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The estrogen levels of Asian women are different from those of Western women, and this could affect estrogen receptor (ER) bioactivity and breast cancer risk. We conducted a case-control study in 169 postmenopausal breast cancer cases and 426 matched controls nested within a population-based prospective cohort study, the Singapore Chinese Health Study, to evaluate the serum levels of estrogens and their receptor (ERa and ERb)-mediated estrogenic activities in relation to breast cancer risk. Breast cancer cases had higher levels of estrogens and ER-mediated bioactivities in baseline serum than the controls. Compared with those in the lowest quartile, women in the highest quartile for estrone (E1) or ERa-mediated bioactivity had increased breast cancer risk. After additional adjustment for ERb bioactivity, free estradiol, and E1 levels, serum ERa-mediated bioactivity remained associated with increased breast cancer risk. Compared with those in the lowest quartile, women in the highest quartile for ERa-mediated bioactivity had an odds ratio of 2.39 (95% CIZ1.17-4.88; P for trendZ0.016). Conversely, the positive association between E1 and cancer risk became null after adjustment for ERa-mediated bioactivity, suggesting that the effect of E1 could be mediated through ERɑ. Factor(s) contributing to increased ERa-mediated estrogenic bioactivity in serum and its role as a predictor for breast cancer risk need to be validated in future studies. [ABSTRACT FROM AUTHOR]

Multinational studies have reported monogenic etiologies in 25%–30% of children with steroid-resistant nephrotic syndrome. Such large studies are lacking in Asia. We established Deciphering Diversities: Renal Asian Genetics Network (DRAGoN) and aimed to describe the genetic and clinical spectrums in Asians. We prospectively studied a cohort of 183 probands with suspected genetic glomerulopathies from South and Southeast Asia, of whom 17% had positive family history. Using multi-gene panel sequencing, we detected pathogenic variants in 26 (14%) probands, of whom one-third had COL4A4 or COL4A5 variants (n = 9, 5%). Of those with COL4A5 defects, only 25% had features suggestive of Alport syndrome. Besides traditional predictors for genetic disease (positive family history and extrarenal malformations), we identified novel predictors, namely older age (6.2 vs. 2.4 years; p = 0.001), hematuria (OR 5.6; 95% CI 2.1–14.8; p < 0.001), and proteinuria in the absence of nephrotic syndrome (OR 4.6; 95% CI 1.8–11.8; p = 0.001) at first manifestation. Among patients who first presented with proteinuria without nephrotic syndrome, the genetic diagnostic rates were >60% when a second risk factor (positive family history or extrarenal manifestation) co-existed. The genetic spectrum of glomerulopathies appears different in Asia. Collagen IV genes may be included in sequencing panels even when suggestive clinical features are absent. [ABSTRACT FROM AUTHOR]

BACKGROUND: MAVERIC (Mitral Valve Repair Clinical Trial) validates the safety and efficacy of the ARTO system. We here report the first two successful cases of utilizing the ARTO system in patients with symptomatic heart failure (HF) with functional mitral regurgitation (FMR) in Asia. METHODS: Two patients, aged 70 and 63, had severe HF with FMR. Transesophageal echocardiography confirmed that the left ventricular ejection fractions were less than 50% with severe mitral regurgitation (MR) in both patients. Optimizing drug treatment could not mitigate their symptoms. Therefore, we used the ARTO system to repair the mitral valve for these patients on March 5 and 6, 2019, respectively. RESULTS: Mitral valve repairs using the ARTO system were successfully performed under general anaesthesia for these two patients. MR was decreased immediately after the procedures in both patients. The 30-day and 3-month transthoracic echocardiography (TTE) revealed a moderate to severe MR in both patients, and the New York Heart Association (NYHA) scales were also partially improved. CONCLUSION: The first two cases in Asia indicate that the ARTO system is feasible for patients with heart failure with FMR, and the patient selection appears to be crucial. [ABSTRACT FROM AUTHOR]

Chinese Gridded Pesticide Emission and Residue Model was applied to simulate long-term environmental fate of β-HCH in Asia spanning 1948-2009. The model captured well the spatiotemporal variation of β-HCH soil concentrations across the model domain. β-HCH use in different areas within the model domain was simulated respectively to assess the influence of the different sources of β-HCH on its environment fate. A mass center of soil residue (MCSR) was introduced and used to explore environmental factors contributing to the spatiotemporal variation of β-HCH soil residue. Results demonstrate that the primary emission dominates β-HCH soil residues during the use of this pesticide. After phase-out of the pesticide in 1999, the change in β-HCH soil residues has been associated with the Asian summer monsoon, featured by northward displacement of the MCSR. The displacement from several major sources in China and northeastern Asia shows a downward trend at a 95% confidence level, largely caused by environmental degradation and northward delivery of β-HCH under cold condition in northern area. The MCSRs away from the India and southern and southeastern Asia sources show a rapid northward displacement at a 99% confidence level, featuring the cold trapping effect of the Tibetan Plateau. [ABSTRACT FROM AUTHOR]