INTRODUCTION: Although pre-exposure prophylaxis (PrEP) has been available in Singapore since 2016, its uptake among gay, bisexual and other men-who-have-sex-with-men (GBMSM) is low. The iPARTY study was established to evaluate the acceptability and feasibility of PrEP and a PrEP teleconsultation service for young GBMSM aged 18 to 29 years. METHOD: A total of 53 young GBMSM were enrolled in the iPARTY study. They had a total of 5 in-person consultations and teleconsultations, at 12-week intervals. Laboratory tests and quarterly baseline surveys were performed to assess PrEP adherence, sexual behaviour, and incidence of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). RESULTS: Thirty-five participants completed the entire 12-month follow-up. Most participants had positive experiences with PrEP teleconsultations. There was a statistically significant fall in participants' aggregate Patient Health Questionnaire-9 scores throughout the study. Self-reported PrEP adherence decreased over the course of the study, denoting improved mental health. Although self-reported condom use for anal intercourse and participants' risk perception of HIV decreased after PrEP adoption, there was no statisti-cally significant increase in STI incidence. CONCLUSION This pilot project has shown that PrEP services provide an opportunity for YMSM to access sexual health testing, treatment and counselling, and may even have tangible benefits on the mental health of this population. Teleconsultation is shown to be a suitable platform for the delivery of such services. Collaborative initiatives are crucial to further enhance the affordability and accessibility of PrEP in Singapore, and to improve patient adherence.
Adolescent ; Adult ; Humans ; Male ; Young Adult ; Anti-HIV Agents/administration & dosage* ; Feasibility Studies ; Health Risk Behaviors ; HIV Infections/psychology* ; Incidence ; Medication Adherence ; Mental Health/statistics & numerical data* ; Pilot Projects ; Pre-Exposure Prophylaxis/statistics & numerical data* ; Sexual and Gender Minorities/statistics & numerical data* ; Sexually Transmitted Diseases/prevention & control* ; Singapore/epidemiology* ; Telemedicine/statistics & numerical data* ; Homosexuality, Male/statistics & numerical data*

Objective: With the development of novel antibody-drug conjugates (ADCs), folate receptor alpha (FOLR1) is a promising therapeutic target for the treatment of platinum-resistant tuboovarian carcinomas. The main aims of this study were to assess FOLR1 protein expression in a large cohort of ovarian carcinoma histotypes. To inform future clinical trial design we identified molecular correlates of FOLR1 expression in low-grade serous carcinoma (LGSC). Methods: One thousand five hundred forty-seven ovarian carcinoma samples from 5 different Canadian cohorts were successfully evaluated by immunohistochemistry for FOLR1 expression using the PS2+ system. Statistical analyses with clinicopathological parameters, LGSC molecular subtypes, and overall survival (OS) were performed. Results: High FOLR1 expression was detected in 44% of high-grade serous carcinomas, and in 30% LGSC, 8% clear cell, 6% endometrioid, and 0% mucinous and/or mesonephrictype adenocarcinomas. In 160 LGSC cases, FOLR1 expression was more frequent in cases with normal MAPK pathway status (37% MAPK wild type vs. 14% canonical MAPK pathway mutations; p=0.002), low progesterone receptor (PR) expression (41%) vs. 23% (Allred score >2; p=0.02), and p16 loss (48% p16 absent vs. 26% normal; p=0.03). Canonical MAPK mutation status and PR expression remained significant on multivariable analysis. No significant associations between OS and FOLR1 expression were observed. Conclusion A significant proportion of LGSC express high FOLR1 levels supporting the development of clinical trials to investigate ADCs targeting FOLR1 as novel agents for treating this disease. In LGSC, high FOLR1 expression was associated with fewer MAPK pathway alterations, low PR expression, and p16 loss.

Humans ; Hong Kong/epidemiology* ; COVID-19

Objectives: This study aimed to investigate the relationships of foot and leg symptoms, structure, and function with functional limitations and osteoarthritis (OA). Methods: We included 1253 participants (mean age 58.1 years) from the Hong Kong Osteoporosis Study who completed an examination on foot posture, function, pain, and presence of deformities such as hallux valgus and varus knee. Using logistic regression, we estimated cross-sectional associations of each foot and knee problem with functional outcomes (slow walking speed, self-reported falls, and functional limitations) and OA. Through linkage to electronic health records, we further examined their associations with incident OA over 8 years using Cox models. All models were adjusted for age, sex, and body mass index. Results: The prevalence of hallux valgus, foot pain, and varus knee were 33.1%, 35.1%, and 25.8%, respectively.Planus foot posture was associated with varus knee, and pronated foot function was associated with hallux valgus. Of the assessed foot problems, only foot pain showed significant associations with functional outcomes, including functional limitations and recurrent falls. Foot pain was also associated with prevalent OA at baseline but not incident OA. Meanwhile, we observed a 3-times increased risk of incident OA associated with varus knee (95% CI = 1.48–6.10), and this association was particularly seen in older adults, women, and obese individuals. Conclusions In community-dwelling Chinese adults, foot pain, but not the reported foot deformities, is associated with functional limitations and falls, while varus knee is associated with incident OA.

Humans ; Colonoscopy ; Colorectal Neoplasms/pathology*

The aging population is an important issue around the world especially in developed countries. Although medical advances have substantially extended life span, the same cannot be said for the duration of health span. We are seeing increasing numbers of elderly people who are frail and/or have multiple chronic conditions; all of these can affect the quality of life of the elderly population as well as increase the burden on the healthcare system. Aging is mechanistically related to common medical conditions such as diabetes mellitus, ischemic heart disease, cognitive decline, and frailty. A recently accepted concept termed 'Accelerated Biological Aging' can be diagnosed when a person's biological age-as measured by biomarkers of DNA methylation-is older than their corresponding chronological age. Taurine, a conditionally essential amino acid, has received much attention in the past few years. A substantial number of animal studies have provided a strong scientific foundation suggesting that this amino acid can improve cellular and metabolic health, including blood glucose control, so much that it has been labelled one of the 'longevity amino acids'. In this review article, we propose the rationale that an adequately powered randomized-controlled-trial (RCT) is needed to confirm whether taurine can meaningfully improve metabolic and microbiome health, and biological age. This trial should incorporate certain elements in order to provide the much-needed evidence to guide doctors, and also the community at large, to determine whether this promising and inexpensive amino acid is useful in improving human metabolic health.

Contrast Media ; Gadolinium ; Glomerular Filtration Rate ; Humans ; Magnetic Resonance Imaging ; Mass Screening