Southeast Asian Populations Research Articles

Comparison of risk prediction scores for cancer-associated thrombosis in ambulatory cancer patients not receiving thromboprophylaxis: A prospective cohort study in a South-East Asian population

IntroductionTo date, there is limited data regarding the incidence and risk prediction of cancer-associated thrombosis among South-East Asian patients who do not receive thromboprophylaxis. Materials and methodsThis was a prospective cohort study conducted at a tertiary medical center from June 2020 to December 2021 in Thailand. We enrolled cancer patients aged ≥ 18 years, with ECOG score ≤ 1, scheduled to receive the first cycle of chemotherapy. We measured incidence of venous thromboembolism (VTE), all-cause mortality and performance of risk prediction scores. ResultsA total of 457 patients were included with a mean age of 58.18 ± 12.60 years. By the end of 6 months period, VTE had occurred in 30 patients (6.56 %, 95%CI 4.36–9.21). The median time to the first thrombosis was 1.94 months (IQR 0.26–3.19). Cancer associated thrombosis incidence was 14.58 % for Khorana score ≥ 3, 6.67 % for scores 1–2 and 2.13 % for score 0. C-statistics were 0.50 (95%CI 0.41–0.60) for Khorana score cut-off ≥ 2, 0.57 (95%CI 0.49–0.65) for Khorana score ≥ 3, 0.55 (95%CI 0.46–0.65) for PROTECHT score ≥ 3, and 0.57 (95%CI 0.49–0.65) for CONKO score ≥ 3. Classifying cholangiocarcinoma as very-high-risk increased the Khorana score cut-off ≥ 3's C-statistic to 0.62 (95%CI 0.53–0.71). ConclusionsA significant proportion of ambulatory South-East Asian cancer patients without thromboprophylaxis developed VTE. Further prospective studies investigating the benefit of thromboprophylaxis in high-risk patients with active cancer are warranted.

Genome-wide association study of heart failure in a multiethnic south-east asian cohort

Abstract NMRC Heart failure (HF) is a leading cause of morbidity and mortality worldwide (1). While existing genome-wide association studies (GWAS) have yielded many different loci and causal genes, most of such studies has been conducted in European populations (2). There has been little insight into the genetic architecture of complex diseases, especially HF among Asians, despite up to 60% of the world population consisting of Asians. Through this study, we aim to uncover the genomic basis of heart failure in a South-East Asian cohort, with deep phenotyping of cardiovascular, metabolic, immune, and inflammatory traits. We conducted the largest multi-ancestry South-east Asian all-cause HF GWAS (n=2310, 1305 cases and 1005 controls), utilizing whole genome sequencing (WGS) data. Eleven independent loci were found to be associated with HF (P-value = 5e10-8). In-silico and functional studies were interrogated, allowing us to map most of the loci (n=9) to various genes implicated in various metabolic diseases - hypertension (HTN), diabetes mellitus (DM), and coronary artery disease (CAD). We further conducted a phenome-wide association study (PWAS) of significant loci, which revealed that they augment signals related to CAD, atrial fibrillation, DM and HTN, suggesting a shared genetic etiology between these metabolic risk factors and Asian HF. Of note, this the first HF GWAS to implicate the PDE9A gene, which was previously discovered as a potential biomarker for HF with preserved ejection fraction (HFpEF) through its involvement in the cGMP signaling pathways, and is currently being explored as a therapeutic target in the treatment of HFpEF (3). Polygenic risk scores (PRS) were calculated for heart failure in this Asian cohort, which identified that the most optimized model (HF PRS), included 19,431 of the most significant genetic variants (p=0.073). The prediction power of the HF PRS on HF risk was tested in UKB Asian subjects (N=10,016; 413 cases and 9,603 controls). Our results showed that the highest 10% percentile HF PRS risk subjects in UKB Asian were at 1.56-fold risks (95% CI: 1.16-2.08) for HF. This study provides a comprehensive understanding of the genetic architecture, and sheds light on novel biological pathways underlying HF in a south-east Asian population, indicating a highly metabolic underpinnings of this disease. It provides a step towards developing a precision-medicine based approach for risk stratification, prevention, and management of HF among Asians. Furthermore, this study provides evidence for the use of WGS in GWAS, to expand the discovery of novel targets for downstream interrogation, biomarker and drug development for complex diseases.

Validation of the Pulmonary Embolism Severity Index Risk Classification and the 2019 European Society of Cardiology Risk Stratification in the Southeast Asian Population with Acute Pulmonary Embolism.

To date, no studies representing the Southeast Asian population have validated the Pulmonary Embolism Severity Index (PESI) and 2019 European Society of Cardiology (ESC) risk stratification. Therefore, this study aimed to validate the PESI score, simplified PESI (sPESI), PESI risk classification, and 2019 ESC risk stratification in Southeast Asian patients with acute pulmonary embolism (APE). The present study is a 10-year cross-sectional study. Here, risk regressions were conducted to identify the PESI risk classification, sPESI, and 2019 ESC risk stratification as predictors for 30-day all-cause and PE-related mortalities. Receiver operating characteristic (ROC) curves were constructed to determine the diagnostic ability of the PESI score, sPESI score, PESI risk classification, and 2019 ESC risk stratification to predict 30-day mortality. A total of 696 patients (male, 286; female, 410; mean age, 57.7±15.7 years) were included in this study from 2011 to 2020. The risk of 30-day all-cause mortality progressively increased with the 2019 ESC risk stratification, being approximately 6-fold higher in the high-risk than in the low-risk class [risk ratio: 6.24 (95% confidence interval (CI), 3.12, 12.47), P＜0.001]. The risk of 30-day all-cause mortality with the PESI risk classification also increased with the risk classes, being approximately 6-fold higher in class V than in class I [adjusted risk ratio: 5.91 (95% CI, 2.25, 15.51), P＜0.001]. The highest area under the receiver operating characteristic curve (AuROC) of the predictive model was the PESI score [AuROC=0.733 (95% CI, 0.685, 0.782)]. Our study represents a good validation of the PESI and 2019 ESC risk stratification to predict 30-day mortality after APE diagnosis in the Southeast Asian population.

Generation of human induced pluripotent stem cell line (MUi033-A) from a male with homozygous for Hemoglobin E

Hemoglobin E (HbE), a common variant in Southeast Asian populations, results from a G to A substitution at codon 26 of the HBB gene, causing abnormal Hb and mild β-thalassemia-like symptoms. Here, we derived an induced pluripotent stem cell (iPSC) line, named MUi033-A, from a male homozygous for HbE. The iPSC line demonstrates a normal karyotype and embryonic stem cell-like properties including pluripotency gene expression, and tri-lineage differentiation potential. This iPSC resource holds the potential for investigating gene therapy targeting HbE mutation.

Body mass index and waist circumference trajectories across the life course and birth cohorts, 1996–2015 Malaysia: sex and ethnicity matter

ObjectiveThe global obesity epidemic remains a significant threat to public health and the economy. Age-period-cohort (APC) analysis is one method to model the trajectory of obesity. However, there is scarce published evidence of such analyses among the South East Asian population. This study aims to explore the sex and ethnic variations of BMI and waist circumference trajectories over time among non-institutionalized Malaysian adults aged 18 to 80 years.MethodsData from four population-based National Health and Morbidity Surveys conducted in 1996, 2006, 2010, and 2015 were pooled. Hierarchical Age-Period-Cohort (HAPC) analysis explored the trajectories of BMI and waist circumference across the life course and birth cohorts by sex and ethnicity. These models assumed no period effect.ResultsGenerally, BMI and waist circumference trajectories increased across age and birth cohorts. These trajectories varied by sex and ethnicity. Females have more profound increasing BMI and waist circumference trajectories than their male counterparts as they age and as cohort recency increases. Chinese have less profound BMI and waist circumference increases across the life course and birth cohorts than other ethnic groups.ConclusionsThe profound increasing cohort trajectories of obesity, regardless of sex and ethnicity, are alarming. Future studies should focus on identifying factors associated with the less profound cohort effect among the Chinese to reduce the magnitude of trajectories in obesity, particularly among future generations.

Lived Experiences of the COVID-19 Pandemic Among the Vietnamese Population in the Region of Peel.

Racial discrimination towards Southeast Asian populations is a longstanding issue in Canada which has intensified during the COVID-19 pandemic. Although extensive work demonstrates inequities among Southeast Asian communities during the pandemic, much work categorizes Asians as one homogenous population neglecting the unique experiences of different Asian subgroups along with the ways COVID-19 differentially affects Southeast Asians. To attend to population variations, this paper explores the lived experiences among Vietnamese individuals during the pandemic in the Peel Region of Ontario Canada. Specifically, this paper examines social and economic impacts of COVID-19, access to healthcare services and vaccines, sources of vaccine information, and impacts of COVID-19 related discrimination among young and older adults. Drawing on in-depth interviews with young and older adults (n=6:8) the results reveal important social and economic impacts created by COVID-19 that vary across generations andimpact health and wellbeing. These impacts are challenged further by barriers to healthcare access which were compounded by intersecting inequities experienced among Vietnamese immigrants in the Peel Region. While vaccine hesitancy was not a main concern, the findings demonstrate important generational differences with respect to commonly used and trusted information related to historical events and social media use. Although racial discrimination was a dominant concern, younger participants did not feel unsafe but expressed concern for the safety of their older family members and friends. The study underscores the need to consider historical dynamics and the ways they shape government opinions and trust, experiences of racial discrimination and socio-economic realities among racialized, immigrant populations.

A Comparison of the Modified Alvarado Score and the Raja Isteri Pengiran Anak Saleha Appendicitis (Ripasa) Score in a Southeast Asian Population With Histopathology as the Gold Standard.

Background The diagnosis of acute appendicitis has remained difficult despite it being one of the most common surgical emergencies in the world. One of the most frequently used scoring systems is the Modified Alvarado Score (MAS). However, the MAS has been known to be less efficient in Asian populations. To overcome this issue, the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score has been specifically developed to improve the diagnosis of acute appendicitis in Asian populations. This study aimed to evaluate the accuracy of the RIPASA score compared to the MAS for the diagnosis of acute appendicitis in a Southeast Asian population keeping histopathology as the gold standard. Methodology The study group comprised 150 patients. Data were collected from each patient using a simple proforma to ascertain both the MAS and the RIPASA score for each patient at the time of presentation. The patients then underwent open appendectomy and histopathology was used as the gold standard to determine the presence or absence of acute appendicitis in the excised specimens. Results The RIPASA score had a sensitivity and specificity of 89.83% and 59.38%, respectively, compared to 64.41% and 53.12%, respectively, for the MAS. Diagnostic accuracy was similarly higher for the RIPASA score at 83.33% versus 62.00% for the MAS. Conclusions The RIPASA score is superior to the MAS for the diagnosis of acute appendicitis. Using the RIPASA score instead of the MAS in Southeast Asian populations can lead to a more accurate and timely clinical diagnosis of patients with suspected acute appendicitis and help improve patient outcomes.

Causal links of α-thalassemia indices and cardiometabolic traits and diabetes: MR study.

Our study aimed to investigate if genetic variants around 16p13.3's HBA1 locus, associated with erythrocyte indices and HbA1c levels, predict α-thalassemia-related erythrocyte indices, cardiometabolic traits, and diabetes risk in Taiwanese individuals. We analyzed Taiwan Biobank data, including whole-genome sequencing from 1,493 participants and genotyping arrays from 129,542 individuals. First, we performed regional association analysis using whole-genome sequencing data to identify genetic variants significantly associated with erythrocyte indices, confirming their linkage disequilibrium with the α0 thalassemia --SEA deletion mutation, a common cause of α-thalassemia in Southeast Asian populations. Deletion mutation sequencing further validated these variants' association with α-thalassemia. Subsequently, we analyzed genotyping array data, revealing associations between specific genetic variants and cardiometabolic traits, including lipid profiles, HbA1c levels, bilirubin levels, and diabetes risk. Using Mendelian randomization, we established causal relationships between α-thalassemia-related erythrocyte indices and cardiometabolic traits, elucidating their role in diabetes susceptibility. Our findings highlight genetic variants around the α-globin genes as surrogate markers for common α-thalassemia mutations in Taiwan, emphasizing the causal links between α-thalassemia-related erythrocyte indices, cardiometabolic traits, and heightened diabetes risk.

Long-term Cardiovascular, Cerebrovascular, and Other Thrombotic Complications in COVID-19 Survivors: A Retrospective Cohort Study.

Growing evidence suggests that some coronavirus disease 2019 (COVID-19) survivors experience a wide range of long-term postacute sequelae. We examined the postacute risk and burden of new-incident cardiovascular, cerebrovascular, and other thrombotic complications after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a highly vaccinated multiethnic Southeast Asian population, during Delta predominance. This cohort study used national testing and healthcare claims databases in Singapore to build a cohort of individuals who had a positive SARS-CoV-2 test between 1 September and 30 November 2021 when Delta predominated community transmission. Concurrently, we constructed a test-negative control group by enrolling individuals between 13 April 2020 and 31 December 2022 with no evidence of SARS-CoV-2 infection. Participants in both groups were followed up for a median of 300 days. We estimated risks of new-incident cardiovascular, cerebrovascular, and other thrombotic complications using doubly robust competing-risks survival analysis. Risks were reported using 2 measures: hazard ratio (HR) and excess burden (EB) with 95% confidence intervals. We included 106 012 infected cases and 1 684 085 test-negative controls. Compared with the control group, individuals with COVID-19 exhibited increased risk (HR, 1.157 [1.069-1.252]) and excess burden (EB, 0.70 [.53-.88]) of new-incident cardiovascular and cerebrovascular complications. Risks decreased in a graded fashion for fully vaccinated (HR, 1.11 [1.02-1.22]) and boosted (HR, 1.10 [.92-1.32]) individuals. Conversely, risks and burdens of subsequent cardiovascular/cerebrovascular complications increased for hospitalized and severe COVID-19 cases (compared to nonhospitalized cases). Increased risks and excess burdens of new-incident cardiovascular/cerebrovascular complications were reported among infected individuals; risks can be attenuated with vaccination and boosting.

South Asian maternal and paternal lineages in southern Thailand and the role of sex-biased admixture.

Previous genome-wide studies have reported South Asian (SA) ancestry in several Mainland Southeast Asian (MSEA) populations; however, additional details concerning population history, in particular the role of sex-specific aspects of the SA admixture in MSEA populations can be addressed with uniparental markers. Here, we generated ∼2.3 mB sequences of the male-specific portions of the Y chromosome (MSY) of a Tai-Kadai (TK)-speaking Southern Thai group (SouthernThai_TK), and complete mitochondrial (mtDNA) genomes of the SouthernThai_TK and an Austronesian (AN)-speaking Southern Thai (SouthernThai_AN) group. We identified new mtDNA haplogroups, e.g. Q3, E1a1a1, B4a1a and M7c1c3 that have not previously reported in Thai populations, but are frequent in Island Southeast Asia and Oceania, suggesting interactions between MSEA and these regions. SA prevalent mtDNA haplogroups were observed at frequencies of ~35-45% in the Southern Thai groups; both of them showed more genetic relatedness to Austroasiatic (AA) speaking Mon than to any other group. For MSY, SouthernThai_TK had ~35% SA prevalent haplogroups and exhibited closer genetic affinity to Central Thais. We also analyzed published data from other MSEA populations and observed SA ancestry in some additional MSEA populations that also reflects sex-biased admixture; in general, most AA- and AN-speaking groups in MSEA were closer to SA than to TK groups based on mtDNA, but the opposite pattern was observed for the MSY. Overall, our results of new genetic lineages and sex-biased admixture from SA to MSEA groups attest to the additional value that uniparental markers can add to studies of genome-wide variation.

Metformin Effectiveness in Reducing Mortality among Covid-19 Patients with Type 2 Diabetes Mellitus at a Tertiary Hospital in Indonesia

Highlights: 1. As there is a scarcity of publications on the use of metformin for COVID-19 in Indonesia, the findings of this present study may contribute more insight to the existing body of research and provide data specific to the Southeast Asian population.2. This study revealed a decreased mortality rate associated with metformin use in diabetic patients with mild to moderate COVID-19 infection.3. This study suggests that diabetic patients may continue metformin treatment during a COVID-19 infection as the medication has sustained therapeutic effects. Abstract COVID-19 patients with comorbidities, such as type 2 diabetes (T2DM), have a higher mortality rate compared to those without any comorbidities. T2DM patients usually receive metformin as their first-line treatment. However, the effectiveness of metformin in reducing mortality rates still requires further analysis. The objective of this study was to analyze the effectiveness of metformin in reducing mortality rates among COVID-19 patients with T2DM. An analytic observational design with a retrospective cohort approach was used in this study. Samples were acquired from hospitalized COVID-19 patients with T2DM medical records at Fatmawati Central General Hospital, Jakarta, Indonesia, throughout 2020–2021. The samples were collected using a purposive sampling technique and analyzed using Chi-square test (p<0.05; RR<1). This study comprised 137 samples, with 56 samples receiving metformin and 81 not receiving metformin. The mortality rate in the sample group that received metformin was lower (19.6%) compared to the group that was not given the medication (38.3%). The Chi-square test results indicated a statistically significant relationship between metformin treatment and a lower mortality rate among COVID-19-contracted individuals with T2DM (p=0.020; RR=0.513). Therefore, this study concludes that the administration of metformin treatment reduces mortality among COVID-19 patients with T2DM.

Migration health ethics in Southeast Asia: a scoping review

Background: Asia hosts the second-largest international migrant population in the world. In Southeast Asia (SEA), key types of migration are labour migration, forced migration, and environmental migration. This scoping review seeks to identify key themes and gaps in current research on the ethics of healthcare for mobile and marginalised populations in SEA, and the ethics of research involving these populations. Methods: We performed a scoping review using three broad concepts: population (stateless population, migrants, refugees, asylum seekers, internally displaced people), issues (healthcare and ethics), and context (11 countries in SEA). Three databases (PubMed, CINAHL, and Web of Science) were searched from 2000 until May 2023 over a period of four months (February 2023 to May 2023). Other relevant publications were identified through citation searches, and six bioethics journals were hand searched. All searches were conducted in English, and relevant publications were screened against the inclusion and exclusion criteria. Data were subsequently imported into NVivo 14, and thematic analysis was conducted. Results: We identified 18 papers with substantial bioethical analysis. Ethical concepts that guide the analysis were ‘capability, agency, dignity’, ‘vulnerability’, ‘precarity, complicity, and structural violence’ (n=7). Ethical issues were discussed from the perspective of research ethics (n=9), clinical ethics (n=1) and public health ethics (n=1). All publications are from researchers based in Singapore, Thailand, and Malaysia. Research gaps identified include the need for more research involving migrant children, research from migrant-sending countries, studies on quality of migrant healthcare, participatory health research, and research with internal migrants. Conclusions: More empirical research is necessary to better understand the ethical issues that exist in the domains of research, clinical care, and public health. Critical examination of the interplay between migration, health and ethics with consideration of the diverse factors and contexts involved is crucial for the advancement of migration health ethics in SEA.

Genetic regulation of testosterone level in overweight males from the Kazakh population and its association with hypogonadism.

Male hypogonadism and erectile dysfunction in different populations are associated with excess body weight. A key aspect in most studies is the metabolism of sexual hormones, primarily testosterone. At the same time, the binding protein sex hormone binding globulin (SHBG) can play a large role, as it determines the ratio of total and bioavailable testosterone in blood, i.e. both the hormone content and level of its production. Recent research has identified common mutations that affect SHBG levels, such as the rs727428 polymorphic locus, which is associated with alterations in histone protein function, affecting the regulation of ribonucleic acid (RNA) protein SHBG synthesis. Similar relationships have been observed for prevalent mutations, including rs5934505 and rs10822184, in diverse populations. This study involved 300 individuals of Kazakh nationality from the Eastern Kazakhstan region, examining three polymorphic variants of the SHBG gene (rs727428, rs5934505, and rs10822184). The participants were categorized into three groups: individuals with hypogonadism and obesity (group 1, n=85), those with excess body weight but no hypogonadism (group 2, n=70), and individuals with neither excess body weight nor hypogonadism (group 3, n=145). The frequency of mutant gene alleles impacting GPS (SHBG) synthesis in the Kazakh population was notably high, comparable to European and South-East Asian populations. However, the association between excess body weight and these mutations exhibited varying patterns. Hypogonadism was linked to decreased GPS levels, strongly correlating with total testosterone but not bioavailable testosterone. The retention of sexual functions in overweight men was not always directly related to BMI levels and GPS concentrations.

Risk Factors of Cardiovascular Diseases in Southeast Asia

Cardiovascular diseases, which include coronary heart disease, cerebrovascular disease, peripheral artery disease, and aortic atherosclerosis, constitute the leading cause of death worldwide. In Southeast Asia, the annual mortality rate from cardiovascular diseases is increasing. As there is limited review literature on the risk factors of these diseases in the region, an examination of articles, periodicals, and reports from online databases worldwide can deepen our insights into the risk factors pertaining to Southeast Asian populations. The review finds two main types of factors of cardiovascular diseases that are mainly responsible for the high mortality rates of cardiovascular diseases in Southeast Asia: biological and environmental. Among biological factors, high sodium intake and tobacco consumption account for increased risks of high blood pressure and atherosclerosis, while environmental factors - air pollution and noise pollution - contribute to vasoconstriction, thrombosis, and coronary heart disease. From the findings in this review, an emphasis on regulations and guidelines to address these risk factors can thus reduce the prevalence of cardiovascular disease and solidify the wellbeing of millions in Southeast Asia.

Validation of the culturally adapted Edinburgh postpartum depression scale among east Asian, southeast Asian and south Asian populations: A scoping review.

The Edinburgh Postnatal Depression Scale (EPDS) is a widely used self-report instrument to screen for postpartum depression (PPD). Assessing the relevance of the EPDS as a screening tool for minority ethnic populations is pertinent for ensuring culturally appropriate care. This scoping review aimed to explore what is known about the cultural adaptations of the EPDS in antepartum and postpartum mothers and fathers in East Asian, Southeast Asian and South Asian populations, and to what extent these adaptations are able to accurately screen for postpartum depression symptoms among these cultural groups. The scoping review was guided by the PRISMA-ScR checklist. The search strategy included databases of MEDLINE, PsycINFO, EMBASE, CINAHL and Grey literature. Included studies were primary articles published in English language peer-reviewed journals that investigated the validation or cultural adaptation of the EPDS in mothers who were pregnant and/or had recently given birth, or fathers who were new parents, and were limited to the following cultural groups, whether living locally or abroad in a foreign country: East Asian, Southeast Asian or South Asian populations. Thirty-six of 2469 studies met criteria for inclusion. Twenty-one of 36 studies utilizing a culturally validated EPDS demonstrated a cut-off score lower than the original recommended cut-off. Important themes identified included the Role of Culture, Somatization of PPD, Method of Interview, and contrasting performance compared to other scales used to assess depression and/or anxiety. Accessibility to translated and validated EPDS and mindfulness of ethnically relevant EPDS cut-off scores are critical when using this tool among minority ethnic populations.

South-East Asian populations of Karualona cf. karua (King. 1853) (Crustacea: Cladocera: Chydoridae) belong to a separate species.

Study of populations of Karualona cf. karua (King, 1853) (rustacea: Cladocera) from South-East Asia and Sri Lanka revealed that they belong to an undescribed taxon. Karualona fatimae sp. nov. differs from the Australian K. karua s. str. by a very small basal spine of postabdominal claw and the presence of small denticle on the anterior margin of labral keel. The latter character is unique for the genus. Morphology, distribution and phylogenetic position of the new species are discussed. Our data suggest that the diversity of Karualona is underestimated in most tropical regions, with at least one more undescribed taxon present in South-East Asia and one more taxon in Australia. An updated key for genus Karualona Dumont & Silva-Briano, 2000 of the Eastern Hemisphere is provided.

Prevalence and Profiles of Late-Onset Hearing Loss in Preschool Children with Autism Spectrum Disorder Who Passed Newborn Hearing Screening in a South East Asian Population.

Prevalence of hearing loss in children with autism spectrum disorder (ASD) is uncertain, as it is more challenging to assess hearing function in children with developmental difficulties (DD). We aimed to determine the prevalence and profiles of hearing loss in preschool children with ASD in a Southeast-Asian population who passed newborn hearing screening. A retrospective study of preschool children with DD (ASD, Global Developmental Delay (GDD), and Speech and Language Delay (SLD)) attending the Child Development Unit (CDU) at our hospital was performed. Three hundred and thirty-three children (ASD: n = 129; GDD: n = 110; and SLD: n = 94) underwent hearing assessments. Of these, 10.8% of children (n = 36, comprising 15 with ASD, 12 with GDD and 9 with SLD) had confirmed hearing loss. Hearing loss was predominantly bilateral in children with ASD and GDD; in those with SLD, unilateral and bilateral hearing loss were equally common. Conductive hearing loss occurred as frequently as sensorineural hearing loss in children with ASD and SLD, but was the dominant subtype in those with GDD. Moderate to severe hearing loss (n = 2) was noted only in children with ASD. Children with ASD and GDD required significantly more audiology visits and procedures to obtain conclusive hearing test results, compared to those with SLD. The need to identify hearing loss and monitor for resolution is particularly important in vulnerable populations with communication deficits, such as in those with ASD.

GENETIC POLYMORPHISMS OF SERINE RACEMASE AND PROTEIN TYROSINE PHOSPHATASE RECEPTOR TYPE D ASSOCIATED WITH TYPE 2 DIABETES IN MALAY SUBJECTS

Background and objectives: Serine racemase (SRR) and protein tyrosine phosphatase receptor type D (PTPRD) were suggested as Type 2 diabetes mellitus (T2DM) candidate genes by a genome-wide association study (GWAS) in the Chinese population. Association of SRR and PTPRD with T2DM have been reported among East Asian Populations. The association of SRR and PTPRD genetic polymorphisms with T2DM still needs to be studied in Southeast Asian Populations. Materials and Methods: This study aimed to evaluate the association of SRR and PTPRD genetic polymorphisms with T2DM in Malay subjects. The single nucleotide polymorphisms (SNPs) of SRR (rs4523957, rs391300, and rs8081273) and PTPRD (rs17584499 and rs649891) were genotyped in 440 T2DM and 398 normal Malay subjects. Results: The recessive genetic model showed that SRR genotype GG of rs4523957 and genotype TT of rs391300 are risk factors for T2DM (OR=1.42; 1.45, p=0.022; 0.020, respectively), whereas the dominant and additive genetic models showed that PTPRD SNPs rs17584499 were protective for T2DM (OR=0.76; 0.77, p=0.033; 0.031, respectively). Conclusion: This study replicated the association of SRR rs4523957, rs391300, and PTPRD rs17584499 genetic polymorphisms with T2DM in Malay, while more investigation in different populations is required to confirm this finding. Peer Review History: Received: 9 March 2023; Revised: 23 April; Accepted: 26 June 2023, Available online: 15 July 2023 Academic Editor: Dr. Amany Mohamed Alboghdadly, Ibn Sina National College for Medical Studies in Jeddah, Saudi Arabia, amanyalboghdadly@gmail.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Rola Jadallah, Arab American University, Palestine, rola@aauj.edu Dr. Dennis Amaechi, MrsFoluBabade Mini Estate , Flat 5 by Old Soldiers Quarter, Sabongari/Bwari, Abuja- Federal Capital Territory, Nigeria. amaechitoexcel@yahoo.com

The first maternal genetic study of hunter-gatherers from Vietnam.

The current limitation of ancient DNA data from Vietnam led to the controversy surrounding the prehistory of people in this region. The combination of high heat and humidity damaged ancient bones that challenged the study of human evolution, especially when using DNA as study materials. So far, only 4kyears of history have been recorded despite the 65kyears of history of anatomically modern human occupations in Vietnam. Here we report, to our knowledge, the oldest mitogenomes of two hunter-gatherers from Vietnam. We extracted DNA from the femurs of two individuals aged 6.2kcal BP from the Con Co Ngua (CCN) site in Thanh Hoa, Vietnam. This archeological site is the largest cemetery of the hunter-gatherer population in Southeast Asia (SEA) that was discovered, but their genetics have not been explored until the present. We indicated that the CCN haplotype belongs to a rare haplogroup that was not detected in any present-day Vietnamese individuals. Further matrilineal analysis on CCN mitogenomes showed a close relationship with ancient farmers and present-day populations in SEA. The mitogenomes of hunter-gatherers from Vietnam debate the "two layers" model of peopling history in SEA and provide an alternative solution for studying challenging ancient human samples from Vietnam.

Identification of the Superficial Peroneal Nerve: Is the Ankle Plantar Flexion Fourth Toe Flexion Sign Useful in a South-East Asian Population?

Identification of the Superficial Peroneal Nerve: Is the Ankle Plantar Flexion Fourth Toe Flexion Sign Useful in a South-East Asian Population?