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Search Results: 1 - 10 of 6033 matches for " Angela Chow "
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Prevalence of and risk factors for MRSA colonization in HIV-positive outpatients in Singapore
Kyaw Win,Lee Linda,Siong Wong,Ping Angela Chow
AIDS Research and Therapy , 2012, DOI: 10.1186/1742-6405-9-33
Abstract: Background Whilst there have been studies on the risks and outcomes of MRSA colonization and infections in HIV-positive patients, local data is limited on the risk factors for MRSA colonization among these patients. We undertook this study in a tertiary HIV care centre to document the risk factors for colonization and to determine the prevalence of MRSA colonization among HIV-positive outpatients in Singapore. Methods This was a cross-sectional study in which factors associated with MRSA positivity among patients with HIV infection were evaluated. A set of standardized questionnaire and data collection forms were available to interview all recruited patients. Following the interview, trained nurses collected swabs from the anterior nares/axilla/groin (NAG), throat and peri-anal regions. Information on demographics, clinical history, laboratory results and hospitalization history were retrieved from medical records. Results MRSA was detected in swab cultures from at least 1 site in 15 patients (5.1%). Inclusion of throat and/or peri-anal swabs increased the sensitivity of NAG screening by 20%. Predictors for MRSA colonization among HIV-positive patients were age, history of pneumonia, lymphoma, presence of a percutaneous device within the past 12 months, history of household members hospitalized more than two times within the past 12 months, and a most recent CD4 count less than 200. Conclusions This study highlights that a proportion of MRSA carriers would have been undetected without multiple-site screening cultures. This study could shed insight into identifying patients at risk of MRSA colonization upon hospital visit and this may suggest that a risk factor-based approach for MRSA surveillance focusing on high risk populations could be considered.
Surveillance for Clostridium difficile Infection: ICD-9 Coding Has Poor Sensitivity Compared to Laboratory Diagnosis in Hospital Patients, Singapore
Monica Chan,Poh Lian Lim,Angela Chow,Mar Kyaw Win,Timothy M. Barkham
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0015603
Abstract: Clostridium difficile infection (CDI) is an increasingly recognized nosocomial infection in Singapore. Surveillance methods include laboratory reporting of Clostridium difficile toxin assays (CDTA) or use of International Classification of Diseases, 9th Revision (ICD-9) discharge code 008.45. Previous US studies showed good correlation between CDTA and ICD-9 codes. However, the use of ICD-9 codes for CDI surveillance has not been validated in other healthcare settings.
Clinical and epidemiological predictors of transmission in Severe Acute Respiratory Syndrome (SARS)
Mark IC Chen, Angela LP Chow, Arul Earnest, Hoe Leong, Yee Leo
BMC Infectious Diseases , 2006, DOI: 10.1186/1471-2334-6-151
Abstract: We used epidemiological and clinical data on probable SARS patients admitted to Tan Tock Seng Hospital. Using a case-control approach, index patients who had probable SARS who subsequently transmitted the disease to at least one other patient were analysed as "cases" against patients with no transmission as "controls", using multivariate logistic regression analysis.98 index patients were available for analysis (22 with transmission, 76 with no transmission). Covariates positively associated with transmission in univariate analysis at p < 0.05 included delay to isolation (Day 7 of illness or later), admission to a non-isolation facility, pre-existing chronic respiratory disease and immunosuppressive disease, need for oxygen, shortness of breath, vomiting, and higher lactate dehydrogenase levels and higher neutrophil counts. In the multivariate analysis, only three factors were significant: delay to isolation, admission to a non-isolation facility and higher lactate dehydrogenase levels of >650 IU/L (OR 6.4, 23.8 and 4.7 respectively).Clinical and epidemiological factors can help us to explain why transmission was observed in some instances but not in others.Severe Acute Respiratory Syndrome (SARS) was the first emerging infectious disease of the new century with epidemic potential. First recognized on 26 Feb 2003, SARS spread rapidly and resulted in 8098 reported cases and 774 deaths in close to 30 countries [1]. While there was no endemic transmission in the majority of these countries, explosive outbreaks were observed in China, Hong Kong, Taiwan, Canada, Vietnam and Singapore. Ongoing research points to an existing animal reservoir for the virus [2,3], and future epidemics may hence sporadically emerge from this source [4].A key feature in the epidemiology of SARS is the widespread variation in the number of secondary infections caused by each potentially infectious case. While multiple secondary infections were traced to single individuals in several super-sprea
Women entrepreneurship in Romania
Angela ON
Revista Romana de Economie , 2011,
Abstract: Considering entrepreneurship the domain with the greatest potential for creativity and innovation, any investigation on this field is recommended, in order to reveal new aspects that can influence the small enterprises development. From this point of view, female entrepreneurship represents an important source of innovation, only partially exploited or even forgotten.
Application of Nonlinear Dynamics in Studying Flashover Fire in a Small Open Kitchen  [PDF]
Wan Ki Chow, Jing Liu
Journal of Applied Mathematics and Physics (JAMP) , 2016, DOI: 10.4236/jamp.2016.45100
Abstract: Open kitchen designs are found in small units in tall residential buildings of Asian-Oceania regions for better space utilization. As many combustibles are stored in small residential units, fire originated in the open kitchen can grow and spread fast. Consequently, flashover can occur to give a big fire and result in severe casualties and property damage. Nonlinear dynamics can be applied to predict critical heat release rate to flashover in the unit with an open kitchen and will be illustrated in this paper. Based on a two-zone model, temperature of the hot smoke layer was taken as the system state variable. An evolution equation was developed with selective control parameters. Onsetting of flashover using a nonlinear dynamical system was demonstrated in the example residential units. Effects of the floor dimensions, the radiation feedback coefficient and thermal properties of wall material on the onset of flashover were then examined and analyzed. The developed nonlinear dynamical model for studying the onset of flashover gives a better understanding of the various control parameters.
Simple Clinical and Laboratory Predictors of Chikungunya versus Dengue Infections in Adults
Vernon J. Lee ,Angela Chow,Xiaohui Zheng,Luis R. Carrasco,Alex R. Cook,David C. Lye,Lee-Ching Ng,Yee-Sin Leo
PLOS Neglected Tropical Diseases , 2012, DOI: 10.1371/journal.pntd.0001786
Abstract: Background Dengue and chikungunya are co-circulating vector-borne diseases with substantial overlap in clinical presentations. It is important to differentiate between them during first presentation as their management, especially for dengue hemorrhagic fever (DHF), is different. This study compares their clinical presentation in Singapore adults to derive predictors to assist doctors in diagnostic decision-making. Methods We compared 117 patients with chikungunya infection diagnosed with reverse transcription-polymerase chain reaction (RT-PCR) with 917 dengue RT-PCR-positive adult patients (including 55 with DHF). We compared dengue fever (DF), DHF, and chikungunya infections by evaluating clinical characteristics of dengue and chikungunya; developing classification tools via multivariate logistic regression models and classification trees of disease etiology using clinical and laboratory factors; and assessing the time course of several clinical variables. Findings At first presentation to hospital, significantly more chikungunya patients had myalgia or arthralgia, and fewer had a sore throat, cough (for DF), nausea, vomiting, diarrhea, abdominal pain, anorexia or tachycardia than DF or DHF patients. From the decision trees, platelets <118×109/L was the only distinguishing feature for DF versus chikungunya with an overall correct classification of 89%. For DHF versus chikungunya using platelets <100×109/L and the presence of bleeding, the overall correct classification was 98%. The time course analysis supported platelet count as the key distinguishing variable. Interpretation There is substantial overlap in clinical presentation between dengue and chikungunya infections, but simple clinical and laboratory variables can predict these infections at presentation for appropriate management.
Accuracy and User-Acceptability of HIV Self-Testing Using an Oral Fluid-Based HIV Rapid Test
Oon Tek Ng, Angela L. Chow, Vernon J. Lee, Mark I. C. Chen, Mar Kyaw Win, Hiok Hee Tan, Arlene Chua, Yee Sin Leo
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0045168
Abstract: Background The United States FDA approved an over-the-counter HIV self-test, to facilitate increased HIV testing and earlier linkage to care. We assessed the accuracy of self-testing by untrained participants compared to healthcare worker (HCW) testing, participants’ ability to interpret sample results and user-acceptability of self-tests in Singapore. Methodology/Principal Findings A cross-sectional study, involving 200 known HIV-positive patients and 794 unknown HIV status at-risk participants was conducted. Participants (all without prior self-test experience) performed self-testing guided solely by visual instructions, followed by HCW testing, both using the OraQuick ADVANCE Rapid HIV 1/2 Antibody Test, with both results interpreted by the HCW. To assess ability to interpret results, participants were provided 3 sample results (positive, negative, and invalid) to interpret. Of 192 participants who tested positive on HCW testing, self-testing was positive in 186 (96.9%), negative in 5 (2.6%), and invalid in 1 (0.5%). Of 794 participants who tested negative on HCW testing, self-testing was negative in 791 (99.6%), positive in 1 (0.1%), and invalid in 2 (0.3%). Excluding invalid tests, self-testing had sensitivity of 97.4% (95% CI 95.1% to 99.7%) and specificity of 99.9% (95% CI: 99.6% to 100%). When interpreting results, 96%, 93.1% and 95.2% correctly read the positive, negative and invalid respectively. There were no significant demographic predictors for false negative self-testing or wrongly interpreting positive or invalid sample results as negative. Eighty-seven percent would purchase the kit over-the-counter; 89% preferred to take HIV tests in private. 72.5% and 74.9% felt the need for pre- and post-test counseling respectively. Only 28% would pay at least USD15 for the test. Conclusions/Significance Self-testing was associated with high specificity, and a small but significant number of false negatives. Incorrectly identifying model results as invalid was a major reason for incorrect result interpretation. Survey responses were supportive of making self-testing available.
Activation of Eosinophils Interacting with Dermal Fibroblasts by Pruritogenic Cytokine IL-31 and Alarmin IL-33: Implications in Atopic Dermatitis
Chun-Kwok Wong, Karen Ming-Lam Leung, Huai-Na Qiu, Joyce Yin-Sau Chow, Angela On Kei Choi, Christopher Wai-Kei Lam
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0029815
Abstract: Background IL-31 is a pruritogenic cytokine, and IL-33 is an alarmin for damaging inflammation. They together relate to the pathogenesis of atopic dermatitis (AD). Eosinophil infiltration into the inner dermal compartment is a predominant pathological feature of AD. We herein investigated the in vitro inflammatory effects of IL-31 and IL-33 on the activation of human eosinophils and dermal fibroblasts. Methodology/Principal Findings Receptors, adhesion molecules and signaling molecules were assessed by Western blot or flow cytometry. Chemokines and cytokine were quantitated by multiplex assay. Functional IL-31 receptor component IL-31RA, OSMR-β and IL-33 receptor component ST2 were constitutively expressed on the surface of eosinophils. Co-culture of eosinophils and fibroblasts significantly induced pro-inflammatory cytokine IL-6 and AD-related chemokines CXCL1, CXCL10, CCL2 and CCL5. Such inductions were further enhanced with IL-31 and IL-33 stimulation. IL-31 and IL-33 could significantly provoke the release of CXCL8 from eosinophils and fibroblasts, respectively, which was further enhanced upon co-culture. In co-culture, eosinophils and fibroblasts were the main source for the release of CCL5, and IL-6, CXCL1, CXCL8, CXCL10 and CCL2, respectively. Direct interaction between eosinophils and fibroblasts was required for CXCL1, CXCL10, CXCL8 and CCL5 release. Cell surface expression of intercellular adhesion molecule-1 on eosinophils and fibroblasts was up-regulated in co-culture upon IL-31 and IL-33 stimulation. The interaction between eosinophils and fibroblasts under IL-31 and IL-33 stimulation differentially activated extracellular signal-regulated kinase, c-Jun N-terminal kinase, p38 mitogen-activated protein kinase, nuclear factor-κB and phosphatidylinositol 3-kinase–Akt pathways. Using specific signaling molecule inhibitors, the differential induction of IL-31 and IL-33-mediated release of cytokines and chemokines such as IL-6 and CXCL8 from co-culture should be related to their distinct activation profile of intracellular signaling pathways. Conclusions/Significance The above findings suggest a crucial immunopathological role of IL-31 and IL-33 in AD through the activation of eosinophils-fibroblasts interaction via differential intracellular signaling mechanisms.
Evaluation of Chikungunya Diagnostic Assays: Differences in Sensitivity of Serology Assays in Two Independent Outbreaks
Grace Yap,Kwoon-Yong Pok,Yee-Ling Lai,Hapuarachchige-Chanditha Hapuarachchi,Angela Chow,Yee-Sin Leo,Li-Kiang Tan,Lee-Ching Ng
PLOS Neglected Tropical Diseases , 2010, DOI: 10.1371/journal.pntd.0000753
Abstract: Background The sensitivity and specificity of two in-house MAC-ELISA assays were tested and compared with the performance of commercially-available CTK lateral flow rapid test and EUROIMMUN IFA assays for the detection of anti-Chikungunya virus (CHIKV) IgM. Each MAC-ELISA assay used a whole virus-based antigen derived from genetically distinct CHIKV strains involved in two chikungunya disease outbreaks in Singapore (2008); a January outbreak strain with alanine at amino acid residue 226 of the E1 glycoprotein (CHIKV-A226) and a May-to-September outbreak strain that possessed valine at the same residue (CHIKV-226V). We report differences in IgM detection efficacy of different assays between the two outbreaks. The sensitivities of two PCR protocols were also tested. Methods and Findings For sera from January outbreak, the average detection threshold of CTK lateral flow test, MAC-ELISAs and EUROIMMUN IFA assays was 3.75, 4.38 and 4.88 days post fever onset respectively. In contrast, IgM detection using CTK lateral flow test was delayed to more than 7 days after fever onset in the second outbreak sera. However, MAC-ELISA using CHIKV-226V detected IgM in the second outbreak sera 3.96 days after fever onset, which was approximately one day earlier compared to the same assay using CHIKV-A226 (4.86 days). Specificity was 100% for both commercial assays, and 95.6% for the in-house MAC-ELISAs. For sensitivity determination of the PCR protocols, the probe-based real time RT-PCR method was found to be 10 times more sensitive than one based on SYBR Green. Conclusion Our findings suggested that the two strains of CHIKV using variants A226 and 226V resulted in variation in sensitivities of the assays evaluated. We postulated that the observed difference in antigen efficacy could be due to the amino acid substitution differences in viral E1 and E2 envelope proteins, especially the E1-A226V substitution. This evaluation demonstrates the importance of appraisal of different diagnostic assays before their application in clinical and operational settings.
A Study of the Chinese Rare Books in Lingnan University Library
Yi Chow
Journal of Library and Information Studies , 2012,
Abstract: The Lingnan University in this article is the Guangzhou Lingnan University, whose forerunner was a Christian College built in 1888 and which ceased operations and was largely absorbed into the Guangzhou Sun Yat-Sen University in 1952. The Chinese rare books of the former Lingnan University Library were by and large merged into the current Sun Yat-Sen University Library and have become a major constituent of its rare books collections. This article analyzes the quantity, sources, and characteristics of the Chinese rare books and shows how the collection development supported the education and research purposes. Lingnan University Library had 174 kinds of Chinese rare books before the Second Sino-Japanese War. It comprised prodominantly Zhao Zeng’s collections and the donations of Gantang Xu, Zongzhou Pan, Shaozhen Xu, Hanchen Gan. The Library of Congress of the United States had influenced the collection of local records in Lingnan. The prominent characteristics of the existing collection included the following: (1) it comprises a large quantity of prints and manuscripts of the Ming dynasty; (2) particularly, it highlights the historical and literary records of the Ming; (3) geographically it emphasizes Guangdong records. [Article content in Chinese]
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