Search Results (368)

Background and Objectives: Metformin, a staple in diabetes care, has recently emerged as a candidate chemotherapeutic agent. In vitro studies suggest that metformin inhibits cancer growth by altering cellular metabolism and enhancing immune responses. Clinical observations further indicate that it suppresses key tumor-promoting pathways such as mTOR and STAT3. This review critically evaluates the therapeutic potential of metformin in oncology through the lens of precision medicine. This review integrates evidence from molecular mechanisms, clinical studies, biomarker-driven trial designs, and the regulatory challenges that continue to delay its approval for oncologic use. Methods: A structured literature search (2015–2025) identified 63 relevant studies, including preclinical, clinical, and translational research. Conclusions: Although metformin shows consistent anticancer effects in laboratory and animal models, its clinical benefits in patients are variable. This inconsistency is likely due to tumor heterogeneity and a lack of biomarker-based patient selection in trials. Targeting these shortcomings through biomarker-enriched, tumor-specific clinical trials is essential to define metformin’s role as a repurposed agent in precision oncology. Full article

Background/Objectives: The mandibular lingula (ML) is a small bony projection on the medial surface of the ramus and serves as the first reference point identified during sagittal split ramus osteotomy (SSRO) or inferior alveolar nerve block (IANB). Anatomical variations in the mandibular ramus have been shown to exist across different populations. Understanding these population-specific differences enhances both clinical safety and diagnostic precision. However, there is a paucity of anthropological data amongst the Mongoloid population, especially in Southeast Asia. Hence, this study aimed to investigate the (i) distance of the lingula to different mandibular anatomical landmarks and its localization, (ii) lingula shape, and (iii) differences between gender and the sides of the mandible amongst the local ethnic groups. Methods: This retrospective cross-sectional study consisted of 206 cone-beam computed tomography (CBCT) images of 77 males and 129 females (mean age 33), with a total of 412 hemimandibles. Measurements were performed on three-dimensionally reconstructed CBCT images. Results: The most common shape was the truncated type. The distance of the lingula to the anterior (LiA), posterior (LiP), superior (LiS), and inferior (LiI) borders of mandible were 17.84 (2.25) mm, 14.46 (3.44) mm, 17.73 (3.00) mm, and 27.05 (4.40) mm, respectively. No significant difference exists between the sides of the mandible. Sexual dimorphism existed for all lingula measurements except LiA. Indians have smaller rami with more anteriorly and inferiorly placed ML than Malay and Chinese. The majority of ML was located 8.55 mm above the occlusal plane. Conclusions: This study provides information on the ML and its surrounding ramus structure in the local population. Such variations must be accounted for in SSRO and IANB. Full article

Background: Effective doctor–patient communication is essential for high-quality care, especially for patients with chronic conditions requiring hemodialysis. However, there is a lack of validated tools in the Malay language to measure this communication. This study aimed to translate and validate the Doctor–Patient Communication Questionnaire (DPCQ) into Malay (MyD-PCQ) for use among patients receiving hemodialysis in Kelantan, Malaysia. Methods: A cross-sectional study was conducted with 300 patients receiving hemodialysis at Hospital Universiti Sains Malaysia. The original English DPCQ was translated and culturally adapted into Malay following international guidelines, including forward and backward translation, expert review, and cognitive debriefing. Data were collected using the Malay version of the questionnaire. Confirmatory factor analysis (CFA) assessed the construct validity, while Raykov’s rho measured internal consistency. Results: The Malay version of the DPCQ demonstrated excellent model fit in CFA (χ²/df = 1.25, p = 0.053; SRMR = 0.037; RMSEA = 0.029; CFI = 0.982; and TLI = 0.979). Factor loadings ranged from 0.493 to 0.640. The internal consistency was high, with Raykov’s rho of 0.887. The average total score among participants was 37.31 out of 60, indicating moderate perceived communication quality. Conclusions: The Malay Doctor–Patient Communication Questionnaire (MyD-PCQ) is a valid and reliable tool for assessing communication between doctors and patients receiving hemodialysis in Malaysia. Its use can help identify communication gaps, support training initiatives, and improve patient-centered care in clinical practice. Future research should evaluate its use in other settings and patient populations. Full article

The Tsushima leopard cat (Prionailurus bengalensis euptilurus), an endangered feline endemic to Tsushima Island, Japan, faces critical threats due to its small and isolated population. Understanding its demographic history and genetic differentiation from continental populations is essential for conservation planning. In this study, we performed whole-genome sequencing of four Tsushima individuals and applied demographic inference methods, including pairwise sequentially Markovian coalescent (PSMC) and Sequentially Markovian Coalescent (SMC++), to reconstruct the historical effective population size (Ne) and estimate divergence times. PSMC revealed a population expansion between 200,000 and 100,000 years ago, followed by a long-term decline. SMC++ inferred a continuous decline and estimated that the divergence from the Korean leopard cat population occurred approximately 30,000–20,000 years ago. Genetic diversity analysis showed that the Tsushima population has significantly lower heterozygosity and higher inbreeding levels than continental populations. Genetic clustering based on genome-wide SNPs indicated that the Tsushima population is genetically closest to the Korean population, forming a northern cluster distinct from southern populations, such as Borneo and the Malay Peninsula. These findings provide valuable insights into the evolutionary history and genetic status of the Tsushima leopard cat and contribute critical data for the design of future conservation strategies targeting this unique insular lineage. Full article

Background/Objectives: Childhood stunting remains a critical public health issue in low- and middle-income countries. Despite Malaysia’s economic growth, there is limited large-scale evidence on the determinants of stunting among children from infancy to primary school age. This cross-sectional study, part of South East Asian Nutrition Surveys II (SEANUTS II), aimed to determine sociodemographic and environmental risk factors for stunting among 2989 children aged 0.5–12 years. Methods: Children were recruited from four regions in Peninsular Malaysia (Central, East Coast, 2022–2030Northern, Southern). Standing height or recumbent length was measured, and stunting was classified based on WHO criteria (height-for-age Z-score below −2 standard deviations). Parents reported information on socioeconomic status, sanitation facilities, and hygiene practices. Multivariate binary logistic regression was used to determine the determinants of stunting. Results: Stunting prevalence was 8.9%, with infants (aOR = 2.92, 95%CI:1.14–7.52) and young children (aOR = 2.92, 95%CI:1.80–4.76) having higher odds than school-aged children. Key biological predictors included low birth weight (aOR = 2.41; 95%CI:1.40–4.13) and maternal height <150 cm (aOR = 2.24; 95%CI:1.36–3.70). Chinese (aOR = 0.56; 95%CI:0.35–0.88) and Indian children (aOR = 0.16; 95%CI:0.05–0.52) had a lower risk of stunting compared to Malays. Conclusions: This study highlights the ongoing challenge of childhood stunting in Malaysia, with age, birth weight, ethnicity, and maternal height identified as key determinants. These findings call for early identification of at-risk households and targeted support, especially through education and financial aid to foster healthy child growth. Full article

In 2023, the VAS international working group on Buerger’s Disease (BD) recommended two diagnostic criteria based on a prior Delphi study: “definitive” and “suspected”. The “definitive” criteria are history of smoking, typical angiography, and typical histopathological features. All three features are mandatory to confirm a “definitive” diagnosis of BD. The conundrum is—what features should be considered typical of BD angiography? According to this review, segmental occlusion of infrapopliteal arteries, corkscrew collaterals that appear to continue the occluded arterial segment (Martorell’s sign) or bypass the segmental occlusion, absence of atherosclerotic plaque or aneurysm could differentiate BD from ASO. Hence, for “typical” BD angiography, these manifestations should certainly be considered. However, data for differentiating angiography patterns of BD from the small- and medium-sized vasculitis including Behcet’s disease, scleroderma, hepatitis associated vasculitis, and anti-phospholipid syndrome are limited. Further studies for investigating the angiography pattern in BD patients in early and late presentation of BD, particularly in the patients with long-term follow up, are highly recommended. Full article

The Palearctic region is characterised by high endemism in the west and east, and a low endemism centre. The endemic lineages occurring at the two ends are largely distinct, and eastern endemics are typically associated with humid climates and forests, representing the start of a continuum from temperate to tropical forest groups and leading to Indo-Malay endemics. In contrast, western Palearctic endemics are typically associated with arid or seasonally dry (Mediterranean) climates and vegetation. Those lineages occurring in the central Palearctic are typically of western origin. Here, we use phylogenetic age (older than 34 million years (My)) to define a list of tetrapod and vascular plant lineages endemic to the western and central Palearctic, map their distributions at the ecoregion scale, and combine these maps to illustrate and understand lineage richness and endemism patterns. Sixty-three ancient lineages were recovered, approximately half of them reptiles, with several herbaceous and shrubby angiosperms, amphibians, and rodents, and single lineages of woody conifers, insectivores, and birds. Overall, we show high lineage richness in the western Mediterranean, eastern Mediterranean, and Iran, with the highest endemism values recorded in the western Mediterranean (southern Iberian Peninsula, southern France). This paints a picture of ancient lineage survival in areas of consistently dry climate since the Eocene, but also in association with persistent water availability (amphibians in the western Mediterranean). The almost complete absence of ancient endemic bird lineages is unusual and perhaps unique among the world’s biogeographic regions. The factors accounting for these patterns include climate since the end of the Eocene, micro-habitats and micro-climates (of mountain terrain), refugia, and patchiness and isolation (of forests). Despite their aridity adaptations, some of the lineages listed here may be tested under anthropogenic climatic change, although some may extend into the eastern Palearctic. We recommend using these lineages as flagships for conservation in the study region, where their uniqueness and antiquity deserve greater recognition. Full article

We explored how VR technology models can be applied to live-streaming e-commerce teaching. We employed relevant real-time data analysis and feedback to design a virtual simulation experimental platform to provide students with personalized experiences in live-streaming e-commerce operations in traditional e-commerce courses. In this study, different contexts were integrated into live-streaming e-commerce teaching, and a standardized course for contextualized live-streaming e-commerce teaching was designed in a standardized process consisting of the following steps: “introduction link”, “theoretical explanation”, “virtual simulation operation”, and “summary and feedback”. Virtual simulation technology was standardized in contextualized live-streaming e-commerce teaching by simplifying the design of live-streaming e-commerce courses to enhance students’ practical skills. Full article

With rapid urbanization and modernization, the deterioration of historical areas has become an increasing concern. While heritage-led regeneration has proven effective, most studies have focused on urban contexts. Rural traditional villages, particularly in developing countries such as China, face even greater challenges and remain understudied. This study addresses this gap by developing a framework for heritage-led rural regeneration, grounded in community-building theory and highlighting heritage capacity as a key driver of village revitalization. Using a two-round systematic literature review, 64 papers from Web of Science and Scopus were analyzed to construct the framework. It consists of two levels: a preliminary framework identifying five key dimensions—public participation, media platform construction, adaptive reuse, heritage industry development, and landscape maintenance—and an integrated framework further detailing 13 sub-dimensions within these areas. Expert interviews were then conducted to validate the framework and examine its practical implementation challenges and future development directions. This framework integrates community-building theory with heritage-led regeneration, offering both theoretical insights and practical guidance for revitalizing traditional villages in China and beyond. Full article

Understanding the economic value of natural resources is essential for the sustainable management of national parks. However, most existing studies focus on single conservation objectives and overlook the valuation of multiple resources within the same ecosystem. This study estimates tourists’ willingness to pay (WTP) for the conservation of four natural resources—crab-eating macaques, coral reefs, dry evergreen forests, and clean air—within Khao Laem Ya-Mu Ko Samet National Park in Thailand. Using the contingent valuation method and seemingly unrelated regression (SUR) analysis, data were collected from 205 tourists using structured surveys. The results show that dry evergreen forests received the highest average WTP (THB 129/year), followed by coral reefs (THB 125), clean air (THB 110), and crab-eating macaques (THB 107). At the population level, aggregate annual WTP values ranged from THB 85.7 million to THB 103.2 million across the resources. Age and awareness levels were consistent positive predictors of WTP, while other influencing factors—such as education, income, nationality, and residential location—varied by resource type. The findings provide empirical insights for designing resource-specific conservation strategies and highlight the potential of economic valuation to support sustainable financing mechanisms and policy development for protected area management. Full article

The genus Musa L. is one of the most important genera worldwide due to its use in food as a source of carbohydrates. A morphological characterization was performed to evaluate the potential of 100 accessions of Musa spp. from the Amazon region of Ecuador, applying 73 qualitative and quantitative descriptors in addition to the ecogeographic characterization. The multivariate analyses identified four large groups: The first is composed of the Musa AAB Simmonds ecotype “Hartón Plantain” and the “Cuerno Clone”. The second group is composed of the Musa acuminata Colla ecotype “Orito”. The third group is composed of the Musa acuminata ecotype “Malay plantain or red plantain”; and the fourth group is composed of the Musa × paradisiaca L. AAB ecotype “Barraganete” and banana or banana materials and the Musa AAB Simmonds ecotype “Plátano Dominico”. The qualitative descriptors with the highest discriminant value were the shape of the ♂ floret bud, the appearance of the rachis, and the pigmentation of the compound tepal, and the quantitative discriminant characters were the height of the pseudostem, the length of the leaf blade, the width of the leaf blade, and the weight of the raceme. The analysis with CAPFITOGEN of these 100 accessions through the ecogeographic characterization map identified 23 categories, highlighting category 20 with a coverage of 40.35%, which mainly includes the provinces of Orellana, Sucumbíos, part of Napo, Pastaza, and Morona Santiago. This category occurs within an annual temperature range between 21.6 °C and 27 °C, an apparent density of 1.25 to 1.44 g cm⁻³, and a cation exchange capacity (CEC) of 4 to 29 Cmol kg⁻¹. The morphological characterization of 100 Musa accessions revealed significant phenotypic variability, with four distinct morphological groups identified through cluster analysis. Key differences were observed in traits such as bunch weight, fruit length, and vegetative vigor. This variability highlights the potential of certain accessions for use in genetic improvement programs. The findings contribute valuable information for the efficient conservation, selection, and utilization of the Musa germplasm in Ecuadorian agroecosystems. The results demonstrate the existence of an important genetic variability in the INIAP Musa Germplasm Bank in the Ecuadorian Amazon region. Full article

Background/Objectives: Mango, which is known as the “King of Tropical Fruits”, is an evergreen plant belonging to the Anacardiaceae family. It belongs to the genus Mangifera, which comprises 69 species of plants found in tropical and subtropical regions, including India, Indonesia, the Malay Peninsula, Thailand, and South China. However, research on the structural information of complete chloroplast genomes of Mangifera is limited. Methods: The rapid advancement of high-throughput sequencing technology enables the acquisition of the entire chloroplast (cp) genome sequence, providing a molecular foundation for phylogenetic research. This work sequenced the chloroplast genomes of six Mangifera samples, performed a comparative analysis of the cp genomes, and investigated the evolutionary relationships within the Mangifera genus. Results: All six Mangifera samples showed a single circular molecule with a quadripartite structure, ranging from 157,604 bp to 158,889 bp in length. The number of RNA editing sites ranged from 60 to 61, with ndhB exhibiting the highest number of RNA editing sites across all species. Seven genes—namely, atpB, cemA, clpP, ndhD, petB, petD, and ycf15—exhibited a Ka/Ks value > 1, suggesting they may be under positive selection. Phylogenetic analysis revealed that Mangifera siamensis showed a close relationship between Mangifera indica and Mangifera sylvatica. Conclusions: Our comprehensive analysis of the whole cp genomes of the five Mangifera species offers significant insights regarding their phylogenetic reconstruction. Moreover, it elucidates the evolutionary processes of the cp genome within the Mangifera genus. Full article

Giant clams are ecologically important coral reef animals, with many species facing imminent local extinction. While many regions have undertaken recent assessments of their biodiversity assets, persistent gaps remain even in otherwise well-surveyed areas. This study sought to understand the geographic distribution of smaller-bodied and morphologically similar giant clams, specifically Tridacna maxima and T. noae, in the eastern Indian Ocean. Due to the difficulties in reliably identifying these species using morphological characters, we confirmed species identity and investigated intraspecific variation using sequence data from the mitochondrial cytochrome C oxidase subunit I gene (COI). Seventy whole animal vouchers were newly sampled from a 1500 km span of remote northwestern Australian coastline over a decade, as part of an ongoing coral reef survey expedition of the Western Australian Museum and partners. Tridacna maxima had a limited distribution and was only genotyped from offshore oceanic reefs in the Rowley Shoals and Cocos Keeling Islands. In contrast, T. noae was well established beyond Ningaloo Reef, and was abundant at inshore sites throughout the Pilbara and Kimberley, and even offshore to Ashmore Reef. Phylogeographically, T. maxima did not group with conspecifics from the Western Pacific Ocean, including the east coast of Australia, but instead clustered with individuals from Malaysia, China, Taiwan, and Indonesia; T. noae exhibited a similar pattern. The affinity of Western Australian individuals with representatives from the Indo-Malay region and not eastern Australia will be an important consideration for these commercially important species. Novel haplotypes in both tested species occur in Western Australia. Continued sampling of eastern and central Indian Ocean giant clams, especially to continue to document the range of T. noae, is encouraged to understand connectivity in this basin. Together, these findings contribute to an improved baseline for conservation initiatives of these iconic coral reef animals in Western Australia. Full article

This article explores the maritime connections relating to Buddhism and diplomacy between polities in Sumatra, the Malay Peninsula, the Indian subcontinent, and China from the beginning of the 11th century up to the 12th century CE. It focuses on new epigraphic evidence from Muara Jambi in the form of two inscribed strips of copper mentioning the Cūḍāmaṇivarmavihāra, a monastery funded by the king of Śrīvijaya in Nagapattinam (South India), and the Bālādityavihāra, probably located in Nālandā (Northeastern India). These new findings are compared to archaeological and textual materials from elsewhere in the Buddhist world that cast light on the web of transregional connections between Nusantara, China, and India in the early centuries of the second millennium. Full article

Background: The COVID-19 pandemic has been associated with rising obesity rates. Autistic children have a higher risk of obesity than neurotypical children. Our study aims to describe the changes in overweight/obesity rates in autistic children during the pandemic, and to identify contributing factors. Methods: This is a retrospective case record review of patients with a clinical diagnosis of autism, who were seen at a developmental-behavioral pediatrics clinic in a tertiary academic hospital, between 1 January 2019 and 24 October 2021. We compared the average monthly rates of overweight/obese status pre- and during the pandemic. We collected data on the patients’ and parents’ demographics, duration of screen time per day, degree of difficulties related to autism symptoms and cognition. We analyzed factors associated with being overweight/obese during the pandemic. Results: 1330 patient visits were included. The mean age was 45.4 months; 78% were male; 52% were Chinese. The average monthly rate of overweight/obese status increased by 1.8% during the pandemic (17.9% pre-pandemic; 19.7% during pandemic). Factors associated with being overweight/obese during the pandemic included: Malay ethnicity (OR 2.321, p < 0.01), developmental delay (OR 2.80, p < 0.01), and lower parental education level (father OR 1.73, p = 0.01; mother OR 1.63, p = 0.03). On multivariate analysis, only Malay ethnicity (OR 2.95, p = 0.01) was significant. Conclusions: Our study demonstrates a rising overweight/obesity rate amongst children with autism spectrum disorder during the pandemic. It also identified higher-risk patient profiles (Malay race, developmental delay, lower parental education). We hope this will facilitate the implementation of preventative health measures specifically supporting the high-risk children. Full article