Indigenous pig breeds in Vietnam represent an important genetic reservoir, offering traits adapted to local environments, cultural preferences, and disease resistance. However, rapid industrialization and the expansion of commercial breeds have endangered many indigenous populations. This review explores the trajectory of conservation efforts for Vietnamese local pig breeds, from the early use of microsatellites and mitochondrial DNA to recent advances in SNP genotyping. Firstly, we summarize the key characteristics and values of 26 local breeds. Secondly, we highlight key findings on genetic diversity, population structure, and inbreeding levels across major breeds. In addition, we discuss challenges in the development of conservation breeding programs and national strategies, as well as challenges in data generation, infrastructure, and policy implementation and provide potential solutions for these challenges. This review provides the first integrated synthesis linking breed-level genetic evidence to practical conservation recommendations for indigenous pigs in Vietnam. By identifying the key breeds for conservation priority, such as Huong, Van Pa, Soc, ChuProng, Co Aluoi, and Lung Pu, as well as highlighting the exotic introgression in H'mong pig populations, this review might provide a resource for sustainable conservation and use of Vietnam's rich pig genetic resources.
The rapid transition toward animal-free chemical safety evaluation has positioned in vitro new approach methodologies (NAMs) as central components of next-generation risk assessment (NGRA). Advances in complex in vitro systems, high-content phenotypic profiling, multi-omics technologies, and AI-assisted analytics have greatly expanded the capacity to characterize human-relevant biological responses. However, despite their scientific promise, the translation of NAM-derived information into regulatory decision-making remains challenging in general. Key bottlenecks include incomplete alignment with apical regulatory endpoints, limited toxicokinetic context in conventional in vitro systems, and substantial variability across assays, data structures, and analytical pipelines. This review aims to summarize the current state of in vitro NAM technologies, evaluate the major barriers limiting their regulatory application, and discuss emerging frameworks that enable their integration into NGRA. To strengthen regulatory relevance, increasing efforts focus on integrating mechanistic NAM outputs into adverse outcome pathway (AOP) frameworks and applying high-throughput toxicokinetic (HTTK) modeling to support in vitro-to-in vivo extrapolation (IVIVE). Early NGRA case studies show that NAM-based points of departure can, in some instances, approximate or bracket traditional in vivo thresholds, although results remain heterogeneous across chemical classes and endpoint domains. Going forward, progress in NAM-based risk assessment will depend not only on advancements in assay technologies but also on decision frameworks capable of effectively incorporating existing NAM evidence. Tiered and evidence-integrated approaches will be essential, particularly in light of the varied NAM data availability across chemicals. Strengthening the iterative exchange between NAM application and method development will help guide future improvements and support a more transparent, adaptive, and human-relevant assessment paradigm.
The study investigates Vietnamese EFL undergraduates' Flow experiences within the online learning context. The research aims to identify the extent to which Vietnamese undergraduates experienced Flow in online EFL contexts through the lens of the eight specific Flow dimensions, highlight the key dimensions with the highest and lowest levels, and explore how students describe their Flow experiences. A mixed-methods design was employed, including a survey conducted with 239 EFL university students and semi-structured interviews with 12 interviewees; all data from the qualitative phase were analyzed using narrative-integrated thematic analysis. Results showed that students' overall level of Flow experience was high (M = 3.77), with Immediate Feedback, Balance between Challenges and Skills, and Loss of Self-consciousness being the three most prominent dimensions, while Highly Focused Concentration/Attention was the lowest reported dimension. However, barriers to achieving Flow include internal struggles, such as difficulty in maintaining focus, obstacles arising from self-directed learning expectations and culturally shaped norms, as well as external challenges related to technology infrastructure. Teacher support and interactive learning activities, clear goals, a constructive learning environment, and positive social interactions were described as important conditions in maintaining Flow. The study highlights the role of Flow in potentially facilitating deep learning in online EFL learning and offers practical implications for educators to design online lessons that set clear goals, provide immediate and constructive feedback, modify task difficulty, minimize distractions to promote immersion, and consider contextual and culturally sensitive factors to maximize Flow among Vietnamese EFL learners.
Integration of non-communicable diseases (NCDs) prevention, screening and treatment into maternal, newborn and child healthcare (MNCH) services has become increasingly important as countries address the dual burden of communicable and NCDs. While global policy attention has grown, practical experiences from low- and middle-income countries on how to operationalise this integration, particularly its implications for the health workforce, remain limited.This practice paper synthesises programme learning from Kyrgyzstan, Tajikistan and Viet Nam, drawing on WHO-supported country assessments, programme reports and practitioner perspectives, with a particular focus on workforce challenges. Health workforce shortages, skills gaps, limited training capacity and uneven distribution remain major barriers to service integration in these countries. We apply Donabedian's quality improvement model, encompassing outcome, process and structure, to elaborate on these challenges. We emphasise the importance of taking a systemic perspective in addressing health workforce issues and improving the quality of care. We recognise the need for additional research in key areas that are instrumental for strengthening the health workforce, particularly for the effective integration of NCD services into MNCH and strengthening primary healthcare. Our insights aim to assist in the development of integrated programmes and to promote advancements in the research agenda for the health workforce.
Venous return depends on compliant vessels, competent valves, and auxiliary pumps such as the calf and thoracic muscles. Disruption of these mechanisms, through immobility, valve dysfunction, or inflammation, creates disturbed flow and heterogeneous shear that drive venous dysfunction and disease progression. Traditional animal models, though informative, fail to replicate human venous geometry and hemodynamics. This review critically evaluates current in vitro and in silico venous models, highlighting their capabilities and limitations in reproducing physiological flow, endothelial responses, and thrombus dynamics. By systematically comparing design parameters, cellular configurations, and flow regimes, we identify key gaps limiting the translational relevance of current NAMs. Building on this analysis, we propose future directions emphasizing hybrid patient-specific modeling, where imaging-derived geometries and digital twins are integrated with venous NAMs to capture individualized hemodynamics and immune-endothelial interactions. We further outline validation strategies linking NAM outputs with clinical and animal benchmarks to establish predictive fidelity. Together, these perspectives position venous NAMs as next-Generation tools to mechanistically dissect thrombosis, advance personalized risk assessment, and accelerate the development of targeted venous therapeutics.
Animal studies have historically informed toxicological testing and safety assessments. However, assessment of the variability in both quantitative and qualitative results has been limited. Biological variability, experimental differences, interpretation of categorical endpoints, and data availability and curation approaches all contribute to the quantified variability. A literature review was conducted to identify publications describing variability analyses for in vivo toxicology studies. Variability analyses were evaluated and summarized for a variety of toxicological endpoints: ocular irritation, dermal sensitization and irritation, acute oral and inhalation lethality, subchronic and chronic toxicity, carcinogenicity, neurotoxicity including DNT, endocrine, and genotoxicity. This review summarizes published investigations of variability within mammalian toxicological studies that have been largely conducted in accordance with health effects test guidelines. The results of this review suggest that replicability of in vivo toxicological guideline studies varies widely by study type, endpoint complexity, and classification approach. While any test system will have inherent variability, understanding its sources and impact on study interpretation will help ensure that appropriate confidence is applied when using the test method. Furthermore, such information aids in establishing relevant metrics to serve as baselines for informing performance characterization of new approach methodologies (NAMs). Future evaluation of NAMs should be contextualized using estimates of uncertainty and variance of the traditional study data to demonstrate "better" performance compared to traditional testing approaches. Robust understanding of guideline study performance is important for risk assessments, where it is important to find species-relevant NAMs that can perform at least as well as existing bioassays.
Psychotherapy's integration into Southeast Asia (SEA) clinical practice is limited despite its recognized effectiveness. This study examined psychiatrists' and psychiatry trainees' perspectives on barriers to accessing psychotherapy, expectations for its future delivery, and attitudes toward digital mental health. A cross-national survey was conducted between March and August 2024 among 253 psychiatrists and psychiatry trainees from Indonesia (n = 121), Malaysia (n = 39), Singapore (n = 6), Thailand (n = 74), and Vietnam (n = 13). The questionnaire explored perspectives on delivering psychotherapy including barriers, provider roles, therapy formats, and digital delivery. Data were analyzed descriptively and comparatively. Key barriers to delivering psychotherapy included time constraints, cost concerns, systemic limitations, and insufficient psychotherapy skills, respectively. Regarding preferences for psychotherapy providers, trainees rated psychiatrists as most suitable, while psychiatrists preferred psychologists. Crisis intervention and individual therapy were the top priorities for training. Although videoconferencing and mobile apps were favored for future delivery, concerns about clinical effectiveness and system-level limitations hindered wider acceptance of digital psychotherapy. A major barrier was that psychotherapy is too time-consuming, and a lack of skills was a significant challenge for healthcare professionals. Both psychiatrists and trainees agreed that training should prioritize crisis intervention and individual therapy. For internet-based psychotherapy, the primary challenge was concern over its low clinical effectiveness, as many felt face-to-face interaction was necessary. The findings highlight the need for enhanced psychotherapy training, systemic support, and digital infrastructure to improve psychotherapy accessibility in SEA. These insights can inform the development of targeted interventions and policies to promote the effective integration of psychotherapy into mental health services in the region.
Globally, alarming trends of psychological distress among physicians and medical students threaten patient care and professionalism. The resilience and well-being of medical educators have been recognised as key influences on learners. However, relevant research is limited, especially in Asian contexts. Using the National Academy of Medicine (NAM) model as a lens, this study explores what external and individual factors impact the resilience of Hong Kong (HK)-based medical educators. HK-based medical educators, who taught medical students and physicians, were recruited using purposive sampling. They participated in semi-structured online interviews from 06/2021 to 04/2022. Anonymous sociodemographic information was collected through an online survey, and video recordings were transcribed anonymously. Guided by the NAM model, a hybrid deductive and inductive thematic analysis was conducted. Twenty medical educators participated. They identified factors capturing all seven NAM model domains as influencing their resilience. Of those, "organisational factors" (institutional expectations, recognition, and rewards) and "personal factors" (social support from family, friends, and colleagues, and a sense of purpose in their roles) were perceived as influencing their resilience to a similar extent, suggesting that both organisational support and individual connections can bolster medical educators' resilience. This study, the first of its kind in Asia, examined the applicability and contextual suitability of the NAM model for use among HK-based medical educators. They perceived organisational and individual factors as complementary in influencing their resilience. Our findings highlighted the importance of considering both system- and individual-level aspects when designing strategies for promoting resilience in this population.
Electronic Medical Records (EMRs) aim to improve efficiency, safety, and quality of care. However, the impact of EMR implementation, particularly in outpatient diabetes care, remains underexplored. This study explored clinicians' perspectives on EMR use in diabetes outpatient care. This qualitative study, conducted in line with COREQ guidelines, involved four focus groups with 22 clinicians (doctors, nurses, and allied health) at a metropolitan diabetes service in Queensland, Australia. Data were analysed using deductive content analysis, guided by the Quintuple Aim and Technology Acceptance Model/Unified Theory of Acceptance and Use of Technology frameworks. Clinicians reported mixed outcomes across the Quintuple Aim domains, shaped by technology adoption constructs. Facilitators such as improved efficiency, access to patient information, and prescribing safety reflected perceived usefulness and positive attitudes, contributing to favourable outcomes across multiple Quintuple Aim. Barriers such as navigation complexity, technical issues, alert fatigue, and overwhelming training led to negative outcomes in EMR use. Tensions around documentation practices and patient expectations of system use, resulted in mixed outcomes. Overall, clinicians viewed EMRs as essential, but sustained adoption required improved usability, tailored training, and better system integration. This study concludes that while the EMRs improved safety, efficiency, and access to information, their design and implementation also introduced burdens that negatively affected clinician experience. EMRs significantly shape the healthcare workforce, influencing workflow, wellbeing, and professional engagement. In outpatient diabetes care, specific workflow challenges such as glycaemic data integration highlight that existing EMR designs may not fully support the complexity of chronic disease management. To maximise benefits, EMR initiatives should be approached as quality improvement activities, with role-specific training, reliable infrastructure, and clinician involvement in system optimisation. Future research should address usability challenges, enhance integration, and ensure that both clinician and patient perspectives guide digital health transformation.
Lobane- and prenyleudesmane-type diterpenoids represent structurally unique and biologically diverse natural products, predominantly isolated from soft corals in the genera Lobophytum and Sinularia. This review comprehensively covers the literature from 1978 to 2025, isolation methods, structural elucidation, biological evaluations, and proposed biosynthetic pathways. Based on their reported bioactivities, the compounds were systematically classified, and their potential biosynthetic pathways were proposed. Additionally, a structure-activity relationship (SAR) analysis was conducted to further elucidate the functional groups responsible for their anti-inflammatory, toxicity and anti-fungal properties. To address the challenge of insufficient supply for biological assays, recent total syntheses of representative compounds were also highlighted, providing alternative solutions for future drug discovery and mechanistic studies. This review not only consolidates current knowledge but also provides perspectives for future biosynthetic studies and the development of marine-derived diterpenoids as therapeutic leads.
Despite the revolution of artificial intelligence (AI), its integration remains limited in healthcare. A comprehensive understanding of the barriers to implementation is crucial to enhance the utilisation of AI. This study applies a conceptual framework-based analysis, to explore stakeholder perspectives of implementation barriers of AI in digital diagnosis in eye care. Purposive sampling was used to identify key individuals across stakeholder groups, including technology developers, clinicians, patients and healthcare leaders. Semi-structured interviews were conducted with 37 stakeholders. Using the updated Consolidated Framework for Implementation Research (CFIR), responses to the question: 'What is the biggest barrier to digital diagnosis or AI for macular disease in Australia?' were analysed. Barriers identified by stakeholders were mapped to thematic constructs of the updated CFIR, and the prominence of each implementation barrier was measured. Data saturation was not assessed. For clinicians and developers, the 'innovation' domain was most frequently cited. Clinicians were most concerned with the costs involved, whereas for developers, a lack of evidence surrounding real-world application was the main challenge. For leaders and patients, 'individuals' domain was the most frequently cited. Leaders were focused on the innovation deliverers: expressing the potential risk of over-reliance on the innovation and the subsequent consequence of clinician deskilling. Patients were more concerned about innovation recipients: emphasising the perceived lack of human empathy with the implementation of AI. Differences were revealed in the identified barriers to the implementation of AI across stakeholder groups. A co-design approach to address the misalignment in key barriers may be essential to the successful implementation of AI in digital health innovations.
Functional regeneration of bone and cartilage remains an urgent clinical challenge in orthopedics, as its repair process involves the synergistic participation of multiple systems and cell types. Traditional studies have mostly focused on the regulatory roles of individual cells or signaling pathways, while recent research has confirmed that bone/cartilage regeneration is governed by a regulatory mechanism centered on the neuro-immune-vascular axis. In this mechanism, mesenchymal stem cells (MSCs), bone marrow mesenchymal stem cells (BMSCs), adipose-derived mesenchymal stem cells (ADSCs), and cartilage progenitor cells (CPCs) serve as key functional cells, interacting sequentially and transcellularly with immune cells and endothelial cells through multiple core signaling pathways. This review systematically summarizes these core signaling pathways, including neurosignal-mediated pathways (CGRP/CRLR, NGF/TrkA, SP/NK1R), immune signal-mediated pathways (IL-4/IL-4R, TGF-β/Smad, TNF-α/NF-κB), endothelial cell-mediated pathways (VEGF/VEGFR, Notch, PDGF/PDGFR), and cross-regulatory pathways (PI3K/Akt, MAPK). These pathways collectively mediate the sequential crosstalk and functional coordination among the four cellular components. Additionally, the review highlights the application achievements of cutting-edge technologies in this field, such as single-cell omics, organoid models, in vivo imaging, new approach methodologies (NAM), microphysiological systems (MPSs), and biosensor-integrated platforms. It thoroughly analyzes the current bottlenecks in network mechanism research and clinical translation, including the spatiotemporal specificity of regulatory targets and the difficulty in simulating complex microenvironments, while proposing breAkthrough directions such as optimizing targeted regulatory strategies, developing intelligent biomaterials, and integrating multi-disciplinary technologies. Notably, the traditional M1/M2 macrophage dichotomy can no longer capture the high heterogeneity of immune cells. Recent single-cell omics studies have identified multiple functionally distinct macrophage subsets in the bone/cartilage regeneration microenvironment. This discovery provides a new perspective for precise immune regulation strategies and also underscores the limitations of the traditional classification framework. Overall, this review aims to establish a systematic framework for understanding the complex regulatory mechanisms of bone/cartilage regeneration and offer theoretical support and research insights for the development of efficient repair strategies.
The pursuit for high-energy, fast-charging all-solid-state lithium-sulfur batteries (ASSLSBs) has intensified due to the increasing demand of next-generation energy storage devices for electric vehicles. Polymer-based solid electrolytes (PSEs) have distinct advantages, including mechanical flexibility, interfacial adaptability, and processability; however, their inherent limits in ionic conductivity, interfacial stability, and polysulfide shuttling impede fast charge-discharge performance. This perspective scrutinizes the primary challenges influencing fast-charging features of PSE-based ASSLSBs, such as constrained lithium-ion transport pathway, polysulfide shuttling, and elevated interfacial polarization. Also, the recent advancements in polymer molecular design, composite engineering, and interfacial modification are outlined, highlighting approaches to attain high ionic conductivity, increased Li-ion transference number, and stable electrode-electrolyte interfaces are addressed. Further, research directions for adaptive, high-rate ASSLSBs are explored, including design strategies for increasing the ionic conductivity, mitigating polysulfide shuttling and designing a stable interface. Moreover, a comprehensive design framework that incorporates ion-transport optimization, chemical selectivity, and interface engineering is proposed to facilitate stable and dendrite-free fast-charging ASSLSBs. We believe this perspective offers a comprehensive overview of the progression of PSEs for practical, high-power Li-S batteries, connecting laboratory advancements with practical applications.
Data-sharing mandates from funders and journals have increased in recent years, but little is known about how shared data are used. Existing research has focused on access frameworks, with less attention to conditions that enable or hinder subsequent analyses and their impact on science and policy. We conducted semi-structured interviews with 22 key informants with experience using clinical research data. Participants included researchers, policy makers and senior staff from funding and pharmaceutical organisations. Interviews explored motivations, ethical and practical challenges, and enabling conditions for reuse. Data were analysed thematically using a combination of deductive and inductive coding. Reporting follows the Consolidated criteria for Reporting Qualitative research framework. Secondary data analyses have, in a few documented cases, shaped clinical guidelines and policy in low- and middle-income countries (LMICs). Individual participant data meta-analyses informed WHO recommendations for maternal and child health interventions, and analyses of COVID-19 data guided decisions at national and subnational levels in several countries. However, such cases remain uncommon. Secondary data users reported that shared data were seldom ready for analysis owing to incomplete metadata and under-resourced data curation. In academia, secondary analyses were driven by the potential for publication rather than health impact. Mistrust, particularly where data contributors feared reputational harm or exploitation, resulted in underutilisation of valuable data as analysts relied on a limited set of well-known or easily accessible datasets. This risks selection bias and limits the evidence base, especially for under-represented groups. Mandating data sharing alone is insufficient to deliver impact in LMICs. Policies must be coupled with resourcing for data curation, efforts to avail machine-actionable metadata and incentives for impact-driven analyses. Equally critical is trust, built through recognition of contributors and equitable, transparent benefit-sharing between analysts and data generators.
Liver steatosis resulting from chemical exposure is a growing clinical concern, pointing to the need for early detection in chemical safety assessments. New approach methodologies (NAMs) based on adverse outcome pathway (AOPs) networks are emerging tools to assess the safety of chemicals as an alternative to animal studies. Amongst others, NAM can include a human-based in vitro system linked to a battery of complementary assays, each measuring an individual key event within the respective AOP network. These AOP-based NAMs allow to acquire mechanistic insight, while facilitating the translation of in vitro data into outcomes relevant to hazard assessment. The current review provides pragmatic guidance for developing NAMs entailing an AOP network-driven in vitro testing platform suitable for steatogenic hazard assessment of chemicals, intended for use in academic, industrial and regulatory settings. In a first part, underlying mechanisms for highly specific key events for liver steatosis are described. In a second part, a workflow is provided for the establishment of NAMs, including the selection of human-based in vitro cell models, functional in vitro assays, reference control chemicals, exposure and treatment conditions. In a third part, future perspectives for AOP-based liver steatosis risk assessment are outlined.
Legumes, esteemed globally for their rich protein content, eco-friendly lifecycle, and versatility in vegetarian, vegan, and flexitarian diets, have emerged as pivotal crops. Peptides derived from legumes, such as soybean, chickpea, pea, lentil, and peanut, can be obtained through various methods, including microbial fermentation and enzymatic hydrolysis, to exhibit several bioactivities, including antioxidant, hypoglycemic, antihypertensive, and anti-inflammatory effects. The structure of these peptides plays a crucial role in determining the bioactivities. However, comprehensive reviews or commentaries on the structure-activity relationship (SAR) of legume-derived peptides (LDPs) are currently lacking. In this review, an overview of the commonly used LDP preparation methods, the biological activities, and mechanisms underlying the SARs of the peptides are discussed. Notably, the degree of hydrolysis, molecular weight, and the amino acid hydrophobicity, basicity, aromatic degree, and position in the peptide chain (particularly at the N- or C-termini) can influence the structural conformation of LDPs to enhance their bioactivities. It was also observed that the impact of higher-order structures on the bioactivity and safety of LDPs has received limited attention in current research. Future research could harness advanced computational methods to explore more complex SARs of LDPs to attain improved applications of LDPs in functional food contexts.
Sugarcane being a high biomass producing crop, massively depletes nutrients from the soil. Thus, optimum supply of mineral nutrients has the greatest impact on growth, development, and yield in sugarcane. Amongst the essential nutrients, the major nutrients nitrogen (N), phosphorus (P) and potassium (K) assume primary importance in cane growth and their availability determines the crop yield. Currently, physiological, molecular, and genetic basis of uptake and assimilation of these nutrients in sugarcane is limited compared to other field crops especially with regard to the root system traits that enhance nutrient uptake. Nonetheless, availability of the polyploid sugarcane genome sequence and genomic information has widened the scope for molecular characterisation of candidate genes involved in uptake, transport and assimilation of N, P, and K. This review summarises the physiological, molecular, and genetic basis of nutrient use efficiency in sugarcane and envisages strategies for production of more cane/crop per unit of nutrient applied.
The oral microbiome is a highly diverse and metabolically active ecosystem that plays a pivotal role in maintaining oral and systemic homeostasis. Disruption of this balance, referred to as oral dysbiosis, has been increasingly implicated in the pathogenesis of neurodegenerative diseases (NDs) such as Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS). Although the precise molecular mechanisms remain incompletely defined, accumulating evidence indicates that oxidative stress and redox signaling act as central mediators linking microbial imbalance to neuroinflammatory responses and progressive neuronal dysfunction. In this review, we critically synthesize interdisciplinary findings on the oral microbiome-brain axis, emphasizing redox-sensitive pathways that mediate communication between oral pathogens and the central nervous system. We discuss how reactive oxygen species (ROS), generated by microbial metabolites and pathogen-associated molecular patterns, activate various signaling cascades, thereby exacerbating neuroinflammation and glial activation. We further evaluate evidence that oral dysbiosis contributes to blood-brain barrier (BBB) disruption, peripheral immune priming, and chronic neuroimmune dysregulation. By integrating mechanistic, cellular, and clinical perspectives, we identify oxidative stress and redox signaling as critical biological bridges between oral dysbiosis and neurodegeneration. This framework highlights not only the translational potential of targeting redox pathways and the oral microbiome for preventive and therapeutic strategies but also the need for future research to clarify causal relationships and validate clinical applications.
Metal-polyphenol networks (MPNs), a novel class of nano-biomaterials, have recently emerged as promising candidates for tumor diagnosis and therapy due to their unique chemical tunability, excellent biocompatibility, and synergistic multifunctionality. Notably, MPNs can be synthesized via one-step or multi-step approaches, allowing precise control over their morphology, size, and drug-loading capacity. The versatility of MPNs is further demonstrated by their ability to integrate multiple therapeutic modalities, including chemotherapy, photothermal therapy, photodynamic therapy, and chemical dynamic therapy. Furthermore, through surface modification with targeted molecules, MPNs enable tumor-specific targeting while facilitating real-time therapeutic monitoring via multimodal imaging. Additionally, MPNs exhibit excellent biocompatibility and superior biodegradability, making them highly suitable for biomedical applications. This review systematically explores MPN synthesis strategies and physicochemical properties. It then comprehensively analyzes MPN-based biomaterials and their tumor therapeutic mechanisms. Furthermore, we evaluate the challenges in MPN clinical translation and propose future perspectives for precise tumor treatment using MPN-based platforms. Ultimately, this review highlights the transformative potential of MPNs in advancing tumor theranostics and lays the foundation for their future clinical applications.
The COVID-19 pandemic forced the world to quarantine to slow the rate of transmission, causing communities to transition into virtual spaces. Asian American and Pacific Islander communities faced the additional challenge of discrimination that stemmed from racist and xenophobic rhetoric in the media. Limited data exist on technology use among Asian American and Pacific Islander adults during the height of the COVID-19 shelter-in-place period and its effect on their physical and mental health. This study aims to examine Asian American and Pacific Islander adults' attitudes, perspectives, and experiences regarding their use of technology during the COVID-19 pandemic. We collaborated with community partners and used social media to distribute the COVID-19 Effects on the Mental and Physical Health of Asian Americans and Pacific Islanders Survey Study, a nationwide multilingual survey available in English, Chinese, Korean, Samoan, and Vietnamese. The survey was administered from October 2020 to February 2021, and participants rated their level of agreement (1=not at all to 5=extremely) on 6 items assessing their attitudes toward technology use. Thematic analysis was conducted on responses to the open-ended question "Is there anything else you want to tell us about your use of technology during COVID-19?" The qualitative responses were reviewed, analyzed, coded, and organized into corresponding themes. The mean age of respondents was 45.9 (SD 16.3; range 18-98) years, with 5398 participants completing the quantitative survey and 1115 (20.66%) providing unique responses to the open-ended question. In the quantitative survey, 68% (3671/5398) of the respondents reported being comfortable using technology; the majority indicated that it helped them keep up with the news (4318/5398, 79.99%), maintain social connections (4102/5398, 75.99%), and provide care for others (2537/5398, 46.99%). However, responses were mixed regarding the usefulness of technology for health: 39.99% (2159/5398) agreed that it was helpful for mental health but disagreed regarding physical health. Four main themes emerged from the qualitative analysis: (1) technology was critical for functioning across many aspects of life and maintaining physical, mental, and emotional well-being; (2) technology was often the only means of interpersonal social connections; (3) overuse led to negative physical and mental health outcomes; and (4) technology use was associated with multiple challenges and barriers. Our findings revealed diverse perspectives and experiences related to technology use by Asian American and Pacific Islander adults during the height of the COVID-19 pandemic. Dependence on technology may have exacerbated social inequities, particularly for those with lack of access to devices and Wi-Fi and limited English proficiency, affecting their ability to work, apply for jobs, and communicate virtually. Further qualitative research would be beneficial in amplifying the perspectives of Asian American and Pacific Islander adults to uncover concerns and address health disparities.