Curating wellness during a pandemic in Singapore: COVID-19, museums, and digital imagination.

OBJECTIVES: The COVID-19 pandemic has caused unexpected disruption to the operation of many museums. However, the disruption also presents an opportunity for local museums to explore new modes of audience engagement that could also help to mitigate the negative health impact of COVID-19 through the imaginative use of technology. This article provides a snapshot of the various digital initiatives that were developed by museums in Singapore during the most challenging time of COVID-19 to exemplify the expanded role of museums as a public health resource. It will also offer a brief reflection on the challenges and benefits of curating wellbeing with digital technologies. STUDY DESIGN: A review of creative responses to COVID-19 by museums in Singapore. METHODS: Scoping search. RESULTS: Several local museums have stepped up efforts to support the wellbeing of people by exploring possibilities with digital virtual platforms. Their swift response to develop online contents following an abrupt closure due to the pandemic exemplifies the caring role of museums in offering people a much-needed respite from social isolation by connecting and interacting with others from a safe distance. Moving forward, it is also important for the museums to be mindful of the barriers that digital virtual platforms might present; since access to technology differs amongst population groups, as do digital competency, and literacy. Museums can benefit from further partnerships with sector experts and organisations to learn about the needs and challenges of different groups in future planning and design. This will help them to gather a holistic overview and help ensure inclusionary strategy and practice. CONCLUSIONS: COVID-19 has challenged museums to adapt their programme and keep the public engaged through virtual programmes on online spaces. Online initiatives have offered opportunities for people to remain socially active and meaningfully engaged despite the stringent measures imposed in response to the viral situation. Postpandemic, we can continue to anticipate a highly connected and inclusive society brought together by virtual technologies.

G-protein-coupled receptor kinase activity is increased in hypertension.

Impaired vascular beta-adrenergic responsiveness may play an important role in the development and/or maintenance of hypertension. This defect has been associated with an alteration in receptor/guanine nucleotide regulatory protein (G-protein) interactions. However, the locus of this defect remains unclear. G-Protein-coupled receptor kinases (GRKs) phosphorylate serine/threonine residues on G-protein-linked receptors in an agonist-dependent manner. GRK activation mediates reduced receptor responsiveness and impaired receptor/G-protein coupling. To determine whether the impairment in beta-adrenergic response in human hypertension might be associated with altered GRK activity, we studied lymphocytes from younger hypertensive subjects as compared with older and younger normotensive subjects. We assessed GRK activity by rhodopsin phosphorylation and GRK expression by immunoblot. GRK activity was significantly increased in lymphocytes from younger hypertensive subjects and paralleled an increase in GRK-2 (beta ARK-1) protein expression. In contrast, no alterations in cAMP-dependent kinase (A-kinase) activity or GRK-5/6 expression were noted. GRK activity was not increased in lymphocytes from older normotensive subjects who demonstrated a similar impairment in beta-adrenergic-mediated adenylyl cyclase activation. These studies indicate that GRK activity is selectively increased in lymphocytes from hypertensive subjects. The increase in GRK activity may underlie the reduction in beta-adrenergic responsiveness characteristic of the hypertensive state.

Localization of G-protein-coupled receptors in health and disease.

G-protein-coupled receptors (GPCRs) represent a superfamily of proteins, characterized by seven transmembrane alpha-helices, that signal through interactions with a family of heterotrimeric GTP-binding proteins, referred to as G proteins. The broad range of physiological functions associated with GPCRs indicates that a better understanding of these receptors and their regulation can provide a solid foundation for novel pharmacological interventions in a variety of disease states.

G protein alterations in hypertension and aging.

Defective vasodilator function could be important in the pathogenesis and/or maintenance of the hypertensive state and the predisposition of the elderly to hypertension. Impaired beta-adrenergic-mediated vasodilation and reduced lymphocyte beta-adrenergic activation of adenyl cyclase have been demonstrated both in aging and with hypertension. The cellular mechanisms responsible for these alterations remain unclear. To determine if these defects may be due to alterations in guanine nucleotide regulatory proteins (G proteins) that link receptor activation with effector function, we assessed (1) human lymphocyte adenyl cyclase activity, (2) stimulatory G proteins by cholera toxin-mediated [32P]ADP ribosylation and, in hypertensive subjects, with alpha s-specific and beta-subunit antisera, and (3) inhibitory G proteins by pertussis toxin-mediated [32P]ADP ribosylation and, in older subjects, with alpha i,1,2- and beta-subunit-specific antisera. Lymphocytes from older subjects and from hypertensive subjects demonstrated a comparable reduction in isoproterenol-stimulated adenyl cyclase. However, aluminum fluoride-stimulated activity was reduced only in lymphocytes from hypertensive subjects. Furthermore, aluminum fluoride-stimulated activity was inversely correlated with mean arterial pressure. In lymphocytes from younger hypertensive subjects, cholera toxin-mediated labeling was significantly increased. In contrast, inhibitory G protein labeling by immunodetection was unaltered. In lymphocytes from older subjects, cholera toxin-mediated labeling was not altered; however, pertussis toxin-mediated labelling was significantly increased. In contrast, inhibitory G protein labeling by immunodetection was unaltered. Overall, the study suggests alterations of G protein function of adenyl cyclase is impaired. However, these defects are associated with divergent alterations in stimulatory and inhibitory G proteins.

G-protein-coupled receptor kinase expression in hypertension.

In human hypertension we have recently identified an increase in lymphocyte G-protein receptor kinase-2 (GRK-2) protein expression, the key protein regulating the interaction between G-protein-coupled receptors and activation of adenylyl cyclase. However, it was not known whether this increase in GRK-2 protein expression was attributable to regulation at the level of translation. Furthermore, the relationship between extent of GRK-2 expression, receptor activation of adenylyl cyclase, and blood pressure was unclear. We therefore studied lymphocytes from 7 young subjects with borderline hypertension and 14 young normotensive subjects. Immunodetectable GRK-2 protein expression in lymphocytes from subjects with hypertension was increased (155%+/-7% of normotensive subjects; P < .05). In addition, GRK-2 protein expression was positively correlated with blood pressure (r = 0.53; P = .013) and inversely correlated with beta-adrenergic-mediated adenylyl cyclase activity (r = -0.54, P = .012). However, lymphocyte GRK-2 messenger ribonucleic acid (mRNA) content was not altered (110%+/-13% of that observed in normotensive control subjects). Increased GRK-2 protein expression may be an important factor in the impairment of beta-adrenergic-mediated vasodilation, characteristic of the hypertensive state.

Vanadate stimulation of adenylyl cyclase: an index of tyrosine kinase vascular effects.

BACKGROUND: Beyond their mitogenic effects, hormones such as insulin, which activate receptor tyrosine kinases, regulate vascular tone. Further, we have demonstrated that receptor tyrosine kinase activation enhances adenylyl cyclase activation, a prominent mechanism that mediates vasodilation. However, whether tyrosine kinase-mediated human vascular responses parallel tyrosine kinase-mediated cellular effects on adenylyl cyclase activity is unknown. METHODS AND RESULTS: To assess tyrosine kinase-mediated vascular responses, vascular sensitivity to insulin was assessed with the dorsal hand vein linear variable differential transformer technique. Insulin infusion resulted in a dose-dependent relaxation in all subjects. Cellular responses were assessed by means of the insulinomimetic vanadate-mediated sensitization of vascular adenylyl cyclase activity. Vanadate stimulated a tyrosine kinase-dependent enhancement of adenylyl cyclase function in human and rat aortic vascular smooth muscle cells, human lymphocytes, and human aortic endothelial cells. Further, maximal insulin-mediated vasodilation was significantly positively correlated with maximal vanadate-mediated enhancement of human lymphocyte adenylyl cyclase activity. CONCLUSION: Insulin-mediated vasodilation is positively correlated with vanadate-mediated enhancement of adenylyl cyclase activity. Vanadate-mediated enhancement of adenylyl cyclase activity in lymphocytes may represent an index of tyrosine kinase-mediated vascular effects.

Cardiac glycosides, calcium and the release of neurotransmitter from peripheral noradrenergic nerves.

The requirement for external Ca (Cao) of neurotransmitter release evoked by cardenolides has been investigated in canine saphenous vein. Basal efflux of 3H-compounds from saphenous veins pre-loaded with 3H-noradrenaline was the same in the absence as in the presence of Cao; Cao is not required for basal efflux of neurotransmitter. Efflux of 3H-compounds was increased by cardenolides. Both ACS and ouabain caused a similar maximum net efflux of 3H suggesting that each evokes release from the same pool of 3H compounds. The similarity of the effects obtained with cardenolides to those obtained during exposure of saphenous vein preparations to potassium-free media suggests that 3H-efflux is the result of Na,K-ATPase inhibition. With ACS (ca. EC50) the net efflux of 3H-compounds early (less than 60 min) in the release period was greater in the absence of Cao than in its presence whereas at longer times the reverse was true; net efflux was less in the absence of Cao than in its presence. The difference in the 3H-efflux pattern was paralleled qualitatively throughout by efflux of 3H-noradrenaline. The ACS-evoked efflux of 3H-compounds in the presence and absence of Cao derives from sympathetic, noradrenergic nerves; 3H present in extraneuronal tissues was not released by the cardenolide. With ouabain (less than EC50) the total efflux of 3H over a 75 min period was greater in the absence of Cao than in its presence. The reverse was found with ouabain (greater than EC50): the total efflux of 3H was less in the absence of Cao than in its presence.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of hyperbaric oxygen and hyperbaric air on the survival of island skin flaps.

The effects of hyperbaric air and oxygen on skin survival were studied in acute 8 X 8 cm neurovascular island flaps in rats. Skin flaps treated with hyperbaric 8% oxygen (equivalent to room air at standard pressure) exhibited no improvement in skin survival. Skin flaps treated with hyperbaric air (21% oxygen) and hyperbaric 100% oxygen exhibited significant increases in survival.

Vascularized muscle allografts and the role of cyclosporine.

This study examined the fate of vascularized muscle allografts using a genetically defined rat model. Its purposes were (1) to analyze the histologic/immunologic responses, (2) to study the effect of cyclosporine on graft survival, and (3) to examine the possibility of inducing tolerance. In rats differing at a major histocompatibility locus, vascularized gastrocnemius muscle transplants were performed based on the sural branches of the femoral artery and vein. Forty-two animals studied were divided into three groups: Group 1, allografts, was treated without cyclosporine; Group 2, allografts, was administered continuous cyclosporine; and Group 3, allografts, was administered cyclosporine for 6 weeks only. Evaluation consisted of gross examination, H&E histology, and immunologic studies (MLC, CML, and complement-dependent 51Cr lysis assay). Lytic units (LU) were derived from the assays and served as the indicator of immune response. Group 1 animals had uniform rejection with intense cell-mediated response (LU 23 to 47) and low humoral response. Group 2 animals had viable allografts throughout with suppressed lytic unit values of 0 to 9 initially, which rose to 14 to 29 at 6 weeks despite continuous cyclosporine treatment. Group 3 animals showed rejection similar to the untreated animals. Autografts were performed as controls and survived indefinitely. Analysis of variance was significant at p less than 0.05. Using a reliable rat model for vascularized muscle allografts, we found that in transplantation across a major histocompatibility barrier, the initial immune response was primarily cell-mediated. Cyclosporine suppressed rejection only when given continuously, and short-term cyclosporine treatment did not induce a tolerant state. These data should be useful for future studies of vascularized muscle allografts.

Relative antigenicity of components of a vascularized limb allograft.

At present, the transplantation of vascularized limb-tissue allografts can be achieved only with generalized host immunosuppression, which results in significant systemic toxicity, thereby precluding their clinical use. A better understanding of the immunogenic mechanisms of these allografts may permit less toxic and thus clinically applicable means of host immunosuppression. In this study, individual vascularized limb tissues (skin, subcutaneous tissue, muscle, bone, and blood vessels) and a whole limb were transplanted microsurgically across a strong histocompatibility barrier in rats. The respective cell-mediated and humoral immune responses generated in the hosts were determined by means of mixed lymphocyte cultures by radioactive 51Cr release assays and compared. No single tissue predominated in the elicited immune response. Rather, the various tissue components interacted with the host immune system in a complex but predictable pattern with differing timing and intensity. Surprisingly, the whole-limb allograft elicited less immune response than did allografts of its individual components. The data presented here also serve as a foundation for further elucidation of the immunogenic mechanisms of vascularized limb-tissue allografts.

Cleaning dental instruments: measuring the effectiveness of an instrument washer/disinfector.

PURPOSE: To analyze the cleaning effectiveness of one type of instrument washer available for use in a dental office. MATERIALS AND METHODS: Dental instruments were heavily contaminated with blood and specific test bacteria. They were placed in cleaning baskets or within instrument cassettes, processed through the instrument washer, and analyzed for remaining blood and viable bacteria. RESULTS: Information obtained indicated that the washer is an effective cleaning system for dental instruments.

Arthroscopically-assisted reduction of intra-articular fractures and soft tissue management of distal radius.

Arthroscopy was used to help to reduce intra-articular fractures of the distal radius and treat soft tissue injuries in 33 acute cases. The fractures were treated by reduction under arthroscopic control and percutaneous fixation either with or without external fixation. The triangular fibrocartilage complex (TFCC) was torn in 18 of 33 patients (54%). All tears were peripheral and were repaired with arthroscopic procedures. Scapholunate (SL) ligament injuries prevailed in six (18%) patients; most of them exhibited instability in the SL joint. They received SL ligament debrided and transfixed with K-wires. Four (12%) of the patients suffered lunotriquetral (LT) ligament injuries; three of them also received transfixation with K-wires. Six (18%) of the patients exhibited chondral fractures. All fractures healed without measurable incongruity of joint surface and at follow-up (24 to 36 months), 11 patients displayed excellent results and 22 patients displayed good results according to the Mayo modified wrist score.

[Assessment of present nutrition status with weight for height method in children of Guangxi].

According to the method of weight for height recommended by WHO in 1979. The present nutritional status of 9459 7-10 year old children in 5 prefectures and 3 cities of Guangxi was assessed. The results showed that the deficient nutrition rate was 19.94% and rate of obese children was 1.85%. The latter was lower than that reported by other provinces and foreign countries. The deficient nutrition rate (26.43%) of city children was higher than that of rural children (15.90%), but no statistically significant difference was found between male and female (P greater than 0.05).

Development and in-vitro characterization of fish oil oleogels containing benzoyl peroxide and salicylic acid as keratolytic agents.

Topical keratolytic agents such as benzoyl peroxide (BP) and salicylic acid (SA) are one of the common treatments for inflammatory skin diseases. However, the amount of drug delivery through the skin is limited due to the stratum corneum. The purposes of this study were to investigate the ability of fish oil to act as penetration enhancer for topical keratolytic agents and to determine the suitable gelator for formulating stable fish oil oleogels. 2 types of gelling agents, beeswax and sorbitan monostearate (Span 60), were used to formulate oleogels. To investigate the efficacy of fish oil oleogel permeation, commercial hydrogels of benzoyl peroxide (BP) and salicylic acid (SA) were used as control, and comparative analysis was performed using Franz diffusion cell. Stability of oleogels was determined by physical assessments at 20°C and 40°C storage. Benzoyl peroxide (BP) fish oil oleogels containing beeswax were considered as better formulations in terms of drug permeation and cumulative drug release. All the results were found to be statistically significant (p<0.05, ANOVA) and it was concluded that the beeswax-fish oil combination in oleogel can prove to be beneficial in terms of permeation across the skin and stability.

Health promotion board-ministry of health clinical practice guidelines: treating tobacco use and dependence.

The Health Promotion Board (HPB) has updated the clinical practice guidelines on Treating Tobacco Use and Dependence to provide health professionals in Singapore with evidence-based interventions for smoking cessation. This article reproduces the introduction and executive summary of key guideline recommendations (with recommendations from the guidelines) from the HPB-MOH Clinical Practice Guidelines on Treating Tobacco Use and Dependence, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Health Promotion Board website: http://www.hpb.gov.sg/cpg-smoking-cessation. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

Medical response to the 2009 Sumatra earthquake: health needs in the post-disaster period.

INTRODUCTION: This paper provides an overview of cases seen by the Singapore Armed Forces (SAF) medical and surgical teams in the 2009 Sumatra earthquake and discusses the role of militaries in the acute phase of a disaster. METHODS: Two SAF primary healthcare clinics prospectively collected patient medical information for comparison. Descriptive analysis of the Emergency Department (ED) and surgical case records was performed. RESULTS: 1,015 patients were seen by the two primary healthcare clinics. In both Koto Bangko and Pariaman, respiratory-related conditions were the most common diagnoses (47.2% and 30.6%, respectively), followed by musculoskeletal/joint conditions (31.6% and 20.6%, respectively). In the ED, 55% and 27% of the 113 patients had trauma-related and infective-related diagnoses, respectively. Lacerations and contusions were the most common forms of trauma. Lung infection was the most common infective diagnosis seen at the ED. The number of ED cases was high during the first week and gradually declined in the second week. 56% of the 102 surgical procedures were performed on dirty or infective wounds. Fractures requiring fixation comprised 38% of surgical procedures. CONCLUSION: Medical aid remains an important component of the overall humanitarian response. Militaries could play an important role in disaster response due to their ability to respond in a timely fashion and logistic capabilities. Pre-launch research on the affected area and knowledge on disaster-specific injury patterns would impact the expertise, equipment and supplies required. The increasing evidence base for disaster preparedness and medical response allows for better planning and reduces the impact of disasters on affected populations.