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Article ; Online: Advance care plan discussion among parents of children with cerebral palsy.

Khalid, Farah / Ng Voon, Swee Im / Ong, Lai Choo / Lim, Wei Kang / Li, Limin / Adnan, Azirah / Ganesan, Vigneswari / Teh, Chee Ming / Fong, Choong Yi

Developmental medicine and child neurology

2022 Volume 64, Issue 8, Page(s) 1025–1033

Abstract: Aim: To evaluate parental perception of advance care plan (ACP) discussions in families of Malaysian children with bilateral cerebral palsy (CP) classified in Gross Motor Function Classification System levels IV or V for (1) acceptance of the ACP ... ...

Abstract	Aim: To evaluate parental perception of advance care plan (ACP) discussions in families of Malaysian children with bilateral cerebral palsy (CP) classified in Gross Motor Function Classification System levels IV or V for (1) acceptance of the ACP discussion, (2) feedback on the usefulness of ACP discussion, and (3) exploration of possible factors related to parental acceptance of ACP. Method: This was a prospective pre- and post-ACP discussion questionnaire study for parents of children with bilateral CP. Results: Sixty-nine patients were recruited to the study; 64 (93%) had at least one additional comorbidity. The median age was 8 years (interquartile range 5 years 1 month-11 years 6 months). Fifty-seven (82.6%) parents found the ACP discussion acceptable, and most reported positive feedback on various components of the discussion (88.4-97.1%). One-third of participants were not comfortable discussing end-of-life care plans. On multivariate analysis, parents who were comfortable discussing end-of-life care plans were more likely to find the ACP discussion acceptable (odds ratio 27.78, 95% confidence interval 2.9-265.1, p = 0.004). Interpretation: Most parents of Malaysian children with bilateral CP reported the ACP discussion as both acceptable and beneficial. Parents need to be comfortable about discussing end-of-life care plans for their child to enable the ACP discussion to be an acceptable experience.
MeSH term(s)	Advance Care Planning ; Cerebral Palsy/therapy ; Child ; Family ; Humans ; Infant ; Parents ; Prospective Studies
Language	English
Publishing date	2022-02-25
Publishing country	England
Document type	Journal Article
ZDB-ID	80369-8
ISSN	1469-8749 ; 0012-1622
ISSN (online)	1469-8749
ISSN	0012-1622
DOI	10.1111/dmcn.15184
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Article ; Online: Evaluation of eight commercial Zika virus IgM and IgG serology assays for diagnostics and research.

Low, Swee Ling / Leo, Yee Sin / Lai, Yee Ling / Lam, Sally / Tan, Hwee Huang / Wong, Judith Chui Ching / Tan, Li Kiang / Ng, Lee Ching

PloS one

2021 Volume 16, Issue 1, Page(s) e0244601

Abstract: Several commercial Zika virus (ZIKV) serology assays have been developed since the recognition of ZIKV outbreaks as a Public Health Emergency of International Concern in 2016. However, test interpretation for ZIKV serology can be challenging due to ... ...

Abstract	Several commercial Zika virus (ZIKV) serology assays have been developed since the recognition of ZIKV outbreaks as a Public Health Emergency of International Concern in 2016. However, test interpretation for ZIKV serology can be challenging due to antibody cross-reactivity with other flaviviruses like dengue virus (DENV). Therefore, we sought to evaluate the performance of eight commercially available ZIKV IgM and IgG assays across three testing platforms, namely, immunochromatographic tests (ICT), ELISAs and immunofluorescence tests (IIFT). The test panel comprised of 278 samples, including acute and convalescent sera or plasma from ZIKV-confirmed, DENV-confirmed, non-ZIKV and non-DENV patients, and residual sera from healthy blood donors. The ZIKV IgM and IgG serology assays yielded higher test sensitivities of 23.5% - 97.1% among ZIKV convalescent samples as compared to 5.6% - 27.8% among ZIKV acute samples; the test specificities were 63.3% - 100% among acute and convalescent DENV, non-DENV samples. Among the ELISAs and IIFTs, the Diapro ZIKV IgM ELISA demonstrated high test sensitivity (96%) and specificity (80%) when tested on early convalescent samples, while the Euroimmun ZIKV IgG ELISA yielded the highest test specificity of 97% - 100% on samples from non-ZIKV patients and healthy blood donors. For rapid ICTs, the LumiQuick IgM rapid ICT yielded low test sensitivity, suggesting its limited utility. We showed that commercial ZIKV IgM and IgG serology assays have differing test performances, with some having moderate to high test sensitivities and specificities when used in a dengue endemic setting, although there were limitations in IgG serology.
MeSH term(s)	Antibodies, Viral/blood ; Antibodies, Viral/immunology ; Cross Reactions ; Dengue/blood ; Dengue/diagnosis ; Dengue/immunology ; Dengue Virus/immunology ; Dengue Virus/isolation & purification ; Enzyme-Linked Immunosorbent Assay/methods ; Fluorescent Antibody Technique/methods ; Humans ; Immunoassay/methods ; Immunoglobulin G/blood ; Immunoglobulin G/immunology ; Immunoglobulin M/blood ; Immunoglobulin M/immunology ; Sensitivity and Specificity ; Serologic Tests ; Zika Virus/immunology ; Zika Virus/isolation & purification ; Zika Virus Infection/blood ; Zika Virus Infection/diagnosis ; Zika Virus Infection/immunology
Chemical Substances	Antibodies, Viral ; Immunoglobulin G ; Immunoglobulin M
Language	English
Publishing date	2021-01-26
Publishing country	United States
Document type	Evaluation Study ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0244601
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Article ; Online: Cost-effectiveness analysis of bilateral cochlear implants for children with severe-to-profound sensorineural hearing loss in both ears in Singapore.

Li-Jen Cheng / Swee Sung Soon / David Bin-Chia Wu / Hong Ju / Kwong Ng

PLoS ONE, Vol 14, Iss 8, p e

2019 Volume 0220439

Abstract: A cochlear implant is a small electronic device that provides a sense of sound for the user, which can be used unilaterally or bilaterally. Although there is advocacy for the benefits of binaural hearing, the high cost of cochlear implant raises the ... ...

Abstract	A cochlear implant is a small electronic device that provides a sense of sound for the user, which can be used unilaterally or bilaterally. Although there is advocacy for the benefits of binaural hearing, the high cost of cochlear implant raises the question of whether its additional benefits over the use of an acoustic hearing aid in the contralateral ear outweigh its costs. This cost-effectiveness analysis aimed to separately assess the cost-effectiveness of simultaneous and sequential bilateral cochlear implantations compared to bimodal hearing (use of unilateral cochlear implant combined with an acoustic hearing aid in the contralateral ear) in children with severe-to-profound sensorineural hearing loss in both ears from the Singapore healthcare payer perspective. Incremental quality-adjusted life year (QALYs) gained and costs associated with bilateral cochlear implants over the lifetime horizon were estimated based on a four-state Markov model. The analysis results showed that, at the 2017 mean cost, compared to bimodal hearing, patients receiving bilateral cochlear implants experienced more QALYs but incurred higher costs, resulting in an incremental cost-effectiveness ratio (ICER) of USD$60,607 per QALY gained for simultaneous bilateral cochlear implantation, and USD$81,782 per QALY gained for sequential bilateral cochlear implantation. The cost-effectiveness of bilateral cochlear implants is most sensitive to utility gain associated with second cochlear implant, and cost of bilateral cochlear implants. ICERs increased when the utility gain from bilateral cochlear implants decreased; ICERs exceeded USD$120,000 per QALY gained when the utility gain was halved from 0.03 to 0.015 in both simultaneous and sequential bilateral cochlear implantations. The choice of incremental utility gain associated with the second cochlear implant is an area of considerable uncertainty.
Keywords	Medicine ; R ; Science ; Q
Subject code	621
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cost-effectiveness analysis of bilateral cochlear implants for children with severe-to-profound sensorineural hearing loss in both ears in Singapore.

Cheng, Li-Jen / Soon, Swee Sung / Wu, David Bin-Chia / Ju, Hong / Ng, Kwong

PloS one

2019 Volume 14, Issue 8, Page(s) e0220439

Abstract	A cochlear implant is a small electronic device that provides a sense of sound for the user, which can be used unilaterally or bilaterally. Although there is advocacy for the benefits of binaural hearing, the high cost of cochlear implant raises the question of whether its additional benefits over the use of an acoustic hearing aid in the contralateral ear outweigh its costs. This cost-effectiveness analysis aimed to separately assess the cost-effectiveness of simultaneous and sequential bilateral cochlear implantations compared to bimodal hearing (use of unilateral cochlear implant combined with an acoustic hearing aid in the contralateral ear) in children with severe-to-profound sensorineural hearing loss in both ears from the Singapore healthcare payer perspective. Incremental quality-adjusted life year (QALYs) gained and costs associated with bilateral cochlear implants over the lifetime horizon were estimated based on a four-state Markov model. The analysis results showed that, at the 2017 mean cost, compared to bimodal hearing, patients receiving bilateral cochlear implants experienced more QALYs but incurred higher costs, resulting in an incremental cost-effectiveness ratio (ICER) of USD$60,607 per QALY gained for simultaneous bilateral cochlear implantation, and USD$81,782 per QALY gained for sequential bilateral cochlear implantation. The cost-effectiveness of bilateral cochlear implants is most sensitive to utility gain associated with second cochlear implant, and cost of bilateral cochlear implants. ICERs increased when the utility gain from bilateral cochlear implants decreased; ICERs exceeded USD$120,000 per QALY gained when the utility gain was halved from 0.03 to 0.015 in both simultaneous and sequential bilateral cochlear implantations. The choice of incremental utility gain associated with the second cochlear implant is an area of considerable uncertainty.
MeSH term(s)	Child ; Cochlear Implantation/economics ; Cochlear Implantation/methods ; Cochlear Implants/economics ; Cost-Benefit Analysis ; Health Care Costs ; Hearing Loss, Sensorineural/economics ; Hearing Loss, Sensorineural/surgery ; Humans ; Models, Theoretical ; Quality-Adjusted Life Years ; Singapore
Language	English
Publishing date	2019-08-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0220439
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Article: Transcriptomic analysis of multi-drug resistant

Lai, Pey-Jiun / Ng, Ee-Von / Yang, Shun-Kai / Moo, Chew-Li / Low, Wai Yee / Yap, Polly Soo-Xi / Lim, Swee-Hua Erin / Lai, Kok-Song

3 Biotech

2020 Volume 10, Issue 7, Page(s) 313

Abstract: To better understand the synergistic antibacterial activity between piperacillin ... ...

Abstract	To better understand the synergistic antibacterial activity between piperacillin and
Language	English
Publishing date	2020-06-21
Publishing country	Germany
Document type	Case Reports
ZDB-ID	2600522-0
ISSN	2190-5738 ; 2190-572X
ISSN (online)	2190-5738
ISSN	2190-572X
DOI	10.1007/s13205-020-02304-3
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Article ; Online: Cost-effectiveness of olaparib maintenance therapy when used with and without restriction by

Cheng, Li-Jen / Wong, Grace / Chay, Wen-Yee / Ngeow, Joanne / Tan, Yongqiang / Soon, Swee Sung / Aziz, Mohamed Ismail Abdul / Pearce, Fiona / Ng, Kwong

Expert review of pharmacoeconomics & outcomes research

2021 Volume 21, Issue 3, Page(s) 441–448

Abstract: ... ...

Abstract	Objectives
MeSH term(s)	BRCA1 Protein/genetics ; BRCA2 Protein/genetics ; Cost-Benefit Analysis ; Female ; Humans ; Molecular Targeted Therapy ; Mutation ; Neoplasm Recurrence, Local ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/economics ; Ovarian Neoplasms/genetics ; Phthalazines/administration & dosage ; Phthalazines/economics ; Piperazines/administration & dosage ; Piperazines/economics ; Poly(ADP-ribose) Polymerase Inhibitors/administration & dosage ; Poly(ADP-ribose) Polymerase Inhibitors/economics ; Quality-Adjusted Life Years ; Randomized Controlled Trials as Topic ; Singapore ; Survival Analysis ; Time Factors
Chemical Substances	BRCA1 Protein ; BRCA1 protein, human ; BRCA2 Protein ; BRCA2 protein, human ; Phthalazines ; Piperazines ; Poly(ADP-ribose) Polymerase Inhibitors ; olaparib (WOH1JD9AR8)
Language	English
Publishing date	2021-03-08
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	2208481-2
ISSN	1744-8379 ; 1473-7167
ISSN (online)	1744-8379
ISSN	1473-7167
DOI	10.1080/14737167.2021.1890587
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Article ; Online: Spatially-resolved transcriptomics reveal macrophage heterogeneity and prognostic significance in diffuse large B-cell lymphoma.

Liu, Min / Bertolazzi, Giorgio / Sridhar, Shruti / Lee, Rui Xue / Jaynes, Patrick / Mulder, Kevin / Syn, Nicholas / Hoppe, Michal Marek / Fan, Shuangyi / Peng, Yanfen / Thng, Jocelyn / Chua, Reiya / Jayalakshmi / Batumalai, Yogeshini / De Mel, Sanjay / Poon, Limei / Chan, Esther Hian Li / Lee, Joanne / Hue, Susan Swee-Shan /

Chang, Sheng-Tsung / Chuang, Shih-Sung / Chandy, K George / Ye, Xiaofei / Pan-Hammarström, Qiang / Ginhoux, Florent / Chee, Yen Lin / Ng, Siok-Bian / Tripodo, Claudio / Jeyasekharan, Anand D

Nature communications

2024 Volume 15, Issue 1, Page(s) 2113

Abstract: Macrophages are abundant immune cells in the microenvironment of diffuse large B-cell lymphoma (DLBCL). Macrophage estimation by immunohistochemistry shows varying prognostic significance across studies in DLBCL, and does not provide a comprehensive ... ...

Abstract	Macrophages are abundant immune cells in the microenvironment of diffuse large B-cell lymphoma (DLBCL). Macrophage estimation by immunohistochemistry shows varying prognostic significance across studies in DLBCL, and does not provide a comprehensive analysis of macrophage subtypes. Here, using digital spatial profiling with whole transcriptome analysis of CD68+ cells, we characterize macrophages in distinct spatial niches of reactive lymphoid tissues (RLTs) and DLBCL. We reveal transcriptomic differences between macrophages within RLTs (light zone /dark zone, germinal center/ interfollicular), and between disease states (RLTs/ DLBCL), which we then use to generate six spatially-derived macrophage signatures (MacroSigs). We proceed to interrogate these MacroSigs in macrophage and DLBCL single-cell RNA-sequencing datasets, and in gene-expression data from multiple DLBCL cohorts. We show that specific MacroSigs are associated with cell-of-origin subtypes and overall survival in DLBCL. This study provides a spatially-resolved whole-transcriptome atlas of macrophages in reactive and malignant lymphoid tissues, showing biological and clinical significance.
MeSH term(s)	Humans ; Prognosis ; Lymphoma, Large B-Cell, Diffuse/pathology ; Gene Expression Profiling ; Transcriptome ; Germinal Center/pathology ; Tumor Microenvironment/genetics
Language	English
Publishing date	2024-03-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-024-46220-z
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Article ; Online: Evaluation of eight commercial Zika virus IgM and IgG serology assays for diagnostics and research.

Swee Ling Low / Yee Sin Leo / Yee Ling Lai / Sally Lam / Hwee Huang Tan / Judith Chui Ching Wong / Li Kiang Tan / Lee Ching Ng

PLoS ONE, Vol 16, Iss 1, p e

2021 Volume 0244601

Abstract	Several commercial Zika virus (ZIKV) serology assays have been developed since the recognition of ZIKV outbreaks as a Public Health Emergency of International Concern in 2016. However, test interpretation for ZIKV serology can be challenging due to antibody cross-reactivity with other flaviviruses like dengue virus (DENV). Therefore, we sought to evaluate the performance of eight commercially available ZIKV IgM and IgG assays across three testing platforms, namely, immunochromatographic tests (ICT), ELISAs and immunofluorescence tests (IIFT). The test panel comprised of 278 samples, including acute and convalescent sera or plasma from ZIKV-confirmed, DENV-confirmed, non-ZIKV and non-DENV patients, and residual sera from healthy blood donors. The ZIKV IgM and IgG serology assays yielded higher test sensitivities of 23.5% - 97.1% among ZIKV convalescent samples as compared to 5.6% - 27.8% among ZIKV acute samples; the test specificities were 63.3% - 100% among acute and convalescent DENV, non-DENV samples. Among the ELISAs and IIFTs, the Diapro ZIKV IgM ELISA demonstrated high test sensitivity (96%) and specificity (80%) when tested on early convalescent samples, while the Euroimmun ZIKV IgG ELISA yielded the highest test specificity of 97% - 100% on samples from non-ZIKV patients and healthy blood donors. For rapid ICTs, the LumiQuick IgM rapid ICT yielded low test sensitivity, suggesting its limited utility. We showed that commercial ZIKV IgM and IgG serology assays have differing test performances, with some having moderate to high test sensitivities and specificities when used in a dengue endemic setting, although there were limitations in IgG serology.
Keywords	Medicine ; R ; Science ; Q
Subject code	621
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Metastatic pulmonary calcification: Experience from a single center in Singapore.

Teh, Swee Ping / Ng, Yuen Li / Yii, Chau Ang Anthony / Choong, Hui Lin Lina / Wong, Jiunn

Hemodialysis international. International Symposium on Home Hemodialysis

2018 Volume 22, Issue 4, Page(s) E63–E67

Abstract: Metastatic pulmonary calcification (MPC) was seen in 79% of patients with end-stage renal disease (ESRD) during autopsy. However, it is not commonly diagnosed in vivo. Its pathogenesis is not fully understood. We report a retrospective series of 5 cases ... ...

Abstract	Metastatic pulmonary calcification (MPC) was seen in 79% of patients with end-stage renal disease (ESRD) during autopsy. However, it is not commonly diagnosed in vivo. Its pathogenesis is not fully understood. We report a retrospective series of 5 cases of MPC from a single center in Singapore. MPC were diagnosed using radiological or histological features. Mean onset of MPC from diagnosis of ESRD was 22.6 ± 3.1 years. One patient remains asymptomatic. Four patients died, one was related to MPC. All patients had calcifications at the lung apices on radiological studies. Three patients with MPC were diagnosed based on radiological features while 2 had histological features. Four patients underwent parathyroidectomy without radiological changes before parathyroidectomy. Median intact parathyroid hormone of this series was 5.6 pmol/L (IQR 1.3-139.4), alkaline phosphatase 74 U/L (IQR 62-461), calcium 2.10 mmol/L (IQR 1.85-2.40), and phosphate 1.30 mmol/L (IQR 0.87-1.63). The observed low iPTH suggests that MPC might occur in low iPTH. Our case series showed MPC might occur in low iPTH after parathyroidectomy, in contrast to existing literature that suggests MPC is diagnosed in patients with elevated iPTH. Parathyroidectomy does not prevent MPC.
MeSH term(s)	Adult ; Aged ; Female ; Humans ; Lung Diseases/diagnosis ; Lung Diseases/pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Retrospective Studies ; Singapore
Language	English
Publishing date	2018-04-02
Publishing country	Canada
Document type	Case Reports
ZDB-ID	2192458-2
ISSN	1542-4758 ; 1492-7535
ISSN (online)	1542-4758
ISSN	1492-7535
DOI	10.1111/hdi.12658
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Article ; Online: Cost-effectiveness of MRI targeted biopsy strategies for diagnosing prostate cancer in Singapore.

Cheng, Li-Jen / Soon, Swee Sung / Tan, Teck Wei / Tan, Cher Heng / Lim, Terence Sey Kiat / Tay, Kae Jack / Loke, Wei Tim / Ang, Bertrand / Chiong, Edmund / Ng, Kwong

BMC health services research

2021 Volume 21, Issue 1, Page(s) 909

Abstract: Background: To evaluate the cost-effectiveness of six diagnostic strategies involving magnetic resonance imaging (MRI) targeted biopsy for diagnosing prostate cancer in initial and repeat biopsy settings from the Singapore healthcare system perspective.! ...

Abstract	Background: To evaluate the cost-effectiveness of six diagnostic strategies involving magnetic resonance imaging (MRI) targeted biopsy for diagnosing prostate cancer in initial and repeat biopsy settings from the Singapore healthcare system perspective. Methods: A combined decision tree and Markov model was developed. The starting model population was men with mean age of 65 years referred for a first prostate biopsy due to clinical suspicion of prostate cancer. The six diagnostic strategies were selected for their relevance to local clinical practice. They comprised MRI targeted biopsy following a positive pre-biopsy multiparametric MRI (mpMRI) [Prostate Imaging - Reporting and Data System (PI-RADS) score ≥ 3], systematic biopsy, or saturation biopsy employed in different testing combinations and sequences. Deterministic base case analyses with sensitivity analyses were performed using costs from the healthcare system perspective and quality-adjusted life years (QALY) gained as the outcome measure to yield incremental cost-effectiveness ratios (ICERs). Results: Deterministic base case analyses showed that Strategy 1 (MRI targeted biopsy alone), Strategy 2 (MRI targeted biopsy ➔ systematic biopsy), and Strategy 4 (MRI targeted biopsy ➔ systematic biopsy ➔ saturation biopsy) were cost-effective options at a willingness-to-pay (WTP) threshold of US$20,000, with ICERs ranging from US$18,975 to US$19,458. Strategies involving MRI targeted biopsy in the repeat biopsy setting were dominated. Sensitivity analyses found the ICERs were affected mostly by changes to the annual discounting rate and prevalence of prostate cancer in men referred for first biopsy, ranging between US$15,755 to US$23,022. Probabilistic sensitivity analyses confirmed Strategy 1 to be the least costly, and Strategies 2 and 4 being the preferred strategies when WTP thresholds were US$20,000 and US$30,000, respectively. Limitations and conclusions: This study found MRI targeted biopsy to be cost-effective in diagnosing prostate cancer in the biopsy-naïve setting in Singapore.
MeSH term(s)	Aged ; Biopsy ; Cost-Benefit Analysis ; Humans ; Magnetic Resonance Imaging ; Male ; Prostatic Neoplasms/diagnostic imaging ; Singapore/epidemiology
Language	English
Publishing date	2021-09-03
Publishing country	England
Document type	Journal Article
ISSN	1472-6963
ISSN (online)	1472-6963
DOI	10.1186/s12913-021-06916-0
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