Search

Objectives: The accuracy of FRAX® as a screening tool to identify osteoporosis and how it compares with tools such as Osteoporosis Self-Assessment Tool for Asians (OSTA), in Southeast Asian women has so far been unexplored. We aimed to determine the FRAX® thresholds that accurately identify densitometric osteoporosis and to compare its performance with that of OSTA for this purpose. Methods: Singaporean postmenopausal women (n = 1056) were evaluated. FRAX® Major Osteoporotic Fracture Probability (MOFP), Hip Fracture Probability (HFP) scores, and OSTA indices were calculated. Receiver operating characteristic (ROC) curves were constructed and via the Youden index, the optimal cut-off points of balanced sensitivity and specificity for dual energy X-ray absorptiometry (DXA)-defined osteoporosis were identified and the performance characteristics were compared. Results: A FRAX® MOFP threshold of ≥3.7% had sensitivity, specificity, positive predictive value and negative predictive value of 0.78 (0.73–0.83), 0.63 (0.59–0.66), 0.4 (0.36–0.44), and 0.9 (0.87–0.92), respectively in identifying osteoporosis. The corresponding values for a HFP threshold of ≥0.6% were 0.85 (0.80–0.89), 0.58 (0.55–0.62), 0.39 (0.35–0.43), and 0.92 (0.9–0.94) and that for an OSTA index cut-off of ≤ −1.2 were 0.76 (0.70–0.81), 0.74 (0.71–0.77), 0.48 (0.43–0.54), and 0.91 (0.88–0.93). The area under the ROC curves were 82.8% (79.9%–85.6%), 77.6% (74.2%–81%), and 79.6% (76.5%–82.8%) for OSTA, MOFP, and HFP thresholds respectively. Conclusions: FRAX® and OSTA perform comparably in identifying osteoporosis in our population. OSTA has only 2 parameters and may be simpler to use. However, FRAX® may also have a role in primary screening to identify the postmenopausal woman to be referred for DXA scanning and may help facilitate fracture risk reduction discussions with the patient.

The engagement of the cerebellum VI in reading was reported in both typically developing and dyslexic readers. However, it is still not clear how the cerebellum VI contributes to reading. Here we have examined the correlation of intrinsic cerebro-cerebellar functional connectivity with two critical reading-related skills—phonological awareness (PA) and rapid automatized naming (RAN)—with fMRI technology. Specifically, we tested the hypothesis that the cerebellum may contribute to reading either by phonological skills or by automatizing skills. We chose the left and right cerebellum VI as ROIs, and we calculated the intrinsic cerebro-cerebellar functional connectivity during a resting state. We further explored whether and how cerebro-cerebellar resting state functional connectivity (RSFC) is associated with individuals’ reading-related skills including PA and RAN. The results showed that the functional connectivity between the left supramarginal gyrus and bilateral cerebellum VI was related to RAN, and the connectivity between the left insula and right cerebellum VI was related to PA. However, the effect of PA did not survive after the RAN was regressed out. Control analyses further confirmed that it was the intrinsic cerebro-cerebellar functional connectivity rather than the local cerebellar functionality that associated with phonological awareness ability and rapid automatized naming ability. For the first time, the relationship between cerebro-cerebellar resting state functional connectivity and specific reading-related skills has been explored, and this has deepened our understanding of the way the cerebellum VI is involved in reading.

Rabies is one of the most feared human diseases as it is almost uniformly fatal once clinical symptoms set in. The majority of deaths were due to a lack of rabies post-exposure prophylaxis (PEP). We review the profile of travellers to Southeast Asia (SEA) seeking rabies PEP in Singapore General Hospital (SGH). Thirty-seven patients visited our travel clinic for rabies PEP from Dec 2010 to Dec 2013. Their mean age was 27.0 years. Twenty-four (65%) received rabies PEP within 24 hours of exposure. Rabies immunoglobulin (RIG) was indicated in 28 cases (76%) but only half were administered; two-thirds were given in our clinic. Only two received rabies pre-exposure prophylaxis and both were non-residents. There is an urgent need to increase the awareness of potential rabies infection amongst Asian travellers.

Alternative fuels such as biodiesel, bio-alcohol and other biomass sources have been extensively research to find its potential as an alternative sources to fossil fuels. This experiment compared the performance of diesel (D), biodiesel (BD) and diesel-organic germanium blend (BG5) at five different speeds ranging from 1200-2400 rpm. BG5 shows significant combustion performance compared to BD. No significant changes of power observed between BG5 and BD at a low speed (1200 rpm). On the contrary, at higher speeds (1800 rpm and 2400 rpm), BG5 blend fuel shows increased engine power of 12.2 % and 9.2 %, respectively. Similarly, torque shows similar findings as engine power, whereby the improvement could be seen at higher speeds (1800 rpm and 2400 rpm) when torque increased by 7.3 % and 2.3 %, respectively. In addition, the emission results indicated that for all speeds, CO2, and NO had reduced at an average of 2.1 % and 177 %, respectively. Meanwhile, CO emission had slightly increased compared to BD at low speeds by 0.04 %. However, the amount of CO released had decreased at an average of 0.03 % as the engine speed increased. Finally, measurement of O2 shows an increment at 16.4 % at all speed range.

A homemade Bonner cylinder spectrometer was used to determine the neutron spectrum from thermal energy up to several GeV at a heavily-shielded light source facility. The spectrometer, similar to the design of Bonner spheres, features high sensitivity of neutron detection because of using a long cylindrical 3He proportional counter. The spectrum measurement was performed during the facility commissioning by intentionally parking the injected electrons at the septum of the storage ring. Based on a high-fidelity FLUKA simulation, the predicted neutron spectrum at the location of measurement was adopted as the initial guess of spectrum unfolding. The unfolded result indicated an underestimation of the calculated neutron spectrum in the high-energy portion, leading to a substantial revision of the neutron dose rate at the location.

In this paper, the dynamic deformation and rupture of thin metal plates subject to underwater shock wave loading are studied by using high-speed 3D digital image correlation (3D-DIC). An equivalent device consist of a gas gun and a water anvil tube was used to supplying an exponentially decaying pressure in lieu of explosive detonation which acted on the panel specimen. The thin metal plate is clamped on the end of the shock tube by a flange. The deformation and rupture process of the metal plates subject to underwater shock waves are recorded by two high-speed cameras. The shape, displacement fields and strain fields of the metal plates under dynamic loading are obtained by using VIC-3D digital image correlation software. The strain gauges also were used to monitor the structural response on the selected position for comparison. The DIC data and the strain gauges results show a high level of correlation, and 3D-DIC is proven to be an effective method to measure 3D full-field dynamic response of structures under underwater impact loading. The effects of pre-notches on the failure modes of thin circular plate were also discussed.