Genetic factors associated with intestinal metaplasia in a high risk Singapore-Chinese population: a cohort study

Background: Intestinal metaplasia (IM) is an important precursor lesion in the development of gastric cancer ( GC). The aim of this study was to investigate genetic factors previously linked to GC risk for their possible association with IM. A total of 18 polymorphisms in 14 candidate genes were evaluated in a Singapore-Chinese population at high risk of developing GC.

Mutational hotspot in Exon 20 of PIK3CA in breast cancer among Singapore Chinese

The recent identification of somatic mutations in the catalytic region of PIK3 (PIK3CA) in breast cancer and demonstration of their oncogenic function has implicated PIK3CA in mammary carcinogenesis. To investigate possible ethnic differences in patterns of PIK3CA mutations in Singaporean Chinese breast cancer and to characterize these in a panel of cell lines, we sequenced exons 9 and 20 in 80 primary tumors, 19 breast cancer cell lines and 7 normal human mammary epithelial cells (HMECs). Searching for novel hotspots of mutation, we sequenced additional exons ( 1, 2, 6, 7, 14 and 18) in 20 primary tumors and 6 breast cancer cell lines. We detected 33 point mutations in 31 of 80 (39%) breast cancers, and 11 mutations in 10 of 19 (53%) breast cancer cell lines. No mutations were detected in normal breast tissue adjacent to the tumor, or in the 6 normal HMECs. The exon 20 A3140G (H1047R) substitution was identified most frequently (22/31, 71%) and showed a significant association with patient age ( p = 0.043) and stage of the disease ( p = 0.025), but not with ER/PR status or histological grade of the tumor. The incidence of point mutations in PIK3CA, the A3140G substitution in particular, in Singapore breast cancers are among the most frequent reported to date for any gene in breast cancer. The results suggest that mutation of PIK3CA might contribute to development of early stage breast cancer and could provide a potent target for early diagnosis and therapy.

Role of AcrR and ramA in fluoroquinolone resistance in clinical Klebsiella pneumoniae isolates from Singapore

The MICs of ciprofloxacin for 33 clinical isolates of K. pneumoniae resistant to extended-spectrum cephalosporins from three hospitals in Singapore ranged from 0.25 to >128 microg/ml. Nineteen of the isolates were fluoroquinolone resistant according to the NCCLS guidelines. Strains for which the ciprofloxacin MIC was >or=0.5 microg/ml harbored a mutation in DNA gyrase A (Ser83-->Tyr, Leu, or IIe), and some had a secondary Asp87-->Asn mutation. Isolates for which the MIC was 16 microg/ml possessed an additional alteration in ParC (Ser80-->IIe, Trp, or Arg). Tolerance of the organic solvent cyclohexane was observed in 10 of the 19 fluoroquinolone-resistant strains; 3 of these were also pentane tolerant. Five of the 10 organic solvent-tolerant isolates overexpressed AcrA and also showed deletions within the acrR gene. Complementation of the mutated acrR gene with the wild-type gene decreased AcrA levels and produced a two- to fourfold reduction in the fluoroquinolone MICs. None of the organic solvent-tolerant clinical isolates overexpressed another efflux-related gene, acrE. While marA and soxS were not overexpressed, another marA homologue, ramA, was overexpressed in 3 of 10 organic solvent-tolerant isolates. These findings indicate that multiple target and nontarget gene changes contribute to fluoroquinolone resistance in K. pneumoniae. Besides AcrR mutations, ramA overexpression (but not marA or soxS overexpression) was related to increased AcrAB efflux pump expression in this collection of isolates.

Endoscopic tri-modal imaging improves detection of gastric intestinal metaplasia among a high-risk patient population in Singapore

BACKGROUND: Detection of pre-neoplastic gastric mucosal changes and early gastric cancer (EGC) by white-light endoscopy (WLE) is often difficult. In this study we investigated whether combined autofluorescence imaging (AFI) and narrow band imaging (NBI) can improve detection of pre-neoplastic lesions and early gastric cancer in high-risk patients.

PATIENTS AND METHODS: Chinese patients who were 50-years-old or above with dyspepsia were examined by both high-resolution WLE and combined AFI followed by NBI (AFI-NBI), consecutively in a prospective randomized cross-over setting, by two experienced endoscopists. The primary outcome was diagnostic ability of the two methods for patients with pre-neoplastic lesions such as intestinal metaplasia (IM) and mucosal atrophy.

RESULTS: Sixty-five patients were recruited. One patient with large advanced gastric cancer was found and excluded from the analysis. Among the remaining 64 patients, 38 (59%) had IM; of these, 26 (68%) were correctly identified by AFI-NBI (sensitivity 68%, specificity 23%) and only 13 (34%) by WLE (sensitivity 34%, specificity 65%). AFI-NBI detected more patients with IM than did WLE (p=0.011). Thirty-one patients (48%) had mucosal atrophy. Ten patients (32%) were identified by AFI-NBI (sensitivity 32%, specificity 79%) and four patients (13%) by WLE (sensitivity 13%, specificity 88%) (p=0.100). No dysplasia or EGC was found.

CONCLUSION: AFI-NBI identified significantly more patients with IM than did WLE. Our result warrants further studies to define the role of combined AFI-NBI endoscopy for detection of precancerous conditions.

Internationalization strategy of Relance Shoes to Singapore

Field lab: SME competitiveness

Manpower development and nation-building : Singapore's experience

Manpower is a basic resource. It is the indispensable means of converting other resources to mankind '.s use and benefit. As a process· of increasing the knowledge, skills, and dexterity of the people of a society, manpower development is the most fundamental means of enabling a nation to acquire the capacities to bring about its desired future state of affairs -- a more mighty and wealthier nation. Singapore's brief nation-building history justifies the emphasis accorded to the importance of good quality human resources and manpower development in economic and socio-political developments. As a tiny island-state with a poor natural resource base, Singapore's long-term survival and development depend ultimately upon the quality and the creative energy of her people. In line with the nation-building goals and strategies of the Republic, as conditioned by her objective setting, Singapore's basic manpower development premise has been one of "quality and not quantity". While implementing the "stop-at-two" family planning and population control programs and the relevant immigration measures to guard against the prospect of a "population explosion", the Government has energetically fostered various educational programs, including vocational training schemes, adult education programs, the youth movement, and the national service scheme to improve the quality of Singaporeans. There is no denying that some of the manpower development measures taken by the Government have imposed sacrifice and hardship on the Singapore citizens. Nevertheless, they are the basic conditions for the island-Republic's long-term survival and development. It is essential iii to note that Singapore's continuing existence and phenomenal-success are largely attributable to the will, capacities and efforts of her leaders and people. In the final analysis, the wealth and the strength of a nation are based upon its ability to conserve, develop and utilize effectively the innate capacities of its people. This is true not only of Singapore but necessarily of other developing nations. It can be safely presumed that since most developing states' concerns about the quality of their human resources and the progress of their nation-building work are inextricably bound to those about the quantity of their population, the "quality and not quantity" motto of Singapore's manpower development programs can also be their guiding principle.

New wine into old skins: the enactment of literacy policy in Singapore

To better comprehend how educational reforms and classroom practice interconnect, we need to understand the epistemic environments created for learning, as well as the pedagogical activities and the modes of classroom discourse related to these activities. This article examines how a particular innovation in English literacy, Strategies for English Language Learning and Reading (STELLAR), has been implemented in Singapore. Outlining the broader curriculum initiatives, current literacy policy landscape and pedagogical effect of classroom discourse, we look at how English language teachers in grades 1 and 2 interpret the STELLAR curriculum. Situated within the larger international zeal of educational reform, Singapore presents a rich case for the study of policy–pedagogy initiatives, literacy instruction and cultural values. Adding to the existing policy enactment research, this investigation provides an opportunity to probe both the prospects and limitations of policy implementation associated with centralised educational structures, examination-oriented systems and societal cultural frameworks.

Planning for development or decline? Education policy for Chinese language in Singapore

This article examines how political discourse, language ideologies, recent Chinese curriculum reforms, and their representations in the media are inextricably related. Using the Speak Mandarin Campaign as background for the inquiry, I focus on textual features of the various media sources, TV advertisements, campaign slogans, official speeches, and newspaper excerpts to illuminate the status and changing role of the Chinese language in Singapore’s sociocultural, economic, and political development. Using critical discourse analysis as an analytical framework, I examine the contradictory ideologies that underpin the government’s language policies and planning activities. On the one hand, the government emphasizes the cultural and economic values of the Chinese language; on the other hand, government schools teach Chinese as a subject. In particular, the recent reforms in Chinese language curriculum have arguably further diluted the content of teaching. In addition I point out how conflicting ideologies behind language policies can lead to cultural confusion and educational uncertainty. These mixed messages make it difficult for schools to offer a consistent language education curriculum that will help students appreciate the value, be it economic, cultural or educational, of the Chinese language.

Competing priorities: Singapore teachers’ perspectives on critical literacy

This paper explores a group of Singaporean English language teachers’ knowledge and beliefs about critical literacy as well as their perspectives on how best to teach literacy and critical literacy in Singapore schools. A face-to-face survey was conducted among 58 English language teachers by using open-ended questions. The survey covered various topics related to literacy instruction including text decoding, meaning construction, and critical analysis of texts. The participating teachers believed strongly that reading and writing are transactional and interactional practices. However, they were less certain in their beliefs about teaching critical literacy including the critical, analytical and evaluative aspects of text reading. Some teachers saw a conflict between using time on teaching critical literacy and preparing students to pass their exams. As critical literacy is not a requirement at exams, they found it difficult to justify using time teaching it. The results suggest that the teachers’ belief systems are strongly influenced by the broad macrostructure of the educational system in Singapore and their own educational experiences.

Morphological awareness and reading development in bilingual English-Chinese children in Singapore

Addressing two aspects of morphological awareness – derivational and compound, this study investigates the relationships between morphological awareness and vocabulary and reading comprehension in English-Chinese bilingual primary 3 children in Singapore (N = 76). Comparable tasks in Chinese and English were administered to examine the children’s morphological awareness, vocabulary, and reading comprehension. The results show that morphological awareness is highly related to vocabulary and reading comprehension, with higher correlations between morphological awareness and reading comprehension than between morphological awareness and vocabulary. This indicates that morphological awareness may have direct influence on reading comprehension beyond the mediating effect of vocabulary. Furthermore, the results indicate that children displayed more compound than derivational morphological awareness for Chinese due to the dominance of compound morphology in Chinese. However the children also displayed similar levels of derivational and compound morphological awareness for English despite far more derivatives than compounds in English. The robust cross-linguistic correlations suggest that Chinese compound morphological knowledge plays a facilitating role not only in learning English compounds, but also in learning transparently derived words that do not involve phonological or orthographic shifts.