Displaying publications 1 - 20 of 52 in total

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  1. Yan W, Vadivelu V, Maspolim Y, Zhou Y
    Waste Manag, 2021 Feb 01;120:221-229.
    PMID: 33310598 DOI: 10.1016/j.wasman.2020.11.047
    Anaerobic digestion is a promising way for resource recovery from waste cooking oil (WCO) due to its high bio-methanation potential. In-situ mild alkaline (pH 8) enhanced two-stage continuous stirred tank reactors (ALK-2-CSTRs) were implemented to explore its efficiency in co-digesting WCO and sewage sludge with stepwise increase of WCO in the co-substrates. Results demonstrate that the ALK-2-CSTRs effectively promoted methane yield from the co-substrates via promoting hydrolysis, long chain fatty acids (LCFAs) degradation and protecting methanogens from exposure to high concentration of LCFAs directly. The maximum methane yield of the ALK-2-CSTRs is 39.2% higher than that of a single stage CSTR system at the optimal feed mixture of 45:55 (WCO:SS [VS]). The thermophilic operation applied to the stage-1 of the ALK-2-CSTRs failed to improve the methane yield when the methanogenic performance was stable; while upon WCO overloaded, the elevated temperature mitigated the deterioration of methanogenesis by stimulating the bioconversion of the toxic LCFAs, especially the unsaturated oleic acid. Microbial community analysis reveals the ALK-2-CSTRs stimulated the growth of lipolytic bacteria and hydrogenotrophic methanogens, which suggests the hydrogenotrophic methanogenic pathway was promoted. Cost evaluation demonstrates the economical superiority of the ALK-2-CSTR over the prevailing strategies developed for enhancing methane yield from the co-substrates.
  2. Zhou Y, Murugan DD, Khan H, Huang Y, Cheang WS
    Antioxidants (Basel), 2021 Jul 22;10(8).
    PMID: 34439415 DOI: 10.3390/antiox10081167
    In different pathological states that cause endoplasmic reticulum (ER) calcium depletion, altered glycosylation, nutrient deprivation, oxidative stress, DNA damage or energy perturbation/fluctuations, the protein folding process is disrupted and the ER becomes stressed. Studies in the past decade have demonstrated that ER stress is closely associated with pathogenesis of obesity, insulin resistance and type 2 diabetes. Excess nutrients and inflammatory cytokines associated with metabolic diseases can trigger or worsen ER stress. ER stress plays a critical role in the induction of endothelial dysfunction and atherosclerosis. Signaling pathways including AMP-activated protein kinase and peroxisome proliferator-activated receptor have been identified to regulate ER stress, whilst ER stress contributes to the imbalanced production between nitric oxide (NO) and reactive oxygen species (ROS) causing oxidative stress. Several drugs or herbs have been proved to protect against cardiovascular diseases (CVD) through inhibition of ER stress and oxidative stress. The present article reviews the involvement of ER stress and oxidative stress in cardiovascular dysfunction and the potential therapeutic implications.
  3. Zhou Y, Nevosadová L, Eliasson E, Lauschke VM
    Hum Genomics, 2023 Feb 28;17(1):15.
    PMID: 36855170 DOI: 10.1186/s40246-023-00461-z
    BACKGROUND: Genetic variability in the cytochrome P450 CYP2C9 constitutes an important predictor for efficacy and safety of various commonly prescribed drugs, including coumarin anticoagulants, phenytoin and multiple non-steroidal anti-inflammatory drugs (NSAIDs). A global map of CYP2C9 variability and its inferred functional consequences has been lacking.

    RESULTS: Frequencies of eight functionally relevant CYP2C9 alleles (*2, *3, *5, *6, *8, *11, *13 and *14) were analyzed. In total, 108 original articles were identified that included genotype data from a total of 81,662 unrelated individuals across 70 countries and 40 unique ethnic groups. The results revealed that CYP2C9*2 was most abundant in Europe and the Middle East, whereas CYP2C9*3 was the main reason for reduced CYP2C9 activity across South Asia. Our data show extensive variation within superpopulations with up to tenfold differences between geographically adjacent populations in Malaysia, Thailand and Vietnam. Translation of genetic CYP2C9 variability into functional consequences indicates that up to 40% of patients in Southern Europe and the Middle East might benefit from warfarin and phenytoin dose reductions, while 3% of patients in Southern Europe and Israel are recommended to reduce starting doses of NSAIDs.

    CONCLUSIONS: This study provides a comprehensive map of the genetic and functional variability of CYP2C9 with high ethnogeographic resolution. The presented data can serve as a useful resource for CYP2C9 allele and phenotype frequencies and might guide the optimization of genotyping strategies, particularly for indigenous and founder populations with distinct genetic profiles.

  4. Zhou Y, Che CC, Chong MC, Zhao H, Lu Y
    Support Care Cancer, 2023 May 30;31(6):361.
    PMID: 37249639 DOI: 10.1007/s00520-023-07826-z
    PURPOSE: Literature on marital self-disclosure interventions for cancer patients lacks consistency in methodology and content. Moreover, the impact of such interventions on physical and psychological health, marital relationships, and self-disclosure ability is controversial. This review aims to systematically analyze the studies of marital self-disclosure intervention, synthesize the structure and topics of marital self-disclosure, and summarize and evaluate its effects on improving physical and psychological outcomes and marital relationships in cancer patients and their spouses.

    METHOD: This systematic review used the preferred reporting items of Systematic Reviews and Meta-Analyses (PRISMA). We conducted a systematic review of randomized controlled and quasi-experimental studies published from the establishment of the database to October 2022. Marital self-disclosure interventions were conducted with both cancer patients and their spouses. Studies published in a language other than English or Chinese, and studies below a quality grade of C were excluded. Data were extracted through a standardized data collection form, and two reviewers independently extracted and evaluated the data. The quality of the included studies was assessed using the Cochrane Handbook of Systematic Reviews of Interventions, and a third reviewer adjudicated in case of disagreement. The data were synthesized by vote counting based on direction of effect according to the Synthesis Without Meta-analysis (SWiM) reporting guideline.

    RESULTS: Thirteen studies were included in the review. Based on quality evaluation, three studies were categorized as grade A (good), and ten studies were grade B (moderate). Seven studies reported moderate rates of participant refusal and attrition. The structure and topics of marital self-disclosure varied across different studies. The five studies had various prespecified disclosure topics, such as fear of cancer recurrence, benefit finding, and emotional distress. The overall results suggest that marital self-disclosure interventions can improve physical and psychological health, enhance marital relationships, and increase self-disclosure ability.

    CONCLUSION: The limited number of studies, small sample sizes, diverse intervention strategies, and methodological heterogeneity weakened the evidence base for the effectiveness of marital self-disclosure interventions. Therefore, further high-quality randomized controlled trials (RCTs) are recommended to confirm the effectiveness of such interventions. These studies should also evaluate the interventions' long-term impact, analyze optional topics and methods, identify key features, and explore the development of the best intervention program.

  5. Zhou Y, Sun Y, Pan D, Xia Q, Zhou C
    J Sci Food Agric, 2023 Aug 30;103(11):5412-5421.
    PMID: 37038882 DOI: 10.1002/jsfa.12616
    BACKGROUND: Goose meat is rough and embedded with dense connective tissue, impairing protein solubility. Therefore, to improve the functional properties of goose myofibrillar protein (GMP), ultrasound was used to assist the phosphorylation of GMP.

    RESULTS: The fact that GMP attached covalently with the phosphate group of sodium tripolyphosphate (GMP-STP) was disclosed directly by Fourier transform infrared spectroscopy. Furthermore, ultrasound significantly improved the hydrophobicity and solubility of GMP-STP, which could be attributed to the conversion of α-helix to β-sheet, β-turns, and random coils by sonication. The spatial stabilization of the protein phosphorylation process was boosted by ultrasound, making the droplets more dispersed, and thus an improvement in the functional properties of GMP-STP was observed. Water-holding capacity, oil-binding capacity, and emulsifying and foaming properties were best at an ultrasound power of 400 W.

    CONCLUSION: Ultrasound-assisted phosphorylation has great potential to modulate the structure-function relationship of proteins. © 2023 Society of Chemical Industry.

  6. Zhu J, Zhou Y, Wei Y, Luo Q, Huang H
    Heliyon, 2024 Mar 15;10(5):e26427.
    PMID: 38434358 DOI: 10.1016/j.heliyon.2024.e26427
    For the classical multi-objective optimal power flow (MOOPF) problem, only traditional thermal power generators are used in power systems. However, there is an increasing interest in renewable energy sources and the MOOPF problem using wind and solar energy has been raised to replace part of the thermal generators in the system with wind turbines and solar photovoltaics (PV) generators. The optimization objectives of MOOPF with renewable energy sources vary with the study case. They are mainly a combination of 2-4 objectives from fuel cost, emissions, power loss and voltage deviation (VD). In addition, reasonable prediction of renewable power is a major difficulty due to the discontinuous, disordered and unstable nature of renewable energy. In this paper, the Weibull probability distribution function (PDF) and lognormal PDF are applied to evaluate the available wind and available solar power, respectively. In this paper, an enhanced multi-objective mayfly algorithm (NSMA-SF) based on non-dominated sorting and the superiority of feasible solutions is implemented to tackle the MOOPF problem with wind and solar energy. The algorithm NSMA-SF is applied to the modified IEEE-30 and standard IEEE-57 bus test systems. The simulation results are analyzed and compared with the recently reported MOOPF results.
  7. Zhou Y, Cheng J, Wu C, Teo KL
    PMID: 36855682 DOI: 10.1007/s40747-023-00976-x
    The problem of blood transshipment and allocation in the context of the COVID-19 epidemic has many new characteristics, such as two-stage, trans-regional, and multi-modal transportation. Considering these new characteristics, we propose a novel multi-objective optimization model for the two-stage emergent blood transshipment-allocation. The objectives considered are to optimize the quality of transshipped blood, the satisfaction of blood demand, and the overall cost including shortage penalty. An improved integer encoded hybrid multi-objective whale optimization algorithm (MOWOA) with greedy rules is then designed to solve the model. Numerical experiments demonstrate that our two-stage model is superior to one-stage optimization methods on all objectives. The degree of improvement ranges from 0.69 to 66.26%.
  8. Chen H, Zeng X, Zhou Y, Yang X, Lam SS, Wang D
    J Hazard Mater, 2020 07 15;394:122570.
    PMID: 32244145 DOI: 10.1016/j.jhazmat.2020.122570
    The removal of antibiotics and resistance genes in wastewater treatment plants has attracted widespread attention, but the potential role of residual antibiotics in the disposal of waste activated sludge (WAS) has not been clearly understood. In this study, the effect of roxithromycin (ROX) on volatile fatty acid (VFA) recovery from WAS anaerobic fermentation was investigated. The experimental results showed that ROX made a positive contribution to the production of VFAs. With the increase of ROX dosages from 0 to 100 mg/kg TSS, the maximum accumulation of VFAs increased from 295 to 610 mg COD/L. Mechanism studies revealed that ROX promoted the solubilization of WAS by facilitating the disruption of extracellular polymeric substances. In addition, ROX enhanced the activity of acetate kinase and inhibited the activities of α-glucosidase and coenzyme F420, and showed a stronger inhibitory effect on methane production than the hydrolysis process, thus resulting in an increase in VFA accumulation. These findings provide a new insight for the role of antibiotics in anaerobic fermentation of WAS.
  9. Yao J, Li S, Zhang L, Yang Y, Gopinath SCB, Lakshmipriya T, et al.
    Int J Biol Macromol, 2020 May 15;151:1133-1138.
    PMID: 31743722 DOI: 10.1016/j.ijbiomac.2019.10.156
    Haemophilia is a blood clotting disorder known as 'Christmas disease' caused when the blood has defect with the clotting factor(s). Bleeding leads various issues, such as chronic pain, arthritis and a serious complication during the surgery. Identifying this disease is mandatory to take the necessary treatment and maintains the normal clotting. It has been proved that the level of factor IX (FIX) is lesser with haemophilia patient and the attempt here is focused to quantify FIX level by interdigitated electrode (IDE) sensor. Single-walled carbon nanotube (SWCNT) was utilized to modify IDE sensing surface. On this surface, dual probing was evaluated with aptamer and antibody to bring the possible advantages. The detection limit with antibody was found to be 1 pM, while aptamer shows 100 fM. Further, a fine-tuning was attempted with sandwich pattern of aptamer-FIX-antibody and antibody-FIX-aptamer and compared. Specific elevation of detection with 10 folds was noticed and displayed the detection at 100 f. in both sandwich patterns. In addition, FIX was detected in the diluted human serum by aptamer-FIX-antibody sandwich, it was found that FIX detected from the dilution factor 1:640. A novel demonstration is with higher discrimination against other clotting factors, XI and VII.
  10. Zhang T, Zhou Y, Su G, Shi D, Gopinath SCB, Lakshmipriya T, et al.
    J Anal Methods Chem, 2019;2019:5872347.
    PMID: 31662948 DOI: 10.1155/2019/5872347
    Hydrocephalus is widely known as "hydrocephaly" or "water in the brain," a building up of abnormal cerebrospinal fluid in the brain ventricles. Due to this abnormality, the size of the head becomes larger and increases the pressure in the skull. This pressure compresses the brain and causes damage to the brain. Identification by imaging techniques on the hydrocephalus is mandatory to treat the disease. Various methods and equipment have been used to image the hydrocephalus. Among them, computerized tomography (CT) scan and nuclear magnetic resonance (NMR) are the most considered methods and gives accurate result of imaging. Apart from imaging, cerebrospinal fluid-based biomarkers are also used to identify the condition of hydrocephalus. This review is discussed on "hydrocephalus" and its imaging captured by CT scan and NMR to support the biomarker analysis.
  11. Ling Q, Sadali NM, Soufi Z, Zhou Y, Huang B, Zeng Y, et al.
    Nat Plants, 2021 05;7(5):655-666.
    PMID: 34007040 DOI: 10.1038/s41477-021-00916-y
    The maturation of green fleshy fruit to become colourful and flavoursome is an important strategy for plant reproduction and dispersal. In tomato (Solanum lycopersicum) and many other species, fruit ripening is intimately linked to the biogenesis of chromoplasts, the plastids that are abundant in ripe fruit and specialized for the accumulation of carotenoid pigments. Chromoplasts develop from pre-existing chloroplasts in the fruit, but the mechanisms underlying this transition are poorly understood. Here, we reveal a role for the chloroplast-associated protein degradation (CHLORAD) proteolytic pathway in chromoplast differentiation. Knockdown of the plastid ubiquitin E3 ligase SP1, or its homologue SPL2, delays tomato fruit ripening, whereas overexpression of SP1 accelerates ripening, as judged by colour changes. We demonstrate that SP1 triggers broader effects on fruit ripening, including fruit softening, and gene expression and metabolism changes, by promoting the chloroplast-to-chromoplast transition. Moreover, we show that tomato SP1 and SPL2 regulate leaf senescence, revealing conserved functions of CHLORAD in plants. We conclude that SP1 homologues control plastid transitions during fruit ripening and leaf senescence by enabling reconfiguration of the plastid protein import machinery to effect proteome reorganization. The work highlights the critical role of chromoplasts in fruit ripening, and provides a theoretical basis for engineering crop improvements.
  12. Xiang Y, Jiang L, Zhou Y, Luo Z, Zhi D, Yang J, et al.
    J Hazard Mater, 2022 Jan 15;422:126843.
    PMID: 34419846 DOI: 10.1016/j.jhazmat.2021.126843
    Nowadays, a growing number of microplastics are released into the environment due to the extensive use and inappropriate management of plastic products. With the increasing body of evidence about the pollution and hazards of microplastics, microplastics have drawn major attention from governments and the scientific community. As a kind of emerging and persistent environmental pollutants, microplastics have recently been detected on a variety of substrates in the world. Therefore, this paper reviews the recent progress in identifying the sources of microplastics in soil, water, and atmosphere and describing the transport and fate of microplastics in the terrestrial, aquatic and atmospheric ecosystems for revealing the circulation of microplastics in the ecosystem. In addition, considering the persistence of microplastics, this study elucidates the interactions of microplastics with other pollutants in the environment (i.e., organic pollutants, heavy metals) with emphasis on toxicity and accumulation, providing a novel insight into the ecological risks of microplastics in the environment. The negative impacts of microplastics on organisms and environmental health are also reviewed to reveal the environmental hazards of microplastics. The knowledge gaps and key research priorities of microplastics are identified to better understand and mitigate the environmental risks of microplastics.
  13. Zhan X, Adnan A, Zhou Y, Khan A, Kasim K, McNevin D
    Sci Rep, 2018 03 16;8(1):4673.
    PMID: 29549272 DOI: 10.1038/s41598-018-22975-6
    The Xinjiang Uyghur Autonomous Region of China (XUARC) harbors 47 ethnic groups including the Manchu (MCH: 0.11%), Mongols (MGL: 0.81%), Kyrgyz (KGZ: 0.86%) and Uzbek (UZK: 0.066%). To establish DNA databases for these populations, allele frequency distributions for 15 autosomal short tandem repeat (STR) loci were determined using the AmpFlSTR Identifiler PCR amplification kit. There was no evidence of departures from Hardy-Weinberg equilibrium (HWE) in any of the four populations and minimal departure from linkage equilibrium (LE) for a very small number of pairwise combinations of loci. The probabilities of identity for the different populations ranged from 1 in 1.51 × 1017 (MCH) to 1 in 9.94 × 1018 (MGL), the combined powers of discrimination ranged from 0.99999999999999999824 (UZK) to 0.9999999999999999848 (MCH) and the combined probabilities of paternal exclusion ranged from 0.9999979323 (UZK) to 0.9999994839 (MCH). Genetic distances, a phylogenetic tree and principal component analysis (PCA) revealed that the MCH, KGZ and UZK are genetically closer to the Han population of Liaoning and the Mongol population of Mongolia while the MGL are closer to Han, Japanese, Korean, Malaysian, Hong Kong Han and Russians living in China.
  14. Luo W, Zhou Y, Liu Z, Kang W, He S, Zhu R, et al.
    Health Place, 2023 Mar 13;81:103000.
    PMID: 37011444 DOI: 10.1016/j.healthplace.2023.103000
    BACKGROUND: In response to COVID-19, Southeast Asian (SEA) countries had imposed stringent lockdowns and restrictions to mitigate the pandemic ever since 2019. Because of a gradually boosting vaccination rate along with a strong demand for economic recovery, many governments have shifted the intervention strategy from restrictions to "Living with COVID-19" where people gradually resumed their normal activities since the second half of the year 2021. Noticeably, timelines for enacting the loosened strategy varied across Southeast Asian countries, which resulted in different patterns of human mobility across space and time. This thus presents an opportunity to study the relationship between mobility and the number of infection cases across regions, which could provide support for ongoing interventions in terms of effectiveness.

    OBJECTIVE: This study aimed to investigate the association between human mobility and COVID-19 infections across space and time during the transition period of shifting strategies from restrictions to normal living in Southeast Asia. Our research results have significant implications for evidence-based policymaking at the present of the COVID-19 pandemic and other public health issues.

    METHODS: We aggregated weekly average human mobility data derived from the Facebook origin and destination Movement dataset. and weekly average new cases of COVID-19 at the district level from 01-Jun-2021 to 26-Dec-2021 (a total of 30 weeks). We mapped the spatiotemporal dynamics of human mobility and COVID-19 cases across countries in SEA. We further adopted the Geographically and Temporally Weighted Regression model to identify the spatiotemporal variations of the association between human mobility and COVID-19 infections over 30 weeks. Our model also controls for socioeconomic status, vaccination, and stringency of intervention to better identify the impact of human mobility on COVID-19 spread.

    RESULTS: The percentage of districts that presented a statistically significant association between human mobility and COVID-19 infections generally decreased from 96.15% in week 1 to 90.38% in week 30, indicating a gradual disconnection between human mobility and COVID-19 spread. Over the study period, the average coefficients in 7 SEA countries increased, decreased, and finally kept stable. The association between human mobility and COVID-19 spread also presents spatial heterogeneity where higher coefficients were mainly concentrated in districts of Indonesia from week 1 to week 10 (ranging from 0.336 to 0.826), while lower coefficients were mainly located in districts of Vietnam (ranging from 0.044 to 0.130). From week 10 to week 25, higher coefficients were mainly observed in Singapore, Malaysia, Brunei, north Indonesia, and several districts of the Philippines. Despite the association showing a general weakening trend over time, significant positive coefficients were observed in Singapore, Malaysia, western Indonesia, and the Philippines, with the relatively highest coefficients observed in the Philippines in week 30 (ranging from 0.101 to 0.139).

    CONCLUSIONS: The loosening interventions in response to COVID-19 in SEA countries during the second half of 2021 led to diverse changes in human mobility over time, which may result in the COVID-19 infection dynamics. This study investigated the association between mobility and infections at the regional level during the special transitional period. Our study has important implications for public policy interventions, especially at the later stage of a public health crisis.

  15. Zhou Y, Loi AM, Tan GW, Lo PS, Lim W
    Data Brief, 2022 Jun;42:108239.
    PMID: 35592771 DOI: 10.1016/j.dib.2022.108239
    The research aims to study the correlations between attitudes of users, social norms, perceived behavioural control, and purchase behaviours. The research population consists of social media users in Malaysia. The data was collected from 205 respondents via a self-administered online survey. The theory of planned behaviour acts as the underlying theory in the research. Next, descriptive and hypothesis-testing quantitative analysis were adopted to probe the relationships between the variables. Moreover, G*Power was used to identify the minimum sample size, and SPSS v.22 was employed to examine the datasets.
  16. Yao L, Zhou K, Zhou Y, Kueh YC, Liu H, Liu Z, et al.
    BMC Public Health, 2024 Jan 10;24(1):151.
    PMID: 38200518 DOI: 10.1186/s12889-023-17596-2
    BACKGROUND: Self-efficacy has been recognized as a critical component in people's participation and maintenance of physical activity. This study aims to validate the Chinese version of the Exercise Self-Efficacy Scale (ESE) among Chinese children and adolescents using confirmatory factor analysis (CFA).

    METHODS: A cross-sectional study was conducted on two primary and two secondary schools in central China. The ESE scale was translated into Chinese (ESE-C) using the standard forward-backward translation method. Data were analyzed using Mplus 8 for the CFA.

    RESULTS: The final model showed a satisfactory level of goodness-of-fit (CFI = 0.918; TLI = 0.905; SRMR = 0.043; RMSEA = 0.066), indicating a good construct validity of the ESE-C for children and adolescents in mainland China. Furthermore, the final ESE-C model achieved composite reliability values of 0.963 and average variance extraction values of 0.597, indicating sufficient convergent and discriminant validity. Besides, the Cronbach's alpha value was 0.964, demonstrating excellent internal consistency of the ESE-C scale.

    CONCLUSION: The ESE-C scale is a valid instrument for assessing exercise self-efficacy among children and adolescents in mainland China.

  17. Sun Y, Zheng Y, Song L, Sun P, Zhao M, Zhou Y, et al.
    R Soc Open Sci, 2022 Jan;9(1):211632.
    PMID: 35242354 DOI: 10.1098/rsos.211632
    The measurement of the droplets' elasticity is vitally important in microfluidic and ink-jet printing. It refers to the ability of the droplet to restore its original shape and strong robustness. This study investigated a novel method to measure elasticity. The plate coated with super-hydrophobic layers pressed on a droplet and the elastic force was recorded by an electronic balance. Meanwhile, a mathematical model was constructed to calculate the changes of the droplet area under the force. The measurement showed that external work mainly converts into surface energy and the damping ratio increases from 0.068 to 0.261 with the increase of mass fraction from 0 to 80 wt%. It also indicates that the novel method can accurately and efficiently measure the elasticity of droplets.
  18. Luo W, Liu Z, Ran Y, Li M, Zhou Y, Hou W, et al.
    medRxiv, 2024 Mar 26.
    PMID: 38585938 DOI: 10.1101/2024.03.25.24304825
    The enforcement of COVID-19 interventions by diverse governmental bodies, coupled with the indirect impact of COVID-19 on short-term environmental changes (e.g. plant shutdowns lead to lower greenhouse gas emissions), influences the dengue vector. This provides a unique opportunity to investigate the impact of COVID-19 on dengue transmission and generate insights to guide more targeted prevention measures. We aim to compare dengue transmission patterns and the exposure-response relationship of environmental variables and dengue incidence in the pre- and during-COVID-19 to identify variations and assess the impact of COVID-19 on dengue transmission. We initially visualized the overall trend of dengue transmission from 2012-2022, then conducted two quantitative analyses to compare dengue transmission pre-COVID-19 (2017-2019) and during-COVID-19 (2020-2022). These analyses included time series analysis to assess dengue seasonality, and a Distributed Lag Non-linear Model (DLNM) to quantify the exposure-response relationship between environmental variables and dengue incidence. We observed that all subregions in Thailand exhibited remarkable synchrony with a similar annual trend except 2021. Cyclic and seasonal patterns of dengue remained consistent pre- and during-COVID-19. Monthly dengue incidence in three countries varied significantly. Singapore witnessed a notable surge during-COVID-19, particularly from May to August, with cases multiplying several times compared to pre-COVID-19, while seasonality of Malaysia weakened. Exposure-response relationships of dengue and environmental variables show varying degrees of change, notably in Northern Thailand, where the peak relative risk for the maximum temperature-dengue relationship rose from about 3 to 17, and the max RR of overall cumulative association 0-3 months of relative humidity increased from around 5 to 55. Our study is the first to compare dengue transmission patterns and their relationship with environmental variables before and during COVID-19, showing that COVID-19 has affected dengue transmission at both the national and regional level, and has altered the exposure-response relationship between dengue and the environment.
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