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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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Post-metallic stent placement bleeding caused by stent-induced ulcers

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World Journal of Gastroenterology 2005年第36期11卷 5739-5741页

作者： Chun-Tao Wai Christopher Khor siew-Eng lim Khek-Yu Ho Department ofMedicine National University Hospital 5 Lower Kent Ridge RoadSingapore 119074 Singapore Department of Hematology and Oncology NationalUniversity Hospital 5 Lower Kent Ridge Road Singapore 119074Singapore

Placement of self-expandable metal stents （SEIVIS） is an effective mode of palliative treatment for patients with malignant gastrointestinal obstruction. Gastrointestinal mucosal bleeding complicates about 5% of placement of SEIVIS but is not well described. We report three cases of gastrointestinal bleeding post-SEIVIS placement and suggest that bleeding is caused by direct mucosal infringement by the sharp edges of the ends of the stents. 2005 The WJG Press and Elsevier Inc. All rights reserved

关键词： Colorectal cancer Gastric cancer Stricture

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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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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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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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Anti-migratory and increased cytotoxic effects of novel dual drug-loaded complex hybrid micelles in triple negative breast cancer cells

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Nano Research 2015年第8期8卷 2533-2547页

作者： Rajaletchumy Veloo Kutty Chor Yong Tay Chen siew lim Si-Shen Feng David Tai Leong Department of Chemical and Biomolecular Engineering National University of Singapore 4 Engineering Drive Singapore 117585 Singapore International Joint Cancer Institute The Second Military Medical University 800 Xiang Yin Road Shanghai 200433 China NUS Graduate School for Integrative Science and Engineering National University of Singapore 28 Medical Drive Singapore 117456 Singapore

A polymer-based nanocarrier was developed for the co-delivery of epigenetic and chemotherapeutic drugs. The sterically stabilized hybrid micelle system uses micelles composed of D-a-tocopheryl polyethylene glycol 1000 succinate （vitamin E TPGS or TPGS） and 1,2-distearoyl-sn-glycero-3-phosphoethanolamine- N-[methoxy（polyethylene glycol）-2000] （DSPE-PEG2000）. In this study, suberoylanilide hydroxamic acid （SAHA） and paclitaxel were used as model drugs for combination chemotherapy to enhance therapeutic efficiency in targeting mesenchyme-like triple negative breast cancer （TNBC） cells. Combination therapy of paclitaxel and SAHA in a dual drug micelle system, （P ＋ S）mic, exhibited an IC50 value of 0.52 μg/mL, which is about 5.91-fold more cytotoxic than the mere combination of free drugs （P ＋ S）. Furthermore, the （P ＋ S）mic formulation was far more effective at inhibiting cell migration by more than 3.4-fold than the control. Thus, our findings show that the co-delivery of these drugs using the micelle system greatly enhances their therapeutic effect at a lower dosage, thereby minimizing toxicity. In addition, this formulation is proved to be remarkably effective in preventing cell migration at low dosage.

关键词： nanomedicine biomaterials nanobiology biodegradable polymers drug targeting

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A novel CARD containing splice-isoform of CIITA regulates nitric oxide synthesis in dendritic cells

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Protein & Cell 2010年第3期1卷 291-306页

作者： Dachuan Huang Sylvia lim Rong Yuan Ray Chua Hong Shi Mah Lee Ng siew Heng Wong Laboratory of Membrane Trafficking and Immunoregulation Department of MicrobiologyImmunology ProgrammeYong Loo Lin School of MedicineNational University of SingaporeBlock MD45 Science Drive 2Singapore 117597Republic of Singapore Laboratory of Flavivirology Department of MicrobiologyImmunology ProgrammeYong Loo Lin School of MedicineNational University of SingaporeBlock MD45 Science Drive 2Singapore 117597Republic of Singapore

MHC class II expression is controlled mainly at transcriptional level by class II transactivator(CIITA),which is a non-DNA binding coactivator and serves as a master control factor for MHC class II genes ***,we describe the function of a novel splice-isoform of CIITA,DC-expressed caspase inhibitory isoform of CIITA(or DC-CASPIC),and we show that the expression of DCCASPIC in DC is upregulated upon lipopolysaccharides(LPS)***-CASPIC localizes to mitochondria,and protein-protein interaction study demonstrates that DC-CASPIC interacts with caspases and inhibits its activity in ***,DC-CASPIC suppresses caspases-induced degradation of nitric oxide synthase-2(NOS2)and subsequently promotes the synthesis of nitric oxide(NO).NO is an essential regulatory molecule that modulates the capability of DC in stimulating T cell proliferation/activation in vitro;hence,overexpression of DC-CASPIC in DC enhances this ***,our findings reveal that DC-CASPIC is a key molecule that regulates caspases activity and NO synthesis in DC.

关键词： dendritic cells caspase CIITA nitric oxide synthase

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Growth and photosynthesis of Chlorella strains from polar,temperate and tropical freshwater environments under temperature stress

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Journal of Oceanology and limnology 2018年第4期36卷 1266-1279页

作者： Kok-Keong LEE Phaik-Eem lim Sze-Wan POONG Chiew-Yen WONG siew-Moi PHANG John BEARDALL Institute of Ocean and Earth Sciences University of Malaya Institute of Graduate Studies University of Malaya School of Health Sciences International Medical University National Antarctic Research Centre University of Malaya Institute of Biological Sciences University of Malaya School of Biological Sciences Monash University

Elevated temperatures as a consequence of global warming have significant impacts on the adaptation and survival of microalgae which are important primary producers in many ecosystems. The impact of temperature on the photosynthesis of microalgae is of great interest as the primary production of algal biomass is strongly dependent on the photosynthetic rates in a dynamic environment. Here, we examine the effects of elevated temperature on Chlorella strains originating from different latitudes, namely Antarctic, Arctic, temperate and tropical regions. Chlorophyll fluorescence was used to assess the photosynthetic responses of the microalgae. Rapid light curves(RLCs) and maximum quantum yield( F_v/F_m) were recorded. The results showed that Chlorella originating from different latitudes portrayed different growth trends and photosynthetic performance. The Chlorella genus is eurythermal, with a broad temperature tolerance range, but with strain-specific characteristics. However, there was a large overlap between the tolerance range of the four strains due to their "eurythermal adaptivity". Changes in the photosynthetic parameters indicated temperature stress. The ability of the four strains to reactivate photosynthesis after inhibition of photosynthesis under high temperatures was also studied. The Chlorella strains were shown to recover in terms of photosynthesis and growth(measured as Chl a) when they were returned to their ambient temperatures. Polar strains showed faster recovery in their optimal temperature compared to that under the ambient temperature from which they were isolated.

关键词： Antarctic Arctic Fv/Fm microalgae pigments recovery

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