Studies on the storage stability of fermented red dragon fruit (Hylocereus polyrhizus) drink

The objective of this work was to study the effect of storage temperatures and duration on the stability of fermented red dragon fruit drink (FRDFD) on its betacyanins content, physicochemical and microbiological qualities (BPM) and determining sensory acceptability. Results showed that both storage temperatures and duration have a significant effect on betacyanins content and physicochemical properties of FRDFD. Aerobic mesophilic and yeast and mold counts were lower than 1 × 103 CFU/mL for FRDFD stored at both temperatures. The loss of betanin (16.53–13.93 g/L) at 4 °C was 15.73% with no significant changes in physicochemical properties from week two onwards compared to 56.32% (16.53–7.22 g/L) of betanin loss at 25 °C. At week eight, FRDFD stored at 4 °C still contained 13.93 g/L betanin with a pH value of 3.46, suggested its potential as a functional drink which is sensory acceptable (mean score > 80% using hedonic test) among consumers

Acculturative Stress among Asian International Students in Singapore

This study aims to identify the level of acculturative stress and to examine the correlations between acculturative stress or its subcategories and variables such as English language proficiency. The results show that international students were challenged by social interactions, lack of English language proficiency and financial issues. The results of this study and their possible implications for educational institutions in Singapore and Asia are considered

Study on bioaccessibility of betacyanins from red dragon fruit (Hylocereus polyrhizus)

Betacyanins are bioactive dietary phytochemicals which can be found in red dragon fruit (RDF). Therefore, the bioaccessibility of betacyanins that present in fermented red dragon fruit drink (RDFD) and pressed red dragon fruit juice (RDFJ) was accessed in simulated gastric and intestinal digestion. Results disclosed that betacyanins from RDFD and RDFJ suffered minor loss (< 25%) at gastric-like environment but greater loss was observed during the intestinal phase digestion. After subjected to intestinal digestion, RDFD retained 46.42% of betanin while RDFJ retained 43.76%, with betanin concentration of 17.12 mM and 12.37 mM, respectively. Findings also revealed that RDFD exhibited higher antioxidant capacity compared to RDFJ after subjected to intestinal digestion, with values of 0.88 mM Trolox equivalent antioxidant capacity (TEAC) and 0.85 mM TEAC, respectively. The data suggests that betacyanins that present in RDF are bioaccessible while fermentation able to enhance the bioavailability with more betacyanins retained after intestinal digestion

Evaluation of Ertapenem use with Impact Assessment on Extended-Spectrum Beta-Lactamases (ESBL) Production and Gram-Negative resistance in Singapore General Hospital (SGH)

BACKGROUND: Ertapenem (preferred choice for ESBL-producing organisms) use exhibited an increasing trend from 2006 to 2008. As extensive use of ertapenem might induce the mutation of resistant bacteria strains to ertapenem, we aimed to assess the appropriateness and impact of ertapenem-use, on ESBL production, the trends of gram-negative bacterial resistance and on the utilization of other antibiotics in our institution. METHODS: Inpatients who received a dose of ertapenem during 1 January 2006 to 31 December 2008, were reviewed. Pertinent patient clinical data was extracted from the pharmacy databases and assessed for appropriateness based on dose and indication. Relevant data from Network for Antimicrobial Resistance Surveillance (Singapore) (NARSS) was extracted, to cross-correlate with ertapenem via time series to assess its impact on hospital epidemiology, trends of gram-negative resistance and consumption of other antibiotics from 2006 to mid-2010. RESULTS: 906 cases were reviewed. Ertapenem therapy was appropriate in 72.4% (93.7% success rate). CNS adverse events were noted in 3.2%. Readmission rate (30-day) due to re-infection (same pathogen) was 5.5%. Fifty cases had cultures growing Pseudomonas aeruginosa within 30 days of ertapenem initiation, with 25 cases growing carbapenem-resistant Pseudomonas aeruginosa. Ertapenem use increased from 0.45 DDD/100 patient days in 2006 to 1.2 DDD/100 patient days in mid-2010. Overall, the increasing trend of ertapenem consumption correlated with 1) increasing incidence-densities of ciprofloxacin-resistant/cephalosporin-resistant E. coli at zero time lag; 2) increasing incidence-densities of ertapenem-resistant Escherichia. coli and Klebsiella spp. at zero time lag; 3) increasing incidence-density of carbapenem-resistant Pseudomonas aeruginosa, at zero time lag. Increasing ertapenem consumption was significantly correlated with decreasing consumption of cefepime (R(2) = 0.37344) 3 months later. It was significantly correlated with a decrease in imipenem consumption (R(2) = 0.31081), with no time lag but was correlated with subsequent increasing consumption of meropenem (R(2) = 0.4092) 6 months later. CONCLUSION: Ertapenem use was appropriate. Increasing Ertapenem consumption did not result in a decreasing trend of ESBL producing enterobacteriaceae and could result in the selection for multi-drug resistant bacteria

Does the Axillary Lymph Node Ratio Have Any Added Prognostic Value over pN Staging for South East Asian Breast Cancer Patients?

10.1371/journal.pone.0045809PLoS ONE79

Fermentation of red dragon fruit (Hylocereus polyrhizus) for betalains concentration

Red dragon fruits (RDF) contain high levels of health-promoting betalains but its bioavailability in plasma is low (< 1.0%). Therefore, fermentation technique was adopted to improve the yield of betalains presenting in fermented red dragon fruit drink (FRDFD) via concentration. Fermentation of RDF was carried out with autochthonous strains. The objectives of present study were to evaluate 1) the effects of fermentation duration 2) white refined cane sugar to flesh ratio and 3) types of sugar on betalainic (betanin, isobetanin) and non-betalainic phenolic compounds in FRDFD using HPLC-DAD, total phenolic content (TPC) and total flavonoid content (TFC) assay. Results indicated that all fermentation parameters showed a significant effect (p < 0.05) on the yields of betalainic (betanin, isobetanin) and non-betalainic phenolic compounds in FRDFD. The best fermentation parameters were 7 days fermentation at 10% white refined cane sugar to flesh ratio. The highest concentration of betanin, TPC and TFC achieved were 131.68 g/L, 1136.85 mg GAE/100mL and 10.39 mg CE/100mL respectively. The concentration of betanin obtained through best fermentation parameters (131.68 g/L) in present study has increased nine-fold compared to non-optimized fermentation (14.23 g/L). This indicated that fermentation is a potential economic processing technique to concentrate bioactive compounds present in functional drinks

Blue Carbon Science, Management and Policy Across a Tropical Urban Landscape

The ability of vegetated coastal ecosystems to sequester high rates of “blue” carbon over millennial time scales has attracted the interest of national and international policy makers as a tool for climate change mitigation. Whereas focus on blue carbon conservation has been mostly on threatened rural seascapes, there is scope to consider blue carbon dynamics along highly fragmented and developed urban coastlines. The tropical city state of Singapore is used as a case study of urban blue carbon knowledge generation, how blue carbon changes over time with urban development, and how such knowledge can be integrated into urban planning alongside municipal and national climate change obligations. A systematic review of blue carbon studies in Singapore was used to support a qualitative review of Singapore’s blue carbon ecosystems, carbon budget, changes through time and urban planning and policy. Habitat loss across all blue carbon ecosystems is coarsely estimated to have resulted in the release of ∼12.6 million tonnes of carbon dioxide since the beginning of the 20th century. However, Singapore’s remaining blue carbon ecosystems still store an estimated 568,971 – 577,227 tonnes of carbon (equivalent to 2.1 million tonnes of carbon dioxide) nationally, with a small proportion of initial loss offset by habitat restoration. Carbon is now a key topic on the urban development and planning agenda, as well as nationally through Singapore’s contributions to the Paris Agreement. The experiences of Singapore show that coastal ecosystems and their blue carbon stocks can be successfully managed along an urban coastline, and can help inform blue carbon science and management along other rapidly urbanizing coastlines throughout the tropics

Establishing and evaluating FRAX® probability thresholds in Taiwan

Background/purpose: The Taiwanese FRAX® calculator was launched in 2010. However, cost-effectiveness thresholds for the prescription of antiosteoporosis medications were not established. This study aims to establish and evaluate FRAX®-based probability thresholds in Taiwan. Methods: Using previous data from Taiwan and literature, we determined cost-effectiveness thresholds for prevention of osteoporotic fractures by alendronate with a Markov model, as well as using two other translational approaches. Sensitivity analysis was applied using different alendronate prices. A clinical sample was used to test these Taiwan-specific thresholds by determining the percentages of high-risk patients who would be qualified for current National Health Insurance reimbursement. Results: With the Markov model, the intervention threshold for hip fracture was 7% for women and 6% for men; for major osteoporotic fracture, it was 15% for women and 12.5% for men. Both translational approach models were cost effective only for certain age groups. However, if branded alendronate was reimbursed at 60% of the current price, they became cost effective in almost all age groups. This clinical screening study showed that the National Health Insurance Administration model identified the highest proportion (44%) of patients qualified for National Health Insurance reimbursements, followed by the Markov model (30%), and the United States model (22%). Conclusion: Three FRAX®-based models of alendronate use were established in Taiwan to help optimize treatment strategies. The government is encouraged to incorporate FRAX®-based approaches into the reimbursement policy for antiosteoporosis medicines

General Public’s knowledge, awareness, and perception of Cardiometabolic diseases: data from a Singapore study population

BackgroundHealth literacy and illness perception play crucial roles in tackling the cardiometabolic disease epidemic. We aim to compare the attitudes, knowledge, self-perceived risks and actions taken, between individuals with and without metabolic risk factors (MFs).MethodsFrom 5 June to 5 October 2022, participants of the general public were invited to complete a self-administered questionnaire. MF status was defined as the presence of hypertension, hyperlipidemia, diabetes mellitus and/or current/previous smoking. Participants were assessed based on four categories (knowledge-based, attitude-based, perceived risk, and action-based) of questions pertaining to four cardiometabolic diseases – diabetes mellitus, hypertension, hyperlipidemia, and non-alcoholic fatty liver disease.ResultsA total of 345 participants were enrolled, of whom 34.5% had at least one MF. Compared to those without MFs, participants with MFs had lower knowledge scores, but higher perceived risk scores across all cardiometabolic diseases. The largest knowledge gap pertained to hypertension-related questions. After adjustment, linear regression demonstrated that the presence of MFs (β:2.752, 95%CI: 0.772–4.733, p = 0.007) and higher knowledge scores (β:0.418, 95%CI: 0.236–0.600, p &lt; 0.001) were associated with higher perceived risk. Despite increased perceived risk in those with MFs, this translated to only few increased self-reported preventive actions, when compared to those without MFs, namely the reduction in red meat/processed food consumption (p = 0.045) and increase in fruits/vegetables consumption (p = 0.009).ConclusionThis study identified a vulnerable subpopulation living with MFs, with high perceived risks, and discordant levels of knowledge and preventive actions taken. Nationwide efforts should be channeled into addressing the knowledge-to-action gap