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Yang Yie Sio,1 Tan Ching Ong,1 Yee-How Say,2 Kavita Reginald,3 Fook Tim Chew1 1Department of Biological Sciences, National University of Singapore, Singapore; 2Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman (UTAR) Kampar Campus, Kampar, Perak, Malaysia; 3Department of Biomedical Sciences, Sir Jeffrey Cheah Sunway Medical School, Faculty of Medical and Life Sciences, Sunway University, Petaling Jaya, Selangor, MalaysiaCorrespondence: Fook Tim Chew, Email dbscft@nus.edu.sgBackground: Sensitization to pet dander allergens has been increasing globally, however, its clinical relevance to allergic disease exacerbation remains underexplored.Objective: We aimed to determine the prevalence of serum-specific IgE (SSIgE) response to the major dog allergen Canis familiaris 1 (Can f 1), and to evaluate its association with asthma-related symptom severity and exacerbation in a Singapore/Malaysia population.Patients and Methods: A comprehensive serological profiling of specific IgE responses to 38 common inhalant and seafood allergen sources was performed in 736 young adults from the Singapore/Malaysia Cross-sequential Genetics and Epidemiology Study (SMCGES) sub-cohort. SSIgE levels were analyzed in relation to asthma diagnosis, symptom frequency, and exacerbation history.Results: Detectable Can f 1-specific IgE was present in 13.5% of participants, predominantly at low-grade Class 1– 2 levels (0.35– 3.49 IU/mL). Individuals with pre-existing sensitization to common inhalant and seafood allergen sources, including house dust mites (HDM), cat dander (Felis domesticus 1, Fel d 1), pollen, fungi, crustaceans, mollusks, and fish, showed a significantly higher rate of Can f 1-specific IgE response. Among asthmatic subjects, elevated Can f 1 SSIgE levels were significantly associated with recent (past 12 months) wheezing (p=0.005), daytime (p=0.019) and nighttime asthma attacks (p=0.033), and asthma exacerbations (p=0.001). These associations remained to be significant and consistent in trend among asthmatic patients sensitized to HDM allergen sources.Conclusion: Sensitization to Can f 1 is associated with increased asthma-related symptom burden and exacerbation risk, particularly in individuals with pre-existing atopy among young adults in Singapore and Malaysia. These findings highlight Can f 1-specific IgE as a potential molecular marker for identifying higher-risk asthma phenotypes in the tropical environment.Keywords: allergens, allergenicity, dogs, lipocalin, immunoglobulin E

Smart tourism technologies are increasingly embedded in nature- based destinations, yet their effects across the tourist journey remain underexplored. The study analyzes how smart technology used before, during, and after a visit influences tourist satisfaction in a mangrove ecotourism context. A survey of 408 visitors was conducted, and the data was examined through descriptive statistics and multiple regression. Findings reveal that on-site technology use has the strongest positive effect on satisfaction (β = 0.543, p < 0.001), while post-visit sharing on social media also contributes significantly (β = 0.139, p < 0.001). Pre-visit technology engagement shows no significant impact (β = 0.031, p = 0.538). The overall satisfaction level was high (M = 4.269, SD = 0.804). The results emphasize the importance of immersive on-site experiences supported by meaningful post-visit engagement. This research advances ecotourism and smart tourism studies by demonstrating the temporal role of technology in shaping satisfaction and provides managerial guidance for improving visitor experiences. Limitations and directions for future research are discussed

There have been several unconfirmed case reports of dermatitis caused by Collembola (springtails). We recently investigated two nurses with dermatitis suspected to be caused by Drepanura Schött (Collembola: Entomobryidae). IgE antibodies to Collembola proteins were not detected in sera from the nurses and skin tests with the Collembola extract and crushed whole Collembola were negative in both the nurses and volunteers. This study suggests that the springtail Drepanura may not cause human dermatitis and that other organisms and organic matter that are also found in the moist environment inhabited by Collembola might instead be responsible.

Mutations in the nucleotide binding domain of the PRR, NOD2, are associated with the autoinflammatory diseases Blau syndrome and early-onset sarcoidosis. Current theories suggest that constitutive activation of the NOD2 pathway may be responsible for pathogenesis of these diseases. Here, we report the phenotype of a kindred with Blau syndrome caused by a novel NOD2 mutation (p.E383D). Signaling protein and cytokine expression were examined, and the results of these experiments challenge current theories of constitutive NOD2 activation in the pathophysiology of Blau syndrome.

Enhanced hot-carrier-induced drain current degradation is observed in ultra-thin gate oxide pMOSFETs stressed under high gate voltage. Electron tunnelling from the gate plus an Auger-recombination-assisted hot hole energy gain process is responsible for this phenomenon. This enhancement in drain current degradation is more severe for devices with thinner gate oxide or devices stressed under lower drain voltage.

IntroductionInformed consent forms (ICFs) for randomised clinical trials (RCTs) can be onerous and lengthy. The process has the potential to overwhelm patients with information, leading them to miss elements of the study that are critical for an informed decision. Specifically, overly long and complicated ICFs have the potential to increase barriers to trial participation for patients with mild cognitive impairment, those who do not speak English as a first language or among those with lower medical literacy. In turn, this can influence trial recruitment, completion and external validity.Methods and analysisSIMPLY-SNAP is a pragmatic, multicentre, open-label, two-arm parallel-group superiority RCT, nested within a larger trial, the Staphylococcus aureus Network Adaptive Platform (SNAP) trial. We will randomise potentially eligible participants of the SNAP trial 1:1 to a full-length ICF or a SIMPlified LaYered (SIMPLY) consent process where basic information is summarised with embedded hyperlinks to supplemental information and videos. The primary outcome is recruitment into the SNAP trial. Secondary outcomes include patient understanding of the clinical trial, patient and research staff satisfaction with the consent process, and time taken for consent. As an exploratory outcome, we will also compare measures of diversity (eg, gender, ethnicity), according to the consent process randomised to. The planned sample size will be 346 participants.Ethics and disseminationThe study has been approved by the ethics review board (Sunnybrook Health Sciences Research Ethics Board) at sites in Ontario. We will disseminate study results via the SNAP trial group and other collaborating clinical trial networks.Trial registration numberClinicalTrials.gov Registry (NCT06168474; www.clinicaltrials.gov).

ObjectivesGram negative bloodstream infections (GN BSI) are a leading cause of mortality worldwide, and antibiotic treatment approaches remain understudied. BALANCE+ is a perpetual Bayesian adaptive platform trial to test multiple treatment questions for hospitalised patients with GN BSI. The vanguard phase objective was to test the feasibility of the main trial.DesignAdaptive platform trial with five initial domains of investigation, each with open label 1:1 randomisation.SettingTen hospitals across four Canadian provinces.ParticipantsIndividuals admitted to hospital with blood cultures yielding Gram negative bacteria.InterventionsThe five initial domains of investigation included: antibiotic de-escalation versus no de-escalation; oral transition to beta-lactam versus non-beta-lactam treatment; routine versus no routine follow-up blood cultures (FUBCs); central vascular catheter replacement versus retention; and, ceftriaxone versus carbapenem treatment for low risk AmpC organisms.Primary outcome measuresDomain-specific recruitment rates and protocol adherence.ResultsDuring the vanguard phase, 719 patients were screened, of whom 563 (78.3%) were eligible, with 179 (31.8%) enrolled into the platform. The platform recruitment rate was 1.37 patients/site-week. Recruitment varied by domain: routine versus no FUBC domain 1.23 patients/site-week; oral beta-lactam versus non-beta-lactam domain 0.48; de-escalation versus no de-escalation domain 0.28; low risk AmpC domain 0.02; catheter replacement versus retention domain 0.01. Domain specific protocol adherence rates were 145/158 (91.8%) for routine versus no routine FUBC, 53/60 (88.3%) for oral beta-lactam versus non-beta-lactam, 26/33 (78.8%) for de-escalation versus no de-escalation, 3/3 (100%) for low risk AmpC, and 0/1 (0%) for line replacement versus retention. There was complete ascertainment of all study outcomes in hospital 170/170 (100%) and near complete ascertainment at 90 days 162/170 (95.3%).ConclusionsThe vanguard phase demonstrated overall trial feasibility by recruitment rate and protocol adherence, with differences across interventions, leading to a transition to the main BALANCE+ platform trial with minimal protocol modifications.Trial registration numberNCT05893147.

A critical gap in the adoption of genomic medicine into medical practice is the need for the rigorous evaluation of the utility of genomic medicine interventions. The Implementing Genomics in Practice Pragmatic Trials Network (IGNITE PTN) was formed in 2018 to measure the clinical utility and cost-effectiveness of genomic medicine interventions, to assess approaches for real-world application of genomic medicine in diverse clinical settings, and to produce generalizable knowledge on clinical trials using genomic interventions. Five clinical sites and a coordinating center evaluated trial proposals and developed working groups to enable their implementation. Two pragmatic clinical trials (PCTs) have been initiated, one evaluating genetic risk APOL1 variants in African Americans in the management of their hypertension, and the other to evaluate the use of pharmacogenetic testing for medications to manage acute and chronic pain as well as depression. IGNITE PTN is a network that carries out PCTs in genomic medicine; it is focused on diversity and inclusion of underrepresented minority trial participants; it uses electronic health records and clinical decision support to deliver the interventions. IGNITE PTN will develop the evidence to support (or oppose) the adoption of genomic medicine interventions by patients, providers, and payers.

A femtosecond (fs) laser application for multi-layer optical recording is investigated. Information patterns at different layer depths were written inside a transparent glass substrate due to micro-void formation by fs laser ablation, which causes re-distribution in glass materials and a refractive index modification. The information bits recorded in a single layer can be retrieved clearly without interference from the neighboring layers. A fs laser irradiation of a transparent polymer matrix (doped with fluorescent materials for use as low-cost recording media) is also studied. A fs laser induced photo-chemical reaction changes the chemical properties of the fluorescent materials and records information bits inside the matrix. With an ultra-fast laser as a new light source, 3D optical recording can be available for high capacity data storage up to 1 TB per disc.