This trio-ethnography, grounded in transformative learning theory and comparative views, explores the academic paths and identity development of three international scholars from the Asian/Asian diaspora community. Transformative learning involves changing interpretations of experiences to influence future actions and critically evaluate perspectives, often sparked by disorienting dilemmas. While existing research emphasizes transformation through crises, this study examines whether such triggers can be positive, future-focused, and deliberately fostered in cross-cultural learning. The findings indicate that transcultural experiences can foster growth, assisting scholars in managing cultural dissonance, reshaping their identities, and gaining agency in academic and personal spheres through intentional transformation. The study compares commonalities and differences in transformative learning experiences and introduces a new perspective that highlights home culture as a vital factor in enabling transformative learning across cultures. These insights enrich the understanding of transformative learning as a dynamic, context-sensitive process, and suggest practical strategies to support current and aspiring international students and scholars.

Background/Objectives: This study assesses the cost-effectiveness of integrating artificial intelligence (AI) into breast cancer screening programs in Singapore. It evaluates AI as a standalone reader and as a companion reader alongside a consultant radiologist and compares these with double reading by two radiologists to determine economic viability and impact on healthcare resource use. Methods: A Markov model compared costs and outcomes of three strategies: double reading, a hybrid AI-assisted model (radiologist plus AI), and AI-only. These were applied to biennial mammography for 10,000 women aged 50-69 years in Singapore, with a 50-year horizon. Epidemiological and cost data were sourced from Asian and local studies and standardized to 2023 values, with a 3% annual discount. Outcomes were incremental cost-effectiveness ratios (ICERs) per quality-adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses assessed uncertainty. Results: Double reading cost USD 19.18 million with 218,460.4 QALYs. The AI-companion model cost USD 18.86 million with 218,476.3 QALYs, saving USD 316,090 and gaining 15.9 QALYs. The AI-only model cost USD 20.53 million with 218,532.4 QALYs, yielding 72.0 QALYs gained and an ICER of USD 18,743 per QALY. Specificity was the most influential parameter. At a willingness-to-pay threshold of USD 50,000 per QALY, AI-only screening had >75% probability of being most cost-effective. Conclusions: AI-assisted screening was cost-saving, while AI-only was cost-effective with greater health gains but higher costs and false positives. A phased, human-in-the-loop approach offers the most economically favourable strategy for AI integration.

Zero-waste Sports Events—A case study of the 19th Asian Games Hangzhou

Model-informed drug development (MIDD) framework was employed to bridge sugemalimab dosing from an Asian population to European patients with non-small cell lung cancer. We evaluated whether a fixed dose of 1200 mg every 3 weeks (Q3W) provides adequate exposure for European patients and, if not, which weight threshold and alternative dose would restore pivotal-trial exposures and projected benefit. A population pharmacokinetic (popPK) model, developed from 1002 subjects (97.6% Asian) across six clinical trials, was externally validated using data from an extended-interval higher-dose regimen. Based on the validated popPK model, exposure simulations for high-weight European patients (80-150 kg) under various dosing scenarios were then compared to exposures in the pivotal Asian study. Results indicated that while the 1200 mg Q3W dose provided adequate exposure for patients weighing up to 115 kg, those weighing 115-150 kg had lower exposures. To match the exposure-efficacy profile of the pivotal study, a 1500 mg Q3W dose was proposed for this higher-weight subgroup. Simulations from exposure-response (ER) models confirmed that the 1500 mg Q3W dose for high-weight patients would achieve comparable survival probabilities to the 1200 mg Q3W dose in Asian patients. The proposed regimen of 1500 mg Q3W for patients weighing over 115 kg ensures consistent therapeutic exposure, efficacy, and safety across diverse populations. The MIDD strategy for bridging dose regimens, substantiated by this study, enabled regulatory approval by the European Medicines Agency (EMA) and the UK Medicines and Healthcare Products Regulatory Agency (MHRA) without the need for additional dedicated clinical trials.

Disaster preparedness and compliance with response protocols are critical components of effective disaster risk management. Previous studies have identified the importance of media exposure, trust in authorities and knowledge in shaping disaster preparedness behaviours. However, the relationship between these factors in shaping preparedness and compliance behaviours has not been widely studied. Based on the data collected from the survivors of a major earthquake in Cianjur, West Java, Indonesia, we study how these factors influence their disaster preparedness and compliance behavioural intention. We apply and extend the theory of planned behaviour (TPB) to examine factors influencing behavioural intentions among disaster survivors and analyse the data using partial least squares structural equation modelling. The findings demonstrate that attitude remains the most influential TPB component, consistent with findings across Southeast Asian studies. Subjective norms also play a significant role, while perceived behavioural control has a comparatively limited impact. Furthermore, media exposure emerged as the most influential exogenous factor, underscoring the need for responsible and accurate disaster risk communication. A key contribution of this study is the empirical evidence it provides on how altruistic fear in disaster contexts is amplified by media. Concern for family, friends, and community members strongly influenced behavioural intentions, suggesting that preparedness strategies should appeal not only to self-preservation but also to collective well-being. Trust and knowledge were also significant predictors, reinforcing the importance of building institutional credibility and enhancing public awareness of disaster risk.

Asians and Asian Americans have experienced increased discrimination due to COVID-19. Building on the rejection-identification model (RIM; Branscombe et al., 1999) and the rejection-disidentification model (RDIM; Jasinskaja-Lahti et al., 2009), we sought to examine how COVID-19 discrimination has impacted Asian Americans’ identities and well-being. Asian and Asian American individuals currently residing in the United States were recruited to participate in our study. The relations between perceived COVID-19 discrimination, identification, and well-being were examined correlationally (Study 1) and experimentally (Studies 2 and 3). Across 3 studies, COVID-19 discrimination is associated with increased levels of anxiety and stress but decreased identification with being American. At the same time, perceived discrimination was unrelated to participants’ Asian (Study 1, 2, and 3) and specific ethnic (Study 3) identities. In Study 2, we experimentally demonstrated that reading about the negative impact of COVID-19 on Asian Americans interacted with perceived discrimination to decrease the extent to which participants identified as American, which has implications for anxiety and stress. Results from Study 2 supported the RDIM predictions and was replicated in a US-born sample in Study 3. Our studies suggest that Asian and Asian Americans’ well-being is harmed through the decrease of a positive identity (i.e., being an American) without the compensation of another positive identity (i.e., being Asian or being a specific ethnicity) to protect them from the negative impactive of COVID-19 discrimination. Thus, Asian Americans need support now more than ever.

Long-term nucleos(t)ide analog (Nuc) therapy in chronic hepatitis B (CHB) may lead to HBV suppression, ALT normalization, improvement of histological lesions, and prevention of liver disease progression, but rarely achieve HBsAg loss, the hallmark of functional cure. HBeAg-negative patients with CHB have often been recommended to continue Nuc therapy until HBsAg loss, which usually means indefinitely. However, long-term/lifelong Nuc therapy is associated with increasing costs and concerns of adverse outcomes subsequent to poor adherence and/or self-cessation/loss-to-follow-up. Hence, 2012 Asian-Pacific guidelines recommended that HBeAg-negative patients with CHB can stop Nuc therapy after ≥12 months of HBV DNA undetectability. Subsequent Asian and few European studies have found the strategy of finite Nuc therapy to be feasible and reasonably safe. In 2016-2017, stopping Nuc was also included as a conditional strategy for HBeAg-negative patients with CHB in the American and European guidelines. Furthermore, progressively increasing HBsAg loss rates with prolongation of off-Nuc follow-up were documented, being higher in Caucasians and more apparent beyond years 4-5 in Asian patients. Recently, a large study in patients with HBV cirrhosis showed not only higher 10-year HBsAg loss rate (15.3% vs. 1.6%) but also ~50% lower 10-year HCC incidence (16.5% vs. 29.5%) and 60% lower liver-related mortality/transplantation rate (6.1 vs. 15.1%) after Nuc cessation, as compared with well-matched patients continuing Nuc therapy. Since novel drug development aiming for functional cure has not been satisfactory, the strategy of finite Nuc therapy in HBeAg-negative CHB seems to be the current best realistic option for functional cure today.

ABSTRACT Between the 1950s and 1970s, the People’s Republic of China (PRC) maintained contact and cooperation with the Communist Party of Thailand (CPT) through multiple channels. The CPT received material support, political training, and ideological guidance from China, particularly from bases in Yunnan Province. Using the development of Thai Studies in China as a case study, this article examines how Chinese academia has engaged with—or avoided—the Cold War history of Thailand. Through a critical review of the field, it identifies structural tensions shaped by political sensitivity and institutional constraints, situating these dynamics within the broader context of Southeast Asian studies. Such constraints influence topic selection, access to sources, and publication practices, resulting in a field characterized by narrowed perspectives, uneven critical engagement, and structurally constrained academic autonomy. In this sense, Thai Studies in China reflects a paradoxical trajectory in which the field has been repeatedly shaped, disrupted, and revived by shifting political imperatives rather than by autonomous scholarly inquiry.

ABSTRACT International student mobility (ISM) flows have historically involved students moving from developing regions to developed countries. However, recently, there has been a shift, with more Chinese students pursuing doctoral studies in several Southeast Asian developing countries, including Malaysia, the Philippines and Thailand. Their decision‐making processes remain under‐researched. This study addresses this gap by contextualising the decision‐making processes of Chinese students choosing to pursue doctoral degrees in these countries. Informed by Bourdieu's thinking tools of field, capital and habitus, this exploratory qualitative study draws upon semi‐structured interviews with 33 Chinese doctoral students. The findings revealed how the broader conditions in which students worked and studied influenced students' decision‐making processes. These conditions related to: the importance of gaining a PhD as a form of cultural capital in the Chinese higher education sub‐field; students' lack of cultural capital in the Chinese higher education sub‐field; the way in which these Southeast Asian countries were construed as homologous destinations within the Chinese social, cultural and academic context, and; increased affinity between Southeast Asian institutions and individual habitus. This research contributes new insights into international student mobility within developing countries.

This article responds to the “Digital Humanities in/and Asian Studies” forum, situating it within broader genealogies of Asian digital humanities and arguing for a multilayered approach to understanding its histories, networks, and organizations. We offer two complementary trajectories: first, tracing the historical intersections of Asian studies and computing—from early initiatives such as the Munkwa Project and the China Biographical Database to the development of regional collaborations and digital centers—and second, examining the institutional and organizational infrastructures that have shaped digital humanities communities across Asia. Moving beyond project- and tool-based analysis, we call for recognition of Asian digital humanities as a deeply interconnected, globally significant field that both challenges and extends Euro-American frameworks. Our reflections highlight the importance of historically informed, relational, and inclusive approaches to studying the evolving landscape of digital scholarship in and about Asia.

Digital humanities (DH) projects in Asian studies have received scant attention. Yet they raise important questions about whom DH projects represent and how they represent them, how the field recognizes labor, the role of digital data in Asian humanities, and the boundaries and affordances of “Asia” as a category of analysis. This essay introduces the forum’s contributions and articulates the critical frameworks and essential questions for analyzing DH in/and Asian studies that emerged from our conversation.

This article examines the place of digital humanities (DH) within Asian studies by tracing a “middle ground” between large-scale DH projects and critical, reflexive scholarship. Through case studies in pedagogy, mapping, and artistic practice—including the Mao Kun Explorer, the Malayan Emergency Digital Map, and Eddie Wong's AI-generated Portrait of the Jungle People—the essay highlights how modest, resource-limited projects can generate innovative insights while foregrounding issues of access, sustainability, and critical inquiry. Framed through the notion of “poor digital humanities,” the article argues for approaches that embrace constraint and reflexivity while expanding the epistemic possibilities of DH in Southeast Asian contexts.

Prevalence and Associated Features of Reticular Pseudodrusen in Neovascular Age-Related Macular Degeneration in an Asian Population.

Despite growing interest in the role of digital humanities (DH) in and beyond East Asian/Asian studies, the breadth of possibilities for DH within area studies is still unclear for many researchers and students. This article introduces three projects by scholars of China, Japan, and Korea: the Local Gazetteers Research Tools (LoGaRT) software for Chinese historical materials, Hoyt Long's Aozora Search platform and scholarship on computational linguistics in Japanese literature, and Javier Cha's work with and on open access datasets of digitized Korean sources. These projects, ranging from collaborative mapping and textual analysis to big data, raise important, if open-ended, questions about what DH can look like and how it manifests in the East Asia corner of area studies. The diversity and depth of these projects demonstrate how fostering innovative, digitally inflected work, if taken seriously, can complement and enhance East Asian studies scholarship.

Abstract Background In colonoscopy, longer withdrawal time is an established quality indicator. In contrast, no equivalent benchmark exists for upper gastrointestinal endoscopy (EGD), despite evidence from Asian studies suggesting that longer examination time improves neoplasia detection. Aims We aimed to evaluate the association between total EGD examination time and lesion detection in a large North American cohort. Methods We performed a secondary analysis of a prospective study including diagnostic, surveillance, and screening EGDs performed at the Centre hospitalier de l’Université de Montréal (CHUM) between November 2023 and August 2025. Procedures with pre-planned polypectomies, interventions and known pathologies (e.g. Barrett’s esophagus) were excluded. Total examination time was measured from endoscope insertion to withdrawal. Detection rates for six abnormality categories (significant visual, significant biopsy/polyp, all significant, all visual, all biopsy/polyp, and all abnormalities) were calculated. Associations between procedure time and detection rates were modeled using logistic regression with generalized estimating equations to account for clustering by endoscopist. Results Among 1169 included EGDs (mean age 55.9 years, 57.5% female), the mean total examination time was 5.6 ± 3.7 minutes. For the primary outcome, each additional minute of examination increased the odds of detecting at least one significant visual abnormality by 10.9% (p < 0.001). Similar associations were observed for all secondary outcomes, with odds ratios ranging from 1.13 to 1.25 per additional minute (all p < 0.001). Detection rates rose steadily until approximately 13–15 minutes, beyond which gains plateaued. These findings indicate that longer total EGD examinations correlate with higher lesion detection yield. Conclusions Increasing EGD examination time yields higher detections of significant lesions. Minimum thresholds for total EGD examination time should become standard similar to colonoscopy withdrawal time recommendations. Funding Agencies PREMIER, Faculty of Medicine, University of Montreal

BackgroundHelicobacter pylori (H. pylori) is a major gastric pathogen and class I carcinogen that causes chronic gastritis, peptic ulcer, and gastric cancer if left untreated. However, evidence on H. pylori prevalence and antimicrobial resistance in Kazakhstan, a country with a high gastric cancer burden, remains scarce. This study presents the first culture-based epidemiological investigation of H. pylori at a single center in Almaty.Materials and methodsWe conducted a cross-sectional study (2024–2025) of 150 dyspeptic patients in Almaty, Kazakhstan. A subset (n = 148) underwent rapid stool antigen (RAS) testing before gastric biopsy collection. Biopsy samples were cultured, and 86 (57.3%) yielded viable H. pylori isolates. Antimicrobial susceptibility testing by the agar dilution method was performed on these 86 isolates. Demographic and clinical data were analyzed, and a regional meta-analysis was conducted using data from recent studies across Central Asia and Russia to estimate pooled prevalence and clarithromycin resistance.ResultsAmong 148 patients tested by RAS, 137 were positive. Resistance rates among 86 isolates were 87.2% to metronidazole, 33.7% to clarithromycin, and 3.5% to amoxicillin; no resistance was detected to minocycline or sitafloxacin. Multidrug resistance (defined as resistance to two or more antibiotics) was observed in 34.8% of isolates. The pooled H. pylori prevalence across Central Asian studies was 70% (95% CI: 59–80%), and pooled clarithromycin resistance was 29% (95% CI: 10–53%).ConclusionThis study provides the first culture-based evidence of H. pylori infection and antimicrobial resistance in Kazakhstan. The high resistance to metronidazole and clarithromycin suggests a likely lower success of standard triple therapy in Almaty. Absence of resistance to minocycline and sitafloxacin supports their use in rescue regimens. These findings highlight the urgent need for national surveillance, updated treatment guidelines, and integration of molecular resistance monitoring to improve evidence-based management of H. pylori in Central Asia.

Renewable energy projects suffer from deep uncertainties associated with volatile market conditions, unstable policy regimes and changing technological landscapes. Traditional valuation tools like Net Present Value (NPV) are increasingly being accepted as insufficient to capture the managerial flexibility needed to deal with this complex environment. As a result, a powerful alternative investment framework, Real Options Analysis (ROA), has been proposed, in which the possibility of strategic adaptability under uncertainty is valued explicitly for renewable energy investment. This paper reports a systematic review between 2000-2025 of research works on ROA application in the renewable energy sector. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework, 288 peer-reviewed studies were identified from twelve major academic databases (Scopus, IEEE Xplore, and Wiley Online Library). Each study was reviewed in terms of key dimensions: renewable technology type, real option category, modelling technique, dominant sources of uncertainty and geographical focus. The results show the dominance of the decision to defer (timing option) as the most important strategic flexibility for all technologies, emphasising the key problem of optimal investment timing. Methodologically, the field has transitioned from basic analytical models to complex simulation-based models, with binomial lattices and Monte Carlo models dominating the scene, followed by a significant move to hybrid, fuzzy, and AI-enhanced models after 2015. The analysis also reveals clear regional patterns in the types of uncertainties modelled with European studies focusing on market and policy risks, Asian studies on resource availability and work in the Americas taking into account technical risks. However, a serious underrepresentation in Africa, especially in Nigeria, is also revealed, which constitutes a major gap in the research. This review concludes that while the methodological foundations of ROA are well established, its practical application remains limited, particularly outside developed countries. Expanding the use of ROA could better support the global energy transition, but achieving this requires addressing barriers such as computational complexity, limited modeling expertise, and regulatory reliance on deterministic valuation methods. Greater integration of these flexible decision-making tools into policy design and project appraisal, especially in high-risk and underrepresented regions, is therefore necessary.

Precision medicine in gastric cancer management involves accurate diagnosis, accurate staging, minimally invasive surgery for early disease, and targeted therapies or immunomodulation for advanced disease. The current approach to the management of gastric cancer relies on the tumor-node and metastasis (TNM) classification, which has been shown to have limitations. Molecular and genetic diagnoses are accurate and available, but expensive. The modified Laurén classification has been proposed and is based on the tumor location, tumor histology, and clinical course. This classification relates well to patient prognosis and could offer an accessible option for achieving individualised care in gastric cancer management. To map the evidence on the patterns of gastric cancer by histopathological subtype and topographical subsite in Sub-Saharan Africa (SSA). Primary studies on gastric cancer, particularly adenocarcinoma, published between 2003 and 2024 in Sub-Saharan Africa were eligible. PubMed, Web of Science, and Google Scholar were searched using a predetermined strategy. Reports not in English, inaccessible abstracts/full texts, and those outside Sub-Saharan Africa were excluded. Data were charted using a pretested Google Form to capture publication year, author, country, study design, population size, sex, age, histological subtype, and topographical subsite. Descriptive analysis was employed for synthesis. After screening 214 studies, the databases yielded 20 studies that were included in the analysis from nine SSA countries. Most of the studies were retrospective in nature. The intestinal histopathological subtype and the non-cardia topographical subsite were the most predominant. Two studies evaluated the association of Helicobacter pylori with the histopathological subtypes. Three studies evaluated early-onset gastric cancer with a predominance of the intestinal histopathological subtype. Although the reviewed studies encompassed diverse regions within SSA, the lack of prospective designs and the concentration of data from only a few countries limit broader applicability. Interestingly, early-onset gastric cancer in these studies predominantly exhibited the intestinal subtype-contrasting with the diffuse subtype commonly reported in Asian and Western studies. These findings highlight the need for regionally representative, prospective research to better scrutinize gastric cancer subtypes, subsites, and epidemiological patterns across the continent.

Associations between Prior Lung Diseases and Risk of Lung Cancer in Populations With No Smoking History: A Systematic Review and Meta-Analysis.

Sleep disturbances can impair cognition, and cognitive impairment can dysregulate sleep-wake cycles. Despite biological plausibility, disparities in the sleep-cognition relationship are understudied in nationallyrepresentative samples. Using National Health Interview Survey data from 2011-2018, we investigated cross-sectional associations between sleep and cognition among adults aged ≥40 years overall and by age, sex, race, and ethnicity. Participants self-reported sleep duration (short [<7-hours], long [>9-hours]); insomnia symptoms (trouble falling asleep or staying asleep ≥3 times/week); and non-restorative sleep (waking feeling unrested ≥4 days/week). Cognitive impairment was defined as "not being able to/having a lot of difficulty remembering or concentrating"based on the Washington Group Short Set on Functioning. Adjusted Poisson regression with robust variance estimated prevalence ratios(PRs) and 95% confidence intervals. Among 73,477 adults (mean age± standard error 58.3± 0.07 years), 31.8% reported short sleep, 4.1% long sleep, 35.7% insomnia symptoms, and 35.5% non-restorative sleep. Overall, 2.2% reported cognitive impairment. All sleep dimensions were associated with a higher prevalence of cognitive impairment (range: PRshort-sleep = 1.23[95% confidence interval:1.07-1.42] to PRlong-sleep = 4.10[3.48-4.83]). Short sleep, insomnia symptom, and non-restorative sleep were more strongly associated with cognitive impairment among middle-aged adults. Associations with long sleep were stronger among older adults. Differences by sex were not observed. While the prevalence of cognitive impairment was slightly higher among Hispanic/Latine and Black adults, associations with short sleep were strongest among White adults and among Asian adults for long sleep (p-interaction<0.05). Sleep disturbances were associated with cognitive impairment. Most associations were stronger among middle-aged adults, although future studies with objective measures are warranted.