The survey is to assess the current state of adaptive radiation therapy (ART) for head and neck (H&N) cases among radiotherapy centers in Malaysia and to identify any implementation limitations. An online questionnaire was sent to all radiotherapy centers in Malaysia. The 24-question questionnaire consists of general information about the center, ART practices, and limitations faced in implementing ART. 28 out of 36 radiotherapy centers responded, resulting in an overall response rate of 78%. About 52% of the responding centers rescanned and replanned less than 5% of their H&N patients. The majority (88.9%) of the respondents reported the use Cone Beam Computed Tomography alone or in combination with other modalities to trigger the ART process. The main reasons cited for adopting ART were weight loss, changes in the immobilization fitting, and anatomical variation. The adaptation process typically occurred during week 3 or week 4 of treatment. More than half of the respondents require three days or more from re-simulation to starting a new treatment plan. Both target and organ at risk delineation on new planning CT relied heavily on manual delineation by physicians and physicists, respectively. All centers perform patient-specific quality assurance for their new adaptive plans. Two main limitations in implementing ART are "limited financial resources or equipment" and "limitation on technical knowledge". There is a need for a common consensus to standardize the practice of ART and address these limitations to improve the implementation of ART in Malaysia.
About two-thirds (67.6%) of 142 Ibans (from birth to 90 years of age) from 26 house-holds in a longhouse in Nanga Atoi in the Second Division of Sarawak were infected with intestinal parasites. The more common helmintic infections were hookworms (47.2%) and Trichuris trichiura (43.0%). Intestinal protozoan infections were less common. Single helmintic infections were more common than multiple infections and the commonest type of multiple infections was Trichuris mixed with hookworms. Malaria and filariasis were not reported among these inhabitants surveyed.
Impending anthropogenic climate change will severely impact coastal organisms at unprecedented speed. Knowledge on organisms' evolutionary responses to past sea-level fluctuations and estimation of their evolutionary potential is therefore indispensable in efforts to mitigate the effects of future climate change. We sampled tens of thousands of genomic markers of ~300 individuals in two of the four extant horseshoe crab species across the complex archipelagic Singapore Straits. Carcinoscorpius rotundicauda Latreille, a less mobile mangrove species, has finer population structure and lower genetic diversity compared with the dispersive deep-sea Tachypleus gigas Müller. Even though the source populations of both species during the last glacial maximum exhibited comparable effective population sizes, the less dispersive C. rotundicauda seems to lose genetic diversity much more quickly because of population fragmentation. Contra previous studies' results, we predict that the more commonly sighted C. rotundicauda faces a more uncertain conservation plight, with a continuing loss in evolutionary potential and higher vulnerability to future climate change. Our study provides important genomic baseline data for the redirection of conservation measures in the face of climate change and can be used as a blueprint for assessment and mitigation of the adverse effects of impending sea-level rise in other systems.