore.
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Jivraj BA, Ahmed N, Karia K, Menon R, Robertson E, Sodha A, Wormald JCR, O'hara J, Jeelani O, Dunaway D, James G, Ong J. A 24-month cost and outcome analysis comparing traditional fronto-orbital advancment and remodeling with endoscopic strip craniectomy and molding helmet in the management of unicoronal craniosynostosis: A retrospective bi-institutional review. JPRAS Open 2020; 20:35-42. [PMID: 32158870 PMCID: PMC7061657 DOI: 10.1016/j.jpra.2019.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 01/23/2019] [Indexed: 11/12/2022] Open
Abstract
Introduction Endoscopic strip craniectomy with helmeting (ESCH) has been shown to be a safe and efficacious alternative to fronto-orbital remodeling (FOR) for selected children with craniosynostosis. In addition to clinical factors, there may be economic benefits from the use of ESCH instead of FOR. Methods A retrospective review of 23 patients with nonsyndromic unicoronal craniosynostosis (UCS) treated with FOR was carried out at Great Ormond Street Hospital (GOSH) for Children in London, UK. Secondary data were used for the ESCH cohort from a paper published by Jimenez and Barone (2013). Data were collected on surgical time, transfusion rates, length of hospital stay, adverse event rates, reintervention rates, and overall costs. Costs were categorized and then assigned to the appropriate data sets. Results The mean age of patients undergoing FOR (vs. ESCH) was 17.4 mo (vs. 3.1 mo) with a mean surgical time of 234 min (vs. 55 min), mean transfusion volume of 221.6 mL (vs. 80.0 mL), mean transfusion rate of 14/23 (vs. 2/115), and a total immediate overnight stay of 3.13 days (vs. 97% next-day discharge). The FOR group had a higher adverse event rate (5/23 vs. 4/115, p=<0.005) and a higher number requiring extraocular muscle surgery (4/23 vs. 7/109, p=0.16). There was a substantial difference in overall costs between the two groups. Total variance cost for the FOR group was £7436.5 vs. £4951.35, representing a cost difference of £2485.15 over the 24-month study period. Conclusion ESCH, in comparison to FOR, appears as a more economical method in the management of USC patients, as well as having clinical benefits including reduced adverse event rate and improved ophthalmic outcomes.
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Affiliation(s)
- B A Jivraj
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - N Ahmed
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - K Karia
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - R Menon
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - E Robertson
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - A Sodha
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - J C R Wormald
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - J O'hara
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - O Jeelani
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - D Dunaway
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - G James
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
| | - J Ong
- Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, UK
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Polubothu S, McGuire N, Al‐Olabi L, Baird W, Bulstrode N, Chalker J, Josifova D, Lomas D, O'Hara J, Ong J, Rampling D, Stadnik P, Thomas A, Wedgeworth E, Sebire N, Kinsler V. Withdrawn:
Does the gene matter? Genotype‐phenotype and genotype‐outcome associations in congenital melanocytic naevi. Br J Dermatol 2020. [DOI: 10.1111/bjd.18747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Polubothu S, McGuire N, Al‐Olabi L, Baird W, Bulstrode N, Chalker J, Josifova D, Lomas D, O'Hara J, Ong J, Rampling D, Stadnik P, Thomas A, Wedgeworth E, Sebire N, Kinsler V. Withdrawn:
基因是否重要?先天性黑素细胞痣的基因型‐表型与基因型结果的相关性. Br J Dermatol 2020. [DOI: 10.1111/bjd.18762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sharnam V, Husni D, Ong J, Ross F, Skarparis Y, Myagerimath S. P847 Echocardiographic imaging in primary cardiac tumour-leiomyosarcoma. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
N.A
Primary cardiac tumours are rare entities with an incidence rate of 0.0017% to 0.019% of which 25% are malignant. Leiomyosarcomas, a form of primary cardiac sarcoma, accounts for 8-9% of all the cardiac sarcomas (1). Primary cardiac sarcomas typically present late with either quite advanced local cardiac symptoms or non-specific symptoms arising from metastasis (2). We herein report a rare presentation of leiomyosarcoma in a sixty-seven year old female Caucasian female, originally suspected following transthoracic echocardiogram.
A large mass filling the Left Atrium(L.A) with a degree obstruction to the Mitral Valve (M.V) was firstly noted on transthoracic echocardiogram. This mass had a broad base, appeared to be originating from the pulmonary veins and was not encapsulated. A small circumferential pericardial effusion was noted. Overall biventricular function was preserved and there was no evidence of pulmonary hypertension. A contrast-enhanced computed tomography scan of the chest, abdomen and pelvis was performed for staging which in addition to known cardiac mass revealed widespread bony metastases. A core biopsy of one of the lumbar paravertebral metastatic deposit was carried out to establish the diagnosis.
We hope to add to the pool of increasing overall understanding of primary cardiac sarcomas and share our fascinating echocardiogram findings. In addition, we believe this case supports our recommendation for general practitioners in the United Kingdom to have open access to requesting echocardiograms in order to identify such aggressive cardiac malignancies at an earlier stage, with the hope to improve prognosis.
Abstract P847 Figure. Depicting LA mass occupying the whole of
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Affiliation(s)
- V Sharnam
- NHS Dumfries and Galloway, Dumfries, United Kingdom of Great Britain & Northern Ireland
| | - D Husni
- NHS Dumfries and Galloway, Dumfries, United Kingdom of Great Britain & Northern Ireland
| | - J Ong
- NHS Dumfries and Galloway, Dumfries, United Kingdom of Great Britain & Northern Ireland
| | - F Ross
- NHS Dumfries and Galloway, Dumfries, United Kingdom of Great Britain & Northern Ireland
| | - Y Skarparis
- Royal Victoria Infirmary, radiology, Newcastle upon Tyne, United Kingdom of Great Britain & Northern Ireland
| | - S Myagerimath
- NHS Dumfries and Galloway, Cardiology, Dumfries, United Kingdom of Great Britain & Northern Ireland
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Ong J, Faiz A, Timens W, van den Berge M, Terpstra MM, Kok K, van den Berg A, Kluiver J, Brandsma CA. Marked TGF-β-regulated miRNA expression changes in both COPD and control lung fibroblasts. Sci Rep 2019; 9:18214. [PMID: 31796837 PMCID: PMC6890791 DOI: 10.1038/s41598-019-54728-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 11/14/2019] [Indexed: 12/11/2022] Open
Abstract
COPD is associated with disturbed tissue repair, possibly due to TGF-β-regulated miRNA changes in fibroblasts. Our aim was to identify TGF-β-regulated miRNAs and their differential regulation and expression in COPD compared to control fibroblasts. Small RNA sequencing was performed on TGF-β-stimulated and unstimulated lung fibroblasts from 15 COPD patients and 15 controls. Linear regression was used to identify TGF-β-regulated and COPD-associated miRNAs. Interaction analysis was performed to compare miRNAs that responded differently to TGF-β in COPD and control. Re-analysis of previously generated Ago2-IP data and Enrichr were used to identify presence and function of potential target genes in the miRNA-targetome of lung fibroblasts. In total, 46 TGF-β-regulated miRNAs were identified in COPD and 86 in control fibroblasts (FDR < 0.05). MiR-27a-5p was the most significantly upregulated miRNA. MiR-148b-3p, miR-589-5p and miR-376b-3p responded differently to TGF-β in COPD compared to control (FDR < 0.25). MiR-660-5p was significantly upregulated in COPD compared to control (FDR < 0.05). Several predicted targets of miR-27a-5p, miR-148b-3p and miR-660-5p were present in the miRNA-targetome, and were mainly involved in the regulation of gene transcription. In conclusion, altered TGF-β-induced miRNA regulation and differential expression of miR-660-5p in COPD fibroblasts, may represent one of the mechanisms underlying aberrant tissue repair and remodelling in COPD.
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Affiliation(s)
- J Ong
- University of Groningen, University Medical Centre Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands.,University of Groningen, University Medical Centre Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | - A Faiz
- University of Groningen, University Medical Centre Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands.,University of Groningen, University Medical Centre Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands.,University of Technology Sydney, Respiratory Bioinformatics and Molecular Biology (RBMB) Faculty of Science, Ultimo, NSW, 2007, Australia
| | - W Timens
- University of Groningen, University Medical Centre Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands.,University of Groningen, University Medical Centre Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | - M van den Berge
- University of Groningen, University Medical Centre Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands.,University of Groningen, University Medical Centre Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - M M Terpstra
- University of Groningen, University Medical Centre Groningen, Department of Genetics, Groningen, The Netherlands
| | - K Kok
- University of Groningen, University Medical Centre Groningen, Department of Genetics, Groningen, The Netherlands
| | - A van den Berg
- University of Groningen, University Medical Centre Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
| | - J Kluiver
- University of Groningen, University Medical Centre Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
| | - C A Brandsma
- University of Groningen, University Medical Centre Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands. .,University of Groningen, University Medical Centre Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands.
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Polubothu S, McGuire N, Al-Olabi L, Baird W, Bulstrode N, Chalker J, Josifova D, Lomas D, O'Hara J, Ong J, Rampling D, Stadnik P, Thomas A, Wedgeworth E, Sebire NJ, Kinsler VA. Does the gene matter? Genotype-phenotype and genotype-outcome associations in congenital melanocytic naevi. Br J Dermatol 2019; 182:434-443. [PMID: 31111470 PMCID: PMC7028140 DOI: 10.1111/bjd.18106] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2019] [Indexed: 12/29/2022]
Abstract
Background Genotype–phenotype studies can identify subgroups of patients with specific clinical features or differing outcomes, which can help shape management. Objectives To characterize the frequency of different causative genotypes in congenital melanocytic naevi (CMN), and to investigate genotype–phenotype and genotype–outcome associations. Methods We conducted a large cohort study in which we undertook MC1R genotyping from blood, and high‐sensitivity genotyping of NRAS and BRAF hotspots in 156 naevus biopsies from 134 patients with CMN [male 40%; multiple CMN 76%; projected adult size (PAS) > 20 cm, 59%]. Results Mosaic NRAS mutations were detected in 68%, mutually exclusive with BRAF mutations in 7%, with double wild‐type in 25%. Two separate naevi were sequenced in five of seven patients with BRAF mutations, confirming clonality. Five of seven patients with BRAF mutations had a dramatic multinodular phenotype, with characteristic histology distinct from classical proliferative nodules. NRAS mutation was the commonest in all sizes of CMN, but was particularly common in naevi with PAS > 60 cm, implying more tolerance to that mutation early in embryogenesis. Facial features were less common in double wild‐type patients. Importantly, the incidence of congenital neurological disease, and apparently of melanoma, was not altered by genotype; no cases of melanoma were seen in BRAF‐mutant multiple CMN, however, this genotype is rare. Conclusions CMN of all sizes are most commonly caused by mutations in NRAS. BRAF is confirmed as a much rarer cause of multiple CMN, and appears to be commonly associated with a multinodular phenotype. Genotype in this cohort was not associated with differences in incidence of neurological disease in childhood. However, genotyping should be undertaken in suspected melanoma, for guidance of treatment. What's already known about this topic? Multiple congenital melanocytic naevi (CMN) have been shown to be caused by NRAS mosaic mutations in 70–80% of cases, by BRAF mosaicism in one case report and by inference in some previous cases. There has been debate about genotypic association with different sizes of CMN, and no data on genotype–outcome.
What does this study add? NRAS mosaicism was found in 68%, BRAF in 7% and double wild‐type in 25% of cases of CMN. NRAS was the commonest mutation in all sizes of CMN, but was nearly universal in projected adult size > 60 cm. BRAF is often associated with a distinct multinodular clinical/histological phenotype. Adverse outcomes did not differ between genotypes on current numbers.
https://doi.org/10.1111/bjd.18747 available online
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Affiliation(s)
- S Polubothu
- Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, U.K.,Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
| | - N McGuire
- Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, U.K
| | - L Al-Olabi
- Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, U.K
| | - W Baird
- Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, U.K
| | - N Bulstrode
- Paediatric Plastic Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
| | - J Chalker
- Paediatric Malignancy Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
| | - D Josifova
- Clinical Genetics, Guy's and St Thomas' Hospital NHS Foundation Trust, U.K
| | - D Lomas
- Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
| | - J O'Hara
- Paediatric Plastic Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
| | - J Ong
- Paediatric Plastic Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
| | - D Rampling
- Paediatric Pathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
| | - P Stadnik
- Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, U.K
| | - A Thomas
- Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, U.K
| | - E Wedgeworth
- Department of Dermatology, Guy's and St Thomas' Hospital NHS Foundation Trust, U.K
| | - N J Sebire
- Paediatric Pathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
| | - V A Kinsler
- Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, U.K.,Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
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Knoops P, Borghi A, Breakey R, Ong J, Jeelani N, Bruun R, Schievano S, Dunaway D, Padwa B. Three-dimensional soft tissue prediction in orthognathic surgery: a clinical comparison of Dolphin, ProPlan CMF, and probabilistic finite element modelling. Int J Oral Maxillofac Surg 2019; 48:511-518. [DOI: 10.1016/j.ijom.2018.10.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/08/2018] [Accepted: 10/12/2018] [Indexed: 11/26/2022]
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Rajarethinam J, Ong J, Lim SH, Tay YH, Bounliphone W, Chong CS, Yap G, Ng LC. Using Human Movement Data to Identify Potential Areas of Zika Transmission: Case Study of the Largest Zika Cluster in Singapore. Int J Environ Res Public Health 2019; 16:ijerph16050808. [PMID: 30841598 PMCID: PMC6427696 DOI: 10.3390/ijerph16050808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/22/2019] [Accepted: 03/01/2019] [Indexed: 12/28/2022]
Abstract
Singapore experienced its first Zika virus (ZIKV) cluster in August 2016. To understand the implication of human movement on disease spread, a retrospective study was conducted using aggregated and anonymized mobile phone data to examine movement from the cluster to identify areas of possible transmission. An origin–destination model was developed based on the movement of three groups of individuals: (i) construction workers, (ii) residents and (iii) visitors out of the cluster locality to other parts of the island. The odds ratio of ZIKV cases in a hexagon visited by an individual from the cluster, independent of the group of individuals, is 3.20 (95% CI: 2.65–3.87, p-value < 0.05), reflecting a higher count of ZIKV cases when there is a movement into a hexagon from the cluster locality. A comparison of independent ROC curves tested the statistical significance of the difference between the areas under the curves of the three groups of individuals. Visitors (difference in AUC = 0.119) and residents (difference in AUC = 0.124) have a significantly larger difference in area under the curve compared to the construction workers (p-value < 0.05). This study supports the proof of concept of using mobile phone data to approximate population movement, thus identifying areas at risk of disease transmission.
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Affiliation(s)
- Jayanthi Rajarethinam
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05-08, Singapore 138667, Singapore.
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05-08, Singapore 138667, Singapore.
| | - Shi-Hui Lim
- Starhub Limited, 67 Ubi Avenue 1, #05-01 StarHub Green, Singapore 408942, Singapore.
| | - Yu-Heng Tay
- Starhub Limited, 67 Ubi Avenue 1, #05-01 StarHub Green, Singapore 408942, Singapore.
| | - Wacha Bounliphone
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05-08, Singapore 138667, Singapore.
| | - Chee-Seng Chong
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05-08, Singapore 138667, Singapore.
| | - Grace Yap
- Environmental Public Health Operations, National Environment Agency, 40 Scotts Road, #13-00 Environment Building, Singapore 228231, Singapore.
| | - Lee-Ching Ng
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05-08, Singapore 138667, Singapore.
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore.
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Mondal A, Rodriguez-Florez N, O’Hara JL, Ong J, Jeelani N, Dunaway DJ, James G. WPI-13 Lack of association of cranial lacunae with intracranial hypertension in children with crouzon syndrome and apert syndrome: a 3D morphometric quantitative analysis. J Neurol Neurosurg Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectivesCranial lacunae on CT is equivalent to the plain X-ray ‘copper beating’ seen in craniosynostosis. Copper beating has not been shown to correlate to intracranial hypertension (IH). However it is a purely quantitative assessment – can qualitative measurement of CT cranial lacunae more accurately predict IH in children with craniosynostosis?DesignRetrospective cohort study.Subjects18 consecutive children with Crouzon and 17 with Apert syndrome were identified.MethodsPatients were divided into IH and non-IH groups defined on an intention to treat basis. 3D software was used to analyse% of calvarial lacunae.ResultsMean age at CT scan was 380 days (range 6–1778). Of the 35 children, 21 required surgery for raised ICP (17 posterior vault expansion 2 ventriculo-peritoneal shunts (VPS), 1 spring-assisted cranioplasty and 1 fronto-orbital advancement) at mean age of 512 days (range 38–1710). Of the 21 children with raised ICP, 15 had lacunae with mean lacuna/calvarium percentage of 3% (0%–28%). Of the 14 non-raised ICP children, 8 had lacunae with mean lacuna/calvarium percentage of 2% (0%–8%). T-test demonstrated no significant difference between the 2 groups. For both groups, parietal bones were most likely to show lacunae (IH 14/21, non-IH 9/14), followed by occipital (IH 8/21, non-IH 3/14), followed by frontal (IH 6/21, non-IH 2/14).ConclusionsResults suggest that cranial lacunae, measured using quantitative 3D methods, do not predict IH, in agreement with evidence from qualitative plain skull radiograph studies.
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Ong J, Liu X, Rajarethinam J, Yap G, Ho D, Ng LC. A novel entomological index, Aedes aegypti Breeding Percentage, reveals the geographical spread of the dengue vector in Singapore and serves as a spatial risk indicator for dengue. Parasit Vectors 2019; 12:17. [PMID: 30621762 PMCID: PMC6325748 DOI: 10.1186/s13071-018-3281-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/27/2018] [Indexed: 01/08/2023] Open
Abstract
Background Aedes aegypti is an efficient primary vector of dengue, and has a heterogeneous distribution in Singapore. Aedes albopictus, a poor vector of dengue, is native and ubiquitous on the island. Though dengue risk follows the dispersal of Ae. aegypti, the spatial distribution of the vector is often poorly characterized. Here, based on the ubiquitous presence of Ae. albopictus, we developed a novel entomological index, Ae. aegypti Breeding Percentage (BP), to demonstrate the expansion of Ae. aegypti into new territories that redefined the dengue burden map in Singapore. We also determined the thresholds of BP that render the specific area higher risk of dengue transmission. Methods We performed analysis of dengue fever incidence and Aedes mosquito breeding in Singapore by utilizing island-wide dengue cases and vector surveillance data from 2003 to 2013. The percentage of Ae. aegypti breeding among the total Aedes breeding habitats (BP), and the reported number of dengue fever cases in each year were calculated for each residential grid. Results The BP of grids, for every year over the 11-year study period, had a consistent positive correlation with the annual case counts. Our findings suggest that the geographical expansion of Ae. aegypti to previously “non-dengue” areas have contributed substantially to the recent dengue fever incidence in Singapore. Our analysis further indicated that non-endemic areas in Singapore are likely to be at risk of dengue fever outbreaks beyond an Ae. aegypti BP of 20%. Conclusions Our analyses indicate areas with increasing Ae. aegypti BP are likely to become more vulnerable to dengue outbreaks. We propose the usage of Ae. aegypti BP as a factor for spatial risk stratification of dengue fever in endemic countries. The Ae. aegypti BP could be recommended as an indicator for decision making in vector control efforts, and also be used to monitor the geographical expansion of Ae. aegypti. Electronic supplementary material The online version of this article (10.1186/s13071-018-3281-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Xu Liu
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | | | - Grace Yap
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Derek Ho
- Environmental Public Health Operations, National Environment Agency, Singapore, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore, Singapore. .,School of Biological Sciences, Nanyang Technological University, Singapore, Singapore.
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Lee WQ, Tan VKM, Choo HMC, Ong J, Krishnapriya R, Khong S, Tan M, Sim YR, Tan BK, Madhukumar P, Yong WS, Ong KW. Factors influencing patient decision-making between simple mastectomy and surgical alternatives. BJS Open 2018; 3:31-37. [PMID: 30734013 PMCID: PMC6354187 DOI: 10.1002/bjs5.50105] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/21/2018] [Indexed: 11/20/2022] Open
Abstract
Background Despite similar survival rates, breast‐conserving therapy (BCT) remains a distant second choice after simple mastectomy for patients with early‐stage breast cancer in Singapore. Uptake of reconstruction after mastectomy is also low (18 per cent). The aim of this study was to explore the factors influencing a patient's choice for mastectomy when eligible for BCT, and why patients decline reconstruction after mastectomy. Methods Patients from the National Cancer Centre Singapore, who were eligible for BCT but chose mastectomy without reconstruction, between December 2014 and December 2015 were included. An interviewer‐administered questionnaire focusing on patients' reasons for choosing mastectomy over BCT and not opting for immediate breast reconstruction after mastectomy was used. Tumour characteristics were retrieved from medical records. Spearman's rank correlation coefficient, Mann–Whitney U and Kruskal–Wallis tests were used to analyse the correlation between the patient's self‐rated influential factors and variables. Statistical significance was taken as P < 0·050. Results Ninety‐one patients were included (90·1 per cent response rate). The main reasons for choosing mastectomy over BCT were: fear of cancer recurrence (considered very important in 74 per cent), the perception that health outweighs breast retention (49 per cent) and the possibility of second surgery for margins (40 per cent). Key factors for rejecting immediate reconstruction after mastectomy were: patient‐perceived ‘old age’ (very important in 53 per cent), concern about two sites of surgery (42 per cent) and financial cost (29 per cent). Given a second chance, 19·8 per cent of patients would undergo BCT instead of mastectomy. Conclusion This study has identified the considerations that women in Singapore have when deciding on breast cancer surgery. Some perceptions need to be addressed for women to make a fully informed decision, especially as one‐fifth regret their initial choice.
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Affiliation(s)
- W Q Lee
- Yong Loo Lin School of Medicine National University of Singapore Singapore
| | - V K M Tan
- Division of Surgical Oncology National Cancer Centre Singapore Singapore.,Singhealth Duke-NUS Breast Centre National Cancer Centre Singapore Singapore
| | - H M C Choo
- Yong Loo Lin School of Medicine National University of Singapore Singapore
| | - J Ong
- Yong Loo Lin School of Medicine National University of Singapore Singapore
| | - R Krishnapriya
- Yong Loo Lin School of Medicine National University of Singapore Singapore
| | - S Khong
- Division of Surgical Oncology National Cancer Centre Singapore Singapore
| | - M Tan
- Division of Surgical Oncology National Cancer Centre Singapore Singapore
| | - Y R Sim
- Division of Surgical Oncology National Cancer Centre Singapore Singapore
| | - B K Tan
- Singhealth Duke-NUS Breast Centre National Cancer Centre Singapore Singapore.,Department of General Surgery Singapore General Hospital Singapore
| | - P Madhukumar
- Division of Surgical Oncology National Cancer Centre Singapore Singapore.,Singhealth Duke-NUS Breast Centre National Cancer Centre Singapore Singapore
| | - W S Yong
- Division of Surgical Oncology National Cancer Centre Singapore Singapore.,Singhealth Duke-NUS Breast Centre National Cancer Centre Singapore Singapore
| | - K W Ong
- Division of Surgical Oncology National Cancer Centre Singapore Singapore.,Singhealth Duke-NUS Breast Centre National Cancer Centre Singapore Singapore
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Koo C, Tien WP, Xu H, Ong J, Rajarethinam J, Lai YL, Ng LC, Hapuarachchi HC. Highly Selective Transmission Success of Dengue Virus Type 1 Lineages in a Dynamic Virus Population: An Evolutionary and Fitness Perspective. iScience 2018; 6:38-51. [PMID: 30240624 PMCID: PMC6137288 DOI: 10.1016/j.isci.2018.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 06/19/2018] [Accepted: 07/13/2018] [Indexed: 11/30/2022] Open
Abstract
Arbovirus transmission is modulated by host, vector, virus, and environmental factors. Even though viral fitness plays a salient role in host and vector adaptation, the transmission success of individual strains in a heterogeneous population may be stochastic. Our large-scale molecular epidemiological analyses of a dengue virus type 1 population revealed that only a subset of strains (16.7%; n = 6) were able to sustain transmission, despite the population being widely dispersed, dynamic, and heterogeneous. The overall dominance was variable even among the “established” lineages, albeit sharing comparable evolutionary characteristics and replication profiles. These findings indicated that virological parameters alone were unlikely to have a profound effect on the survival of viral lineages, suggesting an important role for non-viral factors in the transmission success of lineages. Our observations, therefore, emphasize the strategic importance of a holistic understanding of vector, human host, and viral factors in the control of vector-borne diseases. The sustained transmission of dengue virus 1 lineages is highly selective The overall dominance is variable even among the “established” lineages The lineage dominance is not merely determined by virus evolution and fitness The non-viral factors play an important role in the survival of virus lineages
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Affiliation(s)
- Carmen Koo
- Environmental Health Institute, National Environment Agency, 11, Biopolis Way, #06-05-08, Singapore 138667, Singapore
| | - Wei Ping Tien
- Environmental Health Institute, National Environment Agency, 11, Biopolis Way, #06-05-08, Singapore 138667, Singapore
| | - Helen Xu
- Environmental Health Institute, National Environment Agency, 11, Biopolis Way, #06-05-08, Singapore 138667, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, 11, Biopolis Way, #06-05-08, Singapore 138667, Singapore
| | - Jayanthi Rajarethinam
- Environmental Health Institute, National Environment Agency, 11, Biopolis Way, #06-05-08, Singapore 138667, Singapore
| | - Yee Ling Lai
- Environmental Health Institute, National Environment Agency, 11, Biopolis Way, #06-05-08, Singapore 138667, Singapore
| | - Lee-Ching Ng
- Environmental Health Institute, National Environment Agency, 11, Biopolis Way, #06-05-08, Singapore 138667, Singapore; School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore
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Ong J, Liu X, Rajarethinam J, Kok SY, Liang S, Tang CS, Cook AR, Ng LC, Yap G. Mapping dengue risk in Singapore using Random Forest. PLoS Negl Trop Dis 2018; 12:e0006587. [PMID: 29912940 PMCID: PMC6023234 DOI: 10.1371/journal.pntd.0006587] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 06/28/2018] [Accepted: 06/06/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Singapore experiences endemic dengue, with 2013 being the largest outbreak year known to date, culminating in 22,170 cases. Given the limited resources available, and that vector control is the key approach for prevention in Singapore, it is important that public health professionals know where resources should be invested in. This study aims to stratify the spatial risk of dengue transmission in Singapore for effective deployment of resources. METHODOLOGY/PRINCIPAL FINDINGS Random Forest was used to predict the risk rank of dengue transmission in 1km2 grids, with dengue, population, entomological and environmental data. The predicted risk ranks are categorized and mapped to four color-coded risk groups for easy operation application. The risk maps were evaluated with dengue case and cluster data. Risk maps produced by Random Forest have high accuracy. More than 80% of the observed risk ranks fell within the 80% prediction interval. The observed and predicted risk ranks were highly correlated ([Formula: see text]≥0.86, P <0.01). Furthermore, the predicted risk levels were in excellent agreement with case density, a weighted Kappa coefficient of more than 0.80 (P <0.01). Close to 90% of the dengue clusters occur in high risk areas, and the odds of cluster forming in high risk areas were higher than in low risk areas. CONCLUSIONS This study demonstrates the potential of Random Forest and its strong predictive capability in stratifying the spatial risk of dengue transmission in Singapore. Dengue risk map produced using Random Forest has high accuracy, and is a good surveillance tool to guide vector control operations.
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Affiliation(s)
- Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore
| | - Xu Liu
- Environmental Health Institute, National Environment Agency, Singapore
| | | | - Suet Yheng Kok
- Environmental Health Institute, National Environment Agency, Singapore
| | - Shaohong Liang
- Environmental Health Institute, National Environment Agency, Singapore
| | - Choon Siang Tang
- Environmental Public Health Operations, National Environment Agency, Singapore
| | - Alex R. Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
| | - Grace Yap
- Environmental Health Institute, National Environment Agency, Singapore
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Ong J, Liu X, Rajarethinam J, Kok SY, Liang S, Tang CS, Cook AR, Ng LC, Yap G. Mapping dengue risk in Singapore using Random Forest. PLoS Negl Trop Dis 2018; 12:e0006587. [PMID: 29912940 DOI: 10.1371/journal.pntd.000658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 06/28/2018] [Accepted: 06/06/2018] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Singapore experiences endemic dengue, with 2013 being the largest outbreak year known to date, culminating in 22,170 cases. Given the limited resources available, and that vector control is the key approach for prevention in Singapore, it is important that public health professionals know where resources should be invested in. This study aims to stratify the spatial risk of dengue transmission in Singapore for effective deployment of resources. METHODOLOGY/PRINCIPAL FINDINGS Random Forest was used to predict the risk rank of dengue transmission in 1km2 grids, with dengue, population, entomological and environmental data. The predicted risk ranks are categorized and mapped to four color-coded risk groups for easy operation application. The risk maps were evaluated with dengue case and cluster data. Risk maps produced by Random Forest have high accuracy. More than 80% of the observed risk ranks fell within the 80% prediction interval. The observed and predicted risk ranks were highly correlated ([Formula: see text]≥0.86, P <0.01). Furthermore, the predicted risk levels were in excellent agreement with case density, a weighted Kappa coefficient of more than 0.80 (P <0.01). Close to 90% of the dengue clusters occur in high risk areas, and the odds of cluster forming in high risk areas were higher than in low risk areas. CONCLUSIONS This study demonstrates the potential of Random Forest and its strong predictive capability in stratifying the spatial risk of dengue transmission in Singapore. Dengue risk map produced using Random Forest has high accuracy, and is a good surveillance tool to guide vector control operations.
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Affiliation(s)
- Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore
| | - Xu Liu
- Environmental Health Institute, National Environment Agency, Singapore
| | | | - Suet Yheng Kok
- Environmental Health Institute, National Environment Agency, Singapore
| | - Shaohong Liang
- Environmental Health Institute, National Environment Agency, Singapore
| | - Choon Siang Tang
- Environmental Public Health Operations, National Environment Agency, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
| | - Grace Yap
- Environmental Health Institute, National Environment Agency, Singapore
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Rajarethinam J, Ang LW, Ong J, Ycasas J, Hapuarachchi HC, Yap G, Chong CS, Lai YL, Cutter J, Ho D, Lee V, Ng LC. Dengue in Singapore from 2004 to 2016: Cyclical Epidemic Patterns Dominated by Serotypes 1 and 2. Am J Trop Med Hyg 2018; 99:204-210. [PMID: 29848407 PMCID: PMC6085773 DOI: 10.4269/ajtmh.17-0819] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Singapore has experienced periodic dengue epidemics despite maintaining a low Aedes house index. Each epidemic was associated with a switch in the predominant serotype. We investigated the temporal dynamics of dengue fever and dengue virus (DENV) and analyzed the epidemiological and entomological patterns of dengue in Singapore from 2004 to 2016. The case surveillance is based on a mandatory notification system that requires all medical practitioners to report clinically suspected and laboratory-confirmed cases. Circulating (DENV) serotypes are monitored through a virus surveillance program. Entomological surveillance involves inspections for larval breeding and monitoring of adults using gravitraps. Singapore experienced a similar epidemic pattern during 2004–2007 and 2013–2016. The pattern involved a 2-year DENV-1 epidemic occurring after a switch in the predominant serotype from DENV-2 to DENV-1, followed by a “lull” year. Thereafter, the predominant serotype switched back to DENV-2, tailed by a small-scale epidemic. Across the years, the highest incidence group was in the 25–44 years age group. The incidence rate of those aged ≥ 55 years was about half of that of the 15–24 years age group during DENV-1 predominant years. However, it was almost equal to the younger age group in DENV-2 predominant years. Types of Aedes aegypti breeding habitats remained similar. Dengue incidence was significantly higher in areas with high breeding percentage (BP) than areas with low BP (P < 0.05). In conclusion, the oscillation of DENV-1 and DENV-2, throughout the 13-year period, led to a cyclical epidemic pattern and older adults were more affected by DENV-2 than DENV-1.
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Affiliation(s)
| | - Li-Wei Ang
- Public Health Group, Ministry of Health, Singapore, Singapore
| | - Janet Ong
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Joyce Ycasas
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | | | - Grace Yap
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Chee-Seng Chong
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Yee-Ling Lai
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Jeffery Cutter
- Public Health Group, Ministry of Health, Singapore, Singapore
| | - Derek Ho
- Environmental Public Health Division, National Environment Agency, Singapore, Singapore
| | - Vernon Lee
- Public Health Group, Ministry of Health, Singapore, Singapore
| | - Lee-Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore, Singapore.,School of Biological Sciences, Nanyang Technological University, Singapore
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Affiliation(s)
- L M Trotti
- Emory University School of Medicine, Atlanta, GA
| | - J Ong
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - D Plante
- University of Wisconsin-Madison, Madison, WI
| | - D Powell
- Hypersomnia Foundation, Atlanta, GA
| | - D L Bliwise
- Emory University School of Medicine, Atlanta, GA
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Knutson K, Ong J, von Schantz M. 0271 Sleep Disturbances Associated with Increased Risk of Mortality: UK Biobank Study. Sleep 2018. [DOI: 10.1093/sleep/zsy061.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Knutson
- Northwestern University, Chicago, IL
| | - J Ong
- Northwestern University, Chicago, IL
| | - M von Schantz
- Faculty of Health and Medical Science, University of Surrey, Guildford, UNITED KINGDOM
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Ong J, Plueckhahn I, Cruickshank D, Churilov L, Mileshkin L. A smoking cessation programme for current and recent ex-smokers following diagnosis of a potentially curable cancer. Intern Med J 2017; 46:1089-96. [PMID: 27389637 DOI: 10.1111/imj.13172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/27/2016] [Accepted: 06/27/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cancer patients who quit smoking have improved survival rates. The time of diagnosis provides a 'teachable moment' when healthcare providers can offer smoking-cessation treatment. AIMS To assess the impact on quit rates of a tailored smoking-cessation intervention for patients diagnosed with a potentially curable cancer. METHODS A prospective, one-arm cohort study of current smokers and recent quitters (<30 days) who had commenced treatment for a potentially curable cancer was performed. Intervention involved an initial motivational interview, regular follow up and pharmacotherapy when appropriate. Quit rates were measured at 1, 3, 6 and 12 months by self-reported abstinence and biochemical confirmation. The primary end point was prolonged abstinence at 12 months. Changes in quality of life parameters and distress were also assessed. RESULTS Seventy-one patients were recruited, with a median age of 56 years. Forty-one patients (58%) had a smoking-related cancer. The prolonged abstinence rate at 12 months was 24% (95% confidence interval 14-36%). Factors associated with successful quitting included being in the preparation or action phase of readiness to change at study entry (P = 0.012) and having complications of treatment requiring hospitalisation (P = 0.024). Between baseline and 12 months, quitters reported improvement in self-control (P < 0.001) and reduced levels of distress (P = 0.03) compared to non-quitters. CONCLUSION Patients who continue to smoke after being diagnosed with cancer require intensive support to quit. An individualised behavioural and pharmacological intervention can be successful in helping patients quit smoking, with quality of life improvements seen amongst successful quitters. Population measures to stop people starting smoking remain essential.
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Affiliation(s)
- J Ong
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
| | - I Plueckhahn
- Department of Cancer Experiences Research,, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - D Cruickshank
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - L Churilov
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - L Mileshkin
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Cancer Experiences Research,, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Tucker JD, Ong J, Conserve D, Pan S, Tang W. Scaling up HIV self-testing in China and Africa. J Virus Erad 2017; 3:167. [PMID: 28758026 PMCID: PMC5518247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Joseph D Tucker
- Corresponding author: Joseph D Tucker,
University of North Carolina at Chapel Hill Project-ChinaNumber 2 Lujing Road,
Guangzhou,
China,
510095
| | - J Ong
- University of North Carolina at Chapel Hill Project-China,
Guangzhou,
China,London School of Hygiene and Tropical Medicine,
UK
| | - D Conserve
- Arnold School of Public Health,
Columbia, SC,
USA
| | - S Pan
- University of North Carolina at Chapel Hill Project-China,
Guangzhou,
China,University of North Carolina at Chapel Hill, Institute of Global Health and Infectious Diseases,
USA
| | - W Tang
- University of North Carolina at Chapel Hill Project-China,
Guangzhou,
China,University of North Carolina at Chapel Hill, Institute of Global Health and Infectious Diseases,
USA
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