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result(s) for
"Lim, Rachel"
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Health effects associated with exposure to intimate partner violence against women and childhood sexual abuse: a Burden of Proof study
by
de Andrade, Fabiana Martins Dias
,
Lim, Rachel Q. H.
,
Sorenson, Reed J. D.
in
692/499
,
692/699/578
,
Abortion, Spontaneous
2023
The health impacts of intimate partner violence against women and childhood sexual abuse are not fully understood. Here we conducted a systematic review by comprehensively searching seven electronic databases for literature on intimate partner violence-associated and childhood sexual abuse-associated health effects. Following the burden of proof methodology, we evaluated the evidence strength linking intimate partner violence and/or childhood sexual abuse to health outcomes supported by at least three studies. Results indicated a moderate association of intimate partner violence with major depressive disorder and with maternal abortion and miscarriage (63% and 35% increased risk, respectively). HIV/AIDS, anxiety disorders and self-harm exhibited weak associations with intimate partner violence. Fifteen outcomes were evaluated for their relationship to childhood sexual abuse, which was shown to be moderately associated with alcohol use disorders and with self-harm (45% and 35% increased risk, respectively). Associations between childhood sexual abuse and 11 additional health outcomes, such as asthma and type 2 diabetes mellitus, were found to be weak. Although our understanding remains limited by data scarcity, these health impacts are larger in magnitude and more extensive than previously reported. Renewed efforts on violence prevention and evidence-based approaches that promote healing and ensure access to care are necessary.
A meta-analysis using the burden of proof risk function identified consistent evidence supporting harmful associations between the exposure to intimate partner violence against women and childhood sexual abuse on health outcomes.
Journal Article
Government trust, perceptions of COVID-19 and behaviour change: cohort surveys, Singapore
2021
To evaluate how public perceptions and trust in government communications affected the adoption of protective behaviour in Singapore during the coronavirus disease 2019 (COVID-19) pandemic.
We launched our community-based cohort to assess public perceptions of infectious disease outbreaks in mid-2019. After the first case of COVID-19 was reported in Singapore on 23 January, we launched a series of seven COVID-19 surveys to both existing and regularly enrolled new participants every 2 weeks. As well as sociodemographic properties of the participants, we recorded changing responses to judge awareness of the situation, trust in various information sources and perceived risk. We used multivariable logistic regression models to evaluate associations with perceptions of risk and self-reported adopted frequencies of protective behaviour.
Our cohort of 633 participants provided 2857 unique responses during the seven COVID-19 surveys. Most agreed or strongly agreed that information from official government sources (99.1%; 528/533) and Singapore-based news agencies (97.9%; 522/533) was trustworthy. Trust in government communication was significantly associated with higher perceived threat (odds ratio, OR: 2.2; 95% confidence interval, CI: 1.6-3.0), but inversely associated with perceived risk of infection (OR: 0.6; 95% CI: 0.4-0.8) or risk of death if infected (OR: 0.6; 95% CI: 0.4-0.9). Trust in government communication was also associated with a greater likelihood of adopting protective behaviour.
Our findings show that trust is a vital commodity when managing an evolving outbreak. Our repeated surveys provided real-time feedback, allowing an improved understanding of the interplay between perceptions, trust and behaviour.
Journal Article
The influence of alloying on slip intermittency and the implications for dwell fatigue in titanium
2022
Dwell fatigue, the reduction in fatigue life experienced by titanium alloys due to holds at stresses as low as 60% of yield, has been implicated in several uncontained jet engine failures. Dislocation slip has long been observed to be an intermittent, scale-bridging phenomenon, similar to that seen in earthquakes but at the nanoscale, leading to the speculation that large stress bursts might promote the initial opening of a crack. Here we observe such stress bursts at the scale of individual grains in situ, using high energy X-ray diffraction microscopy in Ti–7Al–O alloys. This shows that the detrimental effect of precipitation of ordered Ti
3
Al is to increase the magnitude of rare pri〈
a
〉 and bas〈
a
〉 slip bursts associated with slip localisation. By contrast, the addition of trace O interstitials is beneficial, reducing the magnitude of slip bursts and promoting a higher frequency of smaller events. This is further evidence that the formation of long paths for easy basal plane slip localisation should be avoided when engineering titanium alloys against dwell fatigue.
It is important to understand dwell fatigue that has been implicated in several uncontained jet engine failures. Here the authors observe stress bursts due to slip intermittency in a Ti alloy using synchrotron x-ray diffraction microscopy to understand the roles of precipitates and trace oxygen.
Journal Article
Patient choice improves self-efficacy and intention to complete tuberculosis preventive therapy in a routine HIV program setting in Uganda
by
Dowdy, David
,
Lim, Rachel K.
,
Sabiti, Laban
in
Acquired immune deficiency syndrome
,
AIDS
,
Beliefs, opinions and attitudes
2021
A 12-dose weekly regimen of rifapentine plus isoniazid (3HP) is recommended for the prevention of active tuberculosis (TB); however, it is unclear whether 3HP should be provided by directly observed therapy (DOT) or self-administered therapy (SAT). In addition, the introduction of patient informed choice between delivery modalities may have a positive impact on factors leading to treatment completion. The authors randomized 252 participants with HIV to a hypothetical scenario of providing preventive therapy by either DOT or an informed choice between DOT and SAT. Out of 104 participants who were randomized to a choice between DOT and SAT, 103 chose therapy by SAT. Participants rated their level of confidence and intention to complete therapy. Compared to those assigned to the DOT scenario, patients assigned to the choice scenario expressed greater confidence and intention to complete preventive therapy. Convenience and travel required to complete 3HP therapy were important factors in deciding between delivery modalities. Those assigned to DOT identified more barriers to completing therapy than those given a choice. Empowering patients to make informed decisions about how they receive TB preventive therapy may improve completion rates.
Journal Article
Coffee consumption and risk of renal cancer
by
Lim, Rachel K.
,
Rhee, Jongeun
,
Purdue, Mark P.
in
Biomedical and Life Sciences
,
Biomedicine
,
Body mass index
2022
Purpose
There is increasing evidence that coffee consumption is related to reduced risks for some cancers, but the evidence for renal cancer is inconclusive. Therefore, we conducted a meta-analysis to summarize the cohort evidence of this relationship.
Methods
A literature search was performed in PubMed and Embase through February 2021. Meta-analyses using a random effects model were conducted for reported relative risk estimates (RRs) relating coffee intake and renal cancer incidence or mortality. We also performed a two-stage random effects exposure–response meta-analysis. Between-study heterogeneity was assessed.
Results
In a meta-analysis of the ten identified cohort studies, we found a summary RR of 0.88 [95% confidence interval (CI) 0.78–0.99] relating the highest vs. the lowest category of coffee intake and renal cancer, with no significant between-study heterogeneity observed (
I
2
= 35%,
p
= 0.13). This inverse association remained among studies of incident cancers (RR 0.85, 95% CI 0.76–0.96) and studies adjusting for smoking and body mass index (RR 0.87, 95% CI 0.77–0.99).
Conclusions
Our findings from this meta-analysis of the published cohort evidence are suggestive of an inverse association between coffee consumption and renal cancer risk.
Journal Article
VEGF-dependent testicular vascularisation involves MEK1/2 signalling and the essential angiogenesis factors, SOX7 and SOX17
by
Western, Patrick S.
,
Lim, Rachel S.
,
Blücher, Rheannon O.
in
Abnormalities
,
Analysis
,
Angiogenesis
2024
Background
Abnormalities of
in utero
testis development are strongly associated with reproductive health conditions, including male infertility and testis cancer. In mouse testes, SOX9 and FGF9 support Sertoli cell development, while VEGF signalling is essential for the establishment of vasculature. The mitogen-activated protein kinase (MAPK) pathway is a major signalling cascade, essential for cell proliferation, differentiation and activation of
Sry
during primary sex-determination, but little is known about its function during fetal testis morphogenesis. We explored potential functions of MAPK signalling immediately after the establishment of testis cords in embryonic day (E)12.5
Oct4
-eGFP transgenic mouse testes cultured using a MEK1/2 inhibitor.
Results
RNA sequencing in isolated gonadal somatic cells identified 116 and 114 differentially expressed genes after 24 and 72 h of MEK1/2 inhibition, respectively. Ingenuity Pathway Analysis revealed an association of MEK1/2 signalling with biological functions such as angiogenesis, vasculogenesis and cell migration. This included a failure to upregulate the master transcriptional regulators of vascular development,
Sox7
and
Sox17,
VEGF receptor genes
,
the cell adhesion factor gene
Cd31
and a range of other endothelial cell markers such as
Cdh5
(encoding VE-cadherin) and gap junction genes
Gja4
and
Gja5
. In contrast, only a small number of Sertoli cell enriched genes were affected. Immunofluorescent analyses of control testes revealed that the MEK1/2 downstream target, ERK1/2 was phosphorylated in endothelial cells and Sertoli cells. Inhibition of MEK1/2 eliminated pERK1/2 in fetal testes, and CD31, VE-cadherin, SOX7 and SOX17 and endothelial cells were lost. Consistent with a role for VEGF in driving endothelial cell development in the testis, inhibition of VEGFR also abrogated pERK1/2 and SOX7 and SOX17 expressing endothelial cells. Moreover, while Sertoli cell proliferation and localisation to the testis cord basement membrane was disrupted by inhibition of MEK1/2, it was unaffected by VEGFR inhibition. Instead, inhibition of FGF signalling compromised Sertoli cell proliferation and localisation to the testis cord basement membrane.
Conclusions
Together, our data highlight an essential role for VEGF-dependent MEK1/2 signalling in promoting vasculature and indicate that FGF signalling through MEK1/2 regulates Sertoli cell organisation in the developing mouse testis.
Journal Article
Consumption of Red Versus White Wine and Cancer Risk: A Meta-Analysis of Observational Studies
by
Qureshi, Abrar A.
,
Lim, Rachel K.
,
Cho, Eunyoung
in
Alcohol
,
Alcohol Drinking - adverse effects
,
Alcoholic beverages
2025
Background/Objectives: While alcoholic beverage consumption increases cancer risk, red wine has been touted as a healthier option. To address this unexplored question, we conducted a meta-analysis to summarize evidence from observational studies. Methods: A literature search of PubMed and EMBASE through December 2023 identified studies examining wine and cancer risk. A random-effects meta-analysis was performed to estimate relative risks (RRs) and 95% confidence intervals (CIs) for an association between wine intake and overall cancer risk. Results: A total of 20 cohort and 22 case–control studies were included. Wine intake was not associated with overall cancer risk (n = 95,923) when comparing the highest vs. lowest levels of consumption, with no differences observed by wine type (red: summary RR = 0.98 [95% CI = 0.87, 1.10], white: 1.00 [0.91, 1.10]; Pdifference = 0.74). However, white wine intake was significantly associated with an increased risk of cancer among women (white: 1.26 [1.05, 1.52], red: 0.91 [95% CI: 0.72, 1.16], Pdifference = 0.03) and in analyses restricted to cohort studies (white: 1.12 [1.03, 1.22], red: 1.02 [95% CI: 0.96, 1.09], Pdifference = 0.02). For individual cancer sites, there was a significant difference in associations between red and white wine intake only in skin cancer risk [6 studies, white: 1.22 (1.14, 1.30), red: 1.02 (0.95, 1.09); Pdifference = 0.0003]. Conclusions: We found no differences in the association between red or white wine consumption and overall cancer risk, challenging the common belief that red wine is healthier than white wine. Our significant results related to white wine intake in subgroup analyses warrant further investigation.
Journal Article
Factors associated with phenotypes of dyspnea in post-COVID-19 condition: a cross-sectional study
2024
Post-COVID-19 condition (PCC) is defined as the persistence of symptoms, like fatigue and dyspnea, at least 3 months post-COVID infection. As dyspnea is a common symptom, we attempted to further clinically phenotype those with PCC-associated dyspnea. 1642 adults (average age of 49.6y with 63% female-predominance and BMI of 31.2 kg/m
2
) with physician confirmed diagnosis of PCC from June 2020–April 2023 in Alberta, Canada were included. Those with dyspnea were more likely to be female (56.5%,
p
= 0.005) and have higher BMI (31.3 kg/m
2
vs. 29.5 kg/m
2
;
p
= 0.0008), history of asthma (21.1% vs. 12.3%;
p
< 0.001), more persistent PCC symptoms (
p
= 0.0001), more functional limitations, as well as lower quality of life (
p
< 0.0001). Multivariable-adjusted logistic regression analysis demonstrated dyspnea was independently associated with fatigue (OR = 4.20; CI = 2.71,6.59) and inversely associated with hospitalization for COVID-19 (OR = 0.53; CI = 0.32,0.91), age (OR = 0.98 per one year of age; CI = 0.96,0.99) and 6-min-walk-distance per 10 m difference (OR = 0.98, CI = 0.96,1.0). Fatigue was a predictor of dyspnea, and was associated with milder infection, higher BMI, and reduced 6-min-walk-distance despite normal pulmonary function. Reduced TLC or DLCO was associated with more severe infection and reduced 6-min-walk-distance. Thus, we speculate there are at least two dyspnea-associated phenotypes: phenotype with pronounced fatigue (normal PFT) and phenotype with pronounced pulmonary abnormalities (abnormal PFT). Improved understanding of the dyspnea-associated phenotypes may allow for better targeted rehabilitation.
Journal Article