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Aims: The concept of using specific dietary components to selectively modulate the gut microbiota to confer a health benefit, defined as prebiotics, originated in 1995. In 2018, a group of scientists met at the International Scientific Association for Probiotics and Prebiotics annual meeting in Singapore to discuss advances in the prebiotic field, focussing on issues affecting functionality, research methodology and geographical differences. Methods and Results: The discussion ranged from examining scientific literature supporting the efficacy of established prebiotics, to the prospects for establishing health benefits associated with novel compounds, isolated from different sources. Conclusions: While many promising candidate prebiotics from across the globe have been highlighted in preliminary research, there are a limited number with both demonstrated mechanism of action and defined health benefits as required to meet the prebiotic definition. Prebiotics are part of a food industry with increasing market sales, yet there are great disparities in regulations in different countries. Identification and commercialization of new prebiotics with unique health benefits means that regulation must improve and remain up‐to‐date so as not to risk stifling research with potential health benefits for humans and other animals. Significance and Impact of Study: This summary of the workshop discussions indicates potential avenues for expanding the range of prebiotic substrates, delivery methods to enhance health benefits for the end consumer and guidance to better elucidate their activities in human studies. [ABSTRACT FROM AUTHOR]

We propose localization push, as an alternative to tacit knowledge, to explain the localization of knowledge diffusion. Sponsors of scientific research enact policies and create institutions for locally-produced knowledge spillovers. We hypothesize that localization necessitated by tacit knowledge renders the local diffusion of such knowledge more productive than distant commercialization. However, this is not the case when the localization push is the primary reason for the localization. We empirically investigate the hypothesis using data on knowledge diffusion in SingaporeOur main findings are as follows: (1) The diffusion of basic research, measured by journal articles cited in patents, is localized, but this is almost exclusively accounted for by Singaporean public institutions; (2) Local patents citing papers authored by Singaporeans are less significant than foreign patents citing such papers; and (3) Singaporean public patent applicants are more willing to seek multijurisdiction patent protection despite the ineffectiveness of their commercialization efforts. [ABSTRACT FROM AUTHOR]

History records that trade and trade finance, vital to economic advancement and prosperity, have benefited profoundly from technological evolution and accompanying supportive transnational law. Today, the blossoming of technology, most notably digitalization, has the potential to greatly facilitate both domestic and international trade and, just as importantly, to assist in fulfilling the environmental and social goals critical to meet the UN Sustainable Development Goals and the Paris Agreement. However, obstacles to digital trade arise from the existing legal and regulatory frameworks. Accordingly, legal reforms are overdue. Impetus is now needed to create a fully supportive transnational legal environment. There are several examples of where the technology exists, but the law frustrates its effective deployment. The laws of most jurisdictions require certain trade documents (like bills of lading, payment, and title instruments) to be recorded in a tangible form (paper). The International Chamber of Commerce (ICC) estimates that digitalizing trade documents could reduce transaction costs by 80 per cent and eliminate billions of paper documents in the trade system. A limited number of jurisdictions have reformed their laws to address this gap and innovative private sector actors have taken the initiative to benefit from these reforms. An example includes the development of the Distributed Ledger Payment Commitment by BAFT that relies on narrow but effective changes in Delaware law governing promissory notes; others chose to be governed by Singapore law, which recently amended to align with the Model Law on Electronic Transferable Records (MLETR). Law can be an enabler of digital trade. To this end, work has begun, including by the ICC and the International Institute for the Unification of Private Law. But the reform needs to be accelerated. This article considers the benefits of digital trade, key legal obstacles, and how transnational law can enable innovation and digitalization not only of the vast volumes of paper but of the entire trade and trade finance processes. [ABSTRACT FROM AUTHOR]

The United Nations Sanctions Ordinance is the primary legal basis of the Hong Kong Special Administrative Region (HKSAR) for implementing the United Nations Security Council's resolutions. However, there are concerns that the Ordinance is potentially violating the separation of powers in its delegation of regulation-making authority to the executive. There are also criticisms against the expediency of the Ordinance as a mechanism lot enforcing Security Council sanctions. Against this background, this paper attempts to examine the separation of powers doctrine, its place in HKSAR's constitutional system and its relevance to the Ordinance. On the issue of expediency, this paper focuses on the scope and speed of implementing the sanctions, and the human rights and criminal justice pro blems it involves. For comparative purposes, references are to be made to the law of the USA, Canada and Singapore. [ABSTRACT FROM AUTHOR]

This paper explores the ethical challenges in deciding whether to vaccinate individuals lacking the decision-making capacity needed to provide informed consent during a public health emergency like COVID-19. The best interests standard ordinarily governs such decisions, which under the law in jurisdictions like England, Wales and Singapore takes into account the individual's past wishes and present preferences. However, in a public health emergency, the interests of third parties become more salient: those whom the unvaccinated individual might expose to infection have an interest in the individual's being vaccinated. While current mental capacity law has not been interpreted to take such public health considerations into account, we argue that such considerations are nevertheless ethically relevant, and can legitimately be weighed up alongside other considerations such as the preferences of the individual and impacts on their health. This is most relevant for individuals lacking decision-making capacity who have previously declined or presently resist vaccination. The public health impact of vaccination may in some instances be enough to outweigh preferences of the individual and justify providing vaccination against their past or present wishes. [ABSTRACT FROM AUTHOR]

Community engagement is crucial for controlling disease outbreak and mitigating natural and industrial disasters. The COVID-19 pandemic has reconfirmed the need to elevate community engagement to build equity, trust and sustained action in future health promotion preparedness strategies. Using the health promotion strategy of strengthening community action enhances the opportunity for better outcomes. There is, therefore, a need to improve our understanding of community engagement practices during crises, scale-up good community engagement initiatives, and improve and sustain people-centered approaches to emergency responses. This paper presents five case studies from the United States, Singapore, Sierra Leone, Kenya and South Africa that demonstrate the potential strengths that can be nurtured to build resilience in local communities to help mitigate the impact of disasters and emergencies. The case studies highlight the importance of co-developing relevant education and communication strategies, amplifying the role of community leaders, empowering community members to achieve shared goals, assessing and adapting to changing contexts, pre-planning and readiness for future emergencies and acknowledgement of historic context. [ABSTRACT FROM AUTHOR]

Introduction: Military forces around the world face an increased risk of the spread of communicable diseases, due to the close living quarters and congregated nature of the military camps. The Singapore Armed Forces (SAF) implemented a multi-pronged surveillance and containment strategy to reduce the risk of a coronavirus disease 2019 (COVID-19) outbreak within the local military camps. This paper details the epidemiological investigations of the COVID-19 cases in the SAF and highlights the strategies and public health measures undertaken, aligned with the national COVID-19 control strategy, to reduce the risk of COVID-19 transmission in the military camps. Materials and Methods: Medical data of our military personnel who were infected with COVID-19 during the first 180 days of the pandemic were extracted from the military electronic health records. Contact tracing and activity mapping results were obtained from unit-level epidemiological data. A review of the organization's response plans, instructions, and orders was conducted to collate the measures implemented across the same time period. Results: Prompt contact tracing and activity mapping was done for each of the 24 SAF military personnel diagnosed with COVID-19 between February 2020 and June 2020, with possible links among the cases identified and investigated. Conclusion: A combination of strategies in the formulation of public health measures based on key principles of early warning and surveillance, prompt diagnosis, and early containment were successful in preventing the formation of COVID-19 clusters within the SAF. This will provide a framework for the management of future pandemics within the military setting, driven by strong governance and leadership, to meet the military's need to maintain operational readiness in a safe manner. [ABSTRACT FROM AUTHOR]

This paper examines how mobile messaging apps have changed the way that people microcoordinate. It is based on five focus groups of young adults in Singapore and Taiwan. Originally, microcoordination usually assumed dyadic interaction using either SMS or mobile voice calls. Increasingly, mediated communication uses mobile messaging apps that allow multisided interactions that facilitate task-based chat groups. Groups are easily formed but can be difficult to manage. This paper advances our understanding of microcoordination via the use of messaging apps. Specifically, it provides insights into the dual roles of instrumental and expressive interaction integral to the functioning of these messaging groups, ambient-mediated sociation in the form of readily available communication partners in groups, and the emergence of meme-based coordination. [ABSTRACT FROM AUTHOR]

Background: Chronic heart failure (CHF) is one of the most common causes of hospital admissions and readmissions. Managing CHF requires a comprehensive treatment plan that consists of medication treatment and behavioural change. However, patients often feel unprepared for their self-management role in the community, especially during the period of transition after discharge from hospital. Therefore, an effective intervention to promote CHF self-management is needed. Aims: This paper describes the development and pilot testing of a multicomponent nursing intervention (i.e. the HOM-HEMP) for a randomised controlled trial to assess its effectiveness in improving self-care behaviour among CHF patients in Singapore. A description of the study intervention is also delineated in detail. Methods: The HOM-HEMP was developed based on the UK Medical Research Council framework for developing and evaluating complex interventions. After the development of the study intervention, a single group pre- and post-repeated measure pilot test was conducted to evaluate the study intervention package for its acceptability and the feasibility of the data collection procedure. Ten participants were recruited through consecutive sampling. All of the participants received the full intervention package with the supplementary mobile application. The data were collected at baseline and immediately after the study intervention (i.e. 6 weeks from baseline). The outcome measures included the Self-Care Heart Failure Index, Cardiac Self-Efficacy Scale, Minnesota Living with Heart Failure Questionnaire, Hospital Anxiety and Depression Scale and Short Form of the Social Support Questionnaire. Results: The results from the pilot testing showed that the programme was feasible and potentially effective in improving patient's self-care management, psychological outcomes and health-related quality of life. Conclusion: A self-management psychosocial education approach is the preferred choice for many patients with chronic diseases. The effectiveness of the HOM-HEMP will next be tested in a full scale randomised control trial. [ABSTRACT FROM AUTHOR]

This paper examines the social history of individuals with leprosy living in Singapore under the law of compulsory segregation. Using official sources and oral history interviews, the paper explores both the colonial and postcolonial states' motivations behind the policy and its effects on leprosy sufferers and the public at large in a cosmopolitan, progressive country. First, by tracing the continuity of the colonial policy into the postcolonial period, segregation, it is argued, stemmed not only from British anxieties towards the Asian 'races', which appeared to be the case in the earlier era, but from a deeper 'high modernist' resolve, shared by both the British and the postcolonial People's Action Party governments, to mould individuals into model subjects and citizens using the principles and techniques of modern science and administration. This paper also presents patient experiences of and responses to segregation and the social stigma against leprosy. It contends that official social control over the leprosarium was never completely hegemonic but was continually contested, individually and collectively, and overtly and covertly, by the residents, giving form in the long run to semi-autonomous ways of everyday life in the institution. [ABSTRACT FROM AUTHOR]

I International Relations of the Asia-Pacific i , doi:10.1093/irap/lcab011. When this paper was first published, the images for figures 1 and 2 had been erroneously swapped. [Extracted from the article]

In April 2015, Singapore introduced an anonymous futures market for wholesale electricity. Using data on prices and other observable characteristics of all competitive retail contracts signed from October 2014 to March 2016, a larger average quantity of open futures contracts that clear during the term of the retail contract a month before the retail contract starts delivery predicts a lower price for the retail contract. This outcome is consistent with increased futures market purchases by independent retailers causing lower retail prices. Consistent with the logic in Wolak (2000) that a larger volume of fixed-price forward contract obligations leads to offer prices closer to the supplier's marginal cost of production, a larger volume of futures contracts clearing against short-term wholesale prices predicts lower half-hourly wholesale prices. Both empirical results support introducing purely financial players to improve both retail and wholesale market performance. The paper then outlines how a regulator-mandated standardized futures market can be used as a long-term resource adequacy mechanism for the wholesale market regime. [ABSTRACT FROM AUTHOR]

Despite the emphasis placed on agility in uncertain situations such as extreme events, no comparative data exist to look into the determinants that drive agility. For crisis response managers, the failure to develop agility threatens organizations’ survival amid uncertainties. This paper investigates the development of agility and explains the emergence of agility against the fight of influenza A/H1N1 pandemics in Singapore and Taiwan in 2009. This paper further provides empirically grounded evidence to identify prerequisites for agility development in response to public health crises in East Asia. [ABSTRACT FROM AUTHOR]

This paper focuses on the major telecommunications policies and corporate strategies that have allowed Singapore to achieve a high degree of success in designing and implementing a modern and high-quality telecommunications infrastructure. This success has been achieved with a specific type of industry structure that is marked by a single public organization protected from market competition by government regulations. [ABSTRACT FROM AUTHOR]

Professional migrants' numbers are rising throughout the world, but the phenomenon itself is changing. Research on professional migration often examines the situation in 'Western' countries. In contrast, this paper investigates the rising numbers of (mainly) young, educated, middle-class EU citizens who relocate to Singapore and Japan. Singapore, as a hub for the Asia-Pacific region and forward-looking industries, attracts career-oriented professionals seeking challenges and adventure. Japan lures with its cultural abundance but is hardly accessible for people without Japanese language proficiency. Despite these differences, migration to both places results in similar outcomes as it introduces migrants to a mobile life involving destinations that are significant for their labor market characteristics. It further demonstrates how a generation that grew up with the concept of borderless Europe construct their individual 'worklife pathways' beyond the European continent. Depending on the socio-cultural context, the intersections of race and gender shape their migration experiences. Such dynamics have to be understood in relation to recent global developments including the challenges that the European Union is currently facing and Japan's struggle to cope with a declining workforce. [ABSTRACT FROM AUTHOR]

Koro is a syndrome in which the penis (or sometimes the nipples or vulva) is retracting, with deleterious effects for the sufferer. In modern psychiatry, it is considered a culture-bound syndrome (CBS). This paper considers the formation and development of psychiatric conceptions of koro and related genital retraction syndromes from the 1890s to the present. It does so by examining the different explanations of koro based on shifting conceptions of mental illness, and considers the increased recognition of the role culture has to play in psychiatric concepts. Conceptions of culture (deriving from colonial psychiatry as well as from anthropology) actively shaped the ways in which psychiatrists conceptualized koro. Cases under consideration, additional to the first Dutch descriptions of koro, include the ways in which koro was identified in white western cases, and the 1967 Singaporean koro epidemic. Following a number of psychiatrists and psychologists who have addressed the same material, attention is also paid to the recent genital-theft panics in sub-Saharan Africa, considering the implications of the differences between koro and other genital-theft panics. Finally, the paper addresses the role played by koro in the development of the concept of CBSs, which was first presented in the DSM IV in 1994. This is explored against the backdrop of emerging ideas about culture and psychiatry from the late colonial period, especially in Africa, which are central to modern ideas about transcultural psychiatry. [ABSTRACT FROM PUBLISHER]

Using both legal and sociological definitions of citizenship, this paper examine how the international community, ASEAN countries and Singapore have responded to the migrant worker question. The first part of this paper uses ASEAN examples and interrogates the question of migrant worker citizenship from an international legal or policy perspective, particularly recent efforts to construct a differentiated citizenship for migrant workers within destination States based on an inclusionary principle. The second part of this paper then undertakes a close case study of foreign domestic workers or "maids" in Singapore. I examine how maids are depicted as non-citizens under Singapore's law and policy, how Singaporean non-governmental organizations have sought to counter this and how the latter may be guided by internationally developed concepts of differentiated citizenship and the inclusionary principle. [ABSTRACT FROM AUTHOR]

In this paper, we examine the use of an ordinary differential equation in modelling the SARS outbreak in Singapore. The model provides an excellent example of using mathematics in a real life situation. The mathematical concepts involved are accessible to students with A level Mathematics backgrounds. Data for the SARS epidemic in Singapore are used for a detailed study. Beginning with a simple logistic model, we discuss how it may be analysed, refined and improved. The exercise serves to provide insight into the processes involved in deterministic modelling using a realistic and relevant example. [ABSTRACT FROM AUTHOR]

The relational turn of IR stresses the processual constitution of the state. The indigenous theory of Chinese IR adopts the relational turn but contends that the Chinese experiences are distinctive. Relying on the case of Singapore-Taiwan relationship, this paper argues that the Chinese relationality attests to a bilateral sensibility that does not confront the relational turn in general, which is multilateral. The case further contributes to the relational turn in showing non-security and affirmative components of relationality to the extent that the studies of the relational turn have remained embedded in the security concerns. The case applies the theory of "balance of relationship," in which nations can practice selfrestraint not in response to unilateral strategic calculus or multilateral rule making, but to bilateral reciprocity. The balance of relationship of the two proceeds at both the statist and the personal levels, introducing the affect of passion to the relational turn. [ABSTRACT FROM AUTHOR]

Despite its excellent public healthcare system and efficient public administration, Singapore has been severely affected by the COVID-19 pandemic. While fatalities in the city-state remain low and contact tracing efforts have been largely successful, it has nonetheless experienced high rates of infection and the emergence of large infection clusters in its foreign worker dormitories. This paper analyses this dual-track policy outcome – low fatalities but high infection rates – from a policy capacity perspective. Specifically, the policy capacities that had contributed to Singapore's low fatality rates and effective contact tracing are identified while the capacity deficiencies that may have caused its high rates of infection are discussed. In doing so, I argue that the presence of fiscal, operational and political capacities that were built up after the SARS crisis had contributed to Singapore's low fatality rate and contact tracing capabilities while deficiencies in analytical capacities may explain its high infection rate. [ABSTRACT FROM AUTHOR]

Background and Objectives Falls among older adults are a significant health problem globally. Studies of multicomponent fall prevention programs in randomized controlled trials demonstrate effectiveness in reducing falls; however, the translation of research into the community remains challenging. Although there is an increasing interest to understand the factors contributing to implementation barriers, the dynamic relationships between factors are less well examined. Furthermore, evidence on implementation barriers from Asia is lacking as most of these studies originate from the West. As such, this study aims to engage stakeholders in uncovering the factors that facilitate or inhibit implementing community-based fall prevention programs in Singapore, with a focus on the interrelationship between those factors. Research Design and Methods Health care professionals familiar with fall prevention programs were invited to discuss the enablers and challenges to the implementation. This effort was facilitated using a systems modeling methodology of Group Model Building (GMB) to share ideas and create a common conceptual model of the challenges. The GMB employs various engagement techniques to draw on the experiences and perceptions of all stakeholders involved. Results This process led to the development of a Causal Loop Diagram (CLD), a qualitative conceptual model of the dynamic relationships between the barriers and facilitators of implementing fall prevention programs. Results from the CLD show that implementation is influenced by two main drivers: health care provider factors that influenced referrals, and patient factors that influenced referral acceptance and long-term adherence. Key leverage points for potential interventions were identified as well. Discussion and Implications The overall recommendation emphasized closer coordination and collaboration across providers to ensure sustainable and effective community-based fall prevention programs. This has to be supported by a national effort, involving a multidisciplinary stakeholder advisory group. These findings generated would be promising to guide future approaches to fall prevention. [ABSTRACT FROM AUTHOR]

The utilization of daylight can significantly affect building performance, energy efficiency, productivity, as well as occupants' comfort and satisfaction in buildings. This paper aims to assess daylight performance for tropical office buildings in a parametric approach. Thus, four passive design categories are investigated, namely interior surface reflectance, glazing visual transmittance, light shelves and shading control. The approach is exemplified using the case study of two selected offices in Singapore. This study contributed to the assessment of the daylight performance and prediction of the consequences of retrofitting alternatives toward fostering the utilization of daylight in existing buildings in the tropics. [ABSTRACT FROM AUTHOR]

The (ideological) aversion many states in Asia have toward universal welfare has led to the development of various solutions that depend on the valorization of the familial. This tends toward limiting state expenditure on public goods. The unevenness and inequalities produced and reproduced by the state's reliance on particular family forms--with its specific connotations around class, ethnicity, gender, and sexuality--also result in particular hierarchies and principles of divi-sion within the society. This paper challenges the assumption embedded in much current scholarship that it is "culture" that determines what states can and cannot do in the realm of public provisions. Instead, it interrogates how states produce and reproduce particular visions of the family through their approach toward welfare, and how this more broadly shapes and reproduces social inequal-ities in state-society relations. [ABSTRACT FROM AUTHOR]

Developments in medical technology, healthcare delivery, and commercial interests in medicine have increased both the potential for conflicts of interest on the part of physicians, and doubts over the sufficiency of patient autonomy as a justification for administering innovative therapy. The legal and regulatory treatment of innovative therapy is therefore an important question, on which there is a current lack of consensus on a number of issues. This paper discusses recent developments in Singapore and uses them as a springboard to flesh out basic regulatory issues that arise from the deployment of innovative treatment: the distinction between innovative treatment and clinical research, the adequacy of the current post hoc scrutiny of innovative therapy under existing legal principles and the need for further specialised regulatory oversight. [ABSTRACT FROM AUTHOR]

This paper studied uneven Internet access amongst young people in Singapore. The study finds that young Singaporeans access the Internet mainly through home, school, borrowed, public, and mobile sources, with different implications for each type of Internet access. For those with home or mobile access, Internet use was routinised and often intense, even burdensome and distracting on occasions. For those who relied on borrowed, school, or public access, intermittent use appeared adequate but hampered their ability to hone online skills to the levels of their peers. The study also finds that although systematic incorporation of IT into the national curriculum can encourage parity in basic exposure to online skills, developing greater Internet proficiency is more likely with home Internet access. [ABSTRACT FROM AUTHOR]

At the Cancún Ministerial Conference, the members of the World Trade Organization (WTO) disagreed on whether to launch negotiations on multilateral disciplines concerning the four areas of government policy collectively known as the 'Singapore issues'. This amounted to a decision not to expand the WTO's boundaries along these dimensions. In this paper, five hypotheses concerning the treatment of the Singapore issues by the WTO's membership are described and assessed. The implications of this assessment for the likelihood that, at some future date, similar proposals can be successfully advanced in the multilateral trade arena are also discussed. [ABSTRACT FROM AUTHOR]

Although studies involving linguistic human rights (LHRs) have focused at length on cases of inter-language discrimination, much less attention has been given to intra-language discrimination (Blommaert 2001a; Skutnabb-Kangas et al. 2001). This paper highlights a number of theoretical issues that the LHRs framework needs to deal with once intra-language discrimination is seriously considered. It does this by analysing the case of English in Singapore, and in particular, debates surrounding the colloquial variety of Singapore English (known as Singlish). Supporters of Singlish are concerned with negotiating a space for the variety, especially in response to the Singapore government's Speak Good English Movement, which seems intent on eliminating Singlish. The implications of the Singlish case raise some very fundamental questions about LHRs, such as whether LHRs can be coherently attributed to groups (rather than just individuals), and whether LHRs can, in fact, be waived. The latter part of the paper considers these questions by drawing upon the work of scholars who have approached the issue of human rights from a more philosophical perspective (Donnelly 1989; Nickel 1987). [ABSTRACT FROM AUTHOR]

This paper describes body composition and dietary intakes of the three major ethnic groups residing in Singapore and how these are related to cardiovascular risk factors in these groups. When the relationship between body mass index (BMI, kg/m[SUP2]) and body fat percentage was studied, Singaporeans were found to have higher percentage of body fat compared with Caucasians with the same BMI. At BMIs that are much lower than WHO-recommended cut-off values for obesity, both the absolute and relative risks of developing cardiovascular risk factors are markedly elevated for all three ethnic groups. The excessive fat accumulation and increased risks at lower BMIs signal a need to re-examine cut-off values for obesity among Chinese, Malays, and Indians. [ABSTRACT FROM AUTHOR]

In this paper, a study on phytoplankton dynamics and size in the tropical coastal waters of Singapore is presented. Chlorophyll-a levels in the Singapore Strait generally range from 0.4 to 10 μg l–1, with an average value of 1.7 μg l–1. In general, higher chlorophyll concentrations are typically found off the east coast of Singapore, as well as in the shallower, more protected waters of the Johor Strait (maximum ~78 μg l–1, average = 21.5 μg l–1). Seasonal trends in chlorophyll and nutrients are also apparent, with higher chlorophyll generally observed during the south-west monsoon compared with the wetter north-east monsoon. Size-fractionated chlorophyll measurements of the phytoplankton community show that for low standing stocks of chlorophyll less than 3 μg l–1, approximately 40% of the phytoplankton lies in the pico- and small nanoplankton (<8 μm) size range. As total chlorophyll levels in the system increase, the relative contribution from the larger size classes (i.e. 8–20 and 20–100 μm) increases, with a subsequent decrease in the smaller size classes. For total chlorophyll greater than 40 μg l–1, it was found that the 20–100 μm size class contributed 60% of total chlorophyll. In contrast, the <8 μm size class contributed only about 5% of total chlorophyll for these waters. [ABSTRACT FROM PUBLISHER]

Who speaks for marginalised communities in dominant-party parliaments, where electoral accountability is weak? While existing work demonstrates the persistent salience of a legislator's personal identity in such settings, we build on recent 'critical actor' theory to argue for factors beyond identity-based selection to explain why representatives might speak for marginalised communities. To this end, we use a mixed-methods approach to analyse the representation of six marginal communities in Singapore's dominant-party system. A quantitative content analysis of all 8246 parliamentary questions filed from 2011 to 2020 shows that in addition to representative gender and ethnics identities, prior careers and political tenure also influence marginal community representation. In-depth interviews with seven Member of Parliament help identify precise mechanisms for such representation, including shared experience, career-derived awareness, political freshness and representative philosophies. That said, not all marginalised communities are well-represented, reflecting constraints on individual legislator-driven representation amidst broader party electoral strategies in non-competitive systems. [ABSTRACT FROM AUTHOR]

The liberal international order (LIO) is undergoing significant challenges, and this has given rise to debates about its purported decline. In this context, most studies of the LIO focus on major powers with little attention paid to small states' conceptualizations of the LIO despite its ubiquity in international life. Focusing on the Singaporean case as a small state, it asks the question: how does Singapore conceptualize the LIO and what are the effects of this conceptualization? Through a mixed-method thematic analysis of 192 parliamentary replies, media interviews and United Nations speeches by Singaporean officials between 2000 to 2022, I find Singapore accepting and defending the existing international order in two main ways: demonstrating respect for international law and the UN Charter, and supporting economic liberalism. Meanwhile, Singapore is contesting the universality of liberal democracy as it sees such discourse as a rebuke to its single-party dominant governance model. This perception of the LIO, in turn, informs Singapore's order-maintaining, order-modifying and order-contesting practices: it seeks to not only protect, but also to modify the LIO—through institutional and legal initiatives—to make it more equitable and open, giving us a glimpse into an instance of a small state's agency in relation to the LIO. [ABSTRACT FROM AUTHOR]

Hitherto marginalized in the extant innovation studies is the role of intermediaries in innovation ecosystems, which require greater coordination and orchestration between manifold organizations. We conduct qualitative research on the Precision Engineering Centre of Innovation to understand how this government-affiliated intermediary in Singapore takes the initiative in shaping an innovation ecosystem through which local/foreign precision engineering firms, government agencies, and multinational corporations harmoniously co-develop advanced manufacturing capabilities. By analyzing the qualitative data through the theoretical lenses of innovation ecosystem and intermediary, our findings reveal that intermediaries nurture ecosystems in four major steps: (1) developing the ecosystem vision, (2) forming the ecosystem community, (3) orchestrating the ecosystem resources, and (4) materializing the new value proposition. Based on this process model, the implications for innovation intermediary research, innovation ecosystem studies, and innovation policy are discussed. [ABSTRACT FROM AUTHOR]

Introduction In the National University Cancer Institute, Singapore (NCIS), 2 pilot programs providing (i) surgical prehabilitation before cancer surgery and (ii) geriatric oncology support for older adults planned for chemotherapy and/or radiotherapy were merged to form the Geriatric Oncology Longitudinal End to eNd (GOLDEN) program in 2019 to support patients from the time of their cancer diagnosis, through their treatment process, to cancer survivorship. Methods and Materials Older adults aged ≥65 years were enrolled in either surgical prehabilitation, the geriatric medical oncology (GO) arm, or both. All patients undergo a geriatric assessment. We assessed if patients had a change in treatment plans based on GOLDEN recommendations, and the impact on patient related outcomes. Results There were 777 patients enrolled in the GOLDEN program over 2 years; 569 (73%) were enrolled in surgical prehabilitation, 308 (40%) were enrolled in the GO arm, with 100 (12.8%) enrolled in both. 56.9% were females. Median age was 73. Lower gastrointestinal (51.2%) and hepatobiliary cancers (24.1%) were the most common cancer types. 43.4% were pre-frail and 11.7% were frail. Of the 308 patients in the GO arm, 86.0% had geriatric syndromes, while 60.7% had a change in their treatment plans based on GOLDEN recommendations. 31.5% reported an improved global health status, while 38.3% maintained their global health status. 226 (73%) responded that they had benefited from the GOLDEN. Conclusion More than half of the population was either pre-frail or frail. Amongst those in the GO arm, the majority had geriatric syndromes and had a change in their treatment plans based on GOLDEN recommendations. Majority reported either improvement or maintenance in global health status, with most feeling they have benefited from the program. Further evaluation of the longitudinal geriatric hematology-oncology program for cancer-related outcomes and sustainability should be carried out. [ABSTRACT FROM AUTHOR]

Background Longitudinal assessment of the determinants of obesogenic growth trajectories in childhood can suggest appropriate developmental windows for intervention. Methods Latent class growth mixture modelling was used to identify body mass index (BMI) z-score trajectories from birth to age 6 years in 994 children from a prospective mother–offspring cohort (Chinese, Indian and Malay ethnicities) based in Singapore. We evaluated the early-life determinants of the trajectories as well as their associations with cardiometabolic risk markers at age 6 years. Results Five BMI z-score trajectory patterns were identified, three within the healthy weight range, alongside early-acceleration and late-acceleration obesogenic trajectories. The early-acceleration pattern was characterized by elevated fetal abdominal circumference growth velocity, BMI acceleration immediately after birth and crossing of the obesity threshold by age 2 years. The late-acceleration pattern had normal fetal growth and BMI acceleration after infancy, and approached the obesity threshold by age 6 years. Abdominal fat, liver fat, insulin resistance and odds of pre-hypertension/hypertension were elevated in both groups. Indian ethnicity, high pre-pregnancy BMI, high polygenic risk scores for obesity and shorter breastfeeding duration were common risk factors for both groups. Malay ethnicity and low maternal educational attainment were uniquely associated with early BMI acceleration, whereas nulliparity and obesogenic eating behaviours in early childhood were uniquely associated with late BMI acceleration. Conclusion BMI acceleration starting immediately after birth or after infancy were both linked to early cardiometabolic alterations. The determinants of these trajectories may be useful for developing early risk stratification and intervention approaches to counteract metabolic adversities linked to childhood obesity. [ABSTRACT FROM AUTHOR]

Emerging reports raise concerns on the potential association between the COVID-19 vaccines and cardiac manifestations. We sought to evaluate cardiac complications associated with COVID-19 vaccination in a pooled analysis from our institution's cohort study and systematic review. Consecutive patients admitted to a tertiary hospital in Singapore between 1 January 2021 and 31 March 2021, with the onset of cardiac manifestations within 14 days following COVID-19 vaccination, were studied. Furthermore, a systematic review was performed, with PubMed, Embase, Research Square, MedRxiv and LitCovid databases accessed from inception up to 29 June 2021. Relevant manuscripts reporting individual patient data on cardiac complications following COVID-19 vaccination were included. Thirty patients were included in the study cohort, with 29 diagnosed with acute myocardial infarction (AMI) and 1 with myocarditis. Five patients developed heart failure, two had cardiogenic shock, three intubated, and one had cardiovascular-related mortality. In the systematic review, 16 studies were included with 41 myocarditis and 6 AMI cases. In the pooled analysis of the study cohort and the systematic review, 35 patients had AMI and 42 had myocarditis. Majority were men, and myocarditis patients were younger than AMI patients. Myocarditis patients tended to present 72 h postvaccination, while AMI patients were older and typically presented 24 h postvaccination. Majority with AMI or myocarditis developed symptoms after the first and second vaccination dose, respectively. This pooled analysis of patients presenting with cardiac manifestations following COVID-19 vaccination highlights the differences between myocarditis and AMI presentations in temporal association with the vaccination. [ABSTRACT FROM AUTHOR]

Objectives Although the association between widowhood and mortality is well established, the impact of widowhood on mortality could differ by social support, gender, and widowhood duration. We studied the association between widowhood and mortality among older Chinese adults in Singapore and analyzed how social support, gender, and widowhood duration may modify this association. Methods We used data from 15,858 participants aged 61–96 years from the third follow-up of the population-based Singapore Chinese Health Study in 2014–2016. Mortality data were obtained through linkage with the national death registry through 31st December 2018, and social support was measured with the Duke Social Support Scale. We used Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between widowhood and mortality risk. Results Compared with those married, widowed adults had a higher mortality risk (HR = 1.18, 95% CI = 1.01–1.38), and this risk was higher for those who were either recently widowed (<5 years; HR = 1.28, 95% CI = 1.00–1.63) or long-term widowed (>10 years; HR = 1.27, 95% CI = 1.07–1.54). Among men, those recently widowed had the highest mortality risk (HR = 1.50, 95% CI = 1.06–2.13), whereas, among women, those long-term widowed had the highest mortality risk (HR = 1.26, 95% CI = 0.99–1.60). In the analysis stratified by social support, widowhood was associated with mortality among those with low social support (HR = 1.27, 95% CI = 1.05–1.54), but not among those with high social support (HR = 1.01, 95% CI = 0.76–1.33). Discussion Widowhood was associated with increased mortality risk, particularly among recently widowed men and long-term widowed women. Having adequate social support could attenuate the adverse effects of widowhood among older adults. [ABSTRACT FROM AUTHOR]

Notwithstanding the frequency with which the word 'colonial' and its variants occur in social work writing, it is treated with a curious lack of inspection and reflection. I will critically assess how social work writing has dealt with the colonial in the light of recent work in the field, before drawing several inferences. I will put forward a series of arguments as to useful ways of considering the nature and significance of late colonialism for social welfare, primarily but not only in countries formerly part of the British Empire in Singapore and Southeast Asia. I will suggest the need for a scholarship for imperial social work. In an endeavour to suggest an agenda for work in this area, and for its consequences for further arguments regarding 'late colonialism', I will signal the relevance of mutual influences between colonies and the metropole; the inter-relation of war and welfare; the role of central and colonial government officials; the significance of work by imperial anthropologists; women in late colonial social welfare; and the meaning of nation-building as part of late and post-colonial welfare programmes. [ABSTRACT FROM AUTHOR]

How can we systematically conceptualize equidistant diplomacy? This article argues that while 'equidistant diplomacy' has its own tactical utility to signal and shape a state's image of political neutrality to the target states, it is not indicative of the state strategy. This is because state strategy is generally determined by material capabilities and is categorized as balancing, bandwagoning, and hedging. Rather, equidistant diplomacy is perception managementmerely an independent diplomatic tactic aimed at signaling a neutral image through three main tools: paralleling, downplaying, and broadcasting. This diplomatic tactic is most likely to be part of 'hedging' behavior. However, states can similarly employ equidistant diplomacy for balancing or bandwagoning if they desire to project a neutral image and their target states do not force them to alter this tactic with diplomatic or material sanctions. With this conceptual framework, Singapore's diplomatic behavior vis-a-vis the United States and China from the 1990s will be examined. [ABSTRACT FROM AUTHOR]

Sigurdson (1991) erected the monospecific genus Murphydoris to include the species Murphydoris singaporensis. This species differed from the rest of the genera in Goniodorididae by the lack of lamellae on the rhinophores and gill branches around the anus. Since its original description, Murphydoris singaporensis has only been found in Singapore and Thailand. Recently, the paratypes of Murphydoris singaporensis were studied and compared with remaining type species of Goniodorididae, showing that the apomorphies of the genus were unclear and some undescribed species reported as Goniodoridella could belong to Murphydoris. In this study, we examined four undescribed species from the Indo-Pacific region. The internal anatomy was studied by dissections, and electron microscope photographs are included to show details of their radulae, labial cuticles and penises. One specimen was also studied under micro-computed tomography. In addition, mitochondrial and nuclear partial sequences of the species were obtained. As a result, we describe in detail four new species of Murphydoris : M. adusta sp. nov. , M. cobbi sp. nov. , M. maracabranchia sp. nov. and M. puncticulata sp. nov. We additionally present the first phylogenetic tree that includes sequences of Murphydoris. [ABSTRACT FROM AUTHOR]

The past few years have witnessed that the success (or failure) of the Belt and Road Initiative (BRI) depends to a large extent upon engagement with and responses from recipient countries. The article explores the impact of Southeast Asian countries' domestic socio-political factors on their foreign policymaking and BRI projects in Southeast Asia. Based on comparative political sociology, the article develops a conceptual typology of foreign policymaking and an explanatory typology of socio-political risks, both of which are further applied to studying the socio-political risks that BRI projects entail in the four maritime Southeast Asian countries of Malaysia, Indonesia, the Philippines, and Singapore. The empirical study suggests that the Philippines' 'populist' type of foreign policymaking creates the highest level of risks—both political and societal—for BRI projects and that Singapore's 'procedural' type produces the lowest. Malaysia's 'arbitrary' type and Indonesia's 'democratic' type, meanwhile, generate medium-level political or societal risks. These findings have important policy implications for Chinese-funded overseas projects. [ABSTRACT FROM AUTHOR]

Background: We report long-term safety and immunogenicity of Takeda's tetravalent dengue vaccine candidate (TAK-003) in healthy children and adults living in dengue-endemic areas in Puerto Rico, Columbia, Singapore, and Thailand.Methods: In part 1 of this phase 2, randomized, placebo-controlled trial we sequentially enrolled 1.5-45 year olds (n = 148) into 4 age-descending groups, randomized 2:1 to receive 2 doses of TAK-003 or placebo 90 days apart. In part 2, 1-11 year olds (n = 212) were enrolled and randomized 3:1 to TAK-003 or placebo groups. We assessed neutralizing antibody titers for the 4 dengue serotypes (DENV) up to month 36 in part 1, and symptomatic dengue and serious adverse events (SAEs) up to month 36 in both parts.Results: At month 36, seropositivity rates were 97.3%, 98.7%, 88.0% and 56.0% for DENV-1, -2, -3 and -4, respectively. Seropositivity rates varied significantly for DENV-4 according to serostatus at baseline (89.5% in seropositives versus 21.6% in seronegatives). No vaccine-related SAEs were reported.Conclusions: The trial demonstrated persistence of neutralizing antibody titers against TAK-003 over 3 years in children and adults living in dengue-endemic countries, with limited contribution from natural infection. TAK-003 was well tolerated.Clinical Trials Registration: NCT01511250. [ABSTRACT FROM AUTHOR]

This article presents information on news and notices related to dermatology research. One of the is the 11th Regional Conference of Dermatology (Asian-Australasian), which will be held on May 21-24, 1994 in Singapore. The theme will be trends and recent developments in dermatology. The Conference will be organized by the Dermatological Society of Singapore. Another is the second workshop of the British Epidermo-Epidemiology Society, which was held on January 22, 1993 at St John's Institute of Dermatology, Great Britain.

This article aims to offer a detailed overview of the Singapore Convention on Mediation (formally known as the UN Convention on International Mediated Settlement Agreements Resulting from Mediation). The Convention establishes a unified, efficient system for the enforcement of international mediated settlement agreements—akin to the framework established for arbitral decisions by the 1958 New York Convention. This article offers a critical assessment of the Convention as well as some commentaries on how it will fit into the current alternative dispute resolution market. This contribution also assesses the Convention's key features, how it is likely to be applied, as well as its perceived strengths and weaknesses. [ABSTRACT FROM AUTHOR]

Objective The Cambridge Neuropsychological Test Automated Battery (CANTAB) is widely used in research and clinical settings. However, little is known about the use of the CANTAB in the local aging context. This study aimed to develop normative data for various CANTAB measures in community-living older adults in Singapore. Normative data were built using the regression-based approach. A secondary aim was to examine the concurrent validity of CANTAB measures with their traditional neurocognitive test counterparts. Method A total of 210 older adults (Mage = 67.27 years, SD = 5.45) from an existing cohort study completed standard neurocognitive tests and a CANTAB battery. A total of 160 were normal aging, 46 diagnosed with Mild Cognitive Impairment (MCI), and one diagnosed with Dementia. Older adults with MCI and Dementia were not included in the calculation of norms but were included in other analyses. For the CANTAB battery, regression-based norms were generated for each CANTAB measure, with age, sex, and education included as covariates. Concurrent validity was examined by correlating the CANTAB measures with their traditional neurocognitive counterparts. Results As expected, performance across most CANTAB measures declined significantly with increasing age and decreasing education levels. There were no significant effects of sex on most CANTAB measures. Our study also showed that some CANTAB measures demonstrated good concurrent validity as they significantly correlated with their traditional neurocognitive test counterparts. Conclusions We have developed age, sex, and education-specific CANTAB norms for use in the local aging context. The advantages and challenges of using the CANTAB in the local aging context are discussed. [ABSTRACT FROM AUTHOR]

The article focuses on the applicability of the 2019 Singapore Convention (UN Convention on International Settlement Agreements Resulting from Mediation) to art and cultural property disputes. The latter are characterized by highly diversified cultural, commercial, political and legal frameworks, which provide the grounds upon which these disputes have to be addressed. A preliminary analysis tackles the nature of the disputes under consideration, highlighting the potential combinations of disputing parties and the different dispute settlement mechanisms drawn by each international instrument. In the context of art-related disputes, mediation plays a critical role, which is witnessed by a number of case studies in the field. Thus, the settlement of international art and cultural heritage controversies may benefit from the entry into force of the Singapore Convention. The main features and challenges of the Convention are addressed by this contribution, with special regard to the effects that the treaty could have on international art and cultural property transactions and dispute resolution. [ABSTRACT FROM AUTHOR]

This article interrogates the question of how a secular state should manage religious disputes within the particular multi-religious context of Singapore, which practises 'secularism with a soul'. Such situations may be addressed by law-based approaches, such as invoking justiciable entitlements or imposing deterrent penal sanctions. Approaches associated with relational constitutionalism, which is concerned with preserving durable relationships and cultivating tolerance and solidarity to preserve the quasi-constitutional norm of 'racial and religious harmony', are better suited to addressing inter-religious tensions where the government is not directly involved, to facilitate rapprochement and civil peace. This expands the vocabulary of constitutional discourse beyond rights to encompass other aspects of human relating such as duty, tolerance, sensitivity, common sense and forgiveness as civic virtues, in serving the public good. In religiously and racially divided societies, a commitment to a just relational political association based on 'soft constitutional law' norms such as those contained in the Declaration on Religious Harmony, operate against the background of legislative sanctions in the Sedition Act and Maintenance of Religious Harmony Act. Nonetheless, a commitment towards maintaining racial and religious harmony, a form of 'constitutional patriotism', is best nurtured not through external regulation, but by dialogue and persuasion. [ABSTRACT FROM AUTHOR]

President of Singapore—elections—democracy—lack of competition—stringent criteria—preselection process—rule of law and unaccountable constitutional organs [ABSTRACT FROM PUBLISHER]

Almost a decade ago, the electronic commerce revolution began, led by such companies as Amazon.com and Ebay.com. These companies have grown into the internet business giants they are today, diversifying in the products they sell, the services they provide and the jurisdictions they conduct business in. However, aside from these rare examples, most medium and small internet-based business enterprises have grown with the dot.com bubble and dissolved when it burst mid-way through the decade. [ABSTRACT FROM AUTHOR]

This study examines the relationship between social media use, disease risk perception, social and political trust, and out-group stereotyping and prejudice during a social upheaval. Analyses of primary data collected during the COVID-19 outbreak in Singapore found that disease risk perception is positively related to stereotyping and prejudice against Chinese immigrants. Individuals who used social media for news were more likely to stereotype and express prejudice. However, those who engaged in frequent heterogenous discussions, and had more extensive social networks, were less likely to stereotype and express prejudice. Higher social and political trust was also associated with lower stereotyping and prejudice. Finally, moderation effects of network characteristics on the relationship between risk perception, social trust, and prejudice were observed. [ABSTRACT FROM AUTHOR]