Health System for Dengue Control in Singapore

Dengue fever/dengue haemorrhagic fever (DF/DHF) first appeared in Singapore in an outbreak in 1960. In 1966, the Ministry of Health established the Vector Control Unit which was charged with the responsibility of controlling the dengue vector mosquitoes, Aedes aegypti and Aedes albopictus. The Unit immediately launched an Aedes control programme based on source reduction and public health education. To obtain reliable statistics on disease incidence, DF/DHF was made administratively notifiable in 1966, and finally, legally notifiable in 1977. It was also recognized early in the control programme that long-term and active participation by the community was essential for its implementation. A new legislation called the Destruction of Disease-Bearing Insects Act was thus enacted in 1968. The Act empowers vector control officers to enter and examine houses for mosquito breeding, to take appropriate control measures, and to serve offenders with orders and summonses which carry a fine or imprisonment by the court. With the new legislation in force, the Aedes control programme adopted an integrated approach of source reduction, public health education and law enforcement. When the new Ministry of the Environment was formed in 1972 to take over the responsibility of environmental health, its Vector Control and Research Department and the Quarantine & Epidemiology Department became responsible for the surveillance and control of DF/DHF in the country. Surveillance of disease incidence and Aedes vectors is important in the prevention and control of DF/DHF outbreaks. Disease surveillance is conducted by officers of the Quarantine & Epidemiology Department based on notifications on clinically diagnosed cases as well as on the number of blood specimens submitted by hospitals, clinics, and private practitioners to the Virology Division of the Department of Pathology in the Ministry of Health and the Department of Microbiology of the National University of Singapore for laboratory confirmation of dengue infection. Aedes surveillance depends on regular surveys of mosquito larvae and adults in designated DF/DHF-sensitive areas. In addition to destruction of breeding habitats, fogging is carried out when the Aedes house index is 2% and above, or when a potential outbreak situation arises such as the occurrence of a focus of two or more DF/DHF cases in an area

Epidemiology of Dengue in Singapore-Current Situation

There has been a resurgence of dengue fever/dengue haemorrhagic fever (DF/DHF) cases in Singapore in recent years. Following the large outreak in 1973 with 1,187 cases and 27 deaths, the incidence of DF/DHF declined with minor bi-annual outbreaks occurring in 1978, 1980 and 1982. Beginning from 1986, however, the DF/DHF situation changed for the worse when outbreaks of increasing size occurred almost annually. In the past 3 years, there were 1,733 cases in 1990, 2,179 cases in 1991 and 2,878 cases in 1992. In the 1991 and 1992 outbreaks, 93-95% of the notified cases required hospitalization and 92-95% of them were serologically confirmed by the IgM capture ELISA and/or the commercial Dengue Blot assay. The number of fatal cases, however, remained low with 3-6 reported deaths in the three outbreaks. All age groups were affected with the highest morbidity rate in children and young adults between 15 and 24 years of age. In contrast, in the earlier 1973 and 1978 outbreaks, more patients below the age of 15 years were observed. There was a slight predominance among males and Chinese had the highest morbidity rate compared with Malays and Indians. The recent outbreaks occurred mainly in highly populated urban and suburban areas in the eastern, northeastern and southeastern parts of the island. Patients living in landed property such as compound houses had a 9X higher morbidity rate than those living in high-rise flats. Cases were reported throughout the year and the number increased during May and June. The increased DF/DHF incidence was preceded by an increase in the Aedes mosquito population. In the 1991 and 1992 outbreaks, although the overall Aedes house index was<1 for both Ae aegypti and Ae albopictus higher indices were detected in localized areas with high dengue transmission. The proportion of compound houses found breeding Ae aegypti was 3-4 times and Ae albopictus 7-10 times higher than that of flats. The major breeding habitats were ornamental and domestic containers and discarded receptacles

Riverine sustainment 2012

Student Integrated ProjectIncludes supplementary materialThis technical report analyzed the Navy's proposed Riverine Force (RF) structure and capabilities for 2012. The Riverine Sustainment 2012 Team (RST) examined the cost and performance of systems of systems which increased RF sustainment in logistically barren environments. RF sustainment was decomposed into its functional areas of supply, repair, and force protection. The functional and physical architectures were developed in parallel and were used to construct an operational architecture for the RF. The RST used mathematical, agent-based and queuing models to analyze various supply, repair and force protection system alternatives. Extraction of modeling data revealed several key insights. Waterborne heavy lift connectors such as the LCU-2000 are vital in the re-supply of the RF when it is operating up river in a non-permissive environment. Airborne heavy lift connectors such as the MV-22 were ineffective and dominated by the waterborne variants in the same environment. Increase in manpower and facilities did appreciable add to the operational availability of the RF. Mean supply response time was the biggest factor effecting operational availability and should be kept below 24 hours to maintain operational availability rates above 80%. Current mortar defenses proposed by the RF are insufficient.N

A stochastic individual-based model to explore the role of spatial interactions and antigen recognition in the immune response against solid tumours

FRM is funded by the Engineering and Physical Sciences Research Council (EPSRC).Spatial interactions between cancer and immune cells, as well as the recognition of tumour antigens by cells of the immune system, play a key role in the immune response against solid tumours. The existing mathematical models generally focus only on one of these key aspects. We present here a spatial stochastic individual-based model that explicitly captures antigen expression and recognition. In our model, each cancer cell is characterised by an antigen profile which can change over time due to either epimutations or mutations. The immune response against the cancer cells is initiated by the dendritic cells that recognise the tumour antigens and present them to the cytotoxic T cells. Consequently, T cells become activated against the tumour cells expressing such antigens. Moreover, the differences in movement between inactive and active immune cells are explicitly taken into account by the model. Computational simulations of our model clarify the conditions for the emergence of tumour clearance, dormancy or escape, and allow us to assess the impact of antigenic heterogeneity of cancer cells on the efficacy of immune action. Ultimately, our results highlight the complex interplay between spatial interactions and adaptive mechanisms that underpins the immune response against solid tumours, and suggest how this may be exploited to further develop cancer immunotherapies.PostprintPeer reviewe

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Carbamazepine-induced DRESS syndrome in a child: Rapid response to pulsed corticosteroids

DRESS syndrome is an idiosyncratic reaction to drugs, which can occur in both adults and children. To date there is no agreed upon criteria for its diagnosis; there is even less consensus on its management. We report the case of a 14- year-old boy with carbamazepine induced DRESS syndrome, predominantly involving the liver. He responded rapidly to high dose pulsed intravenous corticosteroids

Carbamazepine-induced DRESS syndrome in a child: Rapid response to pulsed corticosteroids

DRESS syndrome is an idiosyncratic reaction to drugs, which can occur in both adults and children. To date there is no agreed upon criteria for its diagnosis; there is even less consensus on its management. We report the case of a 14- year-old boy with carbamazepine induced DRESS syndrome, predominantly involving the liver. He responded rapidly to high dose pulsed intravenous corticosteroids

Foreign ownership restrictions and share prices in the China capital market.

This paper looks briefly at the development of the Shanghai and Shenzhen stock markets in the context of China's goal to attract foreign capital to modernise and integrate its economy to the global economy. The analysis of the stock returns revealed that the returns on B shares in Shenzhen generally exhibit little or no correlation with international factors while those in Shanghai do exhibit some correlation. In addition, liquidity as measured by the ratio of the volume of B shares to total volume of A and B shares only explain the returns of Shenzhen B shares. The only factor that explains the returns on both Shanghai and Shenzhen B shares is the effects of firm size. Generally, the results suggest that the Shenzhen B shares have some diversification value while Shanghai B shares are not totally segmented from international factors.Master of Business Administration (Accountancy

The 2000 dotcom crash and the lessons for Singapore dotcoms.

This paper attempts to find out the issues and challenges facing local dotcom companies after the burst of the dotcom bubble that led to the downfall of many dotcom companies. This paper finds out the reasons why dotcoms failed and specifically, how many dotcom companies had failed in Singapore, which was determined by reviewing local dotcom websites obtained from the Department of Statistics

Public's perception of the bus service standards in Singapore.

This report seeks to assess the service quality standards of Singapore's public bus services from a commuter's perspective and compares the performance of SBS Transit and TIBS, using the SERVQUAL model. Recommendations for improvements to the service providers are also suggested