Comparing health-related quality of life and utility scores of patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis in Indonesia.

BACKGROUND: Although both hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) are covered by national healthcare insurance, 98% of kidney failure disease patients are treated with hemodialysis. This study compared the health-related quality of life (HRQoL) and utility scores of patients receiving hemodialysis and CAPD in Indonesia and determined factors associated with HRQoL and utility scores. METHODS: A cross-sectional study was performed using the Kidney Disease Quality of Life-36 and EQ-5D-5L instruments at six hospitals. Utility scores were presented as SF-6D and EQ-5D scores. Factors associated with the EQ-5D were evaluated using Tobit regressions due to ceiling effects, while the SF-6D and HRQoL were assessed using generalized linear models since the data were not normally distributed. RESULTS: Among the 613 patients, 76% were treated with hemodialysis. After adjusting for sociodemographic characteristics and clinical parameters, CAPD patients reported better HRQoL compared to hemodialysis patients in terms of the SF-6D (p = .038), mental component summary (p = .020), symptoms (p = .005), and effects of kidney disease (p<.001), but no significant differences were reported in EQ-5D (p = .083), physical component summary (p = .323), burden of kidney disease (p = .111), and kidney summary scores (p = .068). Poorer HRQoL and utility scores were likely experienced by older patients who were male, married, with diabetes, treated in Class A hospitals, and with lower education, hemoglobin, and albumin levels. CONCLUSION: In Indonesia, patients treated with CAPD had better HRQoL and utility scores compared to patients undergoing hemodialysis. Therefore, CAPD should be promoted by healthcare professionals as the first treatment option for patients who are eligible for both hemodialysis and CAPD.

Cachexia in tuberculosis in South-East Asian and African regions: knowledge gaps and untapped opportunities.

Tuberculosis (TB) and cachexia are clinical entities that have a defined relationship, making them often found together. TB can lead to cachexia, while cachexia is a risk factor for TB. This article reviews cachexia in Tuberculosis patients in Southeast Asian and African regions by conducting a comprehensive literature search across electronic databases such as PubMed, Google Scholar, and Research Gate between 2013 and 2024 using keywords including 'Africa', 'cachexia', 'prevalence', 'implications', 'tuberculosis', and 'Southeast Asia. This article utilized only studies that satisfied the inclusion criteria, revealing knowledge gaps and untapped opportunities for cachexia in TB across Southeast Asian and African regions. Many Southeast Asian and Western Pacific patients initially receive a tuberculosis diagnosis. Sub-Saharan African countries are among the 30 high TB burden nations, according to the WHO. Food inadequacy and heightened energy expenditure can impair the immune system, leading to latent TB and subsequently, active infection. Symptoms needing attention: shortness of breath, productive cough, hyponatremia at 131 mmol/l, hypoalbuminemia at 2.1 g/dl, elevated aspartate transaminase at 75 U/l, increased lactate dehydrogenase at 654, and normocytic anemia. Comorbidities, such as kidney disease, cardiovascular disease, and asthma, can influence the nutritional status of individuals with TB. While efforts like screening, contact tracing, and utilizing gene Xpert to detect TB cases were implemented, only a few proved effective. It is essential to conduct further studies, including RCTs, in Southeast Asia and Africa to evaluate and manage cachexia in TB patients.

Sex disparities in global burden of gallbladder and biliary tract cancer: analysis of Global Burden of Disease study from 2010 to 2019.

BACKGROUND AND AIM: The global burden of gallbladder and biliary tract cancer (GBTC) has been on the rise, making it a major public health concern. We aim to comprehensively analyze sex disparities in the temporal trends of GBTC incidence, mortality, and disability-adjusted life years (DALYs) regionally and globally from 2010 to 2019. METHODS: Age-standardized rates of GBTC incidence, death, and DALYs were analyzed utilizing the Global Burden of Disease study 2019. RESULTS: From 2010 to 2019, the estimated annual percent change (APC) of the age-standardized incidence rates (ASIRs) and age-standardized disability-adjusted life years (ASDALYs) due to GBTC globally decreased in both sexes (males, APC: -0.80%; APC: -1.00%) and (females, APC: -0.89%; APC: -0.96%). At the same time, age-standardized death rates (ASDRs) decreased only in males (APC: -0.82%) and remained stable in females. By regions, ASIRs and ASDR increased in both sexes only in Southeast Asia (SEA) but decreased in the other regions. All regions had decreased ASDALYs except for an increase in ASDALYs for females only in the SEA region (APC: 0.41%), and males have a stable trend. CONCLUSIONS: Our study reveals substantial geographic variance in the burden of GBTC, specifically in the SEA region. Therefore, localized interventional methodologies must be undertaken to effectively address this global burden from GBTC.

Profiling genetically driven alternative splicing across the Indonesian archipelago.

One of the regulatory mechanisms influencing the functional capacity of genes is alternative splicing (AS). Previous studies exploring the splicing landscape of human tissues have shown that AS has contributed to human biology, especially in disease progression and the immune response. Nonetheless, this phenomenon remains poorly characterized across human populations, and it is unclear how genetic and environmental variation contribute to AS. Here, we examine a set of 115 Indonesian samples from three traditional island populations spanning the genetic ancestry cline that characterizes Island Southeast Asia. We conduct a global AS analysis between islands to ascertain the degree of functionally significant AS events and their consequences. Using an event-based statistical model, we detected over 1,500 significant differential AS events across all comparisons. Additionally, we identify over 6,000 genetic variants associated with changes in splicing (splicing quantitative trait loci [sQTLs]), some of which are driven by Papuan-like genetic ancestry, and only show partial overlap with other publicly available sQTL datasets derived from other populations. Computational predictions of RNA binding activity reveal that a fraction of these sQTLs directly modulate the binding propensity of proteins involved in the splicing regulation of immune genes. Overall, these results contribute toward elucidating the role of genetic variation in shaping gene regulation in one of the most diverse regions in the world.

An evaluation of the efficiency and effectiveness of diagnostic tests for foot and mouth disease: are novel diagnostic tests for FMD more feasible than conventional tests in Southeast Asia?

Foot and mouth disease (FMD) remains endemic in many areas of continental Southeast Asia (SEA). It is responsible for substantial economic losses in the smallholder sector and threatens livelihoods. In recent years, novel diagnostic tests have been developed which reportedly detect FMD virus more effectively and efficiently. This critically appraised topic (CAT) aimed to evaluate the feasibility of these diagnostic tests for FMD in SEA compared to conventional tests. Relevant studies that evaluate diagnostic tests are identified and critically assessed, and recommendations are made on suitable potential diagnostic tests for use in the smallholder sector in SEA. A systematic search of electronic databases (CABI: CAB Abstracts, Web of Science Core Collections) was carried out to identify relevant studies that compared novel and conventional diagnostic tests. The search strategy initially identified 12 papers, of which six fulfilled all the inclusion criteria and were selected for this review. Most of the selected studies had limitations in design and comparability, making it difficult to validly compare the effectiveness and efficiency of the relevant diagnostic tests. These limitations include variation in sample characteristics, methodology, measurable outcomes and the different aspects of the diagnostic tests that each study focused on. Most studies concluded that novel diagnostic tests were more effective and efficient than conventional tests: had greater analytical sensitivity and specificity, were more robust, had a wider range of processable sample types and serotypes, could detect various diseases, had faster testing speeds and provided greater value for money. However, strong recommendations on which specific diagnostic test to rely on could not be made, since there was conflicting evidence and multiple confounding factors. Overall, the evidence found did not entirely apply to the target scenario, being SEA smallholder farms. Recommendations for the target scenario were also made based on the study findings.

A Review of Regulatory Frameworks for Biobanking in Southeast Asia.

Southeast Asian countries are at the forefront of public health pressures due to a confluence of factors such as population growth, urbanization, environmental pollution, and infectious diseases (re)emergence. Therefore, the ability to be able to conduct research addressing local and regional needs is of paramount importance. As such, biobanking activities, the standardized collection of biological samples, and associated data, developed over the past few decades supporting ongoing biomedical and clinical research, as well as surveillance are of critical importance. However, the regulatory landscape of biobanking is not widely understood and reported, which this narrative review aims to address for the ASEAN member states. It is evident that there are specific regulatory arrangements within each ASEAN member state, which though may be sufficient for the current level of operations, are unlikely to support a regional sharing of biological samples, data, and eventually benefits from the conducted research. Additionally, legacy and often-overlapping regulatory frameworks exist, which raise the need of an eventual consolidation under a single framework. Thus, this field requires further study as well as the creation of viable, practical proposals that would allow for biobanking harmonization and thus the exchange of biological samples and data to be achieved regionally, if not further afield.

Local anthropometric parameters for assessing double burden of malnutrition in South Asian and Southeast Asian countries: a review and retrospective analysis.

The double burden of malnutrition (DBM) is a significant public health issue in South and Southeast Asia (SA and SEA). This study aimed to assess the impact of using local and regional ethnicity-specific anthropometric references versus international references on the prevalence of DBM in these regions.A narrative review of DBM prevalence using local versus international standards was conducted. Additionally, deidentified datasets from India and Indonesia were analyzed to evaluate the effectiveness of different growth standards in identifying DBM. Anthropometric Z-scores were compared, and sensitivity, specificity, and positive predictive value (PPV) were calculated.WHO standards had the lowest specificity for identifying short stature in India and Indonesia. BMI-for-age charts using WHO Growth Reference (2007) had lower sensitivity and higher specificity for metabolic risk. Local references showed lower stunting and higher overweight or obesity prevalence. International standards overestimated stunting and underestimated obesity, leading to misclassification and missed cases of metabolic risk. Funding: None.

Governing AI in Southeast Asia: ASEAN's way forward.

Despite the rapid development of AI, ASEAN has not been able to devise a regional governance framework to address relevant existing and future challenges. This is concerning, considering the potential of AI to accelerate GDP among ASEAN member states in the coming years. This qualitative inquiry discusses AI governance in Southeast Asia in the past 5 years and what regulatory policies ASEAN can explore to better modulate its use among its member states. It considers the unique political landscape of the region, defined by the adoption of unique norms such as non-interference and priority over dialog, commonly termed the ASEAN Way. The following measures are concluded as potential regional governance frameworks: (1) Elevation of the topic's importance in ASEAN's intra and inter-regional forums to formulate collective regional agreements on AI, (2) adoption of AI governance measures in the field of education, specifically, reskilling and upskilling strategies to respond to future transformation of the working landscape, and (3) establishment of an ASEAN working group to bridge knowledge gaps among member states, caused by the disparity of AI-readiness in the region.

Gauging road safety advances using a hybrid EWM-PROMETHEE II-DBSCAN model with machine learning.

Introduction: Enhancing road safety conditions alleviates socioeconomic hazards from traffic accidents and promotes public health. Monitoring progress and recalibrating measures are indispensable in this effort. A systematic and scientific decision-making model that can achieve defensible decision outputs with substantial reliability and stability is essential, particularly for road safety system analyses. Methods: We developed a systematic methodology combining the entropy weight method (EWM), preference ranking organization method for enrichment evaluation (PROMETHEE), and density-based spatial clustering of applications with noise (DBSCAN)-referred to as EWM-PROMETHEE II-DBSCAN-to support road safety monitoring, recalibrating measures, and action planning. Notably, we enhanced DBSCAN with a machine learning algorithm (grid search) to determine the optimal parameters of neighborhood radius and minimum number of points, significantly impacting clustering quality. Results: In a real case study assessing road safety in Southeast Asia, the multi-level comparisons validate the robustness of the proposed model, demonstrating its effectiveness in road safety decision-making. The integration of a machine learning tool (grid search) with the traditional DBSCAN clustering technique forms a robust framework, improving data analysis in complex environments. This framework addresses DBSCAN's limitations in nearest neighbor search and parameter selection, yielding more reliable decision outcomes, especially in small sample scenarios. The empirical results provide detailed insights into road safety performance and potential areas for improvement within Southeast Asia. Conclusion: The proposed methodology offers governmental officials and managers a credible tool for monitoring overall road safety conditions. Furthermore, it enables policymakers and legislators to identify strengths and drawbacks and formulate defensible policies and strategies to optimize regional road safety.

Challenges of regulating commercial use of marine elapid snakes in the Indo-Pacific.

Marine elapid snakes are a diverse, predominantly Indo-West Pacific species group. The persistent removal of some species has an unquantified but potentially dire impact on populations. We conducted the first comprehensive review of the trade in marine elapid snakes based on published literature (1974-2022) and trade data from the only species (i.e., Hydrophis [Lapemis] curtus) whose trade is monitored internationally. Some species and populations were subjected to targeted harvest for their meat and skins for at least the last century; fisheries are possibly the most significant threat to populations of marine elapids, with the highest numbers being exploited either accidentally, incidentally, or opportunistically in Southeast Asian fisheries targeting other seafood, including demersal trawl and squid fisheries. Southeast Asia is the core region for exploitation of marine elapids. Annual offtake is >225,000 individuals of at least 8 species in the Gulf of Thailand. Of 72 recognized marine elapids (all non-CITES [Convention on International Trade in Endangered Species of Wild Fauna and Flora] species), Hydrophis curtus and Hydrophis cyanocinctus dominate the skin trade. Skins of H. curtus are traded mainly in East and Southeast Asia and, to some extent, Europe. Despite some baseline information on the trade of these species, the sustainability of their harvests, particularly in the context of the burgeoning and unmanaged nature of fisheries in the region, remains the major challenge. In an era of declining fish stocks, there has been an increasing trend to commercialize the harvest and use marine elapids that were once considered accidental bycatch and discarded. This trend will continue to pose a significant risk to these snakes unless appropriate fisheries and trade regulations are enforced. Applying the precautionary principle to prevent the overexploitation of sea snakes is an indispensable measure in which trade in regional populations should be regulated through CITES. Accordingly, management plans to identify core distribution regions of exploited species would be crucial for assigning national responsibilities to sustain species and populations in the long term.

Retos para la regulación del uso comercial de serpientes elápidas marinas en el Indo­Pacífico Resumen Las serpientes elápidas marinas son un grupo diverso de especies, predominante en el Indo­Pacífico Occidental. La eliminación persistente de algunas especies tiene un impacto no cuantificado pero potencialmente negativo sobre las poblaciones. Realizamos la primera revisión exhaustiva del comercio de serpientes elápidas marinas con base en la bibliografía publicada (1974­2022) y en los datos comerciales de la única especie (Hydrophis [Lapemis] curtus) cuyo mercado tiene monitoreo internacional. Algunas especies y poblaciones fueron objeto de capturas selectivas por su carne y pieles durante al menos el siglo pasado, las pesquerías son posiblemente la amenaza más importante para las poblaciones de elápidos marinos, ya que el mayor número se explota de forma accidental, incidental u oportunista en las pesquerías del sudeste asiático enfocadas en otros mariscos, incluidas las pesquerías demersales de arrastre y de calamar. El sudeste asiático es la principal región de explotación de elápidos marinos. La captura anual es >225,000 individuos de al menos ocho especies en el Golfo de Tailandia. De los 72 elápidos marinos reconocidos (ninguna especie está en CITES [Convención sobre el Comercio Internacional de Especies Amenazadas de Fauna y Flora Silvestres]), Hydrophis curtus e H. cyanocinctus dominan el mercado de pieles. La piel de H. curtus se comercializa principalemnte en el este y sudeste asiático y, hasta cierto punto, en Europa. Aunque se dispone de cierta información de referencia sobre el comercio de estas especies, la sostenibilidad de sus capturas, sobre todo en el contexto del auge y la falta de gestión de la pesca en la región, sigue siendo el principal reto. En una época de disminución de las poblaciones de peces, ha aumentado la tendencia a comercializar la captura y el uso de elápidos marinos que antes se consideraban capturas accidentales y se descartaban. Esta tendencia seguirá representando un riesgo importante para estas serpientes a menos que se apliquen las regulaciones pesqueras y comerciales adecuadas. La aplicación del principio de precaución para evitar la sobreexplotación de las serpientes marinas es una medida indispensable para regular el comercio de las poblaciones regionales a través de CITES. Por lo tanto, los planes de gestión para identificar las regiones núcleo de distribución de las especies explotadas serían cruciales para asignar responsabilidades nacionales para mantener las especies y las poblaciones a largo plazo.

Occupational heat stress and its health impacts- an overview of research status and need for further research in Southeast Asia with special emphasis on mitigation strategies in North East India.

The Intergovernmental Panel on Climate Change, IPCC predicts that hot seasons will get even hotter due to global climate change. There exists a critical dependence of human metabolic processes on temperature. Changes in thermal balance therefore, have an adverse effect on health because they raise body temperature, cause excessive sweating, and accelerate the rate of dehydration. Different nations and professional groups use different techniques to measure heat strain. This paper aims to review previous research conducted in the area of heat strain due to heat exposure among workers in Southeast Asia and also to profile mitigation strategies in North East India. Studies conducted between the years 2011 to 2023 in the evaluation of the health impacts of occupational heat stress were searched systematically using several sources of databases like PubMed, Google Scholar, Science Direct, Web of Science, Scopus, etc. It was noted that a greater proportion of previous research on evaluating physiological effects was carried out in controlled environments as opposed to real-world field settings. While such studies give us valuable insights into the relationship, applying the same methodology in the workplace may not be feasible. In India, very few research has been carried out on workplace heat stress, and even fewer have been done in North East India using physiological indicators. North East India is also affected by global climate change leading top more hotter days than before. The region of Northeast India, particularly Guwahati (Assam), has recently seen extreme heat waves during the sweltering summer months. With less literature available in this geographical location, studies with actual field-based settings are much needed to understand the occupational health impacts in this region. This review can formulate a suitable methodology for assessing the health impacts in working environment. This can also help the local health professionals to recognize the heat strain parameters that are acceptable worldwide, and use as pertinent indicators to scrutinize worker's health and develop preventive agendas as climate change advances.

Drug development in LMICs: could the emerging Indian model usher the southeast Asian region?

Low-income and middle-income countries (LMICs) of southeast Asia are passing through a similar phase as India in their tryst with the development of novel drugs. They are beginning to break away from their dependency on the institutions of our developed world. Over the past few years, Tata Memorial Centre-India's premier cancer centre-has shown the tenacity to develop drugs within the national frontiers. By collaborating with the domestic pharmaceutical industries, it has been able to have a steady pipeline of drugs under development, with two of them receiving marketing authorization recently. Lately, Indonesia and Vietnam have also shown an inclination towards public-private partnerships for similar motives. However, due to prolonged innovative stagnation, the entire drug development machinery faces challenges stretching all the way from arranging funds to persuading regulatory bodies. In this Viewpoint, we have tried to address a few of those issues and their potential solutions, with the intention to share our own experience which might be useful to other LMICs in connecting some adamant dots.

Twenty-five years of Nipah outbreaks in Southeast Asia: A persistent threat to global health.

Objectives: Nipah virus (NiV), a bat-borne zoonotic pathogen, poses persistent threats to global public health due to severe clinical manifestation and high case fatality rate (CFR). A critical examination of NiV outbreaks is essential for refining strategies and mitigating the impact of future infections. In this study, we provide a concise update on global NiV outbreaks that occurred during the past 25 years. Methods: In this geospatial study, we conducted an in-depth examination of the epidemiological characteristics of human NiV cases and deaths from 1998 to 2024 through multiple analyses of public data and official reports. Results: NiV emerged in 1998 in Malaysia during an outbreak among pig farmers. Since then, NiV outbreaks have been documented in five countries of South and Southeast Asia (Bangladesh, India, Malaysia, Philippines, and Singapore). As of May 2024, there have been 754 confirmed human NiV cases with 435 deaths (CFR: 58%) reported in these five countries. Bangladesh records the highest incidence (341 cases and 241 deaths; CFR: 71%) followed by Malaysia (283 cases and 109 deaths; CFR: 39%), India (102 cases and 74 deaths; CFR: 73%), the Philippines (17 cases and nine deaths; CFR: 53%), and Singapore (11 cases and one death; CFR: 9%). Conclusions: The clinical outcomes of NiV have been underscoring constant global public health threats as no effective therapies and vaccines are available. Strong global understandings, with an eye on developing vaccines and therapeutics, are required to minimize clinical outcomes and future threats of NiV.

Integrative taxonomy reveals two new giant pill-millipedes of the genus Zephronia Gray, 1832 from eastern Thailand (Diplopoda, Sphaerotheriida, Zephroniidae).

A large amount of material of the millipede genus Zephronia Gray, 1832 was collected during 2014-2023 from many parts of eastern Thailand. An integrative study of morphological characters and genetic data (COI gene) revealed two new species: Z.chantaburiensis Srisonchai & Wesener, sp. nov. and Z.macula Srisonchai & Wesener, sp. nov. The two new species clearly differ from other congeners by their unique characteristics, especially in their colour pattern and telopod shape. The interspecific genetic distances of the 658 bp COI gene barcoding fragment between these new species and all other species of giant pill-millipede from Thailand, Laos and Cambodia are 12.01-23.49% for Z.chantaburiensis sp. nov. and 17.93-25.13% for Z.macula sp. nov. While relationships among species remain preliminary, the phylogenetic tree shows that species of Zephronia are interspersed with species of Sphaerobelum Verhoeff, 1924 and Prionobelum Verhoeff, 1924. Phylogenetic analyses place both new species in a clade termed Zephronia s.s., which receives support also from morphological data, showing a unique position of the organ of Tömösváry. Z.macula sp. nov. appears to occur over a broad distribution whereas Z.chantaburiensis sp. nov. was found only at the type locality. Given that all known records are in the eastern part of Thailand, we thus regard both species as endemic. Morphological illustrations based on SEM micrographs and a distribution map are also provided.

Regional impacts of solar radiation modification on surface temperature and precipitation in Mainland Southeast Asia and the adjacent oceans.

Solar radiation modification (SRM) has been proposed to temporarily reduce anthropogenic warming. This study presents an assessment of the regional impacts of SRM via solar dimming and stratospheric aerosol injection (SAI) on temperature and precipitation over 0°-30° N and 90° E-110° E, covering Mainland Southeast Asia and adjacent oceans. Using data from the Geoengineering Model Intercomparison Project Phase 6 (GeoMIP6), we examine regional impacts of SRM using three SRM experiments: (1) G6Sulfur, which reduces radiative forcing from the high-emission SSP5-8.5 scenario to the moderate-emission SSP2-4.5 scenario by injecting sulfate aerosols; (2) G6Solar, which similarly reduces radiative forcing from the high-emission to moderate-emission scenarios but by uniformly reducing the solar constant; and (3) G1ext, which reduces radiative forcing from a quadrupled carbon dioxide concentration to pre-industrial levels by uniform solar constant reduction. Our findings show that higher greenhouse gas emissions increase overall precipitation, along with tendencies to have extreme rainfall events and more dry episodes in between. While SRM can partially cool down the surface temperature warming caused by increased greenhouse gas emissions, its effects on precipitation are complex: Solar dimming in G6Solar and G1ext tends to reduce overall precipitation, and tropical sulfate injection in G6Sulfur could lead to further drying in the tropics because of the stratospheric warming associated with the injected aerosols. Different SRM strategies might result in different responses on precipitation.

Genetic Characterization of the Co-Invasive Rodent Parasite Heterakis spumosa (Nematoda, Heterakidae).

Heterakis spumosa, a parasitic worm infecting rodents, is globally prevalent in black rats, brown rats, and house mice. It is hypothesized to originate from Asia due to its widespread presence in Southeast Asia in various Murinae. Previous molecular studies focused on European, African, and Japanese specimens, but none included samples from the putative native range. Rodents were collected between 2008 and 2015 across various localities in Southeast Asia and Europe, identified by morphology or genetic barcoding. Viscera were examined or preserved for later inspection. DNA was extracted from H. spumosa. PCR amplification targeting the mtCOI gene and ITS1 region was conducted in this study using newly designed primers (based on Heterakis reference sequences). PCR amplicons were subsequently sequenced and analyzed. In this study, the phylogenetic analysis using ITS1 sequences revealed that Heterakis samples from Thai and Laotian rodents belong to the species H. spumosa, exhibiting low genetic variation compared to samples from other regions. Genetic distance calculations using mtCOI sequences confirmed the marked distinction of H. spumosa from other Heterakis species. Our phylogenetic analyses using partial mtCOI and ITS1 sequences have significantly enhanced our comprehension of the genetic diversity and evolutionary history of the nematode H. spumosa.

Characterization of Streptococcus agalactiae 1a isolated from farmed Nile tilapia (Oreochromis niloticus) in North America, Central America, and Southeast Asia.

Streptococcosis caused by Streptococcus agalactiae 1a in Nile tilapia (Oreochromis niloticus) is a severe disease challenge for the global supply of tilapia. Currently, the extensive use of antibiotics is the primary curative tool used to minimize the impact of the disease. Vaccination is a prophylactic measure that has been shown to reduce antibiotic use in the aquaculture sector substantially. However, no commercially licensed vaccine against Streptococcus agalactiae 1a is currently available. This study aimed to investigate, through molecular and immunological methods, if Streptococcus agalactiae 1a isolates collected from North America (NAM), Central America (CAM), and Southeast Asia (SEA) were similarly suitable for the development of a potentially effective vaccine to serve the global tilapia farming industry. Our comparative data showed that the Streptococcus agalactiae 1a isolates from NAM, CAM and SEA had similar biochemical profiles, and genetic multi-locus sequence typing (MLST) analysis showed that the NAM and CAM isolates belonged to sequence type 7 (ST-7) and clonal complex 1, while isolates from SEA grouped into three sequence types (ST-1650, ST-500, and ST-7) and two distinct clonal complexes (CC1 and CC12). Isolates from NAM, CAM, and SEA displayed similar antigenic profiles determined by western blotting with polyclonal rabbit antisera, which was supported by in vivo cross-protection studies, showing that fish immunized with vaccines based on SEA and CAM isolates with different genetic MLST profiles were highly protected against cross-challenge using the same bacterial strains for challenge. Overall, the data obtained from our investigations provide strong indications that Streptococcus agalactiae 1a distributed in NAM, CAM, and SEA are serologically uniform pathogens, and vaccines based on isolates of Streptococcus agalactiae 1a from these regions may be suited for vaccination of tilapia worldwide.

Awareness, experiences, and beliefs related to ultra-processed foods among young people in Cebu, Philippines.

Ultra-processed food (UPF) intake is rising in low- and middle-income countries, where non-communicable diseases are now the leading contributor to disease burden. The purpose of this study was to assess awareness and knowledge of UPFs, factors that influence consumption of UPFs, and beliefs about the relationship between UPF intake and health among young people (18-20 years old) in a metropolitan area of the Philippines, a lower middle-income country. We conducted eight focus group discussions across four strata defined by gender and urban-rural neighborhood designation. We applied deductive and inductive codes to transcripts and organized codes into themes. Sixty participants were included in the study. Although most were unfamiliar with the concept of UPFs, participants demonstrated an intuitive understanding of the meaning of the term. Vendors in or around schools were commonly reported as a source of UPFs, though most participants reported consuming UPFs at home as well. Factors that were reported as having influence over participants' UPF intake included taste, convenience, cost, influence from parents, peers, and others, and health knowledge and status. Participants expressed various beliefs about the link between overconsumption of UPFs and risk of multiple health outcomes, including diabetes, hypertension, and kidney disease. Some males, but not females, believed that some UPFs were neutral or beneficial with respect to health. Commonly cited sources of information about UPFs and their link to health included parents, schools, and social media. This study provides important insights into the factors that drive UPF consumption among young people in a lower middle-income country and should inform efforts to reduce UPF intake among young people in this and similar settings.

Anthropometric indices in predicting 10-year cardiovascular risk among males and females aged 40-74 years in south and southeast Asia: analysis of 12 WHO STEPS survey data.

Background: The relevance of anthropometric indices in predicting cardiovascular disease (CVD) or CVD risk factors is established across different countries, particularly in the high-income countries. However, past studies severely lacked representation from the south and southeast Asian countries. The main aim of this study was to determine the performance of conventional and new anthropometric indices to best predict 10-year cardiovascular disease (CVD) risk in south Asian and southeast Asian populations. Methods: The present study examined data from 14,532 participants in three south Asian and 13,846 participants (all aged between 40 and 74 years) in six southeast Asian countries, drawn from twelve cross-sectional studies (WHO STEPwise approaches to NCD risk factor surveillance [STEPS] survey data from 2008 to 2019). A Predictive performance of ten anthropometric indices were examined for predicting 10-year CVD risk ≥ 10% (CVD-R ≥ 10%). The 10-year CVD-R ≥ 10% was calculated by utilising the WHO CVD risk non-laboratory-based charts. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal anthropometric index. Findings: Among the ten anthropometric indices, a body shape index (ABSI), body adiposity index (BAI), body roundness index (BRI), hip index (HI), and waist-height ratio (WHtR) performed best in predicting 10-year CVD risk among south Asian males and females. Improved performances were found for ABSI, BRI, conicity index (CI), WHtR, and waist-hip ratio (WHR) for 10-year CVD-R ≥ 10% predictions among southeast Asian males. Contrastingly, among southeast Asian females, ABSI and CI demonstrated optimal performance in predicting 10-year CVD-R ≥ 10%. Interpretation: The performance of anthropometric indices in predicting CVD risk varies across countries. ABSI, BAI, BRI, HI, and WHtR showed better predictions in south Asians, whereas ABSI, BRI, CI, WHtR, and WHR displayed enhanced predictions in southeast Asians. Funding: None.

Gridded dataset on land surface temperature and selected environmental and socioeconomic features in Southeast Asian metropolises.

As Southeast Asia grapples with extreme heat occurrences in recent years, mapping which areas are clustered with elevated temperatures is crucial for monitoring the at-risk population. Identifying the contributing factors to the warming trends in these areas is also vital in formulating adaptation and mitigation strategies. This dataset comprises land surface temperature (LST) in three metropolises in the region - Metropolitan Manila, Bangkok Metropolitan Area, and Greater Jakarta - downloaded and processed from the Moderate Resolution Imaging Spectroradiometer (MODIS) instrument. We used MODIS' inherent grid system to map LST values at the satellite image's most granular level. We combined them with selected environmental and socioeconomic variables, including building and built-up areas, areas of greeneries, industrial zones, and water bodies, nighttime light (to approximate areas of economic activities), gridded population, distance from water bodies, and indicators on which urban infrastructures, i.e. roads and airports, are present in each grid. Available in shapefile and comma-separate variable file format, this dataset is useful for urban studies in these three cities. The dataset can be easily updated as additional data on LST and other variables becomes available.