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  1. Article ; Online: Feeling Alone Together: Loneliness in Older Adults with Cognitive Impairment and Their Family Caregivers with Low Mastery.

    Sung, Pildoo / Chan, Angelique / Lim-Soh, Jeremy

    Dementia and geriatric cognitive disorders

    2024  

    Abstract: Introduction: Loneliness in older persons with cognitive impairment (PCI) may beget loneliness in their family caregivers, depending on buffering resources caregivers possess. This study examined the association between loneliness in older persons with ... ...

    Abstract Introduction: Loneliness in older persons with cognitive impairment (PCI) may beget loneliness in their family caregivers, depending on buffering resources caregivers possess. This study examined the association between loneliness in older persons with cognitive impairment (PCI) and loneliness experienced by their family caregivers, and the moderating role of caregiver mastery in this association.
    Methods: Dyadic data from 135 PCI and their family caregivers in Singapore were analyzed using multivariable regression. Loneliness was measured by a three-item UCLA loneliness scale. Mastery was assessed using a seven-item Pearlin instrument.
    Results: Multivariable regression showed that PCI loneliness and caregiver loneliness were weakly associated, taking other covariates into account. The significant interaction between PCI loneliness and caregiver mastery revealed that PCI loneliness was associated with caregiver loneliness only when caregivers had low mastery.
    Discussion: Lonely PCI may share their feelings of loneliness with their caregivers, and this can lead to loneliness among caregivers if they have low mastery. Promoting caregiver mastery may help reduce caregiver loneliness, directly and indirectly as a buffer against PCI loneliness.
    Language English
    Publishing date 2024-02-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 1026007-9
    ISSN 1421-9824 ; 1013-7424
    ISSN (online) 1421-9824
    ISSN 1013-7424
    DOI 10.1159/000536644
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Health Profiles among Community-Dwelling Older Adults with Cognitive Impairment and Their Implications for Caregiving Experience.

    Sung, Pildoo / Lim-Soh, Jeremy / Chan, Angelique

    Dementia and geriatric cognitive disorders

    2023  Volume 52, Issue 3, Page(s) 169–176

    Abstract: Introduction: Identifying health conditions of persons with cognitive impairment (PCI) in the community and exploring their implications for caregiving experience are vital for effective allocation of healthcare resources. This study examined distinct ... ...

    Abstract Introduction: Identifying health conditions of persons with cognitive impairment (PCI) in the community and exploring their implications for caregiving experience are vital for effective allocation of healthcare resources. This study examined distinct PCI health profiles among community-dwelling PCI and their association with caregiving burden and benefits.
    Methods: Latent profile analysis and multivariable regression were applied to dyadic data from 266 PCI and their caregivers in Singapore.
    Results: Three PCI health profiles were identified: less impaired (40% of PCI), moderately impaired (30%), and severely impaired (30%). Caregivers for severely impaired PCI were more likely to report a higher level of caregiving burden, and caregivers for moderately impaired PCI were more likely to report a higher level of caregiving benefits, compared to caregivers for less impaired PCI.
    Conclusion: The findings captured heterogeneity in health status among PCI in the community. Tailored interventions, based on PCI health profiles, should be designed to reduce caregiving burden and increase caregiving benefits.
    MeSH term(s) Humans ; Aged ; Independent Living ; Cognitive Dysfunction ; Caregivers/psychology ; Caregiver Burden ; Singapore
    Language English
    Publishing date 2023-04-13
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1026007-9
    ISSN 1421-9824 ; 1013-7424
    ISSN (online) 1421-9824
    ISSN 1013-7424
    DOI 10.1159/000530606
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Watching the clock in glioblastoma.

    Chan, Priscilla / Rich, Jeremy N / Kay, Steve A

    Neuro-oncology

    2023  Volume 25, Issue 11, Page(s) 1932–1946

    Abstract: Glioblastoma (GBM) is the most prevalent malignant primary brain tumor, accounting for 14.2% of all diagnosed tumors and 50.1% of all malignant tumors, and the median survival time is approximately 8 months irrespective of whether a patient receives ... ...

    Abstract Glioblastoma (GBM) is the most prevalent malignant primary brain tumor, accounting for 14.2% of all diagnosed tumors and 50.1% of all malignant tumors, and the median survival time is approximately 8 months irrespective of whether a patient receives treatment without significant improvement despite expansive research (Ostrom QT, Price M, Neff C, et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2015-2019. Neurooncology. 2022; 24(suppl 5):v1-v95.). Recently, important roles for the circadian clock in GBM tumorigenesis have been reported. Positive regulators of circadian-controlled transcription, brain and muscle ARNT-like 1 (BMAL1), and circadian locomotor output cycles kaput (CLOCK), are highly expressed also in GBM and correlated with poor patient prognosis. BMAL1 and CLOCK promote the maintenance of GBM stem cells (GSCs) and the establishment of a pro-tumorigenic tumor microenvironment (TME), suggesting that targeting the core clock proteins may augment GBM treatment. Here, we review findings that highlight the critical role the circadian clock plays in GBM biology and the strategies by which the circadian clock can be leveraged for GBM treatment in the clinic moving forward.
    MeSH term(s) Humans ; CLOCK Proteins/metabolism ; Glioblastoma ; ARNTL Transcription Factors/metabolism ; Circadian Clocks ; Brain/metabolism ; Tumor Microenvironment
    Chemical Substances CLOCK Proteins (EC 2.3.1.48) ; ARNTL Transcription Factors
    Language English
    Publishing date 2023-06-16
    Publishing country England
    Document type Review ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2028601-6
    ISSN 1523-5866 ; 1522-8517
    ISSN (online) 1523-5866
    ISSN 1522-8517
    DOI 10.1093/neuonc/noad107
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Availability and quality of data related to cultural and linguistic diversity in the Victorian Suicide Register: A pilot study.

    Truong, Mandy / Dwyer, Jeremy / Chan, Jocelyn / Bugeja, Lyndal

    Australian and New Zealand journal of public health

    2023  Volume 47, Issue 5, Page(s) 100078

    Abstract: Objective: While people from culturally and linguistically diverse (CALD) backgrounds have been identified as a priority for suicide prevention in Australia, little is known about suicide in CALD communities. We aim to describe the availability and ... ...

    Abstract Objective: While people from culturally and linguistically diverse (CALD) backgrounds have been identified as a priority for suicide prevention in Australia, little is known about suicide in CALD communities. We aim to describe the availability and quality of CALD data in the Victorian Suicide Register (VSR).
    Methods: A retrospective consecutive case series review of suicides reported to the Coroners Court of Victoria during 2016 was conducted. Using the VSR, we identify suicides showing evidence of CALD identity and relevant variables were extracted and coded according to an adapted Australian Institute of Health and Welfare framework.
    Results: During 2016, 126 of 652 suicides (19.3%, 95% confidence intervals 16.4-22.6) were flagged as showing evidence of CALD. The two most frequent CALD indicators for which information was recorded were country of birth and year of arrival. There was less information pertaining to citizenship, residency/visa status, preferred language, English language proficiency and religious affiliation.
    Conclusions: This study demonstrates that the VSR, like other databases, has substantial gaps in availability and quality of CALD data.
    Implications: A framework to capture richer data on cultural, religious and linguistic diversity when coding suicides is needed to inform policy on suicide prevention initiatives designed for CALD communities.
    Language English
    Publishing date 2023-08-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1323548-5
    ISSN 1753-6405 ; 1326-0200
    ISSN (online) 1753-6405
    ISSN 1326-0200
    DOI 10.1016/j.anzjph.2023.100078
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The authors reply.

    Teoh, Jeremy Yuen-Chun / Chan, Vinson Wai-Shun

    Critical care medicine

    2021  Volume 49, Issue 10, Page(s) e1056–e1057

    Language English
    Publishing date 2021-09-16
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000005235
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Evolutionary origin and structural ligand mimicry by the inserted domain of alpha-integrin proteins.

    Hollis, Jeremy A / Chan, Matthew C / Malik, Harmit S / Campbell, Melody G

    bioRxiv : the preprint server for biology

    2023  

    Abstract: Heterodimeric integrin proteins transmit signals through conformational changes upon ligand binding between their alpha (α) and beta (β) subunits. Early in chordate evolution, some α subunits acquired an "inserted" (I) domain, which expanded their ligand ...

    Abstract Heterodimeric integrin proteins transmit signals through conformational changes upon ligand binding between their alpha (α) and beta (β) subunits. Early in chordate evolution, some α subunits acquired an "inserted" (I) domain, which expanded their ligand binding capacity but simultaneously obstructed the ancestral ligand-binding pocket. While this would seemingly impede conventional ligand-mediated integrin activation, it was proposed that the I domain itself could serve both as a ligand replacement and an activation trigger. Here, we provide compelling evidence in support of this longstanding hypothesis using high-resolution cryo-electron microscopy structures of two distinct integrin complexes: the ligand-free and E-cadherin-bound states of the αEβ7 integrin with the I domain, as well as the α4β7 integrin lacking the I domain in both a ligand-free state and bound to MadCAM-1. We trace the evolutionary origin of the I domain to an ancestral collagen-collagen interaction domain. Our analyses illuminate how the I domain intrinsically mimics an extrinsic ligand, enabling integrins to undergo the canonical allosteric cascade of conformational activation and dramatically expanding the range of cellular communication mechanisms in vertebrates.
    Language English
    Publishing date 2023-11-06
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2023.11.05.565221
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Orthotic Devices for the Foot and Ankle.

    An, Tonya W / Berke, Gary / Beattie, Wendy / Chan, Jeremy Y

    The Journal of the American Academy of Orthopaedic Surgeons

    2023  

    Abstract: Millions of Americans wear ankle-foot orthotic devices for protection, pain relief, and deformity correction. Inquiries about off-the-shelf and custom devices are a common reason for evaluation with a foot and ankle surgeon or general orthopaedic surgeon. ...

    Abstract Millions of Americans wear ankle-foot orthotic devices for protection, pain relief, and deformity correction. Inquiries about off-the-shelf and custom devices are a common reason for evaluation with a foot and ankle surgeon or general orthopaedic surgeon. Despite limited high-quality evidence for their use, these devices can have a notable clinical impact on physical function. An up-to-date understanding of orthotic device options and their appropriate use in managing musculoskeletal pathologies applies to all orthopaedic providers. This review aims to categorize orthosis types and provide specific device recommendations for common adult conditions such as flatfoot, cavovarus foot, and ankle instability. Collaboration with a certified orthotist can help patients achieve functional and recreational goals with the use of appropriately designed and applied orthoses.
    Language English
    Publishing date 2023-12-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200524-1
    ISSN 1940-5480 ; 1067-151X
    ISSN (online) 1940-5480
    ISSN 1067-151X
    DOI 10.5435/JAAOS-D-23-00832
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: A cost avoidance study of critical care pharmacists' interventions in a tertiary institution in Singapore.

    Chan, Lin En Jeremy / Soong, Jie Lin / Lie, Sui An

    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

    2022  Volume 80, Issue 5, Page(s) 267–283

    Abstract: Purpose: The economic impact of critical care pharmacists in the intensive care unit (ICU) setting has not been evaluated in Singapore despite ICUs being high-cost areas. This study was conducted to determine the costs avoided as a result of pharmacists' ...

    Abstract Purpose: The economic impact of critical care pharmacists in the intensive care unit (ICU) setting has not been evaluated in Singapore despite ICUs being high-cost areas. This study was conducted to determine the costs avoided as a result of pharmacists' interventions within multidisciplinary ICU teams in a tertiary hospital in Singapore.
    Methods: A single-center, retrospective observational study of accepted pharmacists' interventions was conducted over 6 months in 2020. We adopted a previously published systematic approach to estimate the costs avoided by the healthcare system through pharmacists' interventions. Interventions were independently reviewed by a critical care pharmacist, an intensivist, and an investigator. Cost avoidance was calculated in terms of the additional ICU length of stay that would have resulted had a pharmacist not intervened as well as the direct cost savings achieved.
    Results: There were 632 medication-related problems (MRPs) associated with the 527 accepted interventions, as some interventions involved multiple MRPs. The most common interventions included correcting inappropriate drug regimens (n = 363; 57%), recommending drug monitoring (n = 65; 10%) and addressing omission of drugs (n = 50; 8%). Over 6 months, gross cost avoidance and net cost avoidance achieved were $186,852 and $140,004, respectively, resulting in a ratio of potential monetary cost avoidance to pharmacist salary of 3.99:1. The top 3 interventions that resulted in the greatest cost avoidance were those that corrected inappropriate drug regimens ($146,870; 79%), avoided adverse drug events (ADEs) ($10,048; 5%), and led to discontinuation of medications without any indication ($7,239; 4%).
    Conclusion: Pharmacists can reduce healthcare expenditure substantially through cost avoidance by performing various interventions in ICUs, particularly in the areas of correcting inappropriate drug regimens, avoiding ADEs, and discontinuing unnecessary medications.
    MeSH term(s) Humans ; Pharmacists ; Singapore ; Pharmacy Service, Hospital ; Critical Care ; Drug-Related Side Effects and Adverse Reactions ; Cost Savings
    Language English
    Publishing date 2022-10-12
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 1224627-x
    ISSN 1535-2900 ; 1079-2082
    ISSN (online) 1535-2900
    ISSN 1079-2082
    DOI 10.1093/ajhp/zxac340
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Rate of Refracture After Removal of Hardware in Pediatric Femur Fractures.

    Siu, Jeremy W / Chan, Chloe / Swarup, Ishaan / Sabatini, Coleen S

    Journal of pediatric orthopedics

    2023  Volume 43, Issue 8, Page(s) e674–e679

    Abstract: Purpose: Both flexible intramedullary nails (FINs) and plate osteosynthesis are commonly used for the treatment of femoral shaft fractures in pediatric patients. The purpose of this study is to determine the refracture rate after hardware removal in ... ...

    Abstract Purpose: Both flexible intramedullary nails (FINs) and plate osteosynthesis are commonly used for the treatment of femoral shaft fractures in pediatric patients. The purpose of this study is to determine the refracture rate after hardware removal in pediatric femur fractures.
    Methods: This is a retrospective cohort study that utilized the Pediatric Health Information System database to determine the number of pediatric patients ages 4 to 10 who underwent surgical fixation of a femur fracture and subsequent hardware removal between the years 2015 and 2019. All patients had a minimum of a 2-year follow-up to assess for refracture. Patients with metabolic bone disease, neuromuscular conditions, bone fragility disorders, nutritional deficiencies, and pathologic fractures were excluded.
    Results: Of the total, 2805 pediatric patients with 2881 femoral shaft fractures who underwent FIN (48.4%), plate fixation (36.1%), splinting/casting (14.9%), or external fixation (0.6%) were included. The mean age of patients with index fracture was 7.2 years (SD, 2.1) and 69% were males. Eight hundred eighty patients (60%) in the FIN group had their hardware removed compared with 693 patients (68%) in the plate fixation group ( P = 0.07), at an average of 287 ± 191 days versus 320 ± 203 days ( P = 0.03). Refracture occurred in 13 patients (1.5%) who had their hardware retained and in 21 patients (1.4%) who had their hardware removed ( P = 0.732). Among 65% of patients who underwent hardware removal, refracture occurred in 7 patients with FIN (0.8%) and 14 patients with plate fixation (2.2%) ( P = 0.04). Refracture occurred within 365 days from hardware removal in 1 patient with FIN (0.1%) and 7 patients with plate fixation (1%) ( P = 0.01). In logistic regression, patients with FIN fixation had lower odds of refracture after hardware removal compared with plate fixation (adjusted odds ratio: 0.39; 95% CI: 0.15-0.97). Age and payor status did not reach statistical significance in multivariate analysis.
    Conclusions: The rate of refracture after hardware removal for pediatric patients with a femoral shaft fracture was similar between patients with hardware retained and removal. However, patients with FIN had a lower rate of refracture AFTER hardware removal compared with plate fixation. This information can be helpful for advising families regarding the risks of refracture after hardware removal.
    Level of evidence: Level IV-retrospective cohort study.
    MeSH term(s) Male ; Humans ; Child ; Female ; Retrospective Studies ; Femoral Fractures/surgery ; Fracture Fixation, Internal/adverse effects ; Fractures, Spontaneous ; Femur ; Bone Diseases ; Fracture Fixation, Intramedullary/adverse effects ; Treatment Outcome
    Language English
    Publishing date 2023-06-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/BPO.0000000000002454
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Erratum to: 'Adipocyte-derived relaxing factor-a fat load to be learnt'.

    Harky, Amer / Chan, Jeffrey Shi Kai / Hui, Jeremy Man Ho / Soppa, Gopal

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

    2022  Volume 62, Issue 2

    Language English
    Publishing date 2022-03-23
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 639293-3
    ISSN 1873-734X ; 1010-7940 ; 1567-4258
    ISSN (online) 1873-734X
    ISSN 1010-7940 ; 1567-4258
    DOI 10.1093/ejcts/ezac191
    Database MEDical Literature Analysis and Retrieval System OnLINE

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