INTRODUCTION: This scoping review examined the number, types and characteristics of journal publications on ageing in Singapore from 2008 to 2018 to determine how ageing research in medical and social domains in Singapore has transformed over time. METHODS: Using relevant search terms, articles were extracted from multiple databases and then screened and reviewed for eligibility and inclusion by independent reviewers. Data such as article title, authors, year of publication, name of journal, type of journal, study design and the kind of data used were charted from the included articles for evidence synthesis. RESULTS: Since 2008, there has been a steady increase in the number of publications on ageing in medical and social domains in Singapore. In the medical domain, publications on Ophthalmology (22%) made up the largest proportion of the existing medical literature on ageing in Singapore, followed by Physical Functioning (17%), which involved physiological measurements of physical well-being, and Geriatrics (16%). Non-medical publications comprised 38% of all the included publications, with publications on the social aspects of ageing (43%) forming the largest group in this cluster, followed by publications on Prevention (19%) and Healthcare services (18%). The study design was mostly observational (82%), with only 3% of interventional studies. CONCLUSION While ageing research had expanded in Singapore in the last decade, it was predominantly discipline specific and observational in design. As ageing issues are complex, with biology intersecting with psychology and sociology, we call for greater interdisciplinary collaboration, the conduct of more interventional studies, as well as more research in understudied and emerging areas.
Humans ; Singapore ; Aging ; Geriatrics ; Research Design

Background: Response surface methodology (RSM) is a cost-effective multivariate technique employed in optimization of pharmaceutical formulations. Central composite experiment design is one of the common designs under RSM used for determining optimum nanoparticle formulation parameters. Objectives: To optimize a formulation for meropenem-loaded chitosan alginate nanoparticles using central composite experimental design. Methodology: Meropenem loaded chitosan-alginate nanoparticles were fabricated using aqueous sodium alginate solution and ionotropic gelation with calcium chloride and chitosan, using an optimized formulation derived from a central composite design. The fabricated Mer-CS/Alg NPs were characterized for their particle size, zeta potential, encapsulation efficiency, and loading capacity. The central composite design has been used to adequately assess the influence of two factors namely meropenem concentration and Alg/CS mass ratio on the responses based on a limited number of 13 triplicate formulation runs. Results: This study successfully formulated meropenem-loaded chitosan/alginate nanoparticles. The optimal formulation of the Mer- CS/Alg NPs was 1.7 mg/mLcurcumin, and a Alg/CS mass ratio of 9.8:1. Based on the predicted values of the response variable, the optimal formulation would have a particle size of 490.64 nm, zeta potential of -28.59 mVand a loading capacity of 76.89%. Conclusion The central composite experimental design successfully optimized the nanoparticle formulation of meropenem and chitosan/alginate polymer solution. The optimum formulation produced nanoparticles with adequate size, high stability, and high drug load.
Meropenem ; Nanoparticles ; Research Design

BACKGROUND

Dengue is a global health concern, particularly in tropical regions such as the Philippines. In 2019,Cebu City reported the highest number of dengue cases in Central Visayas with 3,290 cases and 20 deaths, an 11.8% increase compared to 20181 . To help predict disease outcomes and provide timely management, a scoring system, the Daily Dengue Severity Score (DDSS)² was utilized.

To determine the clinicodemographic profile of dengue patients, determine the accuracy of the DDSS in assessing disease severity, and determine a cut off score that suggests severe dengue.

Patients 1 month to 18 years admitted for dengue at Perpetual Succour Hospital from January 2018 to December 2020 were included. Cases were classified as Dengue without Warning Signs, Dengue with Warning Signs, and Severe Dengue, and scored using the DDSS. Statistical analysis used were Geometric mean and Area Under the Receiver Operating Characteristic (AUROC) curves to analyze the discriminative performance of the DDSS among the different disease severity states.

Out of 327 cases, 34 were classified as Dengue without Warning Signs, 271 Dengue with Warning Signs, and 22 Severe Dengue. The highest mean DDSS was 17.7 ±14.0 at Day -4 among those with Severe Dengue, and the lowest mean DDSS was 1.1 ± 2.0 at Day +3 among those with Dengue without Warning Signs. A cut off point of 10 on Day -1 predicted subsequent Severe Dengue among patients with Dengue with Warning Signs. In 91.39% of cases, there was a significant relationship between the DDSS and dengue classification, and the higher the DDSS, the more severe the disease.

Majority of dengue patients were males, aged 8.1 to 9.2 years. DDSS showed 66.67% sensitivity, 92.86% specificity, a positive likelihood ratio of 9.3, and a cutoff of 10 is predictive of severe dengue among patients with dengue with warning signs.

Qualitative research is a type of research that provides deeper insights into real-world problems. It gathers participants’ experiences, perceptions, and behaviours and answers the how’s and whys instead of how many or how much. It could be structured as a stand-alone study, purely relying on qualitative data or it could be part of mixed-methods research that combines qualitative and quantitative data. Some of the most common methodologies being used in qualitative research include ethnography, grounded theory, phenomenological study, narrative study, historical study and case studies. This article aimed to discuss how to conduct a qualitative study. The steps in conducting a qualitative study include: 1) Create a purpose statement; 2) Formulate the Research Questions; 3) Perform a Literature Review; 4) Choose a qualitative research methodology to use; 5) Identify and Select the Study Population; 6) Develop the data collection procedure; 7) Collect the data and 8) Analyze the data, which if using thematic analysis, can include writing the final report. In writing and appraising qualitative studies, the Consolidated Criteria for Reporting Qualitative Studies (COREQ) can serve as a useful guide. Lastly, like in quantitative studies, researchers doing qualitative studies should be aware of the ethical issues involved in their work, anticipate possible ethical concerns, craft protection strategies, and make the necessary referrals to research ethics committees, appropriate organizations, and other agencies if the need arises.

INTRODUCTION: Although influenza vaccination reduces rates of pneumonia, hospitalisation and mortality, influenza vaccination uptake remains low in older patients. The primary aim was to compare individualised counselling with educational pamphlets alone in improving influenza vaccination uptake. The secondary aims were to evaluate knowledge and attitudes towards influenza vaccination and factors influencing uptake. METHODS: A randomised controlled study was conducted in two government polyclinics with 160 participants per arm. Patients aged 65 years and above attending for doctor consultation were recruited. All participants received an educational pamphlet on influenza vaccination. The intervention group received additional face-to-face counselling. Participants filled a pre- and postintervention questionnaire assessing knowledge of influenza and attitudes towards the vaccine. Follow-up calls and verification of electronic records was done at three months to determine actual vaccine uptake. RESULTS: At three months, 16 (10%) patients in the intervention group and 20 (12.5%) patients in the control group had completed influenza vaccination (P = 0.48). Factors positively associated with vaccine uptake were willingness to receive vaccination immediately after intervention (adjusted odds ratio [OR] 12.15, 95% confidence interval [CI] 4.42-33.38), and male gender (adjusted OR 2.96, 95% CI 1.23-7.12). Individualised counselling was more effective in improving knowledge (P < 0.01). Overall knowledge scores did not influence actual vaccine uptake rates. (adjusted OR 1.10 [0.90-1.3]). CONCLUSION Both arms of patient education increased uptake of influenza vaccination. Individualised counselling was not superior to pamphlets alone in improving uptake. Performing vaccination at the initial point of contact improves actual uptake rates.
Humans ; Male ; Aged ; Influenza Vaccines ; Influenza, Human/prevention & control* ; Vaccination ; Research Design ; Surveys and Questionnaires ; Health Knowledge, Attitudes, Practice

This paper makes an interpretation of the collection Acupuncture: how to improve the evidence base published by BMJ & BMJ Open. Studies show that the quality of randomized controlled trial (RCT) of acupuncture is low, and multivariable Meta-regression analysis fails to confirm most factors commonly believed to influence the effect of acupuncture. The methodological challenges in design and conduct of RCT in acupuncture were analyzed, and a consensus on how to design high-quality acupuncture RCT was developed. The number of acupuncture systematic reviews was huge but the evidence was underused in clinical practice and health policy, and a large number of western clinical practice guidelines recommended acupuncture therapy, but the usefulness of recommendations needed to be improved. In view of the problems in clinical research on acupuncture mentioned in this collection, combined with the analysis of the purpose of clinical research on acupuncture, perspectives, study types, as well as the relationship between evidence and clinical decision-making, a five-stage study paradigm of clinical research on acupuncture is proposed.
Acupuncture Therapy ; Acupuncture ; Research Design ; Consensus

OBJECTIVE: To re-evaluate the systematic review/Meta-analysis of acupuncture and moxibustion for childhood autism (CA), aiming to provide decision-making basis for clinical diagnosis and treatment. METHODS: The systematic review and/or Meta-analysis of acupuncture and moxibustion for CA were searched in PubMed, EMbase, Cochrane Library, SinoMed, CNKI and Wanfang databases. The retrieval time was from the database establishment to May 5th, 2022. PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and AMSTAR 2 (a measurement tool to assess systematic reviews 2) was used to evaluate the methodological quality, bubble map was used to construct the evidence map and GRADE was used to evaluate the quality of evidence. RESULTS: A total of 9 systematic reviews were included. The PRISMA scores ranged from 13 to 26. The report quality was low, and there was a serious lack in the aspects of program and registration, search, other analysis and funding. The main problems in methodology included not making prespecified protocol, incomplete retrieval strategy, not providing a list of excluded literatures, and incomplete explanation on heterogeneity analysis and bias risk. The evidence map showed that 6 conclusions were valid, 2 conclusions were possible valid and 1 conclusion was uncertain valid. The overall quality of evidence was low, and the main factors leading to the downgrade were limitations, followed by inconsistency, imprecision and publication bias. CONCLUSION Acupuncture and moxibustion has a certain effect for CA, but the quality of reporting, methodology and evidence in included literature need to be improved. It is suggested to perform high-quality and standardized research in the future to provide evidence-based basis.
Child ; Humans ; Acupuncture Therapy/methods* ; Autistic Disorder ; Moxibustion/methods* ; Publication Bias ; Research Design ; Systematic Reviews as Topic ; Meta-Analysis as Topic

Rare and endangered Chinese medicinal materials are the material basis for innovation and development of Chinese medicinal materials and their curative effects are remarkable. However, the resources are in shortage due to various man-made or natural factors such as rising demand, overexploitation and environmental degradation. Therefore, finding alternatives is a feasible and effective solution. This study systematically sorted out the list of rare and endangered Chinese medicinal materials, and combed relevant policies and regulations. According to existing research, the substitution model of rare and endangered Chinese medicinal materials was constructed from the theoretical level. In view of the slow search for substitutes, the failure to follow the basic theory of traditional Chinese medicine in the process of research and development, the difficulty in breaking through technologies and the incomplete guarantee of the clinical efficacy of substitutes, a multi-component replacement was proposed to replace the originals with more effective components from a wide range of sources. This study was expected to promote the study on the substitutes of rare and endangered Chinese medicinal materials to step into a new stage.
Humans ; Drugs, Chinese Herbal/therapeutic use* ; Research Design ; Plants, Medicinal ; Medicine, Chinese Traditional ; Technology

The tight relationships between microbiome and traditional Chinese medicine(TCM)have been widely recognized. New technologies, results, and theories are emerging in the field of microbiomics in recent years with the advances in high-throughput sequencing and multi-omics technologies. Based on the previous research, the present study has proposed the concept of TCM microbiomics(TCMM), which is an interdisciplinary subject aiming at elucidating the functions and applications of microbiome in the areas of herb resources, herb processing, herb storage, and clinical effects by using modern technology of biology, ecology, and informatics. This subject essentially contains the structures, functions, interactions, molecular mechanisms, and application strategies of the microbiome associated with the quality, safety, and efficacy of TCM. Firstly, the development of the TCMM concept was summarized, with the profound understanding of TCMM on the complexity and entirety of microbiome being emphasized. Then, the research contents and applications of TCMM in promoting the sustainable development of herb resources, improving the standardization and diversification of herb fermentation, strengthening the safety of herb storage, and resolving the scientific connotation of theories and clinical efficacy of TCM are reviewed. Finally, the research strategies and methods of TCM microbiomics were elaborated from basic research, application research, and system research. TCMM is expected to promote the integrative development of TCM with frontier science and technology, thereby expanding the depth and scope of TCM study and facilitating TCM modernization.
Ecology ; Fermentation ; High-Throughput Nucleotide Sequencing ; Medicine, Chinese Traditional ; Research Design

Complicated chemical reactions occur in the decoction of traditional Chinese medicines(TCMs) which features complex components, influencing the safety, efficacy, and quality controllability of TCMs. Therefore, it is particularly important to clarify the chemical reaction mechanism of TCMs in the decoction. This study summarized eight typical chemical reactions in the decoction of TCMs, such as substitution reaction, redox reaction, isomerization/stereoselective reaction, complexation, and supramolecular reaction. With the "toxicity attenuation and efficiency enhancement" of aconitines and other examples, this study reviewed the reactions in decoction of TCMs, which was expected to clarify the variation mechanisms of key chemical components in this process and to help guide medicine preparation and safe and rational use of medicine in clinical settings. The current main research methods for chemical reaction mechanisms of decoction of TCMs were also summed up and compared. The novel real-time analysis device of decoction system for TCMs was found to be efficient and simple without the pre-treatment of samples. This device provides a promising solution, which has great potential in quantity evaluation and control of TCMs. Moreover, it is expected to become a foundational and exemplary research tool, which can advance the research in this field.
Medicine ; Medicine, Chinese Traditional ; Research Design