INTRODUCTION: Obstructive sleep apnoea (OSA) is common in Singapore, with moderate to severe OSA affecting around 30% of residents. These consensus statements aim to provide scientifically grounded recommendations for the management of OSA, standar-dise the management of OSA in Singapore and promote multidisciplinary collaboration. METHOD: An expert panel, which was convened in 2024, identified several areas of OSA management that require guidance. The expert panel reviewed the current literature and developed consensus statements, which were later independently voted on using a 3-point Likert scale (agree, neutral or disagree). Consensus (total ratings of agree and neutral) was set a priori at ≥80% agreement. Any statement not reaching consensus was excluded. RESULTS: The final consensus included 49 statements that provide guidance on the screening, diagnosis and management of adults with OSA. Additionally, 23 statements on the screening, diagnosis and management of paediatric OSA achieved consensus. These 72 consensus statements considered not only the latest clinical evidence but also the benefits and harms, resource implications, feasibility, acceptability and equity impact of the recommendations. CONCLUSION The statements presented in this paper aim to guide clinicians based on the most updated evidence and collective expert opinion from sleep specialists in Singapore. These recommendations should augment clinical judgement rather than replace it. Management decisions should be individualised, taking into account the patient's clinical characteristics, as well as patient and caregiver concerns and preferences.
Humans ; Sleep Apnea, Obstructive/diagnosis* ; Singapore ; Consensus ; Adult

Humans ; Carcinoma, Hepatocellular/epidemiology* ; Liver Neoplasms/epidemiology* ; Prothrombin ; Biomarkers

Aims: This study aimed to screen the plant growth-promoting fluorescent bacteria (FLB) which isolated from the healthy rice rhizophere and to evaluate its biocontrol and growth promotion properties against Pyricularia oryzae on aerobic rice seedling of MARDI Aerob 1. Methodology and results: King’s B agar with glycerol was used as the selective medium to isolate FLB from the healthy rice rhizosphere soil. All FLB obtained were in vitro screened for antagonistic activities against P. oryzae using dual culture, volatile substances and hydrogen cyanide productions. The potential FLB isolates were further evaluated on rice seedling early growth promotion before identified using 16S rRNA gene sequencing. A total of 24 FLB were isolated from the healthy rice rhizosphere soil in Setiu, Terengganu, Malaysia. Isolates: FLB4, FLB5, FLB7 and FLB10 scored the total of percentage inhibition radial growth (PIRG) values ranged 99.5-105.0%. Further seedling growth promotion screening revealed that FLB4, FLB7 and FLB10 were significantly improved seedling growth with vigor index of 378.32%, 461.53% and 335.60% over control (133.31%). 16S rRNA sequencing identified that FLB7 as Bacillus subtilis and the FLB4 and FLB10 as Pseudomonas putida. Conclusion, significance and impact of study The selected FLB isolates (FLB4, FLB7 and FLB10) are potential to be developed as biological control agents against P. oryzae with growth promoting property on aerobic rice seedling.
Plant Breeding--methods

Aims: This study aimed to isolate and evaluate the indigenous fluorescent Pseudomonas spp. with bio-control potential against Rhizoctonia solani and promoting growth in chilli seedlings. Methodology: A total of 120 fluorescent bacterial were isolated from the healthy chilli rhizosphere soil from the seven major chilli cultivation localities in Terengganu, Malaysia. Only 115 Gram negative fluorescent isolates were further invitro screened for antagonistic activities against R. solani and plant growth-promoting properties. The 50 most effective fluorescent Pseudomonads antagonist against R. solani with minimum percentage inhibition of radial growth (PIRG) of 65% were selected. Hierarchical cluster analysis was further conducted with two dendrograms derived from SPSS Statistic 20 to facilitate the comparison between these 50 isolates for antagonistic and growth-promoting properties. A total of 40 fluorescent isolates within the most potential cluster were further selected and identified using 16S rRNA sequencing. Thirty four fluorescent isolates were identified as Pseudomonas spp. and six isolates as Burkholderia spp. The top 13 ranked fluorescent Pseudomonas spp. from the scoring index were evaluated for seed germination and vigor index in chilli seedlings. There was no significant difference in germination rate between fluorescent Pseudomonas inoculated with control. However, vigor index of chilli seeds pre-inoculated with fluorescent P. putida (B5C1), P. aeruginosa (B3C56) and P. putida (B5C7) were significantly increased with 4684.9, 4657.3 and 4401.0 over control (P ≤ 0.05). Conclusion, significance and impact of study These selected fluorescent isolates: P. putida (B5C1), P. aeruginosa (B3C56) and P. putida (B5C7) have the potential to be developed as biofungicide against R. solani and as growthpromoter in chilli production system.
Pseudomonas fluorescens ; Rhizoctonia ; Seedlings

INTRODUCTIONDirect oral anticoagulants (DOACs) are establishing themselves as principle choices for the treatment of a variety of thrombotic disorders. DOACs are also known to affect common coagulation tests which are routinely performed for patients in clinical practice. An understanding of their varied effects is crucial for the appropriate ordering of coagulation tests and their interpretation.

MATERIALS AND METHODSLaboratories in public and private healthcare institutions and commercial sectors were surveyed on coagulation tests offered and their methods. A Medline and bibliography search, including a search on search engines, was performed for publications reporting the effects of dabigatran, apixaban and rivaroxaban on these coagulation tests. These papers were reviewed and summarised for consensus recommendations.

RESULTSProthrombin time (PT) and activated partial thromboplastin time (aPTT) are variably affected by the DOACs and dependent of the coagulation assays used. Clinicians must know which laboratory has performed these tests to logically interpret test results. A normal PT or aPTT does not exclude the presence of residual DOACs effect. The thrombin time is sensitive to dabigatran but not apixaban or rivaroxaban. Specialised coagulation tests such as thrombophilia tests are also variably affected by the DOACs. All laboratories in Singapore however, employ similar test methods permitting a common set of recommendations for specialised coagulation testing.

CONCLUSIONKnowledge of the effects of DOACs on coagulation testing is essential to determine the appropriateness of performing such tests and interpreting them coherently. Practical recommendations which are tests and location-specific are set out in this paper.

Antithrombins ; therapeutic use ; Blood Coagulation Tests ; Dabigatran ; therapeutic use ; Factor Xa Inhibitors ; therapeutic use ; Humans ; Partial Thromboplastin Time ; Practice Guidelines as Topic ; Prothrombin Time ; Pyrazoles ; therapeutic use ; Pyridones ; therapeutic use ; Rivaroxaban ; therapeutic use ; Singapore