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Under-Treatment and Poorer Survival Outcomes in Elderly Breast Cancer Patients in Singapore: A Comparison with Younger Patients in a Tertiary Institution

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Journal of Cancer Therapy 2018年第5期9卷 402-416页

作者： Chi Wei Mok siew kuan lim Su-Ming Tan Division of Breast Surgery Department of General Surgery Changi General Hospital Singapore

Introduction: The numbers of elderly patients with breast cancers are increasing with an ageing population, yet clinical research on these patients is still lacking. This study aims to examine the differences between elderly patients and their younger counterparts, with a view to optimize management plans for the former. Methods: Patients ≥ 40 years old with histologically proven breast cancer between 1991 and 2008 were identified from our database, and grouped according to age for analyses: old elderly (≥75 years), young elderly (65 to 74 years) and young (40 to 64 years). Clinicopathologic characteristics, treatment and survival rates were compared across the 3 groups. Results: There were 103 (11.53%) old elderly, 147 (16.5%) young elderly and 643 (72.0%) young patients. The 2 elderly groups presented at later stages, received less adjuvant or palliative chemotherapy (P < 0.001), and less adjuvant radiotherapy (P < 0.001), compared to the younger patients. Both breast cancer specific survival (CSS) and overall survival (OS) in the old elderly (CSS: 64.7% (95% confidence interval [CI]: 53.4% - 73.8%), OS: 46.4% (95% CI: 35.6% - 56.4%)) and young elderly group (CSS: 82.4% (95% CI: 74.4% - 88.0%) OS: 78.6% (95% CI: 70.4% - 84.8%)) were lower than the young patient group (CSS: 84.9% (95% CI: 81.6% - 87.7%), OS: 83.4% (95% CI: 80.0% - 86.3%)) at 5 years. Conclusion: Our findings showed that clinicopathologic characteristics of elderly breast cancer patients differed from their younger counterparts. Poorer survival outcomes among our elderly patients may be the result of their under-treatment.

关键词： Elderly Breast Cancer Under-Treatment Survival Outcome

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Cardiovascular health awareness,risk perception,behavioural intention and INTERHEART risk stratification among middle-aged adults in Malaysia

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Asian Pacific Journal of Tropical Medicine 2024年第2期17卷 61-70页

作者： siew-Keah Lee Ang-lim Chua Clement Heng Yew Fong Ban Hao Brian Cong Wen Ling Ng Jing Feng Kong Yik-Ling Chew Kai Bin Liew Yang Shao M.Kandiah Faculty of Medicine and Health Sciences Universiti Tunku Abdul RahmanMalaysia Faculty of Medicine Universiti Teknologi MARAMalaysia Faculty of Pharmaceutical Sciences UCSI UniversityMalaysia Faculty of Pharmacy University of CyberjayaMalaysia The First Affiliated Hospital of Hainan Medical University China

Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in ***:A cross-sectional survey with convenience sampling was conducted during November 2022 and January *** completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final *** were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent ***:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural ***,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting car

关键词： Cardiovascular risk Knowledge Risk perception Behavioural intention INTERHEART Middle-aged Lifestyle Physical activity Psychosocial stress

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基于大语言模型的糖尿病管理:潜力与展望

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Science Bulletin 2024年第5期69卷 583-588页

作者：盛斌管洲榆 Lee-Ling lim 江泽铧 Nestoras Mathioudakis 李佳佳刘茹涵包玉倩 Yong Mong Bee 王亚星郑颖丰 Gavin siew Wei Tan 纪宏伟 Josip Car 王海波 David C.Klonoff 李华婷覃宇宗黄天荫贾伟平 Shanghai International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases Department of Computer Science and EngineeringSchool of ElectronicInformationand Electrical EngineeringShanghai Jiao Tong UniversityDepartment of Endocrinology and MetabolismShanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai Diabetes InstituteShanghai Clinical Center for DiabetesShanghai 200240China MOE Key Laboratory of Artificial Intelligence Artificial Intelligence InstituteShanghai Jiao Tong UniversityShanghai 200240China Department of Medicine Faculty of MedicineUniversity of MalayaKuala Lumpur 50603Malaysia Department of Medicine and Therapeutics The Chinese University of Hong KongHong KongChina Asia Diabetes Foundation Hong KongChina Tsinghua Medicine of Tsinghua University Beijing 100084China School of Clinical Medicine Beijing Tsinghua Changgung HospitalBeijing 102218China Division of Endocrinology Diabetes&MetabolismJohns Hopkins University School of MedicineBaltimoreMD 21211USA Department of Endocrinology Singapore General HospitalSingapore 169608Singapore Beijing Institute of Ophthalmology Beijing Tongren HospitalCapital University of Medical ScienceBeijing Ophthalmology and Visual Sciences Key LaboratoryBeijing 100730China State Key Laboratory of Ophthalmology Zhongshan Ophthalmic CenterSun Yat-sen UniversityGuangdong Provincial Key Laboratory of Ophthalmology and Visual ScienceGuangzhou 510060China Singapore Eye Research Institute Singapore National Eye CentreSingapore 168751Singapore Department of Cardiology the Affiliated Hospital of Qingdao UniversityQingdao 266011China Centre for Population Health Sciences Lee Kong Chian School of MedicineNanyang Technological University SingaporeSingapore 639798Singapore Department of Primary Care and Public Health School of Public HealthImperial College LondonLondon SW72BUUK Clinical Trial Unit Research Centre of Big Data and Artificial Intelligence in Medicine

The increasing prevalence of diabetes has become a global public health concern in the 21st *** 2021,it was estimated that 537 million people had diabetes,and this number is projected to reach 643 million by 2030,and 783 million by 2045[1].Such a huge burden of diabetes brings great challenges in its prevention and management,including early diagnosis,timely interventions,and regular monitoring of risk factor control and complications *** self-care support and patient empowerment can enhance clinical and psychobehavioural outcomes[2],although these require additional resources including manpower,infrastructure(hard and technology),and *** emergence of digital health technologies(DHTs),especially artificial intelligence(AI),may help address these obstacles and alleviate the burden of diabetes[3].Large language models(LLMs),a generative AI that can accept image and text inputs and produce text outputs,have shown promise in various aspects of medical care.

关键词： prevention diagnosis finance

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Transcriptome analysis creates a new era of precision medicine for managing recurrent hepatocellular carcinoma

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World Journal of Gastroenterology 2023年第5期29卷 780-799页

作者： Chun-Cheng Chiang Hsuan Yeh siew-Na lim Wey-Ran Lin UPMC Hillman Cancer Center University of PittsburghPittsburghPA 15232United States School of Medicine University of PittsburghPittsburghPA 15213United States Department of Neurology Linkou Chang Gung Memorial HospitalTaoyuan 333Taiwan College of Medicine Chang Gung UniversityTaoyuan 333Taiwan

The high incidence of hepatocellular carcinoma(HCC)recurrence negatively impacts outcomes of patients treated with curative intent despite advances in surgical techniques and other locoregional liver-targeting *** the past few decades,the emergence of transcriptome analysis tools,including real-time quantitative reverse transcription PCR,microarrays,and RNA sequencing,has not only largely contributed to our knowledge about the pathogenesis of recurrent HCC but also led to the development of outcome prediction models based on differentially expressed gene *** recent years,the single-cell RNA sequencing technique has revolutionized our ability to study the complicated crosstalk between cancer cells and the immune environment,which may benefit further investigations on the role of different immune cells in HCC recurrence and the identification of potential therapeutic *** the present article,we summarized the major findings yielded with these transcriptome methods within the framework of a causal model consisting of three domains:primary cancer cells;carcinogenic stimuli;and tumor *** provided a comprehensive review of the insights that transcriptome analyses have provided into diagnostics,surveillance,and treatment of HCC recurrence.

关键词： Recurrent hepatocellular carcinoma Microarrays RNA sequencing Singlecell RNA sequencing Precision medicine Tumor heterogeneity Tumor microenvironment

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Bioenergetic alteration in gastrointestinal cancers:The good,the bad and the ugly

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World Journal of Gastroenterology 2023年第29期29卷 4499-4527页

作者： Yu-De Chu Chun-Wei Chen Ming-Wei Lai siew-Na lim Wey-Ran Lin Liver Research Center Linkou Chang Gung Memorial HospitalTaoyuan 333TaiwanChina Department of Gastroenterology and Hepatology Linkou Chang Gung Memorial HospitalTaoyuan 333TaiwanChina Department of Pediatrics Linkou Chang Gung Memorial HospitalTaoyuan 333TaiwanChina Department of Neurology Linkou Chang Gung Memorial HospitalTaoyuan 333TaiwanChina Department of Medicine Chang Gung UniversityTaoyuan 333TaiwanChina

Cancer cells exhibit metabolic reprogramming and bioenergetic alteration,utilizing glucose fermentation for energy production,known as the Warburg ***,there are a lack of comprehensive reviews summarizing the metabolic reprogramming,bioenergetic alteration,and their oncogenetic links in gastrointestinal(GI)***,the efficacy and treatment potential of emerging anticancer drugs targeting these alterations in GI cancers require further *** review highlights the interplay between aerobic glycolysis,the tricarboxylic acid(TCA)cycle,and oxidative phosphorylation(OXPHOS)in cancer cells,as well as hypotheses on the molecular mechanisms that trigger this *** role of hypoxia-inducible transcription factors,tumor suppressors,and the oncogenetic link between hypoxia-related enzymes,bioenergetic changes,and GI cancer are also *** review emphasizes the potential of targeting bioenergetic regulators for anti-cancer therapy,particularly for GI *** the potential of targeting bioenergetic regulators for GI cancer therapy,the review categorizes these regulators into aerobic glycolysis/lactate biosynthesis/transportation and TCA cycle/coupled *** also detail various anti-cancer drugs and strategies that have produced pre-clinical and/or clinical evidence in treating GI cancers,as well as the challenges posed by these *** we highlight that understanding dysregulated cancer cell bioenergetics is critical for effective treatments,although the diverse metabolic patterns present challenges for targeted *** research is needed to comprehend the specific mechanisms of inhibiting bioenergetic enzymes,address side effects,and leverage high-throughput multi-omics and spatial omics to gain insights into cancer cell heterogeneity for targeted bioenergetic therapies.

关键词： Energy metabolism Mitochondria Hypoxia Oxidative phosphorylation Glycolysis Gastrointestinal neoplasms

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Awareness and perceived barriers in practicing healthy living to prevent hypertension among young adults in Malaysia

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Asian Pacific Journal of Tropical Medicine 2022年第12期15卷 542-550页

作者： Lee siew-Keah Kang Waye Hann Shun Kah Hoe Lai Rui En lim Boon Chin Master Manfai Sae Chan Tee Zhi Kang Chua Ang-lim M.Kandiah Faculty of Medicine and Health Sciences Universiti Tunku Abdul RahmanMalaysia Faculty of Medicine Universiti Teknologi MARAMalaysia

Objective:To investigate the knowledge,attitude,and practice levels and perceived barriers towards healthy living to prevent hypertension among young adults in ***:Adults aged 18-25 years reside in Malaysia were recruited via convenience *** characteristics,medical knowledge on hypertension(K1),knowledge(K),attitude(A),practice(P)and perceived barriers in practising healthy living to prevent hypertension were *** scores were categorised into good(80%-100%),upper-moderate(70%-79%),lower-moderate(60%-69%)and poor(<60%).Multivariate analysis was performed to test the difference and relationship of *** correlation test was used to test the association of two continuous ***:A total of 1218 respondents participated in this *** mean score of K1 was 54.1%,while the knowledge,attitude,and practice towards healthy living were 82.7%,78.2%and 68.5%*** prevalence of high salt intake,high fat intakes,low fibre intake,sedentary lifestyle and lack of annual health screening was 83.2%,81.4%,70.3%,and 73.2%,*** BMI was associated with low P scores,while lower socio-economic status,unawareness of self-blood pressure reading and those without family history of hypertension were associated with lower scores in K1,K,A,and P.K1,K,A and P are significantly *** main perceived barriers included self-proclaimed good fit status,frequent consumption of out-of-home food,and addiction to high salt/fat ***:The national strategies for health management should be prioritized in reducing salt and fat,promoting annual health screening,physical activities and fibre intake in this age group.

关键词： Healthy living Physical activity Salt restriction Dietary Hypertension Malaysia Young adults

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Indocyanine green dye and its application in gastrointestinal surgery:The future is bright green

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世界胃肠外科杂志:英文版(电子版) 2023年第9期15卷 1841-1857页

作者： Zavier Yongxuan lim Swetha Mohan Sunder Balasubramaniam Saleem Ahmed Caroline Ching Hsia siew Vishal G Shelat Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore 308232Singapore Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore

Indocyanine green(ICG)is a water-soluble fluorescent dye that is minimally toxic and widely used in gastrointestinal *** facilitates anatomical identi-fication of structures(e.g.,ureters),assessment of lymph nodes,biliary mapping,organ perfusion and anastomosis assessment,and aids in determining the adequacy of oncological *** addition,ICG can be conjugated to artificially created antibodies for tumour markers,such as carcinoembryonic antigen for colorectal,breast,lung,and gastric cancer,prostate-specific antigen for prostate cancer,and cancer antigen 125 for ovarian *** ICG has shown promising results,the optimization of patient factors,dye factors,equipment,and the method of assessing fluorescence intensity could further enhance its *** review summarizes the clinical application of ICG in gastrointestinal surgery and discusses the emergence of novel dyes such as ZW-800 and VM678 that have demonstrated appropriate pharmacokinetic properties and improved target-to-background ratios in animal *** the emergence of robotic technology and the increasing reporting of ICG utility,a comprehensive review of clinical application of ICG in gastrointestinal surgery is timely and this review serves that aim.

关键词： Fluorescence imaging Gastrointestinal surgery Indocyanine green

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Pulse oximeter as a home assessment tool:Knowledge and user experience among the community in Malaysia during the COVID-19 pandemic

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Asian Pacific Journal of Tropical Medicine 2022年第5期15卷 213-219页

作者： siew-Keah Lee Jin Wei Ma Khai Ying Chan Yi Song Cheong Wan Ting Hong Regine Chew Yi Ong Wei Cheng Tay Ang-lim Chua Faculty of Medicine and Health Sciences Universiti Tunku Abdul RahmanMalaysia Faculty of Medicine Universiti Teknologi MARAMalaysia

Objective:To determine the degree of knowledge in the usage of pulse oximeter as a home assessment tool among the community in ***:A cross-sectional survey was conducted in November *** questionnaire assessed the knowledge in using pulse oximeters,user experience and opinions in using pulse oximeter as a home assessment tool during the ***:A total of 504 respondents were included in the study,and the mean score in knowledge related to application of pulse oximetry was 73.00%,while the mean score in knowledge related to factors affecting pulse oximetry readings was only 38.51%.A total of 90.5% of the respondents recognised normal pulse rate and 88.5% knew the blood oxygen saturation levels of a healthy adult,while 69.4% recognised the definition of silent *** addition,the majority of the respondents agreed that factors such as poor blood circulation(71.2%),excessive movements(69.8%),and hand position(60.7%)affected oximetry ***,61.7%,81.7%,77.2% and 76.8% of the respondents could not identify nail polish,skin colour,skin thickness and tattoos as factors that may affect oximetry readings ***:The respondents showed a satisfactory level of knowledge related to application of pulse oximetry,but a poor level of knowledge related to factors affecting pulse oximetry readings among the community in *** efforts in educating the community on the correct use of pulse oximeters are crucial for appropriate home assessment and avoiding unnecessary stress.

关键词： COVID-19 Pulse oximetry SpO2 Home assessment tool Silent hypoxia

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Transparent flexible thin-film p-n junction thermoelectric module

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npj Flexible Electronics 2020年第1期4卷 169-177页

作者： Xizu Wang Ady Suwardi siew Lay lim Fengxia Wei Jianwei Xu Institute of Materials Research and Engineering(IMRE) Agency for ScienceTechnology and Research(A*STAR)#08-03Fusionopolis WayInnovisSingapore138634Singapore Department of Chemistry National University of Singapore3 Science Drive 3Singapore117543Singapore

Transparent and flexible thermoelectrics has been highly sought after for future wearable ***,the main stumbling block to prevent its widespread adoption is the lack of p-type transparent thermoelectrics and the stringent criteria of electrical and thermal properties matching appropriately between p-legs and *** work demonstrates the fabrication of p-type PEDOT:PSS films whose optical properties,electrical conductivity,thermal conductivity,and Seebeck coefficient were engineered to perfectly match the n-type indium tin oxide(ITO)*** dense p-type PEDOT:PSS and n-type ITO thin films show a thermoelectric figure of merit of zT=0.30 and 0.29 at 450 K,and a thermal conductivity of 0.22 and 0.32 W m^(−1) K^(−1),respectively.A flexible thermoelectric generator(TEG)module with a high transmittance of>81%in the visible wavelength range of 400-800 nm is fabricated using 10 pairs of p-type PEDOT:PSS and n-type ITO thin film *** ultra-high power density of 22.2 W m^(−2) at a temperature gradient of 80 K was observed,which is the highest power density reported for organic/hybrid-based flexible TEGs so *** transparent flexible thin-film p-n junction thermoelectric module with exceptionally high power generation may take a tremendous step forward towards multi-functional wearable devices.

关键词： film transparent exceptional

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Metabolic and physiological regulation of Chlorella sp.(Trebouxiophyceae, Chlorophyta) under nitrogen deprivation

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Journal of Oceanology and limnology 2019年第1期37卷 186-198页

作者： YONG Wai-kuan lim Phaik-Eem VELLO Vejeysri SIM Kae-Shin ABDUL MAJID Nazia MUSTAFA Emienour Muzalina NIK SULAIMAN Nik Meriam LIEW Kan-Ern CHEN Brenna Jia-Tian PHANG siew-Moi Institute of Ocean and Earth Sciences University of Malaya Institute of Graduate Studies University of Malaya Institute of Biological Sciences Faculty of Science University of Malaya School of Fisheries and Aquaculture Sciences University of Malaysia Department of Chemical Engineering Faculty of Engineering University of Malaya Airbus Group Malaysia Menara HLA Aerospace Malaysia Innovation Centre

A freshwater green microalgae Chlorella sp., UMACC344 was shown to produce high lipid content and has the potential to be used as feedstock for biofuel production. In this study, photosynthetic effciency, biochemical pro?les and non-targeted metabolic pro?ling were studied to compare between the nitrogen-replete and deplete conditions. Slowed growth, change in photosynthetic pigments and lowered photosynthetic effciency were observed in response to nitrogen deprivation. Biochemical pro?les of the cultures showed an increased level of carbohydrate, lipids and total fatty acids, while the total soluble protein content was lowered. A trend of fatty acid saturation was observed in the nitrogen-deplete culture with an increase in the level of saturated fatty acids especially C16:0 and C18:0, accompanied by a decrease in proportions of monounsaturated and polyunsaturated fatty acids. Fifty-nine metabolites, including amino acids, lipids, phytochemical compounds, vitamins and cofactors were signi?cantly dysregulated and annotated in this study. Pathway mapping analysis revealed a rewiring of metabolic pathways in the cells, particularly purine, carotenoid, nicotinate and nicotinamide, and amino acid metabolisms. Within the treatment period of nitrogen deprivation, the key processes involved were reshu ? ing of nitrogen from proteins and photosynthetic machinery, together with carbon repartitioning in carbohydrates and lipids.

关键词： metabolic profiling Chlorella sp. nitrogen stress lipid fatty acid

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