Breastfeeding and Its Impact on Glucose Trends and Hypoglycaemia Risk in At-Risk Neonates: A Prospective Observational Study.

Introduction: Neonatal glucose regulation undergoes a rapid transition after birth, with glucose levels declining within the first few hours before stabilising. At-risk neonates, including those who are preterm, small-for-gestational-age (SGA), large-for-gestational-age (LGA), or born to mothers with diabetes or obesity, face an increased risk of hypoglycaemia. Early feeding is recommended to support glucose homeostasis, yet the impact of feeding type on glucose trends and hypoglycaemia risk remains unclear.

Prevalence, Clinical Characteristics and Prognosis of Vascular Disease in Valvular Heart Surgery: A Multi-Centre Study.

Background: The clinical significance of atherosclerotic disease in more than one vascular bed, that is, polyvascular disease, in valvular heart surgery remains poorly understood. This study aims to establish the prevalence and prognostic value of polyvascular disease for long-term outcomes after valvular heart surgery.

Methods: Patients receiving valvular heart surgery at two tertiary centres from January 1, 2010 to December 31, 2021 were identified.

Comparative analysis of an automated bone age tool with manual assessment in a multiethnic Southeast Asian paediatric cohort in Singapore.

Background: Bone age assessment is essential for evaluating growth and pubertal disorders, but manual methods such as the Greulich-Pyle atlas are subject to inter-observer variability. Automated tools like BoneXpert may improve accuracy and consistency.

Objective: To validate the accuracy and reliability of BoneXpert, an automated bone age assessment tool, compared to traditional manual methods performed by paediatric endocrinologists and radiologists in a multiethnic paediatric cohort in Singapore.

Glucose Levels in At-risk Newborns (GLEAN): a prospective cohort study on glucose profiles in infants at risk of hypoglycemia.

Objective: To describe glucose patterns in at-risk infants, determine the incidence of hypoglycemia across different risk groups, and evaluate the impact of combined risk factors on odds of developing hypoglycemia.

Study Design: This prospective cohort study was conducted at KK Women's and Children's Hospital from 16 December 2019 to 16 March 2020, during which 2,564 babies were born. Of these, 701 were identified as at-risk of hypoglycemia based on predefined clinical criteria: infants of diabetic mothers (IDM), term infants with birth weight >4000 g or <2600 g, preterm infants, and infants of obese mothers (IOM).

Feasibility and safety of a novel laser-induced adhesive for orthodontic debonding.

Objectives: This study evaluates the feasibility and safety of a laser-induced reversible adhesive (LIRA) by assessing intrapulpal temperature changes (ITC), shear bond strength (SBS) following laser irradiation, and optimal adhesive removal methods.

Methods: Thirty premolars were used to measure ITC under laser powers of 1 W, 2 W, and 3 W until the temperature exceeded the 5.6 ℃ threshold.

Single-Sample, Multiomic Mass Spectrometry for Investigating Drug Effects and Mechanisms.

Poor therapeutic indexes are a principal cause of drug attrition during development. To develop multiomic methods for elucidating potentially targetable mechanisms of drug toxicity, we performed profiling of the response to subtoxic and toxic doses of l-Asparaginase (ASNase) in immune-compromised mice. ASNase is an enzyme-drug approved for the treatment of pediatric acute lymphoblastic leukemia (ALL) but too toxic for use in adults, making it an ideal test case.

High-Sensitive Spatial Proteomics for Pancreatic Cancer Progression Analysis.

Pancreatic cancer remains as one of the most challenging malignancies to diagnose and treat due to the late development of symptoms and limited early diagnostic options. Intraductal papillary mucinous neoplasms (IPMNs) are non-invasive precursors to invasive pancreatic ductal adenocarcinoma (PDAC)and an understanding of the changes in patterns of protein expression that accompany the progression from normal ductal (ND) cell, to IPMN to PDAC may provide avenues for improved earlier detection. In this study, we present an optimized spatial tissue proteomics workflow, termed SP-Max (Spatial Proteomics Optimized for Maximum Sensitivity and Reproducibility in Minimal Sample), designed to maximize protein recovery and quantification from limited laser micro dissected (LMD) samples.

The UBE3A-ATS antisense oligonucleotide rugonersen in children with Angelman syndrome: a phase 1 trial.

Angelman syndrome (AS) is a severe genetic neurodevelopmental disorder with no disease-modifying treatments. AS is caused by deletion or mutation of the neuronally imprinted gene encoding the ubiquitin-protein ligase E3A (UBE3A). Rugonersen (RO7248824) is an antisense oligonucleotide that reinstates UBE3A by derepressing the silenced paternal allele.

Population differences of chromosome 22q11.2 duplication structure predispose differentially to microdeletion and inversion.

The most common genomic disorder, chromosome 22q11.2 microdeletion syndrome (22q11.2DS), is mediated by highly identical and polymorphic segmental duplications (SDs) known as low copy repeats (LCRs; regions A-D) that have been challenging to sequence and characterize.

Optimizing management of stage IV EGFR mutant non-small cell lung cancer in Asia: An expert opinion.

Lung cancer is Asia's most prevalent cancer, accounting for the highest global patient share. A significant number of non-small cell lung cancer (NSCLC) patients in Asia exhibit mutations in the epidermal growth factor receptor (EGFR). Although clinical outcomes are improving with newer therapies, challenges persist in the effective management of EGFR mutant (EGFRm) NSCLC.

Variant Resulting in Hypogonadotropic Hypogonadism, Learning Difficulties, and Ear (Rather Than Eye) Anomalies.

A 15-year-old female individual presented with primary amenorrhea and absence of pubertal signs. Her hormonal profile revealed isolated hypogonadotropic hypogonadism (IHH) with low levels of luteinizing hormone (LH), estradiol, and follicle-stimulating hormone (FSH), with a confirmatory luteinizing hormone-releasing hormone (LHRH) stimulation test. She has a background of global developmental delay and bilateral hearing loss, with computed tomography (CT) findings of an absent right incus lenticular process and a dilated right vestibule.

The Development of Acute Outreach Services in Aged Care Facilities (Nursing Homes): Using Telemedicine in Rural Areas.

Acute outreach services for older patients in nursing homes are being developed as our population ages rapidly, putting stress on the resources of hospitals and emergency departments. Since the COVID pandemic, the acceleration of the utilization of telemedicine has also been adopted for acute outreach services in metropolitan areas, with preliminary evidence supporting safety, but the generalization of the service to other settings, such as rural areas, is less clear.

Artificial intelligence-assisted esophagogastroduodenoscopy improves procedure quality for endoscopists in early stages of training.

Background And Study Aims: Completeness of esophagagogastroduodenoscopy (EGD) varies among endoscopists, leading to a high miss rate for gastric neoplasms. This study aimed to determine the effect of the Cerebro real-time artificial intelligence (AI) system on completeness of EGD for endoscopists in early stages of training.

Patients And Methods: The AI system was built with CNN and Motion Adaptive Temporal Feature Aggregation (MA-TFA).

Human de novo mutation rates from a four-generation pedigree reference.

Understanding the human de novo mutation (DNM) rate requires complete sequence information. Here using five complementary short-read and long-read sequencing technologies, we phased and assembled more than 95% of each diploid human genome in a four-generation, twenty-eight-member family (CEPH 1463). We estimate 98-206 DNMs per transmission, including 74.

Inhibiting Glycolysis and Disrupting the Mitochondrial HK2-VDAC1 Protein-Protein Interaction Using a Bifunctional Lonidamine-Conjugated Metal Probe for Combating Triple-Negative Breast Cancer.

Triple-negative breast cancer (TNBC) relies primarily on aerobic glycolysis for energy and rapid cancer cell proliferation. Hexokinase 2 (HK2), a key enzyme regulating glycolysis, is overexpressed in TNBC, promoting tumor cell proliferation and apoptosis resistance by interacting with the mitochondrial membrane's voltage-dependent anion channel 1 (VDAC1). However, the development of bioactive molecules for effectively disrupting the HK2-VDAC1 interaction remains challenging.

Vitamin D Deficiency and Clinical Outcomes in Critically Ill Pediatric Patients: A Systematic Review and Meta-Analysis.

Context: Vitamin D deficiency (VDD) is common in paediatric populations, and its relationship with critical care outcomes warrants further investigation.

Objective: The aim is to examine the association between VDD and clinical outcomes in children admitted to the Pediatric Intensive Care Unit (PICU).

Methods: This systematic review and meta-analysis investigated the impact of VDD on clinical outcomes in PICU patients.

A photostable luminescent iridium(III) complex probe for imaging endogenous mitochondrial sulfur dioxide in living cells.

Sulfur dioxide (SO) is an important signaling gas molecule, but its aberration is highly associated with inflammatory diseases and cancers. Luminescence probes for SO have emerged as essential instruments for elucidating its biological roles and facilitating disease diagnosis, owing to their high sensitivity and capabilities for real-time detection. Nevertheless, the majority of current probes lack subcellular selectivity and suffer from limited photostability.

Hip-focused strengthening and task-specific movement training for an individual with chronic, recurrent femoroacetabular impingement syndrome.

Objectives: Examine the effects of hip-focused strengthening and task-specific movement training for a female who has undergone multiple surgical procedures yet continues to experience chronic, recurrent FAIS-related symptoms.

Study Design: Case Report.

Methods: A 23-year-old active female with an eleven-year history of FAIS and two previous surgical procedures recently experienced a third recurrence of symptoms brought on by increased physical activity levels.

Development and validation of a novel self-assessment tool for breastfeeding mothers.

Background: Difficulties with breastfeeding can lead to early breastfeeding cessation. Empowering mothers through self-assessment and education of breastfeeding skills can help support them. We aimed to develop and validate a tool for self-screening and education on breastfeeding skills.

AI versus the spinal surgeons in the management of controversial spinal surgery scenarios.

Aims: The use of artificial intelligence (AI) in spinal surgery is expanding, yet its ability to match the diagnostic and treatment planning accuracy of human surgeons remains unclear. This study aims to compare the performance of AI models-ChatGPT-3.5, ChatGPT-4, and Google Bard-with that of experienced spinal surgeons in controversial spinal scenarios.

Caregiver feeding practices for infants and toddlers and their eating behaviors in Singapore.

Introduction: Research on early childhood caregiver feeding practices and eating behaviors is limited, especially within Asian populations. This study examined these practices across key feeding domains of variety, autonomy, and mealtime setting and timing, stratified by three age groups: 0 to <7 months, 7 to <13 months, and 13 to <36 months.

Methods: A cross-sectional survey of 1,307 caregivers from a multi-ethnic population in Singapore captured demographic data, feeding practices, child eating behaviors, and caregivers' knowledge, attitudes, and practices.