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A rare case of minimally invasive follicular thyroid cancer with intraluminal superior vena cava and right atrium metastases

Khoo ACH, Chen SL

World J Nucl Med, 2019 9 14;18(3):301-303.
PMID: 31516376 DOI: 10.4103/wjnm.WJNM_43_18

Follicular thyroid cancers are known to spread hematogenously to the bones and lungs and rarely presenting with massive angioinvasion. We report a case of a middle-aged female who had undergone total thyroidectomy for minimally invasive follicular thyroid cancer with angioinvasion in 2014. She was noted to have a large tumor thrombus extending from the superior vena cava to the right atrium on whole body scan post-Iodine-131 (131I) remnant ablation therapy. We discuss the various imaging modalities, treatment options, and difficulties in managing such massive angioinvasion in patients with well-differentiated thyroid cancers.
The impact of environmental knowledge and green supply chain practices in improving sustainable energy production: the moderating role of green behavior and green leadership

Chen SL, Su YS, Diep GL, Sivanandan P, Sadiq M, Phan TTH

Environ Sci Pollut Res Int, 2023 Apr;30(19):57017-57031.
PMID: 36930320 DOI: 10.1007/s11356-023-26340-7

Global warming and the dreadful climate condition in China demands the sustainable energy transition and production that must be far away from coal-based energy production. The present article, thereby, intends to assess the effectiveness of environmental knowledge and green supply chain practices on sustainable energy production. The study also introduces green behavior and green leadership as a moderator to evaluate the proposed relationship. Primary data has been collected and assessed by PLS-SEM. The findings reveal that environmental knowledge, green purchases, and internal environmental management (IEM) have a positive association with sustainable energy production (SEP) in China. The outcomes also indicate that green behavior significantly moderates among environmental knowledge, green purchases, and SEP, and green leadership significantly moderates among IEM and SEP in China. The research guides the policymakers in establishing policies related to SEP using green behavior, GSC practices, and environmental knowledge.
Fulltext Classification of community-acquired outbreaks for the global transmission of COVID-19: Machine learning and statistical model analysis

Wang WC, Lin TY, Chiu SY, Chen CN, Sarakarn P, Ibrahim M, et al.

J Formos Med Assoc, 2021 Jun;120 Suppl 1:S26-S37.
PMID: 34083090 DOI: 10.1016/j.jfma.2021.05.010

BACKGROUND: As Coronavirus disease 2019 (COVID-19) pandemic led to the unprecedent large-scale repeated surges of epidemics worldwide since the end of 2019, data-driven analysis to look into the duration and case load of each episode of outbreak worldwide has been motivated.
METHODS: Using open data repository with daily infected, recovered and death cases in the period between March 2020 and April 2021, a descriptive analysis was performed. The susceptible-exposed-infected-recovery model was used to estimate the effective productive number (Rt). The duration taken from Rt > 1 to Rt
Fish-associated Streptococcus agalactiae ST283: first human cases reported from Malaysia

Zohari Z, Barkham T, Mohamad Maswan N, Chen SL, Muthanna A, Lee KW, et al.

J Med Microbiol, 2023 Jun;72(6).
PMID: 37389575 DOI: 10.1099/jmm.0.001729

In South East Asia, Streptococcus agalactiae ST283 causes sepsis in healthy adults. Raw freshwater fish consumption is the only known risk factor. These two case reports are the first from Malaysia. Although they cluster with Singapore ST283, the epidemiology is complicated by the flow of people and fish across borders.
Low prevalence of knee and back pain in southeast China; the Shantou COPCORD study

Zeng QY, Chen R, Xiao ZY, Huang SB, Liu Y, Xu JC, et al.

J Rheumatol, 2004 Dec;31(12):2439-43.
PMID: 15570648

To determine whether the previously noted low prevalence of knee pain (KP) and lumbar pain (LP) in rural southern China compared with the high prevalence observed in North China was also true in a southern urban population.
Comparison of combination therapy of high-dose oral N-acetylcysteine and intravenous sodium bicarbonate hydration with individual therapies in the reduction of Contrast-induced Nephropathy during Cardiac Catheterisation and Percutaneous Coronary Intervention (CONTRAST): A multi-centre, randomised, controlled trial

Chong E, Poh KK, Lu Q, Zhang JJ, Tan N, Hou XM, et al.

Int J Cardiol, 2015 Dec 15;201:237-42.
PMID: 26301645 DOI: 10.1016/j.ijcard.2015.07.108

N-acetylcysteine (NAC) and sodium bicarbonate (SOB) therapies may prevent contrast-induced nephropathy (CIN). However, the efficacy of using combination over individual therapies was not established, and there was no large randomised study comparing abbreviated SOB therapy with conventional sustained saline pre-hydration with oral NAC.
Fulltext Clarifying the debate on population-based screening for breast cancer with mammography: A systematic review of randomized controlled trials on mammography with Bayesian meta-analysis and causal model

Chen TH, Yen AM, Fann JC, Gordon P, Chen SL, Chiu SY, et al.

Medicine (Baltimore), 2017 Jan;96(3):e5684.
PMID: 28099330 DOI: 10.1097/MD.0000000000005684

BACKGROUND: The recent controversy about using mammography to screen for breast cancer based on randomized controlled trials over 3 decades in Western countries has not only eclipsed the paradigm of evidence-based medicine, but also puts health decision-makers in countries where breast cancer screening is still being considered in a dilemma to adopt or abandon such a well-established screening modality.
METHODS: We reanalyzed the empirical data from the Health Insurance Plan trial in 1963 to the UK age trial in 1991 and their follow-up data published until 2015. We first performed Bayesian conjugated meta-analyses on the heterogeneity of attendance rate, sensitivity, and over-detection and their impacts on advanced stage breast cancer and death from breast cancer across trials using Bayesian Poisson fixed- and random-effect regression model. Bayesian meta-analysis of causal model was then developed to assess a cascade of causal relationships regarding the impact of both attendance and sensitivity on 2 main outcomes.
RESULTS: The causes of heterogeneity responsible for the disparities across the trials were clearly manifested in 3 components. The attendance rate ranged from 61.3% to 90.4%. The sensitivity estimates show substantial variation from 57.26% to 87.97% but improved with time from 64% in 1963 to 82% in 1980 when Bayesian conjugated meta-analysis was conducted in chronological order. The percentage of over-detection shows a wide range from 0% to 28%, adjusting for long lead-time. The impacts of the attendance rate and sensitivity on the 2 main outcomes were statistically significant. Causal inference made by linking these causal relationships with emphasis on the heterogeneity of the attendance rate and sensitivity accounted for the variation in the reduction of advanced breast cancer (none-30%) and of mortality (none-31%). We estimated a 33% (95% CI: 24-42%) and 13% (95% CI: 6-20%) breast cancer mortality reduction for the best scenario (90% attendance rate and 95% sensitivity) and the poor scenario (30% attendance rate and 55% sensitivity), respectively.
CONCLUSION: Elucidating the scenarios from high to low performance and learning from the experiences of these trials helps screening policy-makers contemplate on how to avoid errors made in ineffective studies and emulate the effective studies to save women lives.
Fulltext The higher prevalence of extended spectrum beta-lactamases among Escherichia coli ST131 in Southeast Asia is driven by expansion of a single, locally prevalent subclone

Chen SL, Ding Y, Apisarnthanarak A, Kalimuddin S, Archuleta S, Omar SFS, et al.

Sci Rep, 2019 09 13;9(1):13245.
PMID: 31519972 DOI: 10.1038/s41598-019-49467-5

The ST131 multilocus sequence type (MLST) of Escherichia coli is a globally successful pathogen whose dissemination is increasing rates of antibiotic resistance. Numerous global surveys have demonstrated the pervasiveness of this clone; in some regions ST131 accounts for up to 30% of all E. coli isolates. However, many regions are underrepresented in these published surveys, including Africa, South America, and Asia. We collected consecutive bloodstream E. coli isolates from three countries in Southeast Asia; ST131 was the most common MLST type. As in other studies, the C2/H30Rx clade accounted for the majority of ST131 strains. Clinical risk factors were similar to other reported studies. However, we found that nearly all of the C2 strains in this study were closely related, forming what we denote the SEA-C2 clone. The SEA-C2 clone is enriched for strains from Asia, particularly Southeast Asia and Singapore. The SEA-C2 clone accounts for all of the excess resistance and virulence of ST131 relative to non-ST131 E. coli. The SEA-C2 strains appear to be locally circulating and dominant in Southeast Asia, despite the intuition that high international connectivity and travel would enable frequent opportunities for other strains to establish themselves.
Fulltext Author Correction: The higher prevalence of extended spectrum beta-lactamases among Escherichia coli ST131 in Southeast Asia is driven by expansion of a single, locally prevalent subclone

Chen SL, Ding Y, Apisarnthanarak A, Kalimuddin S, Archuleta S, Omar SFS, et al.

Sci Rep, 2021 Apr 14;11(1):8563.
PMID: 33854114 DOI: 10.1038/s41598-021-87312-w
Fulltext One hypervirulent clone, sequence type 283, accounts for a large proportion of invasive Streptococcus agalactiae isolated from humans and diseased tilapia in Southeast Asia

Barkham T, Zadoks RN, Azmai MNA, Baker S, Bich VTN, Chalker V, et al.

PLoS Negl Trop Dis, 2019 06;13(6):e0007421.
PMID: 31246981 DOI: 10.1371/journal.pntd.0007421

BACKGROUND: In 2015, Singapore had the first and only reported foodborne outbreak of invasive disease caused by the group B Streptococcus (GBS; Streptococcus agalactiae). Disease, predominantly septic arthritis and meningitis, was associated with sequence type (ST)283, acquired from eating raw farmed freshwater fish. Although GBS sepsis is well-described in neonates and older adults with co-morbidities, this outbreak affected non-pregnant and younger adults with fewer co-morbidities, suggesting greater virulence. Before 2015 ST283 had only been reported from twenty humans in Hong Kong and two in France, and from one fish in Thailand. We hypothesised that ST283 was causing region-wide infection in Southeast Asia.
METHODOLOGY/PRINCIPAL FINDINGS: We performed a literature review, whole genome sequencing on 145 GBS isolates collected from six Southeast Asian countries, and phylogenetic analysis on 7,468 GBS sequences including 227 variants of ST283 from humans and animals. Although almost absent outside Asia, ST283 was found in all invasive Asian collections analysed, from 1995 to 2017. It accounted for 29/38 (76%) human isolates in Lao PDR, 102/139 (73%) in Thailand, 4/13 (31%) in Vietnam, and 167/739 (23%) in Singapore. ST283 and its variants were found in 62/62 (100%) tilapia from 14 outbreak sites in Malaysia and Vietnam, in seven fish species in Singapore markets, and a diseased frog in China.
CONCLUSIONS: GBS ST283 is widespread in Southeast Asia, where it accounts for a large proportion of bacteraemic GBS, and causes disease and economic loss in aquaculture. If human ST283 is fishborne, as in the Singapore outbreak, then GBS sepsis in Thailand and Lao PDR is predominantly a foodborne disease. However, whether transmission is from aquaculture to humans, or vice versa, or involves an unidentified reservoir remains unknown. Creation of cross-border collaborations in human and animal health are needed to complete the epidemiological picture.