A Perspective on Cell Therapy and Cancer Vaccine in Biliary Tract Cancers (BTCs).

Biliary tract cancer (BTC) is a rare, but aggressive, disease that comprises of gallbladder carcinoma, intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma, with heterogeneous molecular profiles. Advanced disease has limited therapeutic options beyond first-line platinum-based chemotherapy. Immunotherapy has emerged as a viable option for many cancers with a similar unmet need. Therefore, we reviewed current understanding of the tumor immune microenvironment and recent advances in cellular immunotherapy and therapeutic cancer vaccines against BTC. We illustrated the efficacy of dendritic cell vaccination in one patient with advanced, chemorefractory, melanoma-associated antigen (MAGE)-positive gallbladder carcinoma, who was given multiple injections of an allogenic MAGE antigen-positive melanoma cell lysate (MCL)-based autologous dendritic cell vaccine combined with sequential anti-angiogenic therapy. This resulted in good radiological and tumor marker response and an overall survival of 3 years from diagnosis. We postulate the potential synergism of adding anti-angiogenic therapy, such as bevacizumab, to immunotherapy in BTC, as a rational scientific principle to positively modulate the tumor microenvironment to augment antitumor immunity

Contemporary Somali piracy : evaluating the effectiveness of counter-piracy measures

This report discusses about the effectiveness of current anti-piracy measures in the Somalia basin, which includes the Gulf of Aden, the Arabian Gulf and the Indian Ocean. Currently, the anti-piracy measures can be split into two groups, namely, the industry efforts, and the international efforts. The industry efforts refer mainly to the Best Management Practices (BMP) and the usage of private armed guards. On the other hand, the international efforts looks at the measures that the governments and the international community has come up with, which includes the international conventions and laws and the deployment of naval forces. Through literature reviews, a hypothesis was drawn up to test if ship owners will most likely adhere to the BMP due to its effectiveness and ability to overcome the limitations imposed by the international measures.Bachelor of Science (Maritime Studies

Taking the single route- the good, the bad and the expectations.

Given the rising trend of women delaying (or eschewing) marriage and the dearth of studies on their subjective experiences of singleness, this research aims to critically examine how singlehood is commonly understood and to find new ways of thinking and talking about singleness. Drawing on in-depth interview data, I find that while there may be noteworthy variations in the ways that women belonging to different age groups experience singlehood, such one-sided representation of singleness fails to capture the multiple aspects of a woman’s single identity and the plurality of meanings that she attaches to marriage and singlehood. To complete the discussion on contemporary singleness, the paper concludes with an analysis of how single women make sense of their own lives living in a society where marriage continues to be the norm.Bachelor of Art

Are Singaporeans selfish, altruistic or dynastic?

With increasing trend of an ageing population and life expectancy, supporting the elderly has become a worrying issue in Singapore. In a prosperous economy, it is important to find out the altruistic nature of parents by examining their ability to support themselves independently or to rely on their children by using bequest as leverage. In this study, we aim to investigate the model of household behavior applicable to Singapore, as well as the degree of altruism in Singapore by analyzing data on Singaporeans attitude towards bequest motives and bequest division. 300 face-to-face interviews are conducted island-wide for Singaporeans aged between 40 to 69 years old. The analysis suggests that the altruism model is the dominant and most applicable household behavioral model in Singapore. Our results suggest that income level is not a key explanatory variable to the level of altruism but in Singapore the prevalence of religion and culture is. Comparing Singapore’s data with Japan, India, China and the United States, we conclude that Singapore ranks in the middle, with Singaporeans being less altruistic than the United States and India, but more altruistic than China and Japan.Bachelor of Art

A Perspective on Cell Therapy and Cancer Vaccine in Biliary Tract Cancers (BTCs)

Biliary tract cancer (BTC) is a rare, but aggressive, disease that comprises of gallbladder carcinoma, intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma, with heterogeneous molecular profiles. Advanced disease has limited therapeutic options beyond first-line platinum-based chemotherapy. Immunotherapy has emerged as a viable option for many cancers with a similar unmet need. Therefore, we reviewed current understanding of the tumor immune microenvironment and recent advances in cellular immunotherapy and therapeutic cancer vaccines against BTC. We illustrated the efficacy of dendritic cell vaccination in one patient with advanced, chemorefractory, melanoma-associated antigen (MAGE)-positive gallbladder carcinoma, who was given multiple injections of an allogenic MAGE antigen-positive melanoma cell lysate (MCL)-based autologous dendritic cell vaccine combined with sequential anti-angiogenic therapy. This resulted in good radiological and tumor marker response and an overall survival of 3 years from diagnosis. We postulate the potential synergism of adding anti-angiogenic therapy, such as bevacizumab, to immunotherapy in BTC, as a rational scientific principle to positively modulate the tumor microenvironment to augment antitumor immunity

Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index

Background: Subclinical atherosclerosis can be present in individuals with an optimal cardiovascular risk factor profile. Traditional risk scores such as the Framingham risk score do not adequately capture risk stratification in low-risk individuals. The aim of this study was to determine if markers of metabolic syndrome and insulin resistance can better stratify low-risk individuals. Methods: A cross-sectional study of 101 healthy participants with a low Framingham risk score and no prior morbidities was performed to assess prevalence of subclinical atherosclerosis using computed tomography (CT) and ultrasound. Participants were compared between groups based on Metabolic Syndrome (MetS) and Insulin-Sensitivity Index (ISI-cal) scores. Results: Twenty three individuals (23%) had subclinical atherosclerosis with elevated CT Agatston score ≥1. Presence of both insulin resistance (ISI-cal <9.23) and fulfillment of at least one metabolic syndrome criterion denoted high risk, resulting in significantly improved AUC (0.706 95%CI 0.588–0.822) over the Framingham risk score in predicting elevated CT Agatston score ≥1, with net reclassification index of 50.9 ± 23.7%. High-risk patients by the new classification also exhibited significantly increased carotid intima thickness. Conclusions: The overlap of insulin resistance and presence of ≥1 criterion for metabolic syndrome may play an instrumental role in identifying traditionally low-risk individuals predisposed to future risk of atherosclerosis and its sequelae.Agency for Science, Technology and Research (A*STAR)National Medical Research Council (NMRC)Published versionThis work was supported financially by the Agency for Science, Technology and Research (A∗ STAR), Singapore (Grant No. I-1701E0B15), Lee foundation through support of the SingHeart study, and core funding from SingHealth and Duke NUS through their institute of Precision Medicine (PRISM) and a center grant awarded to National Heart Centre Singapore from the National Medical Research Council, Ministry of Health, Republic of Singapore (Grant No. NMRC/CG/M006/2017_NHCS). The funding bodies were not involved in design, conduct, data interpretation, or writing of the manuscript