A Comparative Frequency Analysis of Maximum Daily Rainfall for a SE Asian Region under Current and Future Climate Conditions

The impact of changing climate on the frequency of daily rainfall extremes in Jakarta, Indonesia, is analysed and quantified. The study used three different models to assess the changes in rainfall characteristics. The first method involves the use of the weather generator LARS-WG to quantify changes between historical and future daily rainfall maxima. The second approach consists of statistically downscaling general circulation model (GCM) output based on historical empirical relationships between GCM output and station rainfall. Lastly, the study employed recent statistically downscaled global gridded rainfall projections to characterize climate change impact rainfall structure. Both annual and seasonal rainfall extremes are studied. The results show significant changes in annual maximum daily rainfall, with an average increase as high as 20% in the 100-year return period daily rainfall. The uncertainty arising from the use of different GCMs was found to be much larger than the uncertainty from the emission scenarios. Furthermore, the annual and wet seasonal analyses exhibit similar behaviors with increased future rainfall, but the dry season is not consistent across the models. The GCM uncertainty is larger in the dry season compared to annual and wet season.MOE (Min. of Education, S’pore)Published versio

Rapid detection of BRCA1/2 recurrent mutations in Chinese breast and ovarian cancer patients with multiplex SNaPshot genotyping panels.

BRCA1/2 mutations are significant risk factors for hereditary breast and ovarian cancer (HBOC), its mutation frequency in HBOC of Chinese ethnicity is around 9%, in which nearly half are recurrent mutations. In Hong Kong and China, genetic testing and counseling are not as common as in the West. To reduce the barrier of testing, a multiplex SNaPshot genotyping panel that targeted 25 Chinese BRCA1/2 mutation hotspots was developed, and its feasibility was evaluated in a local cohort of 441 breast and 155 ovarian cancer patients. For those who tested negative, they were then subjected to full-gene testing with next-generation sequencing (NGS). BRCA mutation prevalence in this cohort was 8.05% and the yield of the recurrent panel was 3.52%, identifying over 40% of the mutation carriers. Moreover, from 79 Chinese breast cancer cases recruited overseas, 2 recurrent mutations and one novel BRCA2 mutation were detected by the panel and NGS respectively. The developed genotyping panel showed to be an easy-to-perform and more affordable testing tool that can provide important contributions to improve the healthcare of Chinese women with cancer as well as family members that harbor high risk mutations for HBOC

Health-related quality of life mediates associations between multi-morbidity and depressive symptoms in Chinese primary care patients

© The Author 2015. Background. Qualifying the relationship between multi-morbidity, health-related quality of life (HRQOL) and depressive symptoms in primary care can help to inform the development of appropriate interventions and services which can help to enhance HRQOL in patients with chronic disease. Objective. The objective of this study was to determine whether the physical aspect of HRQOL mediates the relationship between chronic disease multi-morbidity and depressive symptoms in Chinese primary care patients. Methods. A cross-sectional survey was conducted on patients recruited from the waiting rooms of 59 primary care clinics distributed across Hong Kong. About 9259 subjects were included for the mediation model analysis. The primary outcome was level of depressive symptoms as measured by the Patient Health Questionniare 9. The mediation model was tested using a bootstrapping method. Results. The prevalence of chronic disease was 50.4%, with 25.4% having two or more comorbidities. The relationship between multi-morbidity and depressive symptoms was found to be mediated by the Physical Component Summary score of the SF-12 v2. Further analysis found the general health (GH) and role physical domains of the SF-12 were the strongest mediators, followed by bodily pain and physical functioning (PF). Conclusion. To enhance the functional capacity of primary care patients with co-existing chronic disease and depressive symptoms, health care interventions should be directed at improving the physical aspects of HRQOL, in particular enhancing patients' GH perception, role functioning and PF, and to better manage chronic pain.Link_to_subscribed_fulltex

The impacts of using smartphone dating applications on sexual risk behaviours in college students in Hong Kong

© 2016 Choi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Dating applications (apps) on smartphones have become increasingly popular. The aim of this study was to explore the association between the use of dating apps and risky sexual behaviours. Data were collected in four university campuses in Hong Kong. Subjects completed a structured questionnaire asking about the use of dating apps, sexual behaviours, and sociodemographics. Multiple linear and logistics regressions were used to explore factors associated with sexual risk behaviours. Six hundred sixty-six subjects were included in the data analysis. Factors associated with having unprotected sexual intercourse with more lifetime sexual partners included use of dating apps (β = 0.93, p < 0.01), having one's first sexual intercourse before 16 years of age (β = 1.74, p < 0.01), being older (β = 0.4, p < 0.01), currently being in a relationship (= 0.69, p < 0.05), having a monthly income at least HKD $5,000 (β = 1.34, p < 0.01), being a current smoker (β = 1.52, p < 0.01), and being a current drinker (β = 0.7, p < 0.01). The results of a multiple logistic regression analysis found that users of dating apps (adjust odds ratio: 0.52, p < 0.05) and current drinkers (adjust odds ratio: 0.40, p < 0.01) were less likely to have consistent condom use. Users of dating apps (adjust odds ratio: 1.93, p < 0.05), bisexual/homosexual subjects (adjust odds ratio: 2.57, p < 0.01) and female subjects (adjust odds ratio: 2.00, p < 0.05) were more likely not to have used condoms the last time they had sexual intercourse. The present study found a robust association between using dating apps and sexual risk behaviours, suggesting that app users had greater sexual risks. Interventions that can target app users so that they can stay safe when seeking sexual partners through dating apps should be developed.published_or_final_versio

Age-specific Multimorbidity Patterns and Burden on All-Cause Mortality and Public Direct Medical Expenditure:A Retrospective Cohort Study

Objective To evaluate age-specific multimorbidity patterns and morbidity burden on mortality and healthcare expenditure across age groups. Patients and Methods Retrospective observational study between January 1, 2009 to December 31, 2017 using electronic health records in Hong Kong: Individuals were stratified by age (< 50, 50–64, 65–79, ≥ 80), and sub-classified by number of morbidities (0, 1, 2, 3, ≥ 4) out of 21 common chronic conditions. Clustering analyses were conducted to identify specific patterns of multimorbidity. Association between the number as well as combinations of morbidities and all-cause mortality and public expenditure was examined. Results 4,562,832 individuals with a median follow-up of 7 years were included. Mental disorders were the top morbidities among young individuals, while cardiovascular diseases were prevalent in the elderly. An increased number of morbidities was associated with a greater relative risk for mortality and medical expenditure, and this relationship was stronger among younger patients. Compared to individuals in the same age group without morbidity, the hazard ratios (HR; 95% CI) of all-cause mortality in patients aged < 50 and ≥ 80 with two comorbidities 3.81 (3.60–4.03) and 1.38 (1.36–1.40), respectively, which increased to 14.22 (9.87–20.47) and 2.20 (2.13–2.26), respectively, as the number of morbidities increased to ≥ 4. The stroke-hypertension cluster was shown to be associated with the highest HR of mortality 2.48 (2.43–2.53) among all identified clusters arising from the clustering analysis. Conclusion Given the stronger association between multimorbidity and all-cause mortality and greater opportunity costs in younger populations, prevention and management of early-onset multimorbidity are warranted. (248 words

Incompressible SPH method based on Rankine source solution for violent water wave simulation

With wide applications, the smoothed particle hydrodynamics method (abbreviated as SPH) has become an important numerical tool for solving complex flows, in particular those with a rapidly moving free surface. For such problems, the incompressible Smoothed Particle Hydrodynamics (ISPH) has been shown to yield better and more stable pressure time histories than the traditional SPH by many papers in literature. However, the existing ISPH method directly approximates the second order derivatives of the functions to be solved by using the Poisson equation. The order of accuracy of the method becomes low, especially when particles are distributed in a disorderly manner, which generally happens for modelling violent water waves. This paper introduces a new formulation using the Rankine source solution. In the new approach to the ISPH, the Poisson equation is first transformed into another form that does not include any derivative of the functions to be solved, and as a result, does not need to numerically approximate derivatives. The advantage of the new approach without need of numerical approximation of derivatives is obvious, potentially leading to a more robust numerical method. The newly formulated method is tested by simulating various water waves, and its convergent behaviours are numerically studied in this paper. Its results are compared with experimental data in some cases and reasonably good agreement is achieved. More importantly, numerical results clearly show that the newly developed method does need less number of particles and so less computational costs to achieve the similar level of accuracy, or to produce more accurate results with the same number of particles compared with the traditional SPH and existing ISPH when it is applied to modelling water waves

The Spill-Over Impact of the Novel Coronavirus-19 Pandemic on Medical Care and Disease Outcomes in Non-communicable Diseases: A Narrative Review

OBJECTIVES: The coronavirus-19 (COVID-19) pandemic has claimed more than 5 million lives worldwide by November 2021. Implementation of lockdown measures, reallocation of medical resources, compounded by the reluctance to seek help, makes it exceptionally challenging for people with non-communicable diseases (NCD) to manage their diseases. This review evaluates the spill-over impact of the COVID-19 pandemic on people with NCDs including cardiovascular diseases, cancer, diabetes mellitus, chronic respiratory disease, chronic kidney disease, dementia, mental health disorders, and musculoskeletal disorders. METHODS: Literature published in English was identified from PubMed and medRxiv from January 1, 2019 to November 30, 2020. A total of 119 articles were selected from 6,546 publications found. RESULTS: The reduction of in-person care, screening procedures, delays in diagnosis, treatment, and social distancing policies have unanimously led to undesirable impacts on both physical and psychological health of NCD patients. This is projected to contribute to more excess deaths in the future. CONCLUSION: The spill-over impact of COVID-19 on patients with NCD is just beginning to unravel, extra efforts must be taken for planning the resumption of NCD healthcare services post-pandemic

Self-powered wireless carbohydrate/oxygen sensitive biodevice based on radio signal transmission

peer-reviewedHere for the first time, we detail self-contained (wireless and self-powered) biodevices with wireless signal transmission. Specifically, we demonstrate the operation of self-sustained carbohydrate and oxygen sensitive biodevices, consisting of a wireless electronic unit, radio transmitter and separate sensing bioelectrodes, supplied with electrical energy from a combined multi-enzyme fuel cell generating sufficient current at required voltage to power the electronics. A carbohydrate/oxygen enzymatic fuel cell was assembled by comparing the performance of a range of different bioelectrodes followed by selection of the most suitable, stable combination. Carbohydrates (viz. lactose for the demonstration) and oxygen were also chosen as bioanalytes, being important biomarkers, to demonstrate the operation of the self-contained biosensing device, employing enzyme-modified bioelectrodes to enable the actual sensing. A wireless electronic unit, consisting of a micropotentiostat, an energy harvesting module (voltage amplifier together with a capacitor), and a radio microchip, were designed to enable the biofuel cell to be used as a power supply for managing the sensing devices and for wireless data transmission. The electronic system used required current and voltages greater than 44 mu A and 0.57 V, respectively to operate; which the biofuel cell was capable of providing, when placed in a carbohydrate and oxygen containing buffer. In addition, a USB based receiver and computer software were employed for proof-of concept tests of the developed biodevices. Operation of bench-top prototypes was demonstrated in buffers containing different concentrations of the analytes, showcasing that the variation in response of both carbohydrate and oxygen biosensors could be monitored wirelessly in real-time as analyte concentrations in buffers were changed, using only an enzymatic fuel cell as a power supply.PUBLISHEDpeer-reviewe