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Evidence generated by randomized controlled trials (RCTs) does not often represent the patient journey and clinical outcomes in the real world due to limited external validity or generalizability. Studies based on real-world data are intended to generalize results to the broader population; however, if the influence of external factors or confounders is not effectively managed, the cause-and-effect relationship and internal validity may be challenged, resulting in flawed results. The collection of quality real-world evidence (RWE) is crucial in Asia as there is often an underrepresentation of Asian populations in RCTs. In addition, few countries in Asia are catching up with the Western world in issuing practical foundational principles and guidance for conducting and adopting evidence for regulatory and reimbursement decisions. However, privacy and data protection laws are generally lagging behind technological developments in electronic medical records. While leveraging RWE in clinical and regulatory decision-making holds excellent potential, collective efforts across industry, governments, and research institutions are required for generating standardized practices and building capabilities for developing fit-for-purpose RWE in Asia. [ABSTRACT FROM AUTHOR]

This study aims to reveal the relationship between self-esteem and cyberbullying by using meta-analysis. We identified 61 articles with 49,406 student participants. The results provide strong evidence regarding the link between self-esteem and cyberbullying. In addition, the meta-analysis has found that factors such as self-esteem measurements, participants' culture, sample size, and participants' age all moderated this relationship. The betas between self-esteem and cyberbullying is stronger in studies that used RSES (Rosenberg Self-Esteem Scale) and weaker in studies that used other measures. The betas coefficient was larger for participants in Asia than those in the U.S. and Europe. Compared to "N < 200″ and "N > 800″, the betas coefficient was larger in "200 < N < 800″. As the participants' age increased, the betas coefficient between self-esteem and cyberbullying was smaller. Implications of this meta-analysis are discussed. [ABSTRACT FROM AUTHOR]

Background: Thorough understanding of developmental changes of human facial shape is lacking. The present study aimed to evaluate developmental shape changes of facial morphology based on a prospective, population-representative, Chinese cohort in Hong Kong. Methods: A population-representative sample of Chinese in Hong Kong was followed. Serial facial images of over 260 participants were obtained at age 12, 15, and 18 years. Facial landmarks were digitized and the corresponding coordinates were submitted for Generalized Procrustes Analysis. The resultant Procrustes shape coordinates, which captured shape information encoded by the facial landmarks, were then used for statistical shape analyses. Results: Small but significant developmental changes in mean facial shape were observed (p < 0.0001 for all pairwise comparisons). Significant age-related changes in the magnitude of variance of facial shape were also observed (p < 0.05). Phenotypic growth trajectories representing developmental shape changes were similar in size (p > 0.05) between sexes but differed in direction (p < 0.05) in shape space and trajectory shape (p < 0.05). The magnitude of shape differences between sexes remained constant from 12 to 18 years. Results of frontal facial shape analyses after removing the effect of allometry were similar to results obtained before removal of allometry. For lateral facial configurations, allometric trajectories among the age-by-sex groups were similar in slope (p > 0.05) but varied in directions in the multidimensional shape space. Conclusions: Our findings suggested significant age-related changes in facial shape and provided a dynamic view of developmental changes in sexual dimorphism of facial shape. Allometry contributed minimally to developmental changes in frontal facial shape. In addition, the allometric trajectories for lateral facial configurations were similar in rate of shape change but differed in their directions in shape space. [ABSTRACT FROM AUTHOR]

Background. Many studies have shown that type 2 diabetes mellitus (DM) increases the risk for several types of cancer but not cervical cancer (CC). Although DM and insulin-like growth factor 1 have preclinical and clinical implications for CC, less is known about the prognostic impact of DM on patients with early stage CC. Patients and Methods. We used the nationwide Taiwan Cancer Registry database to collect the characteristics of stage I-IIA cervical cancer patients diagnosed between 2004 and 2008. DM and other comorbidities were retrieved from the National Health Insurance database. Cervical cancer-specific survival (CSS) and overall survival (OS) times of patients according to DM status were estimated using the Kaplan-Meier method. We used a Cox proportional hazards model to calculate adjusted hazard ratios (HRs) for the effects of DM and other risk factors on mortality. Results. A total of 2,946 patients had primary stage I-IIA CC and received curative treatments, and 284 (9.6%) had DM. The 5-year CSS and OS rates for patients with DM were significantly lower than those without DM (CSS: 85.4% vs. 91.5%; OS: 73.9% vs. 87.9%). After adjusting for clinicopathologic variables and comorbidities, DM remained an independent unfavorable prognostic factor for CSS (adjusted HR: 1.46) and OS (adjusted HR:1.55). Conclusion. In Asian patients with early cervical cancer, DM is an independent unfavorable prognostic factor influencing both OS and CSS, even after curative treatments. [ABSTRACT FROM AUTHOR]

This study examines ‘growth, conservation, neutrality or feedback’ hypotheses in 12 Asian countries for the period 1970 to 2010, using panel causality analysis, which accounts for dependency and heterogeneity across countries, supports evidence on the direction of causality and is consistent with the neutrality hypothesis in two-thirds of these 12 Asian countries. Growth hypothesis and conservation hypothesis hold for India and Philippines, respectively. However, a feedback was found for both Thailand and Vietnam. Thereby, the findings provide important policy implication for 12 Asian countries under study. [ABSTRACT FROM PUBLISHER]

The Japanese encephalitis virus (JEV) is a mosquito-borne flavivirus prevalent in east and southeast Asia, the Western Pacific, and northern Australia. Since viruses are obligatory intracellular pathogens, the dynamic processes of viral entry, replication, and assembly are dependent on numerous host-pathogen interactions. Efforts to identify JEV-interacting host factors are ongoing because their identification and characterization remain incomplete. Three enzymatic activities of flavivirus non-structural protein 3 (NS3), including serine protease, RNA helicase, and triphosphatase, play major roles in the flaviviruses lifecycle. To identify cellular factors that interact with NS3, we screened a human brain cDNA library using a yeast two-hybrid assay, and identified eight proteins that putatively interact with NS3: COPS5, FBLN5, PPP2CB, CRBN, DNAJB6, UBE2N, ZNF350, and GPR137B. We demonstrated that the DnaJ heat shock protein family (Hsp40) member B6 (DNAJB6) colocalizes and interacts with NS3, and has a negative regulatory function in JEV replication. We also show that loss of DNAJB6 function results in significantly increased viral replication, but does not affect viral binding or internalization. Moreover, the time-course of DNAJB6 disruption during JEV infection varies in a viral load-dependent manner, suggesting that JEV targets this host chaperone protein for viral benefit. Deciphering the modes of NS3-interacting host proteins functions in virion production will shed light on JEV pathogenic mechanisms and may also reveal new avenues for antiviral therapeutics. [ABSTRACT FROM AUTHOR]

Background: Asia consists of diverse nations with extremely variable health care systems. Integrated real-world data (RWD) research warehouses provide vast interconnected data sets that uphold statistical rigor. Yet, their intricate details remain underexplored, restricting their broader applications., Objective: Building on our previous research that analyzed integrated RWD warehouses in India, Thailand, and Taiwan, this study extends the research to 7 distinct health care systems: Hong Kong, Indonesia, Malaysia, Pakistan, the Philippines, Singapore, and Vietnam. We aimed to map the evolving landscape of RWD, preferences for methodologies, and database use and archetype the health systems based on existing intrinsic capability for RWD generation., Methods: A systematic scoping review methodology was used, centering on contemporary English literature on PubMed (search date: May 9, 2023). Rigorous screening as defined by eligibility criteria identified RWD studies from multiple health care facilities in at least 1 of the 7 target Asian nations. Point estimates and their associated errors were determined for the data collected from eligible studies., Results: Of the 1483 real-world evidence citations identified on May 9, 2023, a total of 369 (24.9%) fulfilled the requirements for data extraction and subsequent analysis. Singapore, Hong Kong, and Malaysia contributed to ≥100 publications, with each country marked by a higher proportion of single-country studies at 51% (80/157), 66.2% (86/130), and 50% (50/100), respectively, and were classified as solo scholars. Indonesia, Pakistan, Vietnam, and the Philippines had fewer publications and a higher proportion of cross-country collaboration studies (CCCSs) at 79% (26/33), 58% (18/31), 74% (20/27), and 86% (19/22), respectively, and were classified as global collaborators. Collaboration with countries outside the 7 target nations appeared in 84.2% to 97.7% of the CCCSs of each nation. Among target nations, Singapore and Malaysia emerged as preferred research partners for other nations. From 2018 to 2023, most nations showed an increasing trend in study numbers, with Vietnam (24.5%) and Pakistan (21.2%) leading the growth; the only exception was the Philippines, which declined by -14.5%. Clinical registry databases were predominant across all CCCSs from every target nation. For single-country studies, Indonesia, Malaysia, and the Philippines favored clinical registries; Singapore had a balanced use of clinical registries and electronic medical or health records, whereas Hong Kong, Pakistan, and Vietnam leaned toward electronic medical or health records. Overall, 89.9% (310/345) of the studies took >2 years from completion to publication., Conclusions: The observed variations in contemporary RWD publications across the 7 nations in Asia exemplify distinct research landscapes across nations that are partially explained by their diverse economic, clinical, and research settings. Nevertheless, recognizing these variations is pivotal for fostering tailored, synergistic strategies that amplify RWD's potential in guiding future health care research and policy decisions., International Registered Report Identifier (irrid): RR2-10.2196/43741., (©Wen-Yi Shau, Handoko Santoso, Vincent Jip, Sajita Setia. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 11.06.2024.)

Background: Diabetes mellitus (DM) has been implicated in influencing the survival duration of patients with breast cancer. However, less is known about the impact of DM and other comorbidities on the breast cancer-specific survival (BCS) and overall survival (OS) outcomes of Asian patients with early-stage breast cancer., Patients and Methods: The characteristics of female patients with newly diagnosed, early-stage breast cancer were collected from the Taiwan Cancer Registry database for 2003-2004. DM status and other comorbidities were retrieved from Taiwan's National Health Insurance database. The BCS and OS times of patients according to DM status were estimated via the Kaplan-Meier method. Cox's proportional hazard model was used to estimate adjusted hazard ratios (HRs) for the effects of DM, comorbidities, and other risk factors on mortality., Results: In total, 4,390 patients were identified and 341 (7.7%) presented with DM. The 5-year BCS and OS rates were significantly greater in DM patients than in non-DM patients (BCS, 85% versus 91%; OS, 79% versus 90%). Furthermore, after adjusting for clinicopathologic variables and comorbidities, DM remained an independent predictor of shorter BCS (adjusted HR, 1.53) and OS (adjusted HR, 1.71) times. Subgroup analyses also demonstrated a consistent prognostic influence of DM across different groups., Conclusion: In Asian patients with early-stage breast cancer, DM is an independent predictor of lower BCS and OS rates, even after adjusting for other comorbidities. The integration of DM care as part of the continuum of care for early-stage breast cancer should be emphasized.