Podcasts about yong loo lin school

Mental illness is now the biggest health crisis facing Singapore’s youth — and it’s happening largely out of sight. A new study uncovers a stark truth: mental disorders are now the leading cause of disability and death among 10 to 14-year-olds in Singapore — more than in any other ASEAN country. What’s fueling this silent epidemic? And how can Singapore confront a mental health crisis that too often stays hidden behind closed doors? On The Big Story, Hongbin Jeong speaks with Marie Ng, Associate Professor at the Yong Loo Lin School of Medicine, National University of Singapore and an Affiliate Associate Professor at the Institute for Health Metrics and Evaluation to find out.See omnystudio.com/listener for privacy information.

Covid-19 is making a quiet comeback in Singapore. After more than two years of living with the virus as an endemic threat, cases are once again on the rise—with over 14,000 infections reported in a single week, up sharply from the previous week. What’s driving this resurgence? And as the virus continues to evolve, how can individuals and communities stay prepared without returning to old restrictions? Are the current vaccines enough? On The Big Story, Hongbin Jeong speaks to Professor Paul Tambyah, Deputy Chair, Infectious Diseases Translational Research Programme, Yong Loo Lin School of Medicine from National University of Singapore (NUS Medicine), to find out more. See omnystudio.com/listener for privacy information.

https://eggshelltherapy.com/podcast-blog/2025/04/30/brianearp/In this episode, we discuss- Dr. Brian Earp's prolific academic work in philosophy, psychology, and medical ethics.- how his conservative religious upbringing sparked his curiosity about morality and ethics.- his transition from professional theater to academia and his commitment to a PhD at age 30.- his research on love, obsession, and addiction, and his critique of monogamy as a societal default.- his book Love Drugs and the ethics of using medical technologies to enhance relationships.- ethical challenges in AI, his stance on bodily autonomy.- his current projects on AI, personalized digital tools, and more! Some Quotes from Dr. Earp “Whether it's harmful can be kind of contingent on historical and social attitudes.”“If you think love is about fundamentally wanting to contribute to the flourishing of another person… then the question of whether you should possess them… might not be conducive to their flourishing.” “We should advocate for a view of love according to which it's something that is rooted fundamentally in care and respect.”“Addiction can be part of one's identity… if you cure yourself of this addiction, you almost change who you are.”About Dr. Brian Earp Associate Professor Brian D. Earp, PhD, is director of the Oxford-NUS Centre for Neuroethics and Society (OCNS) and the EARP Lab (Experimental Bioethics, Artificial Intelligence, and Relational Moral Psychology Lab) within the Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore (NUS). Brian is also an Associate Professor of Philosophy and of Psychology at NUS by courtesy.See www.brianearp.com for more information.Eggshell Therapy and Coaching: eggshelltherapy.com About Imi Lo: www.imiloimilo.comInstagram:https://www.instagram.com/eggshelltherapy_imilo/ Newsletters: https://eepurl.com/bykHRzDisclaimers: https://www.eggshelltherapy.com/disclaimers Trigger Warning: This episode may cover sensitive topics including but not limited to suicide, abuse, violence, severe mental illnesses, relationship challenges, sex, drugs, alcohol addiction, psychedelics, and the use of plant medicines. You are advised to refrain from watching or listening to the YouTube Channel or Podcast if you are likely to be offended or adversely impacted by any of these topics. Disclaimer: The content provided is for informational purposes only. Please do not consider any of the content clinical or professional advice. None of the content can substitute mental health intervention. Opinions and views expressed by the host and the guests are personal views and they reserve the right to change their opinions. We also cannot guarantee that everything mentioned is factual and completely accurate. Any action you take based on the information in this episode is taken at your own risk.

In the fourth of our top five episodes from the archives, Liling Tan asks Associate Professor Jason Lee, Director of the Heat Resilience and Performance Centre at the Yong Loo Lin School of Medicine in NUS about the risks migrant workers face and what other innovative solutions can employers look at to improve the situation. See omnystudio.com/listener for privacy information.

With temperatures breaking records in Singapore, what risks do migrant workers have? Aside from just drinking more water, what other innovative solutions can employers look at? Liling Tan asks Associate Professor Jason Lee who is also the Director of the Heat Resilience and Performance Centre at the Yong Loo Lin School of Medicine in NUS. See omnystudio.com/listener for privacy information.

Dr Heinrich Nolte graduated with an MBBCh from the University of the Witwatersrand. He received his. doctorate in Exercise Physiology from the University of Pretoria. In addition, Dr Nolte received an MA (HMS) specialising in Biokinetics (Cum Laude) and his BA (HMS) Honours, specialising in Biokinetics from the University of Pretoria. Afterwards, he completed postgraduate courses in Musculoskeletal Ultrasound, Advanced Cardiac Life Support and Advanced Clinical Care in HIV management, to name a few.Dr. Nolte is registered with the Health Professions Council of South Africa (HPCSA) as a Medical Practitioner and Biokineticist. He is a Honorary Researcher at the Movement Physiology Research Laboratory of the School of Physiology, Faculty of Health Sciences, University of the Witwatersrand and is a laboratory member of the Human Potential Translational Research Programme of the Yong Loo Lin School of Medicine at the National University of Singapore. Furthermore, Dr Nolte is a member of the American Physiological Society.Dr. Nolte is an international member of the American Academy of Physical Medicine and Rehabilitation (AAPM&R), a medical speciality organisation representing physicians who specialise in Physical Medicine and Rehabilitation. Dr Nolte has published numerous scientific research papers in international academic journals and presented papers at various international academic conferences.

IMH trial to study efficacy of personalised transcranial magnetic stimulation for depression. Synopsis: Every first Wednesday of the month, The Straits Times helps you make sense of health matters that affect you. Researchers from the Institute of Mental Health (IMH) and the Yong Loo Lin School of Medicine at the National University of Singapore are studying a new personalised treatment for resistant depression.  It is the personalised version of Transcranial Magnetic Stimulation (TMS), a non-invasive treatment that uses magnetic fields to stimulate and reset the specific part of the brain that regulates mood.  A clinical trial that aims to study its efficacy is currently being conducted at IMH. It pairs TMS with the algorithm of each patient's functional magnetic resonance imaging to identify a precise spot on the head where magnetic stimulation can be applied to achieve better outcomes. In this Health Check podcast episode, ST senior health correspondent Joyce Teo speaks to two experts involved in the trial. Dr Tor Phern Chern is a Senior Consultant at the Mood & Anxiety department and Head of Neurostimulation Service, at IMH and Associate Professor Thomas Yeo is from the Centre for Sleep and Cognition at the Yong Loo Lin School of Medicine. Highlights (click/tap above): 1:28 How does TMS work?  8:47 Using a tape measure to ascertain the target area  10:34 What is depression? 23:29 Using Professor Yeo's algorithm to find an individual treatment target 25:52 What is the trial about?  29:27 Envisioning a future of TMS treatments Produced by: Joyce Teo (joyceteo@sph.com.sg), Ernest Luis, and Eden Soh Edited by: Eden Soh Follow Health Check Podcast here every month and rate us: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ SPH Awedio app: https://www.awedio.sg/ Website: http://str.sg/stpodcasts Feedback to: podcast@sph.com.sg Read Joyce Teo's stories: https://str.sg/JbxN --- Discover more ST podcast channels: The Usual Place: https://str.sg/5nfm COE Watch: https://str.sg/iTtE In Your Opinion: https://str.sg/w7Qt Asian Insider: https://str.sg/JWa7 Health Check: https://str.sg/JWaN Green Pulse: https://str.sg/JWaf Your Money & Career: https://str.sg/wB2m ST Sports Talk: https://str.sg/JWRE #PopVultures: https://str.sg/JWad Music Lab: https://str.sg/w9TX Discover ST Podcasts: http://str.sg/stpodcasts --- Special edition series: True Crimes Of Asia (6 eps): https://str.sg/i44T The Unsolved Mysteries of South-east Asia (5 eps): https://str.sg/wuZ2 Invisible Asia (9 eps): https://str.sg/wuZn Stop Scams (10 eps): https://str.sg/wuZB Singapore's War On Covid (5 eps): https://str.sg/wuJa --- Follow our shows then, if you like short, practical podcasts! #healthcheckSee omnystudio.com/listener for privacy information.

IMH trial to study efficacy of personalised transcranial magnetic stimulation for depression. Synopsis: Every first Wednesday of the month, The Straits Times helps you make sense of health matters that affect you. Researchers from the Institute of Mental Health (IMH) and the Yong Loo Lin School of Medicine at the National University of Singapore are studying a new personalised treatment for resistant depression.  It is the personalised version of Transcranial Magnetic Stimulation (TMS), a non-invasive treatment that uses magnetic fields to stimulate and reset the specific part of the brain that regulates mood.  A clinical trial that aims to study its efficacy is currently being conducted at IMH. It pairs TMS with the algorithm of each patient's functional magnetic resonance imaging to identify a precise spot on the head where magnetic stimulation can be applied to achieve better outcomes. In this Health Check podcast episode, ST senior health correspondent Joyce Teo speaks to two experts involved in the trial. Dr Tor Phern Chern is a Senior Consultant at the Mood & Anxiety department and Head of Neurostimulation Service, at IMH and Associate Professor Thomas Yeo is from the Centre for Sleep and Cognition at the Yong Loo Lin School of Medicine. Highlights (click/tap above): 1:28 How does TMS work?  8:47 Using a tape measure to ascertain the target area  10:34 What is depression? 23:29 Using Professor Yeo's algorithm to find an individual treatment target 25:52 What is the trial about?  29:27 Envisioning a future of TMS treatments Produced by: Joyce Teo (joyceteo@sph.com.sg), Ernest Luis, and Eden Soh Edited by: Eden Soh Follow Health Check Podcast here every month and rate us: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ SPH Awedio app: https://www.awedio.sg/ Website: http://str.sg/stpodcasts Feedback to: podcast@sph.com.sg Read Joyce Teo's stories: https://str.sg/JbxN --- Discover more ST podcast channels: The Usual Place: https://str.sg/5nfm COE Watch: https://str.sg/iTtE In Your Opinion: https://str.sg/w7Qt Asian Insider: https://str.sg/JWa7 Health Check: https://str.sg/JWaN Green Pulse: https://str.sg/JWaf Your Money & Career: https://str.sg/wB2m ST Sports Talk: https://str.sg/JWRE #PopVultures: https://str.sg/JWad Music Lab: https://str.sg/w9TX Discover ST Podcasts: http://str.sg/stpodcasts --- Special edition series: True Crimes Of Asia (6 eps): https://str.sg/i44T The Unsolved Mysteries of South-east Asia (5 eps): https://str.sg/wuZ2 Invisible Asia (9 eps): https://str.sg/wuZn Stop Scams (10 eps): https://str.sg/wuZB Singapore's War On Covid (5 eps): https://str.sg/wuJa --- Follow our shows then, if you like short, practical podcasts! #healthcheckSee omnystudio.com/listener for privacy information.

Here Dr Sorrentino discusses his personal longevity protocol and also some of his current work and how this is targeted at moving discoveries into the clinic. Vincenzo Sorrentino is an Italian-born scientist in the fields of aging, mitochondrial biology and neuromuscular degeneration. He obtained his PhD Cum Laude at the University of Amsterdam on LDL-cholesterol regulation by the ubiquitin-proteasome system. Subsequently, he moved to Lausanne, Switzerland, for his postdoctoral research in Prof. Johan Auwerx's lab at the EPFL. His work there focused on the understanding of mitochondria and NAD+ metabolism in neurodegeneration and muscle aging. He then obtained a position as Group Leader at the Nestlé Institute of Health Sciences in Lausanne, to lead research focused on integrating basic discoveries on nutraceuticals and their effects on mitochondria and protein homeostasis with their translation into novel clinical applications. Since December 2022, he is an Assistant Professor at the NUS with the Dept. of Biochemistry and the Healthy Longevity TRP, Yong Loo Lin School of Medicine, to continue to develop his research on how metabolism, nutrition and proteostasis are linked and impact on health and aging.

Here Dr Sorrentino discusses mitochondria and muscle aging and results from trials of Urolithin A and NR in countering some of the ill effects. Vincenzo Sorrentino is an Italian-born scientist in the fields of aging, mitochondrial biology and neuromuscular degeneration. He obtained his PhD Cum Laude at the University of Amsterdam on LDL-cholesterol regulation by the ubiquitin-proteasome system. Subsequently, he moved to Lausanne, Switzerland, for his postdoctoral research in Prof. Johan Auwerx's lab at the EPFL. His work there focused on the understanding of mitochondria and NAD+ metabolism in neurodegeneration and muscle aging. He then obtained a position as Group Leader at the Nestlé Institute of Health Sciences in Lausanne, to lead research focused on integrating basic discoveries on nutraceuticals and their effects on mitochondria and protein homeostasis with their translation into novel clinical applications. Since December 2022, he is an Assistant Professor at the NUS with the Dept. of Biochemistry and the Healthy Longevity TRP, Yong Loo Lin School of Medicine, to continue to develop his research on how metabolism, nutrition and proteostasis are linked and impact on health and aging.

Here Dr Sorrentino discusses proteostasis, how it goes wrong with age and how raising NAD levels can help. Vincenzo Sorrentino is an Italian-born scientist in the fields of aging, mitochondrial biology and neuromuscular degeneration. He obtained his PhD Cum Laude at the University of Amsterdam on LDL-cholesterol regulation by the ubiquitin-proteasome system. Subsequently, he moved to Lausanne, Switzerland, for his postdoctoral research in Prof. Johan Auwerx's lab at the EPFL. His work there focused on the understanding of mitochondria and NAD+ metabolism in neurodegeneration and muscle aging. He then obtained a position as Group Leader at the Nestlé Institute of Health Sciences in Lausanne, to lead research focused on integrating basic discoveries on nutraceuticals and their effects on mitochondria and protein homeostasis with their translation into novel clinical applications. Since December 2022, he is an Assistant Professor at the NUS with the Dept. of Biochemistry and the Healthy Longevity TRP, Yong Loo Lin School of Medicine, to continue to develop his research on how metabolism, nutrition and proteostasis are linked and impact on health and aging.

Apologies for missing the last two release dates. Hopefully back on track now! Here Dr Sorrentino introduces trigonelline a methylated form of nicotinic acid which can boost NAD levels. He also talks about his work at Singapore and the translation of longevity science into the clinic. Vincenzo Sorrentino is an Italian-born scientist in the fields of aging, mitochondrial biology and neuromuscular degeneration. He obtained his PhD Cum Laude at the University of Amsterdam on LDL-cholesterol regulation by the ubiquitin-proteasome system. Subsequently, he moved to Lausanne, Switzerland, for his postdoctoral research in Prof. Johan Auwerx's lab at the EPFL. His work there focused on the understanding of mitochondria and NAD+ metabolism in neurodegeneration and muscle aging. He then obtained a position as Group Leader at the Nestlé Institute of Health Sciences in Lausanne, to lead research focused on integrating basic discoveries on nutraceuticals and their effects on mitochondria and protein homeostasis with their translation into novel clinical applications. Since December 2022, he is an Assistant Professor at the NUS with the Dept. of Biochemistry and the Healthy Longevity TRP, Yong Loo Lin School of Medicine, to continue to develop his research on how metabolism, nutrition and proteostasis are linked and impact on health and aging.

Saturday Mornings host Glenn van Zutphen and co-host, award-winning author Neil Humphreys are joined by Aravindan Srinivasan, Director of Thematic Collaborations at AVPN and Prof. Tikki Pangestu, Visiting Professor at the Yong Loo Lin School of Medicine, National University of Singapore to discuss how Singapore can help alleviate the region's growing healthcare disparities by first tackling cervical cancer risk among our 240,000 female, foreign domestic workers.See omnystudio.com/listener for privacy information.

Whether you're an early bird or a night owl, everyone needs sleep. But, do we adults really need 7 hours of sleep a day? Why do some people get away with less and others need more? We find out more about why sleep matters for our cognitive health, together with neurogeneticist Dr Azlina Ahmad Annuar, and Prof Dr Michael Chee, Director of the Centre for Sleep and Cognition at the Yong Loo Lin School of Medicine, National University of Singapore.Image credit: Shutterstock

Dr Gao Yujia graduated from the Yong Loo Lin School of Medicine, National University Hospital in 2011. He joined the Residency Program at the National University Hospital in 2012, and obtained his Membership of the Royal College of Surgeons of Edinburgh in 2013, and the Master of Medicine (Surgery) in 2017. He is currently an Associate Consultant in the Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery at the National University Hospital and Ng Teng Fong General Hospital, and an Associate Consultant at the Adult Liver Transplant Program, National University Centre for Organ Transplantation. Apart from his clinical work, Dr Gao is deeply involved in undergraduate medical education at the Yong Loo Lin School of Medicine, serving as the Deputy Director for Undergraduate Medical Education and is responsible for the planning and execution of the surgical posting for final year medical students. As the Assistant Group Chief Technology Officer of the National University Health System, Dr Gao spearheads various projects including the development of Holomedicine, Mixed Reality devices, and applications for medical education and clinical medicine. Dr Gao is also the Vice Chairman and Director of Science, Medicine and Technology of the Holomedicine Association, which is an international association aimed at bringing together expertise from around the world to advance the science of Mixed Reality and its application in clinical medicine. https://discovery.nus.edu.sg/24178-gao-yujia https://sg.linkedin.com/in/yujia-gao-7a2117210 https://twitter.com/yujiagao87 https://holomedicine-association.org #health #healthcare #metaverse #mixedreality #hololens XROM- Home of Extended Reality India's 1st AR/VR Focussed Podcast Kindly subscribe to our youtube channel www.youtube.com/xrompodcast  @nuhs-nationaluniversityhea3604 

Advance Directives in Asia: A Socio-Legal Analysis (Cambridge UP, 2023) , edited by Daisy Cheung and Michael Dunn is the first book to consider the concept of advance directives in Asia. It is unique in its depth and breadth as it brings together an extensive number of Asian jurisdictions to draw out the ways that advance directives are regulated in law and practice across the region. In their analysis Cheung and Dunn provide overall observations towards a concept of "generative accomodation". As a concept, generative accomodation has the potential to foreground new explorations of bioethics in Asia and globally. It also seeks to understand the role of the family in medical decision making. These are key concerns that come through in this comprehensive and groundbreaking book. It will be useful for regulators, Asia scholars, students, and practitioners in the field of health-law and ethics, and end of life care. The book has wider application for scholars in law, ethics and healthcare.  Daisy Cheung is an Assistant Professor in the Department of Law and the Centre for Medical Ethics and Law at The University of Hong Kong. Dr Michael Dunn is an Associate Professor and the Co-Director of Education at the Centre for Biomedical Ethics in the Yong Loo Lin School of Medicine. Jane Richards is a doctoral student at the University of Hong Kong. You can find her on twitter where she follows all things related to human rights and Hong Kong politics @JaneRichardsHK Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

Advance Directives in Asia: A Socio-Legal Analysis (Cambridge UP, 2023) , edited by Daisy Cheung and Michael Dunn is the first book to consider the concept of advance directives in Asia. It is unique in its depth and breadth as it brings together an extensive number of Asian jurisdictions to draw out the ways that advance directives are regulated in law and practice across the region. In their analysis Cheung and Dunn provide overall observations towards a concept of "generative accomodation". As a concept, generative accomodation has the potential to foreground new explorations of bioethics in Asia and globally. It also seeks to understand the role of the family in medical decision making. These are key concerns that come through in this comprehensive and groundbreaking book. It will be useful for regulators, Asia scholars, students, and practitioners in the field of health-law and ethics, and end of life care. The book has wider application for scholars in law, ethics and healthcare.  Daisy Cheung is an Assistant Professor in the Department of Law and the Centre for Medical Ethics and Law at The University of Hong Kong. Dr Michael Dunn is an Associate Professor and the Co-Director of Education at the Centre for Biomedical Ethics in the Yong Loo Lin School of Medicine. Jane Richards is a doctoral student at the University of Hong Kong. You can find her on twitter where she follows all things related to human rights and Hong Kong politics @JaneRichardsHK Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/east-asian-studies

Advance Directives in Asia: A Socio-Legal Analysis (Cambridge UP, 2023) , edited by Daisy Cheung and Michael Dunn is the first book to consider the concept of advance directives in Asia. It is unique in its depth and breadth as it brings together an extensive number of Asian jurisdictions to draw out the ways that advance directives are regulated in law and practice across the region. In their analysis Cheung and Dunn provide overall observations towards a concept of "generative accomodation". As a concept, generative accomodation has the potential to foreground new explorations of bioethics in Asia and globally. It also seeks to understand the role of the family in medical decision making. These are key concerns that come through in this comprehensive and groundbreaking book. It will be useful for regulators, Asia scholars, students, and practitioners in the field of health-law and ethics, and end of life care. The book has wider application for scholars in law, ethics and healthcare.  Daisy Cheung is an Assistant Professor in the Department of Law and the Centre for Medical Ethics and Law at The University of Hong Kong. Dr Michael Dunn is an Associate Professor and the Co-Director of Education at the Centre for Biomedical Ethics in the Yong Loo Lin School of Medicine. Jane Richards is a doctoral student at the University of Hong Kong. You can find her on twitter where she follows all things related to human rights and Hong Kong politics @JaneRichardsHK Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/medicine

Advance Directives in Asia: A Socio-Legal Analysis (Cambridge UP, 2023) , edited by Daisy Cheung and Michael Dunn is the first book to consider the concept of advance directives in Asia. It is unique in its depth and breadth as it brings together an extensive number of Asian jurisdictions to draw out the ways that advance directives are regulated in law and practice across the region. In their analysis Cheung and Dunn provide overall observations towards a concept of "generative accomodation". As a concept, generative accomodation has the potential to foreground new explorations of bioethics in Asia and globally. It also seeks to understand the role of the family in medical decision making. These are key concerns that come through in this comprehensive and groundbreaking book. It will be useful for regulators, Asia scholars, students, and practitioners in the field of health-law and ethics, and end of life care. The book has wider application for scholars in law, ethics and healthcare.  Daisy Cheung is an Assistant Professor in the Department of Law and the Centre for Medical Ethics and Law at The University of Hong Kong. Dr Michael Dunn is an Associate Professor and the Co-Director of Education at the Centre for Biomedical Ethics in the Yong Loo Lin School of Medicine. Jane Richards is a doctoral student at the University of Hong Kong. You can find her on twitter where she follows all things related to human rights and Hong Kong politics @JaneRichardsHK Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/south-asian-studies

Advance Directives in Asia: A Socio-Legal Analysis (Cambridge UP, 2023) , edited by Daisy Cheung and Michael Dunn is the first book to consider the concept of advance directives in Asia. It is unique in its depth and breadth as it brings together an extensive number of Asian jurisdictions to draw out the ways that advance directives are regulated in law and practice across the region. In their analysis Cheung and Dunn provide overall observations towards a concept of "generative accomodation". As a concept, generative accomodation has the potential to foreground new explorations of bioethics in Asia and globally. It also seeks to understand the role of the family in medical decision making. These are key concerns that come through in this comprehensive and groundbreaking book. It will be useful for regulators, Asia scholars, students, and practitioners in the field of health-law and ethics, and end of life care. The book has wider application for scholars in law, ethics and healthcare.  Daisy Cheung is an Assistant Professor in the Department of Law and the Centre for Medical Ethics and Law at The University of Hong Kong. Dr Michael Dunn is an Associate Professor and the Co-Director of Education at the Centre for Biomedical Ethics in the Yong Loo Lin School of Medicine. Jane Richards is a doctoral student at the University of Hong Kong. You can find her on twitter where she follows all things related to human rights and Hong Kong politics @JaneRichardsHK Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/law

Advance Directives in Asia: A Socio-Legal Analysis (Cambridge UP, 2023) , edited by Daisy Cheung and Michael Dunn is the first book to consider the concept of advance directives in Asia. It is unique in its depth and breadth as it brings together an extensive number of Asian jurisdictions to draw out the ways that advance directives are regulated in law and practice across the region. In their analysis Cheung and Dunn provide overall observations towards a concept of "generative accomodation". As a concept, generative accomodation has the potential to foreground new explorations of bioethics in Asia and globally. It also seeks to understand the role of the family in medical decision making. These are key concerns that come through in this comprehensive and groundbreaking book. It will be useful for regulators, Asia scholars, students, and practitioners in the field of health-law and ethics, and end of life care. The book has wider application for scholars in law, ethics and healthcare.  Daisy Cheung is an Assistant Professor in the Department of Law and the Centre for Medical Ethics and Law at The University of Hong Kong. Dr Michael Dunn is an Associate Professor and the Co-Director of Education at the Centre for Biomedical Ethics in the Yong Loo Lin School of Medicine. Jane Richards is a doctoral student at the University of Hong Kong. You can find her on twitter where she follows all things related to human rights and Hong Kong politics @JaneRichardsHK

Advance Directives in Asia: A Socio-Legal Analysis (Cambridge UP, 2023) , edited by Daisy Cheung and Michael Dunn is the first book to consider the concept of advance directives in Asia. It is unique in its depth and breadth as it brings together an extensive number of Asian jurisdictions to draw out the ways that advance directives are regulated in law and practice across the region. In their analysis Cheung and Dunn provide overall observations towards a concept of "generative accomodation". As a concept, generative accomodation has the potential to foreground new explorations of bioethics in Asia and globally. It also seeks to understand the role of the family in medical decision making. These are key concerns that come through in this comprehensive and groundbreaking book. It will be useful for regulators, Asia scholars, students, and practitioners in the field of health-law and ethics, and end of life care. The book has wider application for scholars in law, ethics and healthcare.  Daisy Cheung is an Assistant Professor in the Department of Law and the Centre for Medical Ethics and Law at The University of Hong Kong. Dr Michael Dunn is an Associate Professor and the Co-Director of Education at the Centre for Biomedical Ethics in the Yong Loo Lin School of Medicine. Jane Richards is a doctoral student at the University of Hong Kong. You can find her on twitter where she follows all things related to human rights and Hong Kong politics @JaneRichardsHK Learn more about your ad choices. Visit megaphone.fm/adchoices

This podcast episode explores the increasing global burden of dengue disease, focusing on changing demographics in endemic areas and the mounting risk of the disease in traditionally non-endemic areas. Moderated by Sue Saville, an independent health journalist, experts Tikki Pangestu, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, and João Bosco Siqueira, Federal University of Gois, Brazil, discuss the dangers of arboviral diseases, their impact on the healthcare ecosystem, and prevention strategies. This podcast was funded by Merck Sharp & Dohme LLC

#agereversal #science #biotechnology #ageing #health #podcast #toctw Dr. Brian Kennedy is internationally recognized for his research in the basic biology of aging and as a visionary committed to translating research discoveries into new ways of detecting, delaying, preventing, and treating human aging and associated diseases. He is a Distinguished Professor in Biochemistry and Physiology at the Yong Loo Lin School of Medicine at the National University Singapore (NUS) and serves as Director of (1) the Centre for Healthy Longevity at the National University Health System, (2) the Healthy Longevity Translational Research Programme and (3) the Asian Centre for Reproductive Longevity and Equality at NUS. Collectively, NUS aging research seeks to demonstrate that longevity interventions can be successfully employed in humans to extend the health span, the disease-free and highly functional period of life. From 2010 to 2016, Brian was the President and CEO of the Buck Institute for Research on Aging and he maintained a professorship there through 2020. Brian has an adjunct appointment at the Department of Biochemistry at the University of Washington, where he was a faculty member from 2001 to 2010. In addition, he is also actively involved with a number of Biotechnology companies and serves as a Co-Editor-In-Chief at Aging Cell. His Ph.D. was performed in the laboratory of Leonard Guarente at M.I.T., where he published the first paper linking Sirtuins to aging. Dr. Brian is also the scientific Advisor for Rejuvant https://sg.linkedin.com/in/brian-kennedy-69777318 https://twitter.com/bkennedy_aging

VIDEOS: The Cost of Denial Clip (17:33) Hang On, Bill Gates and Dr. Fauci just did WHAT? | Redacted with Clayton Morris (21:43) There is nothing constructive about the pot calling the kettle black. – Clare Daly  (1:17) Clinical trial for nicotinamide riboside: Vitamin safely boosts levels of important cell metabolite linked to multiple health benefits University of Iowa Health Care, October 10, 2022 In a clinical trial of nicotinamide riboside (NR), a newly discovered form of Vitamin B3, researchers have shown that the compound is safe for humans and increases levels of a cell metabolite that is critical for cellular energy production and protection against stress and DNA damage. Studies in mice have shown that boosting the levels of this cell metabolite — known as NAD+ — can produce multiple health benefits, including resistance to weight gain, improved control of blood sugar and cholesterol, reduced nerve damage, and longer lifespan. Levels of NAD+ diminish with age, and it has been suggested that loss of this metabolite may play a role in age-related health decline. These findings in animal studies have spurred people to take commercially available NR supplements designed to boost NAD+. However, these over-the-counter supplements have not undergone many clinical trials to see if they work in people. The new research, reported in the journal Nature Communications, was led by Charles Brenner, PhD, professor and Roy J. Carver Chair of Biochemistry at the University of Iowa Carver College of Medicine The human trial involved six men and six women, all healthy. Each participant received single oral doses of 100 mg, 300 mg, or 1,000 mg of NR in a different sequence with a seven-day gap between doses. After each dose, blood and urine samples were collected and analyzed to measure various NAD+ metabolites in a process called metabolomics. The trial showed that the NR vitamin increased NAD+ metabolism by amounts directly related to the dose, and there were no serious side effects with any of the doses. “This trial shows that oral NR safely boosts human NAD+ metabolism,” Brenner says. “We are excited because everything we are learning from animal systems indicates that the effectiveness of NR depends on preserving and/or boosting NAD+ and related compounds in the face of metabolic stresses. Because the levels of supplementation in mice that produce beneficial effects are achievable in people, it appears than health benefits of NR will be translatable to humans safely.” Consumption of a bioactive compound from Neem plant could significantly suppress development of prostate cancer National University of Singapore, September 29, 2022 Oral administration of nimbolide, over 12 weeks shows reduction of prostate tumor size by up to 70 per cent and decrease in tumor metastasis by up to 50 per cent A team of international researchers led by Associate Professor Gautam Sethi from the Department of Pharmacology at the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) has found that nimbolide, a bioactive terpenoid compound derived from Azadirachta indica or more commonly known as the neem plant or curry leaf common in throughout Indian cuisine, could reduce the size of prostate tumor by up to 70 per cent and suppress its spread or metastasis by half. In this research, we have demonstrated that nimbolide can inhibit tumor cell viability — a cellular process that directly affects the ability of a cell to proliferate, grow, divide, or repair damaged cell components — and induce programmed cell death in prostate cancer cells,” said Assoc Prof Sethi. The researchers observed that upon the 12 weeks of administering nimbolide, the size of prostate cancer tumor was reduced by as much as 70 per cent and its metastasis decreased by about 50 per cent, without exhibiting any significant adverse effects. “This is possible because a direct target of nimbolide in prostate cancer is glutathione reductase, an enzyme which is responsible for maintaining the antioxidant system that regulates the STAT3 gene in the body. The activation of the STAT3 gene has been reported to contribute to prostate tumor growth and metastasis,” explained Assoc Prof Sethi. “We have found that nimbolide can substantially inhibit STAT3 activation and thereby abrogating the growth and metastasis of prostate tumor,” he added. Mindfulness training provides a natural high, study finds University of Utah, October 20, 2022 New research from the University of Utah finds that a mindfulness meditation practice can produce a healthy altered state of consciousness in the treatment of individuals with addictive behaviors. Not unlike what one might experience under the influence of psychedelic drugs—achieving this altered state through mindful meditation has the potential lifesaving benefit of decreasing one's addictive behaviors by promoting healthy changes to the brain. The findings come from the largest neuroscience study to date on mindfulness as a treatment for addiction. The study, published in the journal Science Advances, provides new insight into the neurobiological mechanisms by which mindfulness treats addiction. Study findings provide a promising, safe and accessible treatment option for the more than 9 million Americans misusing opioids. Eric Garland is the lead author of the paper and is a distinguished professor and directs the University of Utah's Center on Mindfulness and Integrative Health Intervention Development. Garland's study builds on previous research measuring the positive effects of theta waves in the human brain. Researchers have found that individuals with low theta waves tend to experience a wandering mind, trouble concentrating or they ruminate on thoughts about themselves. Low theta waves result in a loss of self-control as the brain slips into its default mode of automatic habits. In contrast, when a person is focused, present and fully absorbed in a task, EEG scans will show increased frontal midline theta wave activity. “With high theta activity, your mind becomes very quiet, you focus less on yourself and become so deeply absorbed in what you are doing that the boundary between yourself and the thing you are focusing on starts to fade away. You lose yourself in what you are doing,” said Garland. Garland's new study showed it is in this mindful, theta wave state that people begin to experience feelings of self-transcendence and bliss, and the brain changes in ways that actually reduce one's addictive behaviors. Garland's research team recruited 165 adults with long-term opioid use for the study. Participants were randomly placed into either the control group that participated in supportive group psychotherapy or the experimental group taught to incorporate Mindfulness-Oriented Recovery Enhancement (MORE) into their daily lives. Participants showed more than twice as much frontal midline theta brain activity following treatment with MORE, whereas those in supportive therapy showed no increase in theta. Participants in MORE who showed the biggest increases in theta waves reported more intense experiences of self-transcendence during meditation, including the sense of one's ego fading away, a sense of oneness with the universe or feelings of blissful energy and love. MORE also led to significant decreases in opioid misuse through the nine-month follow-up. These reductions in opioid misuse were caused in part by the increases in frontal midline theta brain waves. Garland explained that by achieving “tastes of self-transcendence” through meditation, mindfulness therapy boosted theta waves in the frontal lobes of the brain to help participants gain self-control over their addictive behaviors. Free radicals blamed for toxic buildup in Alzheimer's brains Rutgers University, October 11, 2022. A study reported in Cell Death & Disease revealed a previously unknown mechanism that may contribute to traumatic brain injury and Alzheimer's disease. While a buildup of the protein amyloid-beta has been hypothesized to be the major driver of Alzheimer's disease, the study suggests that another protein, after undergoing oxidation by free radicals, could be a causative factor. “Indeed, scientists have known for a long time that during aging or in neurodegenerative disease cells produce free radicals,” explained lead researcher Federico Sesti, who is a professor of neuroscience and cell biology at Rutgers Robert Wood Johnson Medical School. “Free radicals are toxic molecules that can cause a reaction that results in lost electrons in important cellular components, including the channels.” Dr Sesti and colleagues determined that oxidation of a potassium channel known as KCNB1 results in a toxic buildup of this protein, leading to increased amyloid-beta production and damage to brain function. “The discovery of KCNB1's oxidation/build-up was found through observation of both mouse and human brains, which is significant as most scientific studies do not usually go beyond observing animals,” Dr Sesti reported. “Further, KCBB1 channels may not only contribute to Alzheimer's but also to other conditions of stress as it was found in a recent study that they are formed following brain trauma.” Study: Maternal, paternal exercise affects metabolic health in offspring Ohio State University, October 19, 2022 A mouse study by Kristin Stanford, with The Ohio State University College of Medicine at the Wexner Medical Center, provides new ways to determine how maternal and paternal exercise improve metabolic health of offspring. This study used mice to evaluate how their lifestyles—eating fatty foods vs. healthy and exercising vs. not—affected the metabolites of their offspring. Metabolites are substances made or used when the body breaks down food, drugs or chemicals, or its own fat or muscle tissue. This process, called metabolism, makes energy and the materials needed for growth, reproduction and maintaining health. Metabolites can serve as disease markers, particularly for type 2 diabetes and cardiovascular disease. “Tissue metabolites contribute to overall metabolism, including glucose or fatty acid metabolism, and thus systemic metabolism. We have previously shown that maternal and paternal exercise improve health of offspring. Tissue and serum metabolites play a fundamental role in the health of an organism, but how parental exercise affects offspring tissue and serum metabolites has not yet been investigated. This new data contributes to how maternal or paternal exercise could improve metabolism in offspring,” Stanford said. This study found that all forms of parental exercise improved whole-body glucose metabolism in offspring as adults, and metabolomics profiling of offspring serum, muscle, and liver reveal that parental exercise results in extensive effects across all classes of metabolites in all of these offspring tissues. Regular consumption of fried food before pregnancy increases risk of developing gestational diabetes Kennedy Shriver National Institute of Child Health and Human Development, October 10, 2022 New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) shows that women who eat fried food regularly before conceiving are at increased risk of developing gestational diabetes during pregnancy. Gestational diabetes (GDM) is a complication that can arise during pregnancy, and is characterised by abnormally high blood glucose during the pregnancy (especially in the final 3 months). It can lead to increased birthweight of the child, as well jaundice and other complications. When left untreated, it can cause complications or stillbirth. Women who have GDM are more likely to later develop full blown type 2 diabetes. The authors included 21,079 singleton pregnancies from 15,027 women in the Nurses' Health Study II (NHS II) cohort. NHS II is an ongoing prospective cohort study of 116,671 female nurses in the USA aged 25-44 years at the start of study. For fried food consumption, participants were asked “how often do you eat fried food away from home (e.g. French fries, fried chicken, fried fish)?” and “how often do you eat food that is fried at home?” Both questions had four possible frequency responses: less than once per week, 1-3 times per week, 4-6 times per week, or daily. The researchers analysed fried food consumption at home and away from home separately, as well as total fried food consumption. In addition, they asked the participants what kind of frying fat/oils they usually used at home, with the possible responses as follows: real butter, margarine, vegetable oil, vegetable shortening, or lard. The association persisted after further adjustments were made for varying body-mass index (BMI). After this, the risk ratios of GDM among women who consumed total fried foods 1-3, 4-6, and 7 or more times per week, compared with those who consumed less than once per week, were 1.06, 1.14, and 1.88 respectively (thus an 88% increased risk for 7 or more times per week compared with less than once per week). The authors say: “The potential detrimental effects of fried food consumption on GDM risk may result from the modification of foods and frying medium and generation of harmful by-products during the frying process. Frying deteriorates oils through the processes of oxidation and hydrogenation, leading to an increase in the absorption of oil degradation products by the foods being fried, and also a loss of unsaturated fatty acids such as linoleic and linolenic acids and an increase in the corresponding trans fatty acids such as trans-linoleic acids and trans-linolenic acids.” They add: “Frying also results in significantly higher levels of dietary advanced glycation end products (AGEs), the derivatives of glucose-protein or glucose-lipid interactions. Recently, AGEs have been implicated in insulin resistance, pancreatic beta-cell damage, and diabetes, partly because they promote oxidative stress and inflammation. Moreover, intervention studies with a diet low in AGEs have shown significantly improved insulin sensitivity, reduced oxidant stress, and alleviated inflammation.” When analysed separately, the authors found that there was a statistically significant association of GDM with fried food consumption away from home, but not with fried food consumption at home. The authors say: “Deterioration of oils during frying is more profound when the oils are reused, a practice more common away from home than at home. This may partly explain why we observed a stronger association of GDM risk with fried foods consumed away from home than fried foods consumed at home.”

Synopsis: Every first and third Wednesday of the month, The Straits Times helps you make sense of health matters that affect you. Today, there are countless distractions keeping us up at night and stopping us from having a good night's sleep. Yet, sleep is one of the three pillars of a healthy lifestyle (nutrition and exercise are the other two), and in recent years, there has been much interest in how we can sleep better. But are personal measures enough to improve sleep? This, given he erosion of work-life boundaries and the overwhelming amount of digital distractions today. In Part 2, ST senior health correspondent Joyce Teo continues the conversation on sleep with Professor Michael Chee, the director of the Centre for Sleep and Cognition at the Yong Loo Lin School of Medicine at the National University of Singapore. Prof Chee has spent close to two decades studying sleep and its impact on cognition and behaviour.   Highlights (click/tap above): 00:49 Balancing structural measures with personal commitment to improve sleep 04:10 Benefits of starting school later in Singapore; effects of sleep for students 07:38 Consequence of chronic short sleep for adults and the elderly 09:12 Tips for effective short naps; should you avoid exercise at night? 10:23 Why alcohol at night really affects sleep quality; debate on caffeinated drinks Produced by: Joyce Teo (joyceteo@sph.com.sg), Ernest Luis and Hadyu Rahim Edited by: Eden Soh Follow our previous episodes on sleep issues here: https://str.sg/w8TE Follow Health Check Podcast episodes out here every first and third Wednesday of the month: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Google Podcasts: https://str.sg/J6Wv  SPH Awedio app: https://www.awedio.sg/ Website: http://str.sg/stpodcasts Feedback to: podcast@sph.com.sg Read Joyce Teo's stories: https://str.sg/JbxN --- Discover ST's special edition podcasts: Singapore's War On Covid: https://str.sg/wsfD The Unsolved Mysteries of South-east Asia Embed: https://str.sg/ws76 Stop Scams: https://str.sg/wnBi --- Discover more ST podcast series: In Your Opinion Podcast: https://str.sg/w7Qt SG Extra Podcast: https://omny.fm/shows/st-bt/playlists/sg-extra Asian Insider Podcast: https://str.sg/JWa7 Green Pulse Podcast: https://str.sg/JWaf Health Check Podcast: https://str.sg/JWaN #PopVultures Podcast: https://str.sg/JWad ST Sports Talk Podcast: https://str.sg/JWRE Bookmark This! Podcast: https://str.sg/JWas Lunch With Sumiko Podcast: https://str.sg/J6hQ Discover BT Podcasts: https://bt.sg/pcPL Follow our shows then, if you like short, practical podcasts! See omnystudio.com/listener for privacy information.

Synopsis: Every first and third Wednesday of the month, The Straits Times helps you make sense of health matters that affect you. Today, there are countless distractions keeping us up at night and stopping us from having a good night's sleep. Yet, sleep is one of the three pillars of a healthy lifestyle (nutrition and exercise are the other two), and in recent years, there has been much interest in how we can sleep better. But are personal measures enough to improve sleep? This, given he erosion of work-life boundaries and the overwhelming amount of digital distractions today. In Part 2, ST senior health correspondent Joyce Teo continues the conversation on sleep with Professor Michael Chee, the director of the Centre for Sleep and Cognition at the Yong Loo Lin School of Medicine at the National University of Singapore. Prof Chee has spent close to two decades studying sleep and its impact on cognition and behaviour.   Highlights (click/tap above): 00:49 Balancing structural measures with personal commitment to improve sleep 04:10 Benefits of starting school later in Singapore; effects of sleep for students 07:38 Consequence of chronic short sleep for adults and the elderly 09:12 Tips for effective short naps; should you avoid exercise at night? 10:23 Why alcohol at night really affects sleep quality; debate on caffeinated drinks Produced by: Joyce Teo (joyceteo@sph.com.sg), Ernest Luis and Hadyu Rahim Edited by: Eden Soh Follow our previous episodes on sleep issues here: https://str.sg/w8TE Follow Health Check Podcast episodes out here every first and third Wednesday of the month: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Google Podcasts: https://str.sg/J6Wv  SPH Awedio app: https://www.awedio.sg/ Website: http://str.sg/stpodcasts Feedback to: podcast@sph.com.sg Read Joyce Teo's stories: https://str.sg/JbxN --- Discover ST's special edition podcasts: Singapore's War On Covid: https://str.sg/wsfD The Unsolved Mysteries of South-east Asia Embed: https://str.sg/ws76 Stop Scams: https://str.sg/wnBi --- Discover more ST podcast series: In Your Opinion Podcast: https://str.sg/w7Qt SG Extra Podcast: https://omny.fm/shows/st-bt/playlists/sg-extra Asian Insider Podcast: https://str.sg/JWa7 Green Pulse Podcast: https://str.sg/JWaf Health Check Podcast: https://str.sg/JWaN #PopVultures Podcast: https://str.sg/JWad ST Sports Talk Podcast: https://str.sg/JWRE Bookmark This! Podcast: https://str.sg/JWas Lunch With Sumiko Podcast: https://str.sg/J6hQ Discover BT Podcasts: https://bt.sg/pcPL Follow our shows then, if you like short, practical podcasts! See omnystudio.com/listener for privacy information.

Synopsis: Every first and third Wednesday of the month, The Straits Times helps you make sense of health matters that affect you. We continue the conversation on sleep in this episode. Sleep is one of the three pillars of a healthy lifestyle and there has been much interest in how we can sleep better in recent years. The COVID-19 pandemic has shaken up our daily routines, with so many people still working from home. In this episode, ST senior health correspondent Joyce Teo speaks to Professor Michael Chee, the director of the Centre for Sleep and Cognition at the Yong Loo Lin School of Medicine at the National University of Singapore. Prof Chee has spent close to two decades studying sleep and its impact on cognition and behaviour.   They discuss how the pandemic has affected sleep, the lessons learned from the last two years and the relevance of sleep targets set by the US-based National Sleep Foundation (NSF). Highlights (click/tap above): 01:05 What has Covid-19 taught us about sleep? 03:39 Sleep targets set by US NSF - how relevant is it to Singapore? 06:27 Difference between self-reported sleep and objectively measured sleep 09:24 Sleep targets and recommendations differ based on individuals 13:08 Effects of sleep habits on health Produced by: Joyce Teo (joyceteo@sph.com.sg), Ernest Luis, Fa'izah Sani and Hadyu Rahim Edited by: Hadyu Rahim and Fa'izah Sani Follow our previous episodes on sleep issues here: https://str.sg/w8TE Follow Health Check Podcast episodes out here every first and third Wednesday of the month: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Google Podcasts: https://str.sg/J6Wv  SPH Awedio app: https://www.awedio.sg/ Website: http://str.sg/stpodcasts Feedback to: podcast@sph.com.sg Read Joyce Teo's stories: https://str.sg/JbxN --- Discover ST's special edition podcasts: Singapore's War On Covid: https://str.sg/wsfD The Unsolved Mysteries of South-east Asia Embed: https://str.sg/ws76 Stop Scams: https://str.sg/wnBi --- Discover more ST podcast series: In Your Opinion Podcast: https://str.sg/w7Qt SG Extra Podcast: https://omny.fm/shows/st-bt/playlists/sg-extra Asian Insider Podcast: https://str.sg/JWa7 Green Pulse Podcast: https://str.sg/JWaf Health Check Podcast: https://str.sg/JWaN #PopVultures Podcast: https://str.sg/JWad ST Sports Talk Podcast: https://str.sg/JWRE Bookmark This! Podcast: https://str.sg/JWas Lunch With Sumiko Podcast: https://str.sg/J6hQ Discover BT Podcasts: https://bt.sg/pcPL Follow our shows then, if you like short, practical podcasts! See omnystudio.com/listener for privacy information.

Synopsis: Every first and third Wednesday of the month, The Straits Times helps you make sense of health matters that affect you. We continue the conversation on sleep in this episode. Sleep is one of the three pillars of a healthy lifestyle and there has been much interest in how we can sleep better in recent years. The COVID-19 pandemic has shaken up our daily routines, with so many people still working from home. In this episode, ST senior health correspondent Joyce Teo speaks to Professor Michael Chee, the director of the Centre for Sleep and Cognition at the Yong Loo Lin School of Medicine at the National University of Singapore. Prof Chee has spent close to two decades studying sleep and its impact on cognition and behaviour.   They discuss how the pandemic has affected sleep, the lessons learned from the last two years and the relevance of sleep targets set by the US-based National Sleep Foundation (NSF). Highlights (click/tap above): 01:05 What has Covid-19 taught us about sleep? 03:39 Sleep targets set by US NSF - how relevant is it to Singapore? 06:27 Difference between self-reported sleep and objectively measured sleep 09:24 Sleep targets and recommendations differ based on individuals 13:08 Effects of sleep habits on health Produced by: Joyce Teo (joyceteo@sph.com.sg), Ernest Luis, Fa'izah Sani and Hadyu Rahim Edited by: Hadyu Rahim and Fa'izah Sani Follow our previous episodes on sleep issues here: https://str.sg/w8TE Follow Health Check Podcast episodes out here every first and third Wednesday of the month: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Google Podcasts: https://str.sg/J6Wv  SPH Awedio app: https://www.awedio.sg/ Website: http://str.sg/stpodcasts Feedback to: podcast@sph.com.sg Read Joyce Teo's stories: https://str.sg/JbxN --- Discover ST's special edition podcasts: Singapore's War On Covid: https://str.sg/wsfD The Unsolved Mysteries of South-east Asia Embed: https://str.sg/ws76 Stop Scams: https://str.sg/wnBi --- Discover more ST podcast series: In Your Opinion Podcast: https://str.sg/w7Qt SG Extra Podcast: https://omny.fm/shows/st-bt/playlists/sg-extra Asian Insider Podcast: https://str.sg/JWa7 Green Pulse Podcast: https://str.sg/JWaf Health Check Podcast: https://str.sg/JWaN #PopVultures Podcast: https://str.sg/JWad ST Sports Talk Podcast: https://str.sg/JWRE Bookmark This! Podcast: https://str.sg/JWas Lunch With Sumiko Podcast: https://str.sg/J6hQ Discover BT Podcasts: https://bt.sg/pcPL Follow our shows then, if you like short, practical podcasts! See omnystudio.com/listener for privacy information.

In 2017, the 2nd Interventions in Aging Conference on "Understanding Mechanisms & Compressing Morbidity in Aging Humans" was held in Cancun, Mexico. The co-chairs of this conference, and speakers in this Aging (Aging-US) video, are Drs. Dame Linda Partridge DBE, FRS, FRSE, FMedSci, and Brian Kennedy Ph.D. Dr. Partridge is currently the Weldon Professor of Biometry in the Department of Genetics, Evolution and Environment at the University College London (UCL), Director of UCL's Institute of Healthy Ageing, and the Founding Director of the Max Planck Institute for the Biology of Ageing. Dr. Kennedy is a Distinguished Professor in the Department of Biochemistry and Physiology at the National University of Singapore (NUS)'s Yong Loo Lin School of Medicine. Dr. Kennedy is also Director of the National University Health System (NUHS) Centre for Healthy Ageing in Singapore, Professor at the Buck Institute for Research on Ageing, Adjunct Professor at the University of Southern California's Leonard Davis School of Gerontology, and Affiliate Faculty in Department of Biochemistry at the University of Washington. In this video, these two prominent researchers briefly discussed the state of aging research in 2017, and postulated what the future of aging interventions may look like. Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.101221 DOI - https://doi.org/10.18632/aging.101221 Full Text - https://www.aging-us.com/article/101221/text#fulltext Correspondence to: Brian K. Kennedy email: bkennedy@buckinstitute.org and Linda Partridge email: partridge@age.mpg.de Keywords: healthspan, organismal aging, epigenetics, longevity, cellular mechanisms, metabolism, aging, conference About Aging (Aging-US) Launched in 2009, Aging-US publishes papers of general interest and biological significance in all fields of aging research and age-related diseases, including cancer—and now, with a special focus on COVID-19 vulnerability as an age-dependent syndrome. Topics in Aging-US go beyond traditional gerontology, including, but not limited to, cellular and molecular biology, human age-related diseases, pathology in model organisms, signal transduction pathways (e.g., p53, sirtuins, and PI-3K/AKT/mTOR, among others), and approaches to modulating these signaling pathways. Please visit our website at http://www.Aging-US.com​​ or connect with us on: SoundCloud - https://soundcloud.com/Aging-Us Facebook - https://www.facebook.com/AgingUS/ Twitter - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/agingus​ LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Aging-US is published by Impact Journals, LLC please visit http://www.ImpactJournals.com​​ or connect with @ImpactJrnls Media Contact 18009220957 MEDIA@IMPACTJOURNALS.COM

The Omicron variant, the latest variant of concern listed by the World Health Organisation has the whole world in a panic, after being described as potentially more contagious than Delta. But as much of the world takes precautions and imposes a travel ban against South Africa and its neighbours, is South Africa being punished for its genomic surveillance and transparency? Prof Tikki Pangestu, Visiting Professor, Yong Loo Lin School of Medicine, National University of Singapore joins us to discuss what we know about Omicron and why vaccine equity is more important than ever. Editor's note - Around 18:00, it should be noted that at the time of the interview, it is estimated that only about 10% of Africa's population has gotten their first dose.Image credit: Shutterstock

In the Straits Times’ The Big Story, Multimedia journalist Hairianto Diman spoke to Associate professor David Allen from the Infectious Diseases Translational Research Programme at NUS' Yong Loo Lin School of Medicine who shared more about the new Omicron variant - including its capabilities and how effective the current vaccines are against it. See omnystudio.com/listener for privacy information.

In The Straits Times' The Big Story, the surge in Covid-19 cases has placed significant pressure on public hospitals here. Multimedia journalist Hairianto Dirman spoke to Infectious diseases clinician David Allen about the situation in hospitals. Associate Professor Allen, who is from the Infectious Diseases Translational Research Programme at NUS' Yong Loo Lin School of Medicine, also explains the strain the healthcare system is under. See omnystudio.com/listener for privacy information.

Can low temperature-aged garlic enhance exercise performance? Korea Univesity & National Institute of Agricultural Sciences (South Korea), October 8, 2021 Scientists from South Korea's National Institute of Agricultural Sciences and Korea University looked at aged garlic to see whether it could help reduce fatigue. To do this, they conducted a study on mice fed with a special low-temperature-aged garlic (LTAG). Their findings were published in the Journal of Medicinal Food. Testing the fatigue-fighting effects of low temperature-aged garlic The researchers chose to use LTAG because it lacked the pungent odor and spicy flavor of regular garlic, making it easier to use for animal testing. To create the LTAG, the researchers stored garlic in a sealed container, aging at 60 C for 60 days. The resulting LTAG was then peeled and pulverized, before being added to 200 milliliters of 70 percent ethanol (EtOH), which was then subjected to ultrasonic extraction three times. This 70 percent EtOH and LTAG extract was then concentrated under a vacuum at 45 C and then lyophilized to create a dry LTAG residue. After the creation of the LTAG, the researchers then separated mice into six groups. The first group was given a low dose of LTAG extract; the second was fed a high dose of LTAG extract; the third was given a low dose of garlic extract; and the fourth was given a high dose of garlic extract. The fifth and sixth groups consisted of normal mice that were given phosphate-buffered saline (PBS) instead of garlic. One of these control groups was made to exercise while the other group was not. The mice in the five groups were forced to run on a treadmill for four weeks. With each passing week, the amount of exercise the mice would have to do on the treadmills would increase. This was done by increasing both the speed that the mice had to run, and the amount of time they had to spend running. (Related: How to alleviate fatigue with herbal medicine.) After 28 days of treatment, five mice from each group were subjected to a final, exhaustive treadmill test. This test increased the treadmill speed from 15 meters per minute (m/min) to 40 m/min every 3 minutes. During this test, the running time was monitored until each mouse failed to follow the increase in speed on three consecutive occasions and lag occurred. At this point, the mouse's total running time was recorded. The effect of the LTAG on the levels of glucose, lactate dehydrogenase (LDH), free fatty acid (FFA) and lactate in the mice's blood. Following the final exercise, the mice were killed and blood samples were collected from them. In addition, the mice's gastrocnemius muscles were also isolated and frozen in liquid nitrogen for testing. LTAG treated mice demonstrated less fatigue Following the exhaustive running tests, the researchers found that the mice treated with LTAG extract were able to run for much longer than the control mice. Meanwhile, looking at the blood tests, they noted that the mice treated with LTAG extract exhibited lower levels of glucose, LDH, FFA and lactate. More importantly, the LTAG treated mice had increased amounts of glycogen and creatine kinase (CK) in their muscles. Glycogen storage is an important source of energy during exercise. It serves a central role in maintaining the body's glucose homeostasis by supplementing blood glucose. Because of this, glycogen is seen as an accurate marker for fatigue, with increased glycogel levels closely associated with improved endurance and anti-fatigue effects. CK, on the other hand, is known to be an accurate indicator of muscle damage. During muscle degeneration, muscle cells are dissolved and their contents enter the bloodstream. As a result, when muscle damage occurs, muscle CK comes out into the blood. As such, fatigue tends to lead to lower muscle CK levels and higher blood CK levels. Higher levels of glycogen and muscle CK in the LTAG treated mice indicated that they experienced less fatigue than the other groups. Based on these findings, the researchers believe that LTAG has potential for use as an anti-fatigue agent.       Mindfulness meditation helps preterm-born adolescents University of Geneva (Switzerland), October 7, 2021 Adolescents born prematurely present a high risk of developing executive, behavioral and socio-emotional difficulties. Now, researchers from Geneva University Hospitals (HUG) and the University of Geneva (UNIGE) have revealed that practicing mindfulness may help improve these various skills. The study, published in the journal Scientific Reports, suggests using mindfulness as a means of clinical intervention with adolescents, whether prematurely born or not. Several studies have already shown that very preterm (VPT) children and adolescents are at higher risk of exhibiting cognitive and socio-emotional problems that may persist into adulthood. To help them overcome the difficulties they face, researchers from the HUG and UNIGE have set up an intervention based on mindfulness, a technique known to have beneficial effects in these areas. Mindfulness consists in training the mind to focus on the present moment, concentrating on physical sensations, on breathing, on the weight of one's body, and even on one's feelings and thoughts, completely judgment-free. The mindfulness-based interventions generally take place in a group with an instructor along with invitations to practice individually at home. To accurately assess the effects of mindfulness, a randomized controlled trial was performed with young adolescents aged 10 to 14, born before 32 weeks gestational weeks. Scientists quickly found that mindfulness improves the regulation of cognitive, social and emotional functions, in other worlds, our brain's ability to interact with our environment. Indeed, it increases the ability to focus on the present—on thoughts, emotions and physical sensations, with curiosity and non-judgment. Thanks to this practice, adolescents improve their executive functions, i.e. the mental processes that enable us to control our behavior to successfully achieve a goal. As a result, young people find it easier to focus, manage and regulate their behavior and emotions in everyday life. For eight weeks, the young teens spent an hour and a half each week with two mindfulness instructors. They were further encouraged to practice mindfulness daily at home. Parents were also involved in this study. They were asked to observe their child's executive functions, for example the ability to regulate their emotions and attentional control, their relationships with others and their behavior. The adolescents also underwent a series of computerized tasks to assess their reactions to events. A comparison of their test results with a control group that did not practice mindfulness shows a positive impact of the intervention on the adolescents' everyday life and on their ability to react to new events. "Each teenager is unique, with their own strenghts and difficulties. Through their involvement in this study, our volunteers have contributed to show that mindfulness can help many young people to feel better, to refocus and to face the world, whether they were born preterm born or not," agree Dr. Russia Hà-Vinh Leuchter, a consultant in the Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics at Geneva University Hospitals, and Dr. Vanessa Siffredi, a researcher at the Child Development Laboratory at the Department of Paediatrics, Gynaecology and Obstetrics at the UNIGE Faculty of Medicine, two of the authors of this work. "However, while the practice of meditation can be a useful resource, it is important to be accompanied by well-trained instructors", they specify. The adolescents who took part in the program are now between 14 and 18 years. Scientists are currently evaluating the long-term effects of mindfulness-based intervention on their daily attention and stress. Furthermore, to validate their clinical data with neurobiological measurements, researchers are currently studying the effects of mindfulness on the brain using magnetic resonance imaging (MRI).   Iron deficiency in middle age is linked with higher risk of developing heart disease University Heart and Vasculature Centre Hamburg (Germany) 6 October 2021 Approximately 10% of new coronary heart disease cases occurring within a decade of middle age could be avoided by preventing iron deficiency, suggests a study published today in ESC Heart Failure, a journal of the European Society of Cardiology (ESC).1 “This was an observational study and we cannot conclude that iron deficiency causes heart disease,” said study author Dr. Benedikt Schrage of the University Heart and Vasculature Centre Hamburg, Germany. “However, evidence is growing that there is a link and these findings provide the basis for further research to confirm the results.” Previous studies have shown that in patients with cardiovascular diseases such as heart failure, iron deficiency was linked to worse outcomes including hospitalisations and death. Treatment with intravenous iron improved symptoms, functional capacity, and quality of life in patients with heart failure and iron deficiency enrolled in the FAIR-HF trial.2 Based on these results, the FAIR-HF 2 trial is investigating the impact of intravenous iron supplementation on the risk of death in patients with heart failure. The current study aimed to examine whether the association between iron deficiency and outcomes was also observed in the general population. The study included 12,164 individuals from three European population-based cohorts. The median age was 59 years and 55% were women. During the baseline study visit, cardiovascular risk factors and comorbidities such as smoking, obesity, diabetes and cholesterol were assessed via a thorough clinical assessment including blood samples. Participants were classified as iron deficient or not according to two definitions: 1) absolute iron deficiency, which only includes stored iron (ferritin); and 2) functional iron deficiency, which includes iron in storage (ferritin) and iron in circulation for use by the body (transferrin). Dr. Schrage explained: “Absolute iron deficiency is the traditional way of assessing iron status but it misses circulating iron. The functional definition is more accurate as it includes both measures and picks up those with sufficient stores but not enough in circulation for the body to work properly.” Participants were followed up for incident coronary heart disease and stroke, death due to cardiovascular disease, and all-cause death. The researchers analysed the association between iron deficiency and incident coronary heart disease, stroke, cardiovascular mortality, and all-cause mortality after adjustments for age, sex, smoking, cholesterol, blood pressure, diabetes, body mass index, and inflammation. Participants with a history of coronary heart disease or stroke at baseline were excluded from the incident disease analyses. At baseline, 60% of participants had absolute iron deficiency and 64% had functional iron deficiency. During a median follow-up of 13.3 years there were 2,212 (18.2%) deaths. Of these, a total of 573 individuals (4.7%) died from a cardiovascular cause. Incidence coronary heart disease and stroke were diagnosed in 1,033 (8.5%) and 766 (6.3%) participants, respectively. Functional iron deficiency was associated with a 24% higher risk of coronary heart disease, 26% raised risk of cardiovascular mortality, and 12% increased risk of all-cause mortality compared with no functional iron deficiency. Absolute iron deficiency was associated with a 20% raised risk of coronary heart disease compared with no absolute iron deficiency, but was not linked with mortality. There were no associations between iron status and incident stroke. The researchers calculated the population attributable fraction, which estimates the proportion of events in 10 years that would have been avoided if all individuals had the risk of those without iron deficiency at baseline. The models were adjusted for age, sex, smoking, cholesterol, blood pressure, diabetes, body mass index, and inflammation. Within a 10-year period, 5.4% of all deaths, 11.7% of cardiovascular deaths, and 10.7% of new coronary heart disease diagnoses were attributable to functional iron deficiency. “This analysis suggests that if iron deficiency had been absent at baseline, about 5% of deaths, 12% of cardiovascular deaths, and 11% of new coronary heart disease diagnoses would not have occurred in the following decade,” said Dr. Schrage. “The study showed that iron deficiency was highly prevalent in this middle-aged population, with nearly two-thirds having functional iron deficiency,” said Dr. Schrage. “These individuals were more likely to develop heart disease and were also more likely to die during the next 13 years.” Dr. Schrage noted that future studies should examine these associations in younger and non-European cohorts. He said: “If the relationships are confirmed, the next step would be a randomised trial investigating the effect of treating iron deficiency in the general population.”     Consumption of a bioactive compound from Neem plant could significantly suppress development of prostate cancer National University of Singapore, September 29, 2021   Oral administration of nimbolide, over 12 weeks shows reduction of prostate tumor size by up to 70 per cent and decrease in tumor metastasis by up to 50 per cent   A team of international researchers led by Associate Professor Gautam Sethi from the Department of Pharmacology at the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) has found that nimbolide, a bioactive terpenoid compound derived from Azadirachta indica or more commonly known as the neem plant, could reduce the size of prostate tumor by up to 70 per cent and suppress its spread or metastasis by half.   Prostate cancer is one of the most commonly diagnosed cancers worldwide. However, currently available therapies for metastatic prostate cancer are only marginally effective. Hence, there is a need for more novel treatment alternatives and options.   "Although the diverse anti-cancer effects of nimbolide have been reported in different cancer types, its potential effects on prostate cancer initiation and progression have not been demonstrated in scientific studies. In this research, we have demonstrated that nimbolide can inhibit tumor cell viability -- a cellular process that directly affects the ability of a cell to proliferate, grow, divide, or repair damaged cell components -- and induce programmed cell death in prostate cancer cells," said Assoc Prof Sethi.   Nimbolide: promising effects on prostate cancer   Cell invasion and migration are key steps during tumor metastasis. The NUS-led study revealed that nimbolide can significantly suppress cell invasion and migration of prostate cancer cells, suggesting its ability to reduce tumor metastasis. The researchers observed that upon the 12 weeks of administering nimbolide, the size of prostate cancer tumor was reduced by as much as 70 per cent and its metastasis decreased by about 50 per cent, without exhibiting any significant adverse effects.   "This is possible because a direct target of nimbolide in prostate cancer is glutathione reductase, an enzyme which is responsible for maintaining the antioxidant system that regulates the STAT3 gene in the body. The activation of the STAT3 gene has been reported to contribute to prostate tumor growth and metastasis," explained Assoc Prof Sethi. "We have found that nimbolide can substantially inhibit STAT3 activation and thereby abrogating the growth and metastasis of prostate tumor," he added.   The findings of the study were published in the April 2016 issue of the scientific journal Antioxidants & Redox Signaling. This work was carried out in collaboration with Professor Goh Boon Cher of Cancer Science Institute of Singapore at NUS, Professor Hui Kam Man of National Cancer Centre Singapore and Professor Ahn Kwang Seok of Kyung Hee University.   The neem plant belongs to the mahogany tree family that is originally native to India and the Indian sub-continent. It has been part of traditional Asian medicine for centuries and is typically used in Indian Ayurvedic medicine. Today, neem leaves and bark have been incorporated into many personal care products such as soaps, toothpaste, skincare and even dietary supplements.       Review looks at the efficacy of acupuncture in treating insulin resistance Guangzhou University of Chinese Medicine (China), October 8, 2021 In their report, researcherss from Guangzhou University of Chinese Medicine in China explored the role of acupuncture in treating insulin resistance. The study was published in the journal Complementary Therapies in Clinical Practice. Earlier studies have reported the effectiveness of acupuncture in treating insulin resistance and related conditions. The review looked at acupuncture and its effects on clinical outcomes. The researchers searched the following databases for randomized controlled trials involving insulin resistance patients treated with acupuncture: Cochrane Central Register of Controlled Trials Embase Medline (via OVID) China National Knowledge Infrastructure (CNKI) Wan Fang and China Science and Technology Journal Database (VIP) The studies show that homeostasis model assessment of insulin resistance significantly decreased with acupuncture treatment. Other significant decreases include fasting blood glucose, postprandial blood glucose and fasting insulin. Acupuncture increased insulin sensitivity with very few adverse effects. In sum, acupuncture is a safe and effective alternative treatment for insulin resistance.     Blueberries may improve attention in children following double-blind trial University of Reading (UK), October 10, 2021  Primary school children could show better attention by consuming flavonoid-rich blueberries, following a study conducted by the University of Reading. In a paper published in Food & Function, a group of 7-10 year olds who consumed a drink containing wild blueberries or a matched placebo and were tested on their speed and accuracy in completing an executive task function on a computer. The double blind trial found that the children who consumed the flavonoid-rich blueberry drink had 9% quicker reaction times on the test without any sacrifice of accuracy. In particular, the effect was more noticeable as the tests got harder. Professor Claire Williams, a neuroscience professor at the University of Reading said: "This is the first time that we have seen the positive impact that flavonoids can have on the executive function of children. We designed this double blind trial especially to test how flavonoids would impact on attention in young people as it's an area of cognitive performance that hasn't been measured before. "We used wild blueberries as they are rich in flavonoids, which are compounds found naturally in foods such as fruits and their juices, vegetables and tea. They have been associated with a range of health benefits including antioxidant and anti-inflammatory effects, and our latest findings continue to show that there is a beneficial cognitive effect of consuming fruit and vegetables, tea, coffee and even dark chocolate which all contain flavonoids." The children were then asked to pay attention to an array of arrows shown on a PC screen and press a key corresponding to the direction that the central arrow was facing. The task was repeated over a number of trials, where cognitive demand was manipulated by varying how quickly the arrows appeared, whether there were additional arrows appearing either side of the central arrow, and whether the flanking arrows were pointing in the same/different direction as the central arrow. Previous Reading research has shown that consuming wild blueberries can improve mood in children and young people, simple memory recall in primary school children, and that other flavonoid rich drinks such as orange juice, can also improve memory and concentration. The Wild Blueberry Association of North America provided a freeze-dried powder made from wild blueberries which was used in the study but did not provide any additional financial support and did not play a role in the design of the study. Wild blueberries are grown and harvested in North America, and are smaller than regular blueberries, and are higher in flavonoids compared to regular varieties. The double-blind trial used a flavonoid-rich wild blueberry drink, with a matched placebo contained 8.9g of fructose, 7.99g of glucose and 4 mg of vitamin C matching the levels of nutrients found in the blueberry drink. The amount of fructose is akin to levels found in a standard pear. This was an executive function task- requiring participants to pay attention to stimuli appearing on screen and responding correctly. The task was a simple one- responding to the direction of an arrow in the middle of a screen (by pressing left/right arrow key) but we then varied how quickly the stimuli appeared, whether there was additional arrows appearing either side of the stimuli and whether those flanking arrows were pointing in the same/different direction as they direction you had to respond. There are 6 main classes of flavonoids: Anthocyanins – found in berry fruits such as the blueberries used in this study and also in red wine. Flavonols - found in onions, leeks, and broccoli Flavones - found in parsley and celery, Isoflavones - found in soy and soy products, Flavanones - found in citrus fruit and tomatoes Flavanols—found in green tea, red wine, and chocolate     Nocebo effect: Does a drug's high price tag cause its own side effects? University Medical Center Hamburg (Germany), October 5, 2021  Pricey drugs may make people more vulnerable to perceiving side effects, a new study suggests—and the phenomenon is not just "in their heads." The study delved into the so-called "nocebo effect." It's the negative version of the well-known placebo effect, where people feel better after receiving a therapy because they expected good things. With the nocebo effect, patients' worries over treatment side effects make them feel sick. In this study, researchers found that people were more likely to report painful side effects from a fake drug when told it was expensive. But it wasn't just something people were "making up." Using brain imaging, the researchers traced the phenomenon to specific activity patterns in the brain and spine. "These findings are a strong argument against the perception of placebo and nocebo effects as being only 'fake' effects—created purely by imagination or delusions of the patient," said lead researcher Alexandra Tinnermann. She is with the University Medical Center Hamburg-Eppendorf, in Germany. Dr. Luana Colloca, a researcher at the University of Maryland in Baltimore, agreed. "This is not merely a reflection of people's biases," said Colloca, who wrote an editorial published with the study. "Expectations do modulate symptoms and patients' responses to treatment," she said. For the study, Tinnermann's team recruited 49 healthy volunteers and randomly assigned them to test one of two itch-relieving "medical creams." In reality, both creams were identical and contained no active ingredients. However, people in both groups were told that the products could have the side effect of making the skin more sensitive to pain. There was only one apparent difference between the two phony creams: One came in fancy packing with a high price tag; the other was cheap. After participants applied the creams to their forearms, the researchers had them undergo a standard test that measured their tolerance for heat-induced pain. It turned out that people who'd used the expensive cream were more sensitive to pain during the tests. On average, their pain rating hovered around a 15—within the "mild" pain range—whereas people using the cheap cream barely registered any discomfort. It's likely, Tinnermann said, that people expect a pricey medication to be potent—which could also make them expect more side effects. Colloca agreed. We are all "vulnerable" to such outside influences, she said, be it a drug's price or how it's given (by IV versus mouth, for instance). However, we are not just imagining those placebo or nocebo effects, both researchers noted. Using functional MRI brain scans, Tinnermann's team found specific patterns of nervous system activity in people who had a nocebo response to the pricey cream. That included a change in "communication" between certain brain structures and the spinal cord, Tinnermann said. According to Colloca, research like this can have practical uses. Doctors could, for instance, inform patients that drug prices or other factors can sway their expectations about a treatment's benefits and risks—and that, in turn, can influence whether they feel better or develop side effects. There is, however, no research into whether that kind of knowledge helps prevent patients from the nocebo effect, Tinnermann said. But, she added, health professionals can be aware that patients' expectations "play a huge role in medicine"—and be mindful of how they talk about a medication and its possible side effects. It's an important matter, Colloca said, because the nocebo effect can cause people to stop taking needed medications. Colloca pointed to the example of cholesterol-lowering statins. The potential for those medications to cause muscle pain has been widely reported. And one recent study found evidence that this knowledge can make statin users more likely to report muscle pain side effects. Other research, Colloca said, has shown that when people stop taking their statins, their risk of heart attack and stroke rises.

Singapore is preparing to live with COVID-19 as an endemic disease, just like the flu, while the UK plans to scrap regulations on face masks and physical distancing by 19 July. What does it mean to live with COVID-19, and when would it be appropriate for Malaysia to consider this approach? Prof Tikki Pangestu, Visiting Professor at the Yong Loo Lin School of Medicine, National University of Singapore, joins Dr George Lee on the show to discuss this. Image source: Shutterstock

New technology can come from nowhere and change the world – whether it's vaccines, the jet-plane, or the internet. But what might society's next big game-changer be? In the final episode of the Rebuilding America series, Stephen speaks to experts and researchers from all around the world and investigates the cutting-edge new technology that could provide solutions to our biggest problems. Roman Orus, from Spain, is CSO at Multiverse Computing. Professor Kevin Gurney, from Arizona, is lead scientist on the Vulcan Project, a Northern Arizona University research project focusing on CO2 emission analytics. Professor Dean Ho is Director of WisDM, at the national University of Singapore's Yong Loo Lin School of Medicine.

In The Straits Times' The Big Story, multimedia journalist Hairianto Dirman spoke to Professor Dale Fisher, an infectious disease expert from the Yong Loo Lin School of Medicine at NUS, about Singapore's Covid-19 progress in the lead up to June 13, when the Heightened Alert period is slated to end.  See omnystudio.com/listener for privacy information.

 Dr. Brian Kennedy is Distinguished Professor, Department of Biochemistry and Physiology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Director of National University Health System (NUHS) Centre for Healthy Ageing, Singapore, Professor, Buck Institute for Research on Ageing, Adjunct Professor, Leonard Davis School of Gerontology, USC, and Affiliate Faculty, Department of Biochemistry, University of Washington. With a Ph.D. in Biology from Massachusetts Institute of Technology (MIT), research in the Kennedy lab is directed at understanding the biology of ageing and translating research discoveries into new ways of delaying, detecting, preventing and treating human ageing and associated diseases. Current research projects in Dr. Kennedy's lab include systems biology strategies to understand ageing and murine longevity studies and disease models. Dr. Kennedy has published over 80 manuscripts in prestigious journals including Cell, Nature, Science, Genes & Development, and PNAS and serves as a Co-Editor-In-Chief at Aging Cell. 

 Perspectives on the Pandemic | "The Illusion of Evidence Based Medicine"  Leemon McHenry 10 mins   Leemon McHenry is Emeritus Professor in the Department of Philosophy , California State University, Northridge. Leemon does research in Philosophy of Science, Metaphysics and Bioethics. His current project is 'Evidence Based Medicine'.   Vitamin A for nerve cells University Medical Center Freiburg (Germany), April 1, 2021 Neuroscientists agree that a person's brain is constantly changing, rewiring itself and adapting to environmental stimuli. This is how humans learn new things and create memories. This adaptability and malleability is called plasticity. "Physicians have long suspected that remodeling processes also take place in humans at the contact points between nerve cells, i.e. directly at the synapses. Until now, however, such a coordinated adaptation of structure and function could only be demonstrated in animal experiments," says Prof. Dr. Andreas Vlachos from the Institute of Anatomy and Cell Biology at the University of Freiburg. But now Vlachos, together with Prof. Dr. Jürgen Beck, head of the Department of Neurosurgery at the University Medical Center Freiburg, has provided experimental evidence for synaptic plasticity in humans. In addition to Vlachos and Beck, the research team consists of Dr. Maximilian Lenz, Pia Kruse and Amelie Eichler from the University of Freiburg, Dr. Jakob Strähle from the University Medical Center Freiburg and colleagues from Goethe University Frankfurt. The results were presented in the scientific journal eLife. In the experiments, the team investigated whether so-called dendritic spines change when exposed to a vitamin A derivative called retionic acid. Dendritic spines are the parts of the synapse that receive, process and transmit signals during communication between neurons. As such, they play a crucial role in brain plasticity and are constantly adapting to everyday experience. For example, learning can change the number and shape of dendritic spines. However, a transformation in the number or shape of the spines is also found in diseases such as depression or dementia. The research shows that retinoic acid not only increases the size of dendritic spines, but also strengthens their ability to transmit signals between neurons. "We have concluded from our results that retinoic acids are important messengers for synaptic plasticity in the human brain. Thus, this finding contributes to the identification of key mechanisms of synaptic plasticity in the human brain and could support the development of new therapeutic strategies for brain diseases, such as depression," says Vlachos. To experimentally demonstrate that synaptic plasticity also exists in humans, the researchers use tiny samples of human cerebral cortex, which must be compulsorily removed during neurosurgical procedures for therapeutic reasons. The removed brain tissue was then treated with retinoic acid before functional and structural properties of neurons were analyzed using electrophysiological and microscopic techniques.       Study: Chemical compound in certain essential oils promotes wound healing Indiana University, April, 2021 A study from Indiana University revealed that a chemical compound in essential oils may enhance wound healing, especially when applied topically. According to co-author Sachiko Koyama, essential oils – like those from lavender, rosemary, ylang-ylang and black pepper – contain a chemical compoundcalled beta-caryophyllene. This contributes to improved wound healing, based on a murine model. “This is the first finding at the chemical-compound level showing improved wound healing in addition to changes in gene expression in the skin,” said Koyama. Beta-caryophyllene may decrease inflammation and accelerate re-epithelialization. The latter refers to the restoration of structure and function of injured tissues. During this process, epithelial cells at the wound start to migrate and cover the injured area. The researchers added that beta-caryophyllene may prevent cell death, allowing cells to survive and proliferate. “I thought maybe wound healing would be accelerated if inflammation was suppressed, stimulating an earlier switch from the inflammatory stage to the next stage,” she added. The team also noted increased gene expression of hair follicle stem cells in the treated tissue. This potentially indicate that there’s more to wound-healing activity of beta-caryophyllene than just activating genes. “It’s possibly more complicated,” she added. “Our findings suggest the involvements of some other routes in addition to CB2. I hope to clarify the mechanisms of action in the near future.” Koyama, a social neuroscientist at Indiana University, said that she wasn’t interested in studying essential oils at first, as her field of expertise was in pheromone and social status. However, her interest was sparked when she saw students working on the wound healing process in mice. She knew from experience that beta-caryophyllene can also activate cannabinoid receptor 2 (CB2), which has anti-inflammatory and analgesic properties. Healing beyond smell Most people know essential oils by way of aromatherapy. These are often used with diffusers, aromatic spritzers, inhalers, facial steamers and clay masks to bring out the aroma coming from the oil. Essential oils, in particular, may help with asthma, insomnia, fatigue and depression, among others. In the study, the researchers did not find any relationship between the sense of smell and the healing properties of beta-caryophyllene. (Related: Curcumin found to aid in the healing of skin wounds.) Koyama also offered a caveat for those looking to use essential oils for treatment, in particular, warning against the use of any essential oils. In the study, the researchers used essential oils that underwent purification processes to achieve that result. “It’s not very precise to use the essential oils themselves because there are differences,” she added. “Even if you say you used lavender, when the lavender was harvested, where it was harvested, how it was stored—all of this makes a difference in the chemical composition.” The team is also hopeful that their results will warrant further studies to determine an exact chemical composition for beta-caryophyllene that can be used to treat skin wounds. “There are many things to test before we can start using it clinically, but our results are very promising and exciting; someday in the near future, we may be able to develop a drug and drug delivery methods using the chemical compounds found in essential oils,” she added.     Exercise may help slow cognitive decline in some people with Parkinson's disease Hallym University (South Korea), April 1, 2021 For people with Parkinson's disease, problems with thinking and memory skills are among the most common nonmotor symptoms of the disease. A new study shows that exercise may help slow cognitive decline for some people with the disease. The study is published in the March 31, 2021, online issue of Neurology. Research has suggested that people with Parkinson's who have the gene variant apolipoprotein E e4, or APOE e4, may experience faster cognitive decline and earlier in the disease than people without the variant. APOE e4 is known as a genetic risk factor for Alzheimer's disease. The study looked at whether exercise could play a role in slowing cognitive decline for people with APOE e4. "Problems with thinking skills and memory can have a negative impact on people's quality of life and ability to function, so it's exciting that increasing physical activitycould have the potential to delay or prevent cognitive decline," said study author Jin-Sun Jun, M.D., of Hallym University in Seoul, Korea. The study involved 173 people with early Parkinson's disease who were on average 63 years old at the time and 59 years old when they developed the disease. A total of 27% had the APOE e4 gene variant. People reported their physical activity with a questionnaire on how much activity they had in the previous week through leisure activities such as walking or biking, household activities such as dusting or yard work and work activities for pay or as a volunteer. People took a test of their thinking skills at the beginning of the study and then one and two years later. Overall, scores at the beginning of the study averaged 26 points. For people with the APOE e4 gene variant, test scores declined by an average of 1.33 points by the end of the study compared to those without the variant. But researchers also found that greater physical activity at the start of the study lessened APOE e4-related cognitive decline two years later by an average of 0.007 points. "Additional research is needed to confirm our findings, but these results would support the use of interventions that target physical activity as a way to delay cognitive decline in people with early Parkinson's who have the APOE e4 gene variant," Jun said. A limitation of the study was that participants reported their own levels of physical activity, so there is the possibility that they would not remember their levels exactly.   Time to shift from 'food security' to 'nutrition security' to increase health and well-being Tufts and Georgetown Universities, April 1, 2021   In the 1960s, a national focus on hunger was essential to address major problems of undernutrition after World War II. In the 1990s, the nation shifted away from hunger toward "food insecurity" to better capture and address the challenges of food access and affordability. Now, a new Viewpoint article argues that today's health and equity challenges call for the U.S. to shift from "food insecurity" to "nutrition insecurity" in order to catalyze appropriate focus and policies on access not just to food but to healthy, nourishing food. The Viewpoint, by Dariush Mozaffarian of the Friedman School of Nutrition Science & Policy at Tufts University, Sheila Fleischhacker of Georgetown Law School, and José Andrés of World Central Kitchen, was published online in JAMA this week. The concept of food security focuses on access to and affordability of food that is safe, nutritious, and consistent with personal preferences. In reality, however, the "nutritious" part often has been overlooked or lost in national policies and solutions, with resulting emphasis on quantity, rather than quality, of food, say the authors. "Food is essential both for life and human dignity. Every day, I see hunger, but the hunger I see is not only for calories but for nourishing meals. With a new focus on nutrition security, we embrace a solution that nourishes people, instead of filling them with food but leaving them hungry," said Chef José Andrés, founder of World Central Kitchen. The authors define nutrition security as having consistent access to and availability and affordability of foods and beverages that promote well-being, while preventing -- and, if needed, treating -- disease. Nutrition security provides a more inclusive view that recognizes that foods must nourish all people. "'Nutrition security' incorporates all the aims of food security but with additional emphasis on the need for wholesome, healthful foods and drinks for all. COVID-19 has made clear that Americans who are most likely to be hungry are also at highest risk of diet-related diseases including obesity, diabetes, heart disease, and many cancers - a harsh legacy of inequities and structural racism in our nation. A new focus on nutrition security for all Americans will help crystallize and catalyze real solutions that provide not only food but also well-being for everyone," said first author Dariush Mozaffarian, dean of the Friedman School of Nutrition Science & Policy at Tufts University. "It's the right time for this evolution," said Sheila Fleischhacker, adjunct professor at Georgetown Law School, who has drafted food, nutrition and health legislation and campaign positions at the local, state, tribal and federal levels. "By prioritizing nutrition security, we bring together historically siloed areas - hunger and nutrition - which must be tackled together to effectively address our modern challenges of diet-related diseases and disparities in clinical care, government food and food assistance policies, public health investments, and national research." "The current approach is not sufficient," the authors write, and "traditionally marginalized minority groups as well as people living in rural and lower-income counties are most likely to experience disparities in nutrition quality, food insecurity, and corresponding diet-related diseases."     Fasting acts as diet catalyst in those with metabolic syndrome Max Delbruck Center for Molecular Medicine (Germany), March 30, 2021 One in four Germans suffers from metabolic syndrome. Several of four diseases of affluence occur at the same time in this 'deadly quartet': obesity, high blood pressure, lipid metabolism disorder and diabetes mellitus. Each of these is a risk factor for severe cardiovascular conditions, such as heart attack and stroke. Treatment aims to help patients lose weight and normalise their lipid and carbohydrate metabolism and blood pressure. In addition to exercise, doctors prescribe a low-calorie and healthy diet. Medication is often also required. However, it is not fully clear what effects nutrition has on the microbiome, immune system and health.  A research group led by Dr Sofia Forslund and Professor Dominik N. Müller from the Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) and the Experimental and Clinical Research Center (ECRC) has now examined the effect a change of diet has on people with metabolic syndrome. The ECRC is jointly run by the MDC and Charité Universitätsmedizin Berlin. "Switching to a healthy diet has a positive effect on blood pressure," says Andras Maifeld, summarising the results. "If the diet is preceded by a fast, this effect is intensified." Maifeld is the first author of the paper, which was recently published in the journal "Nature Communications". Broccoli over roast beef Dr Andreas Michalsen, Senior Consultant of the Naturopathy Department at Immanuel Hospital Berlin and Endowed Chair of Clinical Naturopathy at the Institute for Social Medicine, Epidemiology and Health Economics at Charité - Universitätsmedizin Berlin, and Professor Gustav J. Dobos, Chair of Naturopathy and Integrative Medicine at the University of Duisburg-Essen, recruited 71 volunteers with metabolic syndrome and raised systolic blood pressure. The researchers divided them into two groups at random.  Both groups followed the DASH (Dietary Approach to Stop Hypertension) diet for three months, which is designed to combat high blood pressure. This Mediterranean-style diet includes lots of fruit and vegetables, wholemeal products, nuts and pulses, fish and lean white meat. One of the two groups did not consume any solid food at all for five days before starting the DASH diet. On the basis of immunophenotyping, the scientists observed how the immune cells of the volunteers changed when they altered their diet. "The innate immune system remains stable during the fast, whereas the adaptive immune system shuts down," explains Maifeld. During this process, the number of proinflammatory T cells drops, while regulatory T cells multiply.  A Mediterranean diet is good, but to also fast is better The researchers used stool samples to examine the effects of the fast on the gut microbiome. Gut bacteria work in close contact with the immune system. Some strains of bacteria metabolise dietary fibre into anti-inflammatory short-chain fatty acids that benefit the immune system. The composition of the gut bacteria ecosystem changes drastically during fasting. Health-promoting bacteria that help to reduce blood pressure multiply. Some of these changes remain even after resumption of food intake. The following is particularly noteworthy: "Body mass index, blood pressure and the need for antihypertensive medication remained lower in the long term among volunteers who started the healthy diet with a five-day fast," explains Dominik Müller. Blood pressure normally shoots back up again when even one antihypertensive tablet is forgotten.  Blood pressure remains lower in the long term - even three months after fasting Together with scientists from the Helmholtz Centre for Infection Research and McGill University, Montreal, Canada, Forslund's working group conducted a statistical evaluation of these results using artificial intelligence to ensure that this positive effect was actually attributable to the fast and not to the medication that the volunteers were taking. They used methods from a previous study in which they had examined the influence of antihypertensive medication on the microbiome. "We were able to isolate the influence of the medication and observe that whether someone responds well to a change of diet or not depends on the individual immune response and the gut microbiome," says Forslund.  If a high-fibre, low-fat diet fails to deliver results, it is possible that there are insufficient gut bacteria in the gut microbiome that metabolise fibre into protective fatty acids. "Those who have this problem often feel that it is not worth the effort and go back to their old habits," explains the scientist. It is therefore a good idea to combine a diet with a fast. "Fasting acts as a catalyst for protective microorganisms in the gut. Health clearly improves very quickly and patients can cut back on their medication or even often stop taking tablets altogether." This could motivate them to stick to a healthy lifestyle in the long term.   Rice bran adds microbiome diversity, slows growth of colon cancer cells University of Colorado, April 5, 2021    At the American Association for Cancer Research (AACR) Annual Meeting, University of Colorado Cancer Center researchers at Colorado State University present results of a phase II clinical trial of 29 people exploring the effects of adding rice bran or navy beans to the diets of colorectal cancer survivors. After the 4-week randomized-controlled trial during which people added rice bran, navy bean powder or neither, both the rice bran and navy bean groups showed increased dietary fiber, iron, zinc, thiamin, niacin, vitamin B6, folate, and alpha-tocopherol. The rice bran group also showed increased microbiome richness and diversity. When researchers treated colorectal cancer cells with stool extracts from these groups, they saw reduced cell growth from the groups that had increased rice bran and navy bean consumption.   Previous work shows the ability of these diets to decrease colorectal cancer risk in animal models. The current trial confirms that people can eat enough bean- and rice bran-enhanced foods to promote gut health at levels shown to prevent colorectal cancer in animals. Guidelines from the American Institute for Cancer Research recommend reducing the risk of cancer by eating more vegetables, fruits, whole grains and legumes, such as beans. Ryan has established from these studies that eating a half-cup of beans and 30 grams of rice bran per day is enough to see changes in small molecules that can confer protection against colorectal cancer.   "The simple message is, 'Food is medicine,' and we are looking at how to simplify that and make it apply to our everyday lives," says study co-author Regina Brown, MD, assistant professor at the CU School of Medicine and oncologist for CUHealth.   Brown is long-time collaborator of CU Cancer Center investigator and CSU assistant professor, Elizabeth Ryan, PhD. The Ryan Lab in the CSU College of Veterinary Medicine and Biomedical Sciences studies the potential power of navy beans and rice bran to promote digestive health and to prevent metabolic alterations in obesity, heart disease and certain cancers.   "The evidence is there in animals and we can now study this in people. The question is, what are we doing to achieve adequate levels of intake of these foods?" Ryan said. "It's not enough to say 'I eat them once in a while.' That's not going to work, particularly if you are at higher risk. You have to meet a dose, just like you need a dose of a certain drug, you need to reach intake levels and consume increased amounts of these foods, and that's where people, including me, are challenged. Not everyone wants to open up a can of beans and eat them every day."   The two met about 10 years ago, when Ryan was a researcher in CSU professor Henry Thompson's Cancer Prevention Lab, and Brown was practicing medicine in Fort Collins and caring for her mother, who had uterine cancer. "It was kind of a novel partnership and had we not dug in our heels it could have died, but I told Elizabeth, 'Your work is so interesting and so valuable. We have to take this translational research from the benchtop to the clinic.' I guarantee, nine out of 10 of my patients, the first thing they ask is about their diet," Brown said.   The study's lead author is Erica Borresen, Ryan's research associate and study coordinator, who worked with colorectal cancer survivors to make sure they ate their beans and rice bran provided in meals and snacks, and that they filled out their food logs and gastrointestinal health questionnaires. It was sometimes intimate and awkward, but so is getting a colonoscopy and being treated for colorectal cancer. "Our participants donated their time and effort, and I want to make sure they understand they are appreciated," said Borresen, who earned her Master of Public Health at the Colorado School of Public Health, and plans to become a physician's assistant. "I came to realize I love the patient interaction - that's one of my favorite parts about coordinating our studies."   The next phase of Ryan's research examines effects of the cooked navy bean powder and rice bran on the colon tissue of people who have already had colorectal cancer and are at high risk for recurrence. "I really feel that there's hope in this being a practical solution to improve gut health and specifically colorectal cancer prevention," says Ryan.       Research suggests L-tryptophan supplements might help prevent impulsivity associated with psychological disorders University of California Berkeley, April 2, 2021 According to news reporting originating from Berkeley, California, research stated, “Emotion-related impulsivity, defined as the tendency to say or do things that one later regret during periods of heightened emotion, has been tied to a broad range of psychopathologies. Previous work has suggested that emotion-related impulsivity is tied to an impaired function of the serotonergic system.” Our news editors obtained a quote from the research from the University of California Berkeley, “Central serotonin synthesis relies on the intake of the essential amino acid, tryptophan and its ability to pass through the blood brain barrier. The aim of this study was to determine the association between emotion-related impulsivity and tryptophan intake. Undergraduate participants (N = 25, 16 women, 9 men) completed a self-rated measure of impulsivity (Three Factor Impulsivity Index, TFI) and daily logs of their food intake and exercise. These data were coded using the software NutriNote to evaluate intakes of tryptophan, large neutral amino acids, vitamins B6/B12, and exercise. Correlational analyses indicated that higher tryptophan intake was associated with significantly lower scores on two out of three subscales of the TFI, Pervasive Influence of Feelings scores r = -.502, p< .010, and (lack-of) Follow-Through scores, r = -.407, p< .050. Findings provide further evidence that emotion-related impulsivity is correlated to serotonergic indices, even when considering only food habits.” According to the news editors, the research concluded: “It also suggests the need for more research on whether tryptophan supplements might be beneficial for impulsive persons suffering from a psychological disorder.” This research has been peer-reviewed.         Nutritional supplementation in preconception and pregnancy linked to reduced risk of preterm birth University of Southampton (UK), March 30, 2021 Increasing evidence suggests that a mother's nutritional status at the onset of pregnancy has an important influence on the growth and development of her baby, and that a good nutritional status during pregnancy may help reduce the risk of pregnancy complications. A specific blend of nutrients and probiotics was tested in an international multicentre double blind randomized controlled trial NiPPeR (Nutritional Intervention Preconception and during Pregnancy to maintain healthy glucosE levels and offspRing health). Researchers from the international EpiGen Global Research Consortium, an academic group of clinicians and scientists including from around the world, including the University of Southampton, specifically assessed the effects of a nutritional intervention, a combination of myo-inositol, probiotics and micronutrients, consumed both before and during pregnancy, on maintaining healthy blood sugar levels in pregnancy and sustaining a healthy pregnancy and delivery. As published in the journal Diabetes Care, (Myo-inositol, Probiotics and Micronutrient Supplementation from Preconception for Glycemia in Pregnancy: the NiPPeR study involved 1,729 women from the UK, New Zealand and Singapore who were planning pregnancy—one of the largest international preconception randomized controlled trials of its type. While the study found that the intervention did not influence the mother's blood sugar levels or birthweights of the 585 babies born, the nutritional supplement decreased the incidence of preterm birth, particularly the cases associated with preterm pre-labor rupture of membranes. "Preterm delivery is a serious, common and costly public health problem worldwide that continues to increase in incidence," said Professor Keith Godfrey from the MRC Lifecourse Epidemiology Unit at the University of Southampton. "Preterm pre-labor rupture of membranes is a major cause of preterm birth. Our study presents for the first time a clinical trial of a novel non-pharmacological approach that started preconception and extended throughout pregnancy, through the innovative use of a combination of nutritional ingredients. The study findings highlight the potential value of the mix of nutrients and probiotics in reducing the risk of preterm birth and supporting a timely delivery," Professor Godfrey continued.  Associate Professor Shiao-Yng Chan, a principal investigator on the study from the Yong Loo Lin School of Medicine, National University of Singapore, deputy executive director at the Singapore Institute for Clinical Sciences, A*STAR, and Senior Consultant, Department of Obstetrics & Gynaecology, National University Hospital, commented "One of the strengths of our study is the diversity of its participants as we have involved women of multiple ethnicities from the general population across three countries, which means that the outcomes have wide relevance to women planning for pregnancy. Additionally, the study included blinded intervention and control groups, so bias is minimized." Sharing his thoughts, Professor Wayne Cutfield, principal investigator on the study from the University of Auckland, New Zealand, said, "The importance of the preconception period on maternal and offspring health is being increasingly recognized, but there are very few randomized control trials seeking to optimize preconception nutrition." Dr. Isabelle Bureau-Franz, Head of Nestlé Research, who partnered with EpiGen for this academic-led trial, says, "We are focused on discovering science-based solutions for mothers and their infants during preconception, pregnancy and while breastfeeding. The NiPPeR study is a great example of how a public-private partnership can build scientific evidence on nutritional interventions in a largely understudied group."

Health Check Ep 56: How a mother's well-being can have a large impact on her baby 27:39 mins Synopsis: This is a fortnightly podcast series on Wednesdays by The Straits Times that aims to help you make sense of health matters that affect you.   In early March 2021, the Ministry of Health announced during the debate on its budget, that it has set up a task force to oversee the development and implementation of a five-year action plan to provide comprehensive support to women and their children, as part of its larger efforts to improve the population's health. In this episode, ST senior health correspondent Joyce Teo hosts Professor Chong Yap Seng, the dean of the National University of Singapore's Yong Loo Lin School of Medicine and the executive director of the Singapore Institute for Clinical Sciences at the Agency for Science, Technology and Research. They discuss what more can be done to improve maternal and child health. Prof Chong is also an obstetrician and the lead principal investigator of the Growing Up In Singapore Towards Healthy Outcomes or Gusto study, which started in 2009 to study how conditions in pregnancy and early childhood influence the health and development of women and their children here. Its findings show that a mother's health can directly impact her child's development. Critical interventions to ensure better well-being of Singaporean mothers (2:27) Using latest scientific tests for more precise studies of Singaporean babies, from as early as the first week of life in the "Gusto" study (7:36) If mothers have depression symptoms during pregnancy, how it can be scientifically shown that their children would have a higher chance of developing mood anxiety disorders (11:40) What can such parents do to nurture corrective methods after their children are born (14:46) An obstetrician's tips for women planning pregnancy (18:50) Produced by: Joyce Teo (joyceteo@sph.com.sg), Penelope Lee and Ernest Luis  Edited by: Penelope Lee Subscribe to Health Check Podcast channel, hear the latest episodes fortnightly on Wednesdays and rate us on your favourite audio apps: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Google Podcasts: https://str.sg/J6Wv  Website: http://str.sg/stpodcasts Feedback to: podcast@sph.com.sg Read Joyce Teo's stories: https://str.sg/JbxN --- Discover more ST podcast series: Asian Insider Podcast: https://str.sg/JWa7 Green Pulse Podcast: https://str.sg/JWaf ST Sports Talk Podcast: https://str.sg/JWRE Life Weekend Picks Podcast: https://str.sg/JWa2 #PopVultures Podcast: https://str.sg/JWad Bookmark This! Podcast: https://str.sg/JWas Lunch With Sumiko Podcast: https://str.sg/J6hQ Discover BT Podcasts:  http://bt.sg/podcasts Follow our shows then, if you like short, practical podcasts! See omnystudio.com/listener for privacy information.

Health Check Ep 56: How a mother's well-being can have a large impact on her baby 27:39 mins Synopsis: This is a fortnightly podcast series on Wednesdays by The Straits Times that aims to help you make sense of health matters that affect you.   In early March 2021, the Ministry of Health announced during the debate on its budget, that it has set up a task force to oversee the development and implementation of a five-year action plan to provide comprehensive support to women and their children, as part of its larger efforts to improve the population's health. In this episode, ST senior health correspondent Joyce Teo hosts Professor Chong Yap Seng, the dean of the National University of Singapore's Yong Loo Lin School of Medicine and the executive director of the Singapore Institute for Clinical Sciences at the Agency for Science, Technology and Research. They discuss what more can be done to improve maternal and child health. Prof Chong is also an obstetrician and the lead principal investigator of the Growing Up In Singapore Towards Healthy Outcomes or Gusto study, which started in 2009 to study how conditions in pregnancy and early childhood influence the health and development of women and their children here. Its findings show that a mother's health can directly impact her child's development. Critical interventions to ensure better well-being of Singaporean mothers (2:27) Using latest scientific tests for more precise studies of Singaporean babies, from as early as the first week of life in the "Gusto" study (7:36) If mothers have depression symptoms during pregnancy, how it can be scientifically shown that their children would have a higher chance of developing mood anxiety disorders (11:40) What can such parents do to nurture corrective methods after their children are born (14:46) An obstetrician's tips for women planning pregnancy (18:50) Produced by: Joyce Teo (joyceteo@sph.com.sg), Penelope Lee and Ernest Luis  Edited by: Penelope Lee Subscribe to Health Check Podcast channel, hear the latest episodes fortnightly on Wednesdays and rate us on your favourite audio apps: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Google Podcasts: https://str.sg/J6Wv  Website: http://str.sg/stpodcasts Feedback to: podcast@sph.com.sg Read Joyce Teo's stories: https://str.sg/JbxN --- Discover more ST podcast series: Asian Insider Podcast: https://str.sg/JWa7 Green Pulse Podcast: https://str.sg/JWaf ST Sports Talk Podcast: https://str.sg/JWRE Life Weekend Picks Podcast: https://str.sg/JWa2 #PopVultures Podcast: https://str.sg/JWad Bookmark This! Podcast: https://str.sg/JWas Lunch With Sumiko Podcast: https://str.sg/J6hQ Discover BT Podcasts:  http://bt.sg/podcasts Follow our shows then, if you like short, practical podcasts! See omnystudio.com/listener for privacy information.

The Big Story Ep 55: Pfizer's Covid-19 good news, but situation remains murky 6:57 mins Synopsis: This is a special episode of The Straits Times' video series The Big Story. Work to distribute the experimental Covid-19 vaccine developed by Pfizer and BioNTech is gearing up after the companies announced successful interim data earlier on Monday (Nov 9), but it will not be coming to local pharmacies for the general public any time soon. The Big Story hosts Hairianto Diman and Olivia Quay discuss this topic with Professor Dale Fisher from the Yong Loo Lin School of Medicine. Produced and edited by: ST Video team and Muhammad Firmann Discover The Straits Times Videos: https://str.sg/JPrc Discover ST & BT podcasts: Channel: https://str.sg/JWVR Spotify: https://spoti.fi/2PwZCYU Apple Podcasts: https://apple.co/2Lu4rPP Google podcasts: http://str.sg/googlestbt Websites: http://str.sg/stbtpodcasts https://bt.sg/moneyhacks Feedback to: podcast@sph.com.sg  --- Discover more niche podcast series by ST and BT below: Follow BT Money Hacks Podcast on: http://bt.sg/btmoneyhacks Follow Health Check Podcast on: https://str.sg/JWaN Follow Asian Insider Podcast on: https://str.sg/JWa7 Follow Green Pulse Podcast on: https://str.sg/JWaf Follow Life Weekend Picks Podcast on: https://str.sg/JWa2 Follow #PopVultures Podcast on: https://str.sg/JWad Follow Bookmark This! Podcast on: https://str.sg/JWas Follow #GameOfTwoHalves Podcast on: https://str.sg/JWRE Follow our shows then, if you like short, practical podcasts! See omnystudio.com/listener for privacy information.

In The Straits Times’ The Big Story, ST’s multimedia correspondent Hairianto Diman and assistant video editor Olivia Quay spoke to Professor Dale Fisher from the Yong Loo Lin School of Medicine about the experimental Covid-19 vaccine developed by Pfizer and BioNTech after the companies announced successful interim data earlier on Monday. See omnystudio.com/listener for privacy information.

In this episode we talking with philosopher and bioethicists, Voo Teck Chuan from the Centre for Biomedical Ethics in the Yong Loo Lin School of Medicine at the National University of Singapore. We discuss the idea of Asian bioethics or bioethics in Asia, Teck Chuan's work on the ethics of immunity passports, and complexities of family and physical presence during the time of COVID. We also talk about the importance of ethics as a creative pursuit, not merely pointing out problems. ReferencesEthical Implementation of Immunity Passports During the COVID-19 Pandemic Family Presence for Patients and Separated Relatives During COVID-19: Physical, Virtual, and SurrogateArt and MusicCity Plaza - Dan BodanPhoto by Keith Yap on Unsplash 

Health Check Ep 40: Covid-19 airborne transmission doubts and immunity 18:23 mins Synopsis: This is a fortnightly podcast series on Wednesdays by The Straits Times. Recently, an open letter that 239 researchers addressed to the World Health Organisation calling for it to acknowledge that the coronavirus is airborne, made headlines around the world. (0:35) To counter any public misconceptions, ST senior health correspondent Joyce Teo hosts Professor Paul Tambyah, an infectious disease expert from the National University of Singapore's Yong Loo Lin School of Medicine, to give his take on this development. (1:20)  Professor Tambyah, who's also a senior consultant at the National University Hospital, also discusses recent findings on Covid-19 immunity. (8:40) Lastly, he talks about his new role as president-elect of the United States-based International Society of Infectious Diseases. (15:30) Produced by: Joyce Teo (joyceteo@sph.com.sg) and Ernest Luis Edited by: Adam Azlee Follow Health Check Podcast series fortnightly on Wednesdays and rate us on: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Google Podcasts: https://str.sg/JWax Website: http://str.sg/stpodcasts Feedback to: podcast@sph.com.sg See omnystudio.com/listener for privacy information.

Health Check Ep 40: Covid-19 airborne transmission doubts and immunity 18:23 mins Synopsis: This is a fortnightly podcast series on Wednesdays by The Straits Times. Recently, an open letter that 239 researchers addressed to the World Health Organisation calling for it to acknowledge that the coronavirus is airborne, made headlines around the world. (0:35) To counter any public misconceptions, ST senior health correspondent Joyce Teo hosts Professor Paul Tambyah, an infectious disease expert from the National University of Singapore's Yong Loo Lin School of Medicine, to give his take on this development. (1:20)  Professor Tambyah, who's also a senior consultant at the National University Hospital, also discusses recent findings on Covid-19 immunity. (8:40) Lastly, he talks about his new role as president-elect of the United States-based International Society of Infectious Diseases. (15:30) Produced by: Joyce Teo (joyceteo@sph.com.sg) and Ernest Luis Edited by: Adam Azlee Follow Health Check Podcast series fortnightly on Wednesdays and rate us on: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Google Podcasts: https://str.sg/JWax Website: http://str.sg/stpodcasts Feedback to: podcast@sph.com.sg See omnystudio.com/listener for privacy information.

Health Check Ep 40: Covid-19 airborne transmission doubts and immunity 18:23 mins Synopsis: This is a fortnightly podcast series on Wednesdays by The Straits Times. Recently, an open letter that 239 researchers addressed to the World Health Organisation calling for it to acknowledge that the coronavirus is airborne, made headlines around the world. (0:35) To counter any public misconceptions, ST senior health correspondent Joyce Teo hosts Professor Paul Tambyah, an infectious disease expert from the National University of Singapore's Yong Loo Lin School of Medicine, to give his take on this development. (1:20)  Professor Tambyah, who's also a senior consultant at the National University Hospital, also discusses recent findings on Covid-19 immunity. (8:40) Lastly, he talks about his new role as president-elect of the United States-based International Society of Infectious Diseases. (15:30) Produced by: Joyce Teo (joyceteo@sph.com.sg) and Ernest Luis Edited by: Adam Azlee Follow Health Check Podcast fortnightly on Wednesdays and rate us on: Channel: https://str.sg/JWVR Apple Podcasts: https://apple.co/2Lu4rPP Spotify: https://spoti.fi/2PwZCYU Google podcasts: http://str.sg/googlestbt Websites: http://str.sg/stbtpodcasts Feedback to: podcast@sph.com.sg    See omnystudio.com/listener for privacy information.

Why is Singapore interested in Aging research so much? What AI lets us do today in Aging research that 10 years ago wasn't possible?Can we modify Aging? I had the pleasure to host Dr. Brian Kennedy, he is a leading Aging researcher and the former president and CEO of the Buck Institute. Today he serves as a part-time professor in the institute while he lives in Singapore and serves as the Director of the Centre for Healthy Ageing at the Yong Loo Lin School of Medicine at the National University Singapore. He is Internationally known for his commitment and effort to translating research discoveries into new ways of delaying, detecting, preventing, and treating human aging and associated diseases. 

Researcher Frederic Bard has studied coronaviruses' step-by-step entry and replication inside cells. He explains to listeners which stages are the most promising for interference.  Along the way, he describes The parasitic nature and structure of virus binding and replicating mechanisms, How the ph of the endosome enables viruses to enter the cytosol where the viruses' RNA replicates, and  The promising identification of the VCP spike protein that the virus binds with and efforts to inhibit it. Frederic Bard is an adjunct associate professor in the Department of Biochemistry at Yong Loo Lin School of Medicine at the National University of Singapore and is part of the Institute of Cellular and Molecular Biology with the Agency for Science, Technology, and Research (A Star) in Singapore. He explains to listeners about the importance of host genes for coronavirus replication. He reminds us that viruses are parasites and need the machinery of a cell to replicate—he has researched different proteins and machines inside the cell that help the structure of viruses to replicate: if we can understand that, he says, maybe we can block replication. He describes the two moments that show the most promise for disturbing this process, namely when viruses bind with spike proteins on the outside of the cell and when they enter the cytosol for the viruses' RNA replication. A few years ago, he published work identifying the VCP protein that coronaviruses bind with and is now researching the possibility of inhibiting that protein without hurting the cell. That is part of the challenge, he explains—to make the cell a little bit sick to inhibit the virus replication but not enough to damage the cell and health of the person. Along the way, he explains cell mechanisms in response to viruses, how the structure of virus works with the endosomes and cytosol. For more, see his lab websites with links to his publications and contact information: https://www.a-star.edu.sg/imcb/science/scientific-programmes/multi-modal-molecular-(m3)-biology  and https://bch.nus.edu.sg/fredericbard.htm.

Do you feel anxious every time you see a rise in COVID-19 cases? Have you been waking earlier than usual or finding yourself awake many times during the night? Michelle Martin speaks to Professor Kua Ee Heok, Author of Speaking Up for Mental Illness and Professor in Psychiatry and Neuroscience & Senior Consultant Psychiatrist, Department of Psychological Medicine, Yong Loo Lin School of Medicine at the National University of Singapore, for expert tips on dealing with COVID-19 related stress.

From being aware of how increased carbon dioxide in your mask can affect your state of mind to which apps you can use today to cope with isolation, renowned mental health expert, and author of Speaking Up for Mental Illness and Professor in Psychiatry and Neuroscience & Senior Consultant Psychiatrist, Department of Psychological Medicine, Yong Loo Lin School of Medicine at the National University of Singapore, Professor Kua Ee Heok discusses how we can build our resilience and overcome the mental burden of this pandemic on all of us.   

Brian Kennedy, Ph.D. is the Director at the Centre for Healthy Aging at the National University Health System and Professor in the Department of Biochemistry and Physiology, Yong Loo Lin School of Medicine, at the National University of Singapore since 2017.

Health Check Ep 8: Can munching on half a plate of mushrooms a week slow mental decline? 9:46 mins Synopsis: In this fortnightly podcast series on Wednesdays, The Straits Times guides you to healthier living and debunks the myths with expert guests. ST correspondent Joyce Teo and podcasting head Ernest Luis host two experts from the Yong Loo Lin School of Medicine at the National University of Singapore to discuss the results of the six-year study they had conducted on more than 600 Singaporeans aged 60 and above, to see the relation between consuming mushrooms and mental decline. The study's principal investigator, Assistant Professor Feng Lei, who is from NUS' Department of Psychological Medicine, and Dr Irwin Cheah - a senior research fellow at the NUS Department of Biochemistry - are asked the following questions: 1. Can consuming more than two portions (300g or half a plate) of mushrooms each week, reduce the risk of having mild cognitive impairment? 2. It can help with Alzheimer's, but how about Parkinson's disease?  3. The study focused on six types of mushrooms commonly eaten in Singapore. How about others like portobello?  Mushrooms contain high levels of a compound known as ergothioneine. The compound acts as an antioxidant and an anti-inflammatory agent, and can protect brain cells from damage. Produced by: Joyce Teo and Ernest Luis Edited by: Adam Azlee Follow more Health Check podcasts and rate us on: Spotify: http://str.sg/oeGY  Apple Podcasts: http://str.sg/oeXP  Google Podcasts: http://str.sg/oeLN  Playlist: https://str.sg/Jw7R  Website: http://str.sg/stpodcasts  Feedback to: podcast@sph.com.sg  See omnystudio.com/listener for privacy information.

Health Check Ep 8: Can munching on half a plate of mushrooms a week slow mental decline? 9:46 mins Synopsis: In this fortnightly podcast series on Wednesdays, The Straits Times guides you to healthier living and debunks the myths with expert guests. ST correspondent Joyce Teo and podcasting head Ernest Luis host two experts from the Yong Loo Lin School of Medicine at the National University of Singapore to discuss the results of the six-year study they had conducted on more than 600 Singaporeans aged 60 and above, to see the relation between consuming mushrooms and mental decline. The study's principal investigator, Assistant Professor Feng Lei, who is from NUS' Department of Psychological Medicine, and Dr Irwin Cheah - a senior research fellow at the NUS Department of Biochemistry - are asked the following questions: 1. Can consuming more than two portions (300g or half a plate) of mushrooms each week, reduce the risk of having mild cognitive impairment? 2. It can help with Alzheimer's, but how about Parkinson's disease?  3. The study focused on six types of mushrooms commonly eaten in Singapore. How about others like portobello?  Mushrooms contain high levels of a compound known as ergothioneine. The compound acts as an antioxidant and an anti-inflammatory agent, and can protect brain cells from damage. Produced by: Joyce Teo and Ernest Luis Edited by: Adam Azlee Follow more Health Check podcasts and rate us on: Spotify: http://str.sg/oeGY  Apple Podcasts: http://str.sg/oeXP  Google Podcasts: http://str.sg/oeLN  Playlist: https://str.sg/Jw7R  Website: http://str.sg/stpodcasts  Feedback to: podcast@sph.com.sg 

Dr Carolyn Lam:                Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore.                                                 FDG-PET CT was recently introduced as a new tool for the diagnosis of prosthetic valve endocarditis. However, can we improve on its diagnostic performance? Well, to learn more you have to listen to the upcoming featured discussion, right after these summaries.                                                 Our first original paper this week describes a potential novel therapy for hypertension. In this study from first author Dr Hu, corresponding author Dr Soong, from Yong Loo Lin School of Medicine National University of Singapore, authors showed that galectin-1 is a key regulator for proteasomal degradation of CaV 1.2 channels. L-type CaV 1.2 channels are known to play crucial roles in the regulation of blood pressure. In a series of elegant in vitro and in vivo experiments, the authors showed that galectin-1 promotes CaV 1.2 degradation by replacing CaV-beta and thereby, exposing specific glycines for polyubiquitination. This mechanistic understanding provided the basis for targeting CaV 1.2 galectin-1 interaction and demonstrated the modulatory role that galectin plays in regulating blood pressure. The study, therefore, offers a potential novel approach for the therapeutic management of hypertension.                                                 Direct oral anticoagulants or DOACs, are surpassing warfarin as the anticoagulant of choice for stroke prevention in non-valvular atrial fibrillation. However, DOACs outcomes in elective peri-procedural settings have not been well elucidated and remain a source of concern for clinicians.                                                 The next paper in today's issue was a meta-analysis designed to evaluate the peri-procedural safety and ethicacy of DOACs versus warfarin. For author Dr Nazha, corresponding author Dr Spyropoulos, from the Feinstein Institute for Medical Research in Northwell Health at Lenox Hill Hospital in New York, reviewed the literature for data from phase three randomized controlled trials comparing DOACs with warfarin in the peri-procedural period among patients with non-valvular atrial fibrillation. Sub study from four trials were included namely RE-LY, ROCKET-AF, ARISTOTLE, and ENGAGE-AF. The short-term safety and ethicacy of DOACs and warfarin were not different in patients with non-valvular atrial fibrillation peri-procedurally. Under an uninterrupted anticoagulation strategy, DOACs were associated with a 38% lower risk of major bleeds compared to warfarin.                                                 The next paper presents results from the Sarcomeric Human Cardiomyopathy Registry or SHARE, which combined longitudinal data sets curated by eight international hypertrophic cardiomyopathy specialty centers to provide a better understanding of the factors that contribute to heterogeneous outcomes in lifetime disease burden in patients with hypertrophic cardiomyopathy. First and corresponding author Dr Ho from Brigham and Women's Hospital and colleagues analyzed longitudinal clinical information on 4,591 patients with hypertrophic cardiomyopathy. By examining the data set spanning more than 24,000 patient-years, the mortality of patients with hypertrophic cardiomyopathy was shown to be 3-fold higher than the general population at similar ages. The lifetime cumulative morbidity of hypertrophic cardiomyopathy was considerable, particularly for patients diagnosed before age 40 years and patients with sarcomere mutations. Atrial fibrillation and heart failure were the dominant components of disease burden. Thus, young age of diagnosis and the presence of sarcomere mutations are powerful predictors of adverse outcomes in hypertrophic cardiomyopathy. These findings highlight the need for close surveillance throughout life and the need to develop disease-modifying therapies.                                                 The final original paper this week provides molecular insights into atherosclerosis and it shows that defective base excision repair of oxidative DNA damage in vascular smooth muscle cells promotes atherosclerosis. Now, we know that atherosclerotic blocks demonstrate extensive accumulation of oxidative DNA damage, predominantly as 8-oxoguanine lesions. In today's paper, first author Dr Shah, corresponding author Dr Bennett from University of Cambridge and colleagues studied levels of 8-oxoguanine and its regulatory enzymes in human atherosclerosis. They found that human plaque vascular smooth muscle cells showed defective nuclear 8-oxoguanine repair, associated with reduced acetylation of the base excision repair enzyme 8-oxoguanine-DNA-glycosylase-1. Furthermore, correcting the base excision repair defect in vascular smooth muscle cells alone markedly reduced plaque formation, thus indicating that endogenous levels of oxidative DNA damage in vascular smooth muscle cells promoted plaque development.                                                 And that brings us to the end of this week's summaries. Now for our feature discussion.                                                 Prosthetic valve endocarditis is a life-threatening complication. However, making a timely diagnosis of prosthetic valve endocarditis before the occurrence of severe complications is really difficult. Now, FDG-PET CT has recently been introduced as a new tool for the diagnosis of prosthetic valve endocarditis. However, previous studies reported only modest diagnostic accuracy and may have been hampered by confounders. But today's study, our feature study in Circulation, addresses this issue. We have none other than the corresponding author, Dr Ricardo Budde from Erasmus Medical Center in Rotterdam, the Netherlands, and our dear associate editor, Dr Victoria Delgado, who is in Leiden University Medical Center, also in the Netherlands.                                                 So please tell us, how does your study help us address this issue of the accuracy of FDG-PET CT Dr Ricardo Budde:           What we actually did is that of course endocarditis is a relatively rare disease, so we had six hospitals in the Netherlands that collaborated on this study and in each of the hospitals we searched for PET CT scans that were performed in patients with a prosthetic heart valve, either because they were suspected of having endocarditis, or if they were meant for other purposes, for example oncological follow-up. Then we grouped all those CT scans together, interpreted the PET CTs anew by dedicated interpreters, and then compared the findings with the actual diagnosis in the patient, which of course is always difficult in endocarditis because to make the diagnosis is difficult. So, also, one year follow-up period was included in that to be absolutely certain whether the patient had endocarditis or not. By taking this whole cohort of patients, we were able to determine the diagnostic accuracy of PET CT, as well as by using a logistics model, identify confounders which influence the diagnostic accuracy of PET CT.                                                 I think the study that we did addresses several important aspects and the way it helps physicians in actually interpreting and implementing PET CT to diagnose endocarditis is two-fold. First of all, we identified confounders that have to be taken into account when interpreting and using the PET CT. For instance, low inflammatory activity at the time of imaging and the use of surgical adhesive during a prosthetic heart valve implantation are confounders which should be taken into account when interpreting the PET CT. Furthermore, the guidelines have always insisted on not to use or use it very cautiously PET CT within the first three months after prosthetic heart valve implantation. However, we showed that actually this period after implantation does not necessarily have to be taken into account as also a good diagnostic accuracy can be obtained within the first three months after implantation. Dr Carolyn Lam:                Ricardo, that's wonderfully put. I don't do a CT, PET CT, routinely. In fact, I am echocardiologist and it used to be that infective endocarditis was diagnosed with echo. So Victoria, tell us, how does echo stand now with this information? Dr Victoria Delgado:        That's a very good question but I think the guidelines set a very clear figure of how the diagnostic workup of patients with prosthetic valve endocarditis should be performed. An echocardiography is the first imaging technique. The point is that transthoracic echocardiography in patients with suspicion of prosthetic valve endocarditis is very challenging. In terms of ideal, echocardiography is probably the best imaging technique to do first to evaluate whether it is endocarditis or not. It's difficult, we have to take into account that for a specific prosthetic valve, particularly mechanical, the shadowing can make that we don't see the [inaudible 00:10:22] and sometimes it's difficult, particularly in the early phase immediately after implantation, all the inflammation can be confounder for presence of endocarditis. In those cases, I think that this study provides additional and important data highlighting which are the confounders when you use PET CT to evaluate depressions of endocarditis. I think that, when you take into account those confounders, the accuracy of this technique is very good in order to make or help in the diagnosis of these patients. So, echocardiography, I think that will remain as our first imaging technique to rule out [inaudible 00:11:10] we can see but in those cases where the diagnosis is not confirm or rule out with transthoracic and transesophageal echocardiography this study provides additional data and important data showing that PET CT is a valuable complementary imaging diagnostic test for these patients. Dr Carolyn Lam:                Ricardo, would you agree with that because I think your study also emphasized that perhaps FDG-PET CT should be implemented early in the diagnostic workup to prevent the negative confounding effect of the low inflammatory activity? So how do we put this all together? Dr Ricardo Budde:           Well actually, I agree with Dr Delgado that echocardiography is and should be the first-line test that you do if you have a patient that has a suspicion of endocarditis. I mean, the advantages of echocardiography are many and it's non-invasive, it's bedside-available if needed, it's patient-friendly, and it provides a huge amount of information so you should always start with echocardiography. However, sometimes it can be difficult by echocardiography, for the reasons just explained by Dr Delgado, and I think then PET CT should be considered. And when you want to do a PET CT, then you should do it early within the diagnostic workup.                                                 Actually, in the article, one of the figures is a flow chart which we provide, and it provides information on how we think PET CT can best be implemented in the workup of endocarditis. In this flow chart we also start with doing an echocardiography and also, importantly, consult the endocarditis time to make initial classification of whether it's a rejected, possible, or definite prosthetic heart valve endocarditis. After that, you can follow the flow chart and see when you can best implement PET CT, in our opinion. Dr Carolyn Lam:                Indeed Ricardo, I am so glad you brought up this figure and listeners, you have to take a look at it. I can imagine that everybody will be using this and discussing it and how to incorporate this in the workflow. And indeed you do start with either transthoracic or transesophageal echo and blood cultures, so thank you for clarifying that.                                                 Now, for our clinicians out there, are there any situations you may be telling us to be a little more careful? Could you put it simply for us when it comes to the FDG-PET? Dr Ricardo Budde:           You mean when not to perform a PET CT? Dr Carolyn Lam:                Yeah, or when we have to be really careful about inaccuracies. Dr Ricardo Budde:           I think, of course, the confounders that we indicate in the article, especially if bioglue has been used by the surgeon during the initial surgery. We know that bioglue can be seen on a PET CT as a false positive uptake of FDG and it's also important to note that this is a phenomenon that can persist for a very long time after a valve implantation. It could be for years, so especially that I think is a very important confounder to take into account and be careful when you interpret PET CT or use the PET CT and always read the original surgical report if it is available to obtain this information. Dr Carolyn Lam:                That's wonderful advice. Victoria, do you have anything to add? Dr Victoria Delgado:        No, I think that Dr Budde explained perfectly this figure that is key in the article and also how to evaluate patients with suspected endocarditis of prosthetic valve. One thing that sometimes we forget is starting from the first step that is a good clinical history which includes also a good evaluation of previous history and, if possible, what has been done in the patient. I think that this key information to understand the findings on the echocardiography, transthoracic or transesophageal, and the subsequent investigations that you are going to perform. Either CT which is considered, for example, when you have a definitive prosthetic valve endocarditis and you want to rule out potential complications such as abscess, for example, and if you perform a PET CT or other imaging modalities that then also indicate the presence of infection like, for example, [inaudible 00:15:26] leukocytes with PET, for example. Dr Carolyn Lam:                And I just want to end up with one little point. Ricardo, how about the fact that part of your results don't corroborate the ESC guideline recommendations that they say you have to avoid FDG-PET in the recently implanted prosthetic valve. How do you feel it's going to play out for clinicians? Dr Ricardo Budde:           Well, I think the 2015 ESC guidelines on endocarditis are a very important document. One must take into account that the inclusion of PET CT in the ESC guidelines was a major step, and some might say that it was a little premature to include the use of PET CT because the number of data that was out there were still relatively limited. I think it's something that we are learning along the way. Now that we are using PET CT more often we are more aware of what we do to findings that we get and also the findings that we have within specific timeframes after the implantation of a prosthetic heart valve. One of the things that I think is desperately needed also at the moment is to have a prospective study where we would do PET CT in patients after implantation of a prosthetic heart valve that do not show any signs of endocarditis where we do PET CT just to determine these normal uptake values. I think that would be a major contribution to the whole learning experience that we're currently having with implementing PET CT within prosthetic heart valve endocarditis. Dr Carolyn Lam:                Indeed, and Ricardo your paper has added significantly to our understanding. Readers, remember, it's Figure 6 of our feature paper this week. It is a beautiful figure. Pick it up, take a look. In the meantime just thank you so much Ricardo and Victoria for joining me today.                                                 Listeners, don't forget to tune in again next week.  

While the public sector in some countries struggles to provide for the people, the private sector remains an untapped reservoir of resource. How can public and private sectors collaborate for successful partnerships to provide quality healthcare ? Guests: Dr Chia Shi-Lu, Member of Parliament, Singapore, Chairperson, Government Parliamentary Committee, Health (Singapore); Raman Singh, Chief Executive Officer of Mundipharma; Peh Kim Choo, Chief Executive Officer of Tsao Foundation; Associate Professor Lim Yee Wei, Yong Loo Lin School of Medicine, National University of Singapore.

Daryl Cheng is one of Singapore’s most prominent CrossFit Athlete and currently the fittest Singaporean in Singapore. Daryl is also a Singapore Armed Forces Medicine Scholarship holder and is currently completing his final year of Medical School at Yong Loo Lin School of Medicine at the National University of Singapore.In this episode we cover topics like how he balances his time being a full time student and competitive CrossFit athlete, his life in the army and why he is possibly not competing in CrossFit as an individual anymore. We also cover topics like PEDs in CrossFit and his sponsorship with reebok. Please enjoy!

Daryl Cheng is one of Singapore’s most prominent CrossFit Athlete and currently the fittest Singaporean in Singapore. Daryl is also a Singapore Armed Forces Medicine Scholarship holder and is currently completing his final year of Medical School at Yong Loo Lin School of Medicine at the National University of Singapore.In this episode we cover topics like how he balances his time being a full time student and competitive CrossFit athlete, his life in the army and why he is possibly not competing in CrossFit as an individual anymore. We also cover topics like PEDs in CrossFit and his sponsorship with reebok. Please enjoy!