Duke-NUS Medical School

Patient perceptions of emergency department versus GP visits and of GPFirst: a qualitative study

Abstract Introduction: Overcrowding in emergency departments (EDs) has long been a concern, contributing to adverse outcomes. To address inappropriate attendances, Changi General Hospital (CGH) introduced GPFirst, a programme that encourages patients with mild conditions to visit...

Comparison of Biometric Measurements Between Anterior Segment Hyperparallel and Swept-Source Optical Coherence Tomography

Purpose: To evaluate the inter-device agreement between hyperparallel optical coherence tomography (HP-OCT) and swept-source OCT (SS-OCT) in quantitative anterior segment parameters. Methods: Phakic subjects aged ≥40 years were consecutively recruited at a tertiary eye hospital....

Impact of Optical Coherence Tomography Angiography Scan Protocols on Quantitative Microvascular Biomarkers in Diabetic Retinopathy

Purpose: The purpose of this study was to evaluate the influence of optical coherence tomography angiography (OCTA) scan protocols on quantitative measurements of diabetic retinopathy (DR) biomarkers and their diagnostic performance for DR staging. Methods: In this cross-sectiona...

Targeting MDA5 induces immunogenic cell death and promotes anti-tumor immunity

Identifying targets to enhance tumor immunity is an urgent need. Although nucleic acid sensors play critical roles in promoting tumor immune clearance, their exceptionally low mutation rate in cancers suggests potential unexplored roles in tumor progression. Here, we demonstrate...

Cost-Effectiveness of Annual Atrial Fibrillation Screening Compared with Current Opportunistic Screening in Australian Primary Care: A Model-Based Economic Evaluation

Although the guidelines recommend opportunistic screening for adults ≥ 65 years, screening for atrial fibrillation (AF) remains underutilised in Australia. The absence of guidance on how often to screen has resulted in variable practice and missed opportunities for AF detection....

Implementing reproductive carrier screening to include diverse Asian populations: insights from Singapore

Abstract Background As part of Singapore’s effort towards precision medicine tailored to Asian diversity, we describe the implementation of a nationwide reproductive carrier screening program. Using a customised 112-gene panel, targeting population-specific recessive genetic dise...

Association of microbial pathways predicted/inferred using 16S and shotgun metagenome with faecal metabolite abundances

The gut microbiome is an essential metabolic organ influencing host health through metabolite production. While metabolite production levels can be directly measured by gas or liquid chromatography, they are commonly inferred from the abundance of metagenomic functional pathways....

Evaluation of Intervention Strategies to Improve Follow-Up Colonoscopy After Abnormal FIT/FOBT Result

Importance Colorectal cancer is the second leading cause of cancer mortality worldwide. Early detection through screenings has been shown to improve morbidity and mortality. While fecal immunochemical test (FIT) or fecal occult blood test (FOBT) are established cost-effective scr...

Dietary and Nutritional Considerations for Metabolic Dysfunction-Associated Steatotic Liver Disease in Psoriasis and Hidradenitis Suppurativa: A Narrative Review

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognised in patients with chronic inflammatory skin disease, particularly psoriasis, for which epidemiological evidence of increased MASLD prevalence is relatively strong; corresponding data in hid...

Surgical outcomes of trabecular micro-bypass minimally invasive glaucoma surgery devices in eyes with high myopia: a 24-month retrospective multicenter cohort study

BACKGROUND: To describe outcomes of two trabecular bypass minimally invasive glaucoma surgery (MIGS) devices in highly myopic (HM) eyes with glaucoma up to 24 months postoperatively. METHODS: A retrospective, observational multicenter study of HM eyes (phakic refractive spherical...

Functional myocardial ischemia assessment based on HF-ECG microstructural features

Early detection and stratification of functional myocardial ischemia are critical for timely intervention but remain constrained by the limited sensitivity of conventional electrocardiography (ECG) and the cost and accessibility of imaging-based diagnostics. We present a non-inva...

Which aspects of continuity of care in primary care are associated with better self-rated health? A cross-sectional study among older adults in Berlin

Abstract Background Global population ageing and rapid urbanization are increasing the prevalence of multimorbidity and complex health needs among older adults, emphasizing the importance of accessible and high-quality primary care. Continuity of care (CoC) is a core feature of p...

Functional antibody responses and protection against symptomatic dengue

Exposure to dengue virus (DENV) triggers the development of anti-viral antibodies that may contribute to either protection or disease progression. Antibodies exist in different isotypes and subtypes, with diverse specificities and functions. IgG antibodies are produced during pri...

Early Intraretinal Fluid Reduction is Linked to Vision Gains in Patients with Diabetic Macular Edema

This analysis evaluated the impact of early intraretinal fluid (IRF) reduction on long-term visual outcomes in patients with diabetic macular edema (DME). This was a treatment-agnostic, post hoc analysis of pooled data from patients with DME in YOSEMITE/RHINE (NCT03622580/NCT0362...

Pediatric outpatient referrals to a tertiary centre in Singapore: a 10-year review of referral characteristics and attendance patterns

Singapore, a high-income country with declining birth rates, operates a primary care–led referral system for pediatric specialist services. Understanding referral characteristics, waiting times and attendance rates are important for service planning and the efficient use of healt...

Update on the Physiopathology of Keratoconus

Keratoconus (KC) is a progressive corneal ectasia characterized by stromal thinning, steepening, and biomechanical instability. Although historically considered primarily a structural disorder, current evidence supports a multifactorial pathogenesis involving complex interactions...

Dimensional accuracy and flexural strength of 3D-printed photopolymer resins for point-of-care surgical guides after steam and plasma sterilization: an in-vitro comparative study

Abstract Background Three-dimensional (3D) printing enables the fabrication of patient-specific guides (PSGs) for oral and craniomaxillofacial procedures. Before clinical use, guides must be sterilized, which may compromise dimensional accuracy and mechanical performance. The eff...

Knowledge-enhanced LLMs for multilingual biomedical concept normalization: a multilingual benchmarking and behavioral analysis

Abstract Biomedical concept normalization (BCN)—mapping clinical terms to standardized concepts in biomedical terminologies—is a key bottleneck for semantic interoperability across health information systems, particularly in multilingual settings and when terms appear with minima...

Peri‐operative glucagon‐like peptide‐1 receptor agonist use and outcomes: a national prospective multicentre cohort study

Summary Introduction Peri‐operative glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA) use is associated with delayed gastric emptying. It is unclear what proportion of patients having anaesthetic care are receiving GLP‐1 RAs; what strategies are used in their peri‐operative man...

Automated Vision-Based Sensing of Paediatric Pain Using 2D-Facial Landmark Trajectories Derived from 3D Geometric Normalisation and a Spatial-Temporal Attention Long Short-Term Memory (STA-LSTM) Network

Background: Accurate pain assessment in children remains challenging because conventional behavioural assessment tools are subjective and provide only intermittent observations. This study evaluated a vision-based sensing system for automated paediatric pain detection using two-d...