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Background Surgery for oesophageal squamous cell carcinoma involves dissecting lymph nodes along the recurrent laryngeal nerve. This is technically challenging and injury to the recurrent laryngeal nerve may lead to vocal cord palsy, which increases the risk of pulmonary complications. The aim of this study was to compare the efficacy and safety of robot-assisted oesophagectomy (RAO) versus video-assisted thoracoscopic oesophagectomy (VAO) for dissection of lymph nodes along the left RLN. Methods Patients with oesophageal squamous cell carcinoma who were scheduled for minimally invasive McKeown oesophagectomy were allocated randomly to RAO or VAO, stratified by centre. The primary endpoint was the success rate of left recurrent laryngeal nerve lymph node dissection. Success was defined as the removal of at least one lymph node without causing nerve damage lasting longer than 6 months. Secondary endpoints were perioperative and oncological outcomes. Results From June 2018 to March 2022, 212 patients from 3 centres in Asia were randomized, and 203 were included in the analysis (RAO group 103; VAO group 100). Successful left recurrent laryngeal nerve lymph node dissection was achieved in 88.3% of the RAO group and 69% of the VAO group (P < 0.001). The rate of removal of at least one lymph node according to pathology was 94.2% for the RAO and 86% for the VAO group (P = 0.051). At 1 week after surgery, the RAO group had a lower incidence of left recurrent laryngeal nerve palsy than the VAO group (20.4 versus 34%; P = 0.029); permanent recurrent laryngeal nerve palsy rates at 6 months were 5.8 and 20% respectively (P = 0.003). More mediastinal lymph nodes were dissected in the RAO group (median 16 (i.q.r. 12–22) versus 14 (10–20); P = 0.035). Postoperative complication rates were comparable between the two groups and there were no in-hospital deaths. Conclusion In patients with oesophageal squamous cell carcinoma, RAO leads to more successful left recurrent laryngeal nerve lymph node dissection than VAO, including a lower rate of short- and long-term recurrent laryngeal nerve injury. Registration number: NCT03713749 (http://www.clinicaltrials.gov). [ABSTRACT FROM AUTHOR]

As botanicals and dietary supplements are used increasingly in many countries, the issue of safety is particularly critical for regulation of food products containing these substances. Seabuckthorn (Hippophae rhamnoides L.) has been used for centuries as a medicine and nutritional supplement in Asia and Europe. However, data regarding to the safety assessment of the plant and its extracts is still rare. This study was to evaluate the potential toxicity of seabuckthorn berry (SB) oil conducted in three genotoxicity studies and a teratogenicity study. Results of the genotoxicity studies indicated that SB oil has no genotoxicity under the experimental conditions of this study. Specifically, SB oil did not display any mutagenic activity on histidine dependent strains of Salmonella typhimurium under exposure concentrations of 8, 40, 200, 1000, and 5000 μg/plate; SB oil did not have significant effect on sperm morphology and have no influence on micronucleus rate of polychromatic erythrocytes in mice at doses of 9.36, 4.68, and 2.34 g/kg body weight. In the teratogenicity study, pregnant rats were treated with 4.68, 2.34, and 1.17 g/kg SB oil from gestation day 7 to 16 and no treatment-related maternal toxicity or embryo toxicity was observed. Taken together, these results support the safe use of seabuckthorn berry oil for potential dietary consumption in food or as a dietary supplement. [ABSTRACT FROM AUTHOR]

[Display omitted] • Exploring global PM 2.5 exposure risk from a multi-scale spatiotemporal perspective. • Structuring a localized assessment framework for SDG 11.6.2 at diverse spatial scales. • Increased inequality in PM 2.5 exposure risk of developing and developed countries. Assessing the spatiotemporal patterns, exposure risks and sustainability of PM 2.5 pollution from multi–scale spatial and temporal characteristics are relevant for achieving Goal 11.6.2 of the 2030 Agenda for Sustainable Development (assessing the effects of urban fine particulate matter pollution on public health). According to this study, methodological models combining trend analysis, spatial statistics, and population exposure risk assess the spatiotemporal patterns, exposure risks, and sustainability characteristics of PM 2.5 pollution at global, continental, and national scales, and ultimately achieve SDG 11.6.2 Assessment framework at different spatial scales. The results indicate that: (1) The annual decline in global PM 2.5 concentrations exhibited a rate of –0.023 µg/m3/yr, with more than 30 % of regions experiencing a decrease in PM 2.5 concentrations of more than 0.1 µg/m3/yr, and showed significant spatial distribution differences. (2) The global population exposed to <10 µg/m3 continues to grow from 4.8 % in 2000 to 6.2 % in 2010 and further to 10.3 % in 2020 during the study period. By comparison, the population exposed to >70 µg/m3 shows a U–shaped change. Spatially, more than 60 % of the world's regions are exposed to low risk (Low risk and Lower risk) and less than 30 % are exposed to high risk (Higher, High and Extremely high risk). Asia has the highest exposure (2.95), while Oceania has the lowest (0.11). (3) Inequalities in sustainable PM 2.5 exposure risks between developed and developing countries will continually increase. The results of the study not only shed light on the present state of sustainable global air quality progress but also offer valuable insights and a blueprint for conducting similar multi–scale assessments in the coming times. [ABSTRACT FROM AUTHOR]

Quercus variabilis plays a key role in soil remediation, erosion control, and in the economic and ecosystemic development in eastern Asia. In this study, we sequenced the complete chloroplast genome of Q. variabilis based on next-generation sequencing and used these data to assess genomic resources. The size of the Q. variabilis chloroplast genome is 161,168 bp, including a large single-copy region (90,464 bp), a small single-copy region (19,070 bp), and a pair of inverted repeats regions (25,817 bp). The overall GC content of the Q. acutissima chloroplast genome was 35.7%. The chloroplast genome of Q. variabilis encodes 112 different genes, including 78 protein-coding genes, 30 transfer RNAs (tRNA) and four ribosomal RNAs (rRNA). A phylogenetic tree constructed based on complete chloroplast genome sequences of 15 Quercus species showed that Q. variabilis was sister to Q. acutissima. [ABSTRACT FROM AUTHOR]

As the largest independent east–west-trending mountain in the world, Mt. Tianshan exerts crucial impacts on climate and pollutant distributions in central Asia. Here, the vertical structures of meteorological elements and black carbon (BC) were first derived at Mt. Tianshan using an unmanned aerial vehicle system (UAVS). Vertical changes in meteorological elements can directly affect the structure of the planet boundary layer (PBL). As such, the influences of topography and meteorological elements' vertical structure on aerosol distributions were explored from observations and model simulations. The mass concentrations of BC changed slightly with the increasing height below 2300 m above sea level (a.s.l.), which significantly increased with the height between 2300–3500 m a.s.l. and contrarily decreased with ascending altitude higher than 3500 m. Topography and mountain–valley winds were found to play important roles in the distributions of aerosols and BC. The prevailing valley winds in the daytime were conducive to pollutant transport from surrounding cities to Mt. Tianshan, where the aerosol number concentration and BC mass concentration increased rapidly, whereas the opposite transport pattern dominated during nighttime. [ABSTRACT FROM AUTHOR]

The sea cucumber (Apostichopus japonicus) is becoming one of the most important fishery resources in Asia. Spartina alterniflora is a common invasive plant in China, that has not been effectively controlled or utilized. Some studies have shown that the organic detritus of S. alterniflora can be used by benthic animals. This study investigated the effects of the addition of S. alterniflora in the diet of juvenile A. japonicus on growth performance, digestive enzyme activity, non-specific immunity and gut microbiota. Powdered S. alterniflora and Sargassum polycystum were mixed in five proportions (0,100, 25,75; 50:50; 75:25; 100:0) along with muddy sediment (60% of total food) to create five different experimental diets for sea cucumbers. The results showed that specific growth rates (SGRs) improved with the addition of S. alterniflora , but did not increased with the increasing proportion of S. alterniflora. The increase in the ratio of S. alterniflora also improved the food conversion efficiency (FCE) of A. japonicus. The cellulase activity was highest in P20 group, which is a mixture of 20% S. alterniflora , 20% S. polycystum and 60% muddy sediment. Non-specific immune enzyme activity was not altered by the addition of S. alterniflora. In addition, the addition of S. alterniflora reduced the abundance of pathogenic bacteria and increased the abundance of bacteria associated with the degradation of high-molecular carbohydrates. The results of this study indicated that S. alterniflora could be a potential food source for A. japonicus and might be beneficial to A. japonicus growth. The findings of this study are important for the development of suitable feed for A. japonicus and the management and utilization of invasive plants. • A new way for the utilization of the invasive species Spartina alterniflora is proposed. • Spartina alterniflora can be used as a food source in the cultivation of Apostichopus japonicus. • The addition of Spartina alterniflora is beneficial to the gut microbiota and growth of sea cucumbers. [ABSTRACT FROM AUTHOR]

Background: Kashin-Beck disease (KBD) is an endemic, chronic, degenerative osteoarthropathy. KBD is usually diagnosed by using X-ray image and clinical symptoms, lacking of serological biomarkers. The serum level of PIICP, PIIANP, and PIIBNP can specifically reflect the damage of the cartilage. So, in this study, the serum levels of PIICP, PIIANP, and PIIBNP were detected in order to determine whether they can be used as potential biomarkers for the diagnosis of KBD. Method: Using a status survey, the survey sites were selected in the KBD historical endemic areas and non-endemic areas in Jilin and Heilongjiang provinces. All local residents have undergone clinical examination, X-ray examination of the hands and knees, and questionnaire survey. A total of 554 people were surveyed, and 184 residents who are eligible for inclusion criteria were selected as our subjects. Fifty-six cases were diagnosed as KBD and 63 individuals were included as internal control and 65 subjects were included as external control. And blood samples of surveyed subjects were collected, and the serum was separated to detect the levels of PIICP, PIIANP, and PIIBNP by ELISA. Statistical analysis was performed using the SPSS software. Results: There were no statistically significant differences in age and sex among the three groups. The Kruskal-Wallis H test showed that the serum levels of PIICP, PIIANP, and PIIBNP were significantly different among the three groups. Multiple comparisons using Dunnett's T3 test revealed that serum levels of PIICP, PIIANP, and PIIBNP were significantly lower in KBD patients than in internal and external control. However, there was no significant difference between the internal and external control. Conclusions: The results preliminarily indicated that the levels of PIICP, PIIANP, and PIIBNP in serum could reflect the abnormal synthesis of type II collagen in KBD patients and suggested that these indicators might be used as potential biomarkers for the diagnosis of KBD. [ABSTRACT FROM AUTHOR]

The sea cucumber Apostichopus japonicus is an economically important species in Asia. Large growth differences have been recorded for A. japonicus during field surveys and culture practices. These growth differences can seriously impact the recovery of wild populations and breeding efficiencies in aquaculture systems. This study explored differences in movement behavior, feeding behavior, digestive ability and intestinal microbes of A. japonicus that displayed obvious differences in growth under the same culture conditions. The results showed that there was no significant difference in the movement behavior of A. japonicus with different growth rates, but the feeding behavior of slow-growing A. japonicus was significantly reduced. The activity of trypsin, the main digestive enzyme in A. japonicus , was significantly decreased in slow-growing individuals. There was a marked variation in the gut microbiota composition of sea cucumbers with different growth rates. Compared with slow-growing A. japonicus , fast-growing A. japonicus had a higher α diversity, and abundance of Rhodobacteraceae, Rubritaleaceae, and Pirellulaceae. Many of these bacteria were related to the algal polysaccharide degradation. However, the abundance of Vibrionaceae and Burkholderiaceae was higher in slow-growing A. japonicus, which contained potential pathogenic bacteria. This indicated the differences in feeding behavior, digestive ability and intestinal microbiota was related to different growth rates of A. japonicus. These differences will continue to promote growth differences over time. This research provided new insights for understanding the large growth differences in A. japonicus. • New insights for the large growth differences of sea cucumbers were provided. • The feeding behavior of slow-growing sea cucumbers is significantly reduced. • The reduction of digestive ability and the quality of intestinal microbiota was related to the slow growth of sea cucumbers. [ABSTRACT FROM AUTHOR]

• R. tomentosa is a kind of valuable edible medicinal herb resource in food industry. • R. tomentosa have extensive bioactivities and potential development value. • The research progress of phytochemistry of R. tomentosa was summarized until 2019. • The advances of bioactivities and food applications of R. tomentosa are reviewed. Rhodomyrtus tomentosa (Aiton) is a flowering plant native to southern and southeastern Asia. Up to date, 106 chemical constituents have been isolated and identified from R. tomentosa. Among these compounds, triterpenoids, flavonoids, phenols and meroterpenoids are the major constituents. Investigations of pharmacological activities of R. tomentosa revealed that this edible medicinal herb exhibits a wide range of therapeutic potential including antibacterial, antitumor, anti-inflammatory and antioxidant activities both in vivo and in vitro. The purpose of this review is to provide an overview of R. tomentosa studies until 2019. This article also intends to review advances in the botanical, phytochemical, pharmacological studies and industrial applications of R. tomentosa , which will provide a useful bibliography for further investigations and applications of R. tomentosa in medicines and foods. [ABSTRACT FROM AUTHOR]

Background: This trial aimed to assess the efficacy, acceptability, and safety of a first-trimester screen-and-prevent strategy for preterm preeclampsia in Asia., Methods: Between August 1, 2019, and February 28, 2022, this multicenter stepped wedge cluster randomized trial included maternity/diagnostic units from 10 regions in Asia. The trial started with a period where all recruiting centers provided routine antenatal care without study-related intervention. At regular 6-week intervals, one cluster was randomized to transit from nonintervention phase to intervention phase. In the intervention phase, women underwent first-trimester screening for preterm preeclampsia using a Bayes theorem-based triple-test. High-risk women, with adjusted risk for preterm preeclampsia ≥1 in 100, received low-dose aspirin from <16 weeks until 36 weeks., Results: Overall, 88.04% (42 897 of 48 725) of women agreed to undergo first-trimester screening for preterm preeclampsia. Among those identified as high-risk in the intervention phase, 82.39% (2919 of 3543) received aspirin prophylaxis. There was no significant difference in the incidence of preterm preeclampsia between the intervention and non-intervention phases (adjusted odds ratio [aOR], 1.59 [95% CI, 0.91-2.77]). However, among high-risk women in the intervention phase, aspirin prophylaxis was significantly associated with a 41% reduction in the incidence of preterm preeclampsia (aOR, 0.59 [95% CI, 0.37-0.92]). In addition, it correlated with 54%, 55%, and 64% reduction in the incidence of preeclampsia with delivery at <34 weeks (aOR, 0.46 [95% CI, 0.23-0.93]), spontaneous preterm birth <34 weeks (aOR, 0.45 [95% CI, 0.22-0.92]), and perinatal death (aOR, 0.34 [95% CI, 0.12-0.91]), respectively. There was no significant between-group difference in the incidence of aspirin-related severe adverse events., Conclusions: The implementation of the screen-and-prevent strategy for preterm preeclampsia is not associated with a significant reduction in the incidence of preterm preeclampsia. However, low-dose aspirin effectively reduces the incidence of preterm preeclampsia by 41% among high-risk women. The screen-and-prevent strategy for preterm preeclampsia is highly accepted by a diverse group of women from various ethnic backgrounds beyond the original population where the strategy was developed. These findings underpin the importance of the widespread implementation of the screen-and-prevent strategy for preterm preeclampsia on a global scale., Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03941886., Competing Interests: L.C.P. has received speaker fees and consultancy payments from Roche Diagnostics and Ferring Pharmaceuticals. In addition, she has received in-kind contributions from Roche Diagnostics, Revvity Inc (formerly PerkinElmer Life and Analytical Sciences), Thermo Fisher Scientific, Ningbo Aucheer Biological Technology Co, Ltd, and GE HealthCare. D.S.S. has received in-kind contributions from Revvity Inc, Thermo Fisher Scientific, Roche Diagnostics, Diabetomics, and Ningbo Aucheer Biological Technology Co, Ltd. R.K.P. is chief executive officer of Ritz Medical Co Ltd, a genetic testing company, and holds shares in and receives executive compensation from it. The other authors report no conflicts.

Background: The incidence of malignant tumors has increased in patients with non-paraneoplastic pemphigus, although there has been no systematic analysis of global epidemiology., Objective: To explore the epidemiology of various types of non-paraneoplastic pemphigus associated with malignant tumors., Methods: Five databases from establishment through October 20, 2023, were searched. STATA SE 17 was used for the data analysis. Subgroup, meta-regression, and sensitivity analyses were used to evaluate the heterogeneity of pooled studies., Results: A total of 6679 participants were included in our meta-analysis from 16 studies. The aggregated prevalence of tumors in patients diagnosed with pemphigus was 8%. The prevalence was 7% in patients with pemphigus vulgaris, 10% in those with pemphigus foliaceus, and 12% in individuals diagnosed with other types of pemphigus. The prevalence was 8% in Asia, 11% in Europe, and 8% in North America. From a country-specific perspective, patients with pemphigus from Israel, Greece, and Germany exhibited a higher prevalence of tumors at 11%. Furthermore, when categorized by the duration of the study period, the highest prevalence was observed in studies spanning 10 to 20 years, at 11%., Conclusion: These findings demonstrate the incidence and prevalence of malignant tumors in patients with non-paraneoplastic pemphigus, which may achieve early detection and intervention, and then reduce mortality rates., (© 2024. The Author(s).)

Background: The microdeletion of chromosome 13 has been rarely reported. Here, we report a 14-year old Asian female with a de novo microdeletion on 13q12.3., Case Presentation: The child suffered mainly from two types of epileptic seizures: partial onset seizures and myoclonic seizures, accompanied with intellectual disability, developmental delay and minor dysmorphic features. The electroencephalogram disclosed slow waves in bilateral temporal, together with generalized spike-and-slow waves, multiple-spike-and-slow waves and slow waves in bilateral occipitotemporal regions. The exome sequencing showed no pathogenic genetic variation in the patient's DNA sample. While the single nucleotide polymorphism (SNP) array analysis revealed a de novo microdeletion spanning 2.324 Mb, within the cytogenetic band 13q12.3., Conclusions: The epilepsy may be associated with the mutation of KATNAL1 gene or the deletion unmasking a recessive mutation on the other allele, and our findings could provide a phenotypic expansion.

Background: Double Burden of Malnutrition (DBM)-the coexistence of undernutrition along with overnutrition-is a significant public health issue in the Asia-Pacific region. The scope of the DBM in this region is largely unknown. This review aims to determine the prevalence of under- and overnutrition as major DBM components and to investigate whether there has been a shift from under- to overnutrition in the Asia-Pacific region., Methods: Online databases including PubMed and Web of Science were searched for original studies on DBM prevalence in the Asia-Pacific region; particularly, those published from January 2008 to December 2018 were screened for eligibility. We collected data on indicators of under- and overnutrition on the population level and adapted the ratio of prevalence of overweight/obesity versus prevalence of underweight as the main outcome indicator. Pooled prevalence estimates of DBM and the ratio of overnutrition versus undernutrition were generated using R (3.4.0)., Results: In total, 33 studies were included in this review. Pooled analysis demonstrated that DBM was generally presented among countries/areas in the Asia-Pacific region except in high-income countries (HICs). Overall, the prevalence of undernutrition was 8.8% (95% CI 7.3-10.6%) while overnutrition among the same population reached 23.0% (95% CI 20.3-26.0%). Countries in the Oceania region or HICs reported low level of undernutrition (less than 3%). All subgroup analysis (geolocation, income level, sex, age) reported pooled prevalence of overweight/obesity as more than 18%. Overall, the whole region and all subgroups were more likely to experience a higher prevalence of overnutrition than undernutrition, except that low- and lower-middle-income countries (L-MICs) had similar prevalence for over- and undernutrition., Conclusion: DBM in the Asia-Pacific region is alarmingly high and is titled toward overnutrition. As a result, future interventions/policy targeting to maintain a healthy weight for the population should not just focus on prevention and treatment toward one direction., Competing Interests: The authors declare no conflicts of interest., (© 2019 Atlantis Press International B.V.)