Asia Pacific Research Articles

Building Spaces for Dialogues to Rethink Evaluator Competencies: Lessons from the Webinars Organized by the Evaluation Centre for Complex Health Interventions

Background: There is a need to rethink evaluator competencies given the harsh and paralyzing realities of COVID. The pandemic was a time where there was a need to balance diverse perspectives given the limited scientific evidence that existed when faced with a genuinely unprecedented time. In the Fall of 2021 (September to October), the Evaluation Centre for Complex Health Interventions in partnership with the Asia Pacific Evaluation Association organized a three-part webinar series in response to the multiple issues that surfaced during COVID-19, and specifically, the implications of the pandemic for rethinking evaluator competencies and evaluator training. The presenters were from multiple countries including India, Canada, USA, UK, and South Africa.
 Purpose: The presenters pushed for more responsive evaluation approaches to address inequities and sustainability and for a decolonized approach to knowledge building. The webinar raised a number of themes that have potential implications for future discussions on evaluator competencies including: enhancing evaluation contributions to the Sustainable Development Goals (SDGs), the need to rethink evaluation criteria, the need to embrace and address varieties of uncertainties, focus on diversity and heterogeneity; understanding the role of contexts in complex programs and policies; the need to reconceptualize sustainability; being more explicit about inequities and vulnerabilities; and the need to pay attention to systems and system dynamics.
 Setting: The webinars were organized by the Evaluation Centre and the Asia Pacific Evaluation Association on a Zoom platform.
 Intervention: Not applicable.
 Research Design: Not applicable.
 Data Collection and Analysis: Not applicable.
 Findings: Not applicable.

The search for hybrids between Myriophyllum sibiricum and M. spicatum (Haloragaceae) in North Eurasia allowed to clarify their morphological differences and distribution

Myriophyllum sibiricum and M. spicatum are sympatric in large part of their vast ranges in Eurasia and North America and have different habitat preferences only in East Europe and Siberia. Such absence of both geographic and ecological isolation should trigger extensive hybridization between these species that is indeed observed in North America. The hybrid could be reliably documented only with genetic markers, and in Eurasia this was done only in China. Using genetic markers (ITS2 region of nuclear ribosomal DNA and trnL-trnF intergenic spacer of cpDNA) we documented hybrids between M. sibiricum and M. spicatum on the North Asian Pacific islands with dynamic geological history and climate (Commander and the southern Kuril islands). The hybrid also originated in East Europe (Ivanovo Region) as a result of ecological isolation break due to rapid artificial habitat change. Using genetically verified material throughout temperate Eurasia we clarified morphological characters discriminating M. sibiricum and M. spicatum and, basing on them, refined the species distribution. For the first time we provide a full morphological characteristic of the hybrid between M. sibiricum and M. spicatum and suggest a name for it, M. × hybridum.

The becoming of worker mothers: The untold narratives of an identity transition

AbstractWorker mothers still struggle to find a good balance between their care and work identities. Most research on motherhood at work focuses on how organizational structures can enable professional women to find a balance between caring and work identities neglecting their personal experiences and how they understand themselves in relation to both motherhood and work. We propose to use a liminal identity work perspective to explore the identity tensions that professional women experience during their transition into motherhood and how they manage it. To explore this question, we conducted a qualitative study over 2 years with worker mothers in Latin and North America, Europe, Asia Pacific, and Africa. The thematic and narrative analysis of 80 individual narrative interviews shows the emergence of two coexisting identity narratives. The first narrative understands motherhood as a linear process, where women experience liminality, uncertainty, and identity loss but eventually return to work after having aggregated their new worker mother identities during maternity leaves. The second coexisting narrative challenges this linear and finite view by highlighting the transition to motherhood as a continuous, liminoid, and never‐ending process. The two narratives are contextualized and managed differently according to the different cultural, historical, and social contexts where they are developed; the overall results present motherhood as a ‘liminoid’ experience that requires constant identity work to navigate the tensions emerging between potentially new and customary identities and behaviors in work contexts.

Crypto goes East: analyzing Bitcoin, technological and regulatory contagions in Asia–Pacific financial markets using asset pricing

PurposeThis study provides a comprehensive analysis of the potential contagion of Bitcoin on financial markets and sheds light on the complex interplay between technological advancements, accounting regulatory and financial market stability.Design/methodology/approachThe study employs a multi-faceted approach to analyze the impact of BTC systemic risk, technological factors and regulatory variables on Asia–Pacific financial markets. Initially, a single-index model is used to estimate the systematic risk of BTC to financial markets. The study then uses ordinary least squares (OLS) to assess the potential impact of systemic risk, technological factors and regulatory variables on financial markets. To further control for time-varying factors common to all countries, a fixed effect (FE) panel data analysis is implemented. Additionally, a multinomial logistic regression model is utilized to evaluate the presence of contagion.FindingsResults indicate that Bitcoin's systemic risk to the Asia–Pacific financial markets is relatively weak. Furthermore, technological advancements and international accounting standard adoption appear to indirectly stabilize these markets. The degree of contagion is also found to be stronger in foreign currencies (FX) than in stock index (INDEX) markets.Research limitations/implicationsThis study has several limitations that should be considered when interpreting the study findings. First, the definition of financial contagion is not universally accepted, and the study results are based on the specific definition and methodology. Second, the matching of daily financial market and BTC data with annual technological and regulatory variable data may have limited the strength of the study findings. However, the authors’ use of both parametric and nonparametric methods provides insights that may inspire further research into cryptocurrency markets and financial contagions.Practical implicationsBased on the authors analysis, they suggest that financial market regulators prioritize the development and adoption of new technologies and international accounting standard practices, rather than focusing solely on the potential risks associated with cryptocurrencies. While a cryptocurrency crash could harm individual investors, it is unlikely to pose a significant threat to the overall financial system.Originality/valueTo the best of the authors knowledge, they have not found an asset pricing approach to assess a possible contagion. The authors have developed a new method to evaluate whether there is a contagion from BTC to financial markets. A simple but intuitive asset pricing method to evaluate a systematic risk from a factor is a single index model. The single index model has been extensively used in stock markets but has not been used to evaluate the systemic risk potentials of cryptocurrencies. The authors followed Morck et al. (2000) and Durnev et al. (2004) to assess whether there is a systemic risk from BTC to financial markets. If the BTC possesses a systematic risk, the explanatory power of the BTC index model should be high. Therefore, the first implied contribution is to re-evaluate the findings from Aslanidis et al. (2019), Dahir et al. (2019) and Handika et al. (2019), using a different method.

Innovative innovation in journalism

Previous studies over the past 23 years have illustrated how the journalistic field has embraced innovative processes. While some of these processes were fully developed at that time, others were still in the process of development or implementation. An ad hoc analysis sheet was designed using innovation categories, where each item is assigned a score based on the level of innovation, ranging from low to high. This methodological instrument is proposed for the analysis of high innovation in news websites and it is applied to narratives, data journalism, audience involvement, co-creation, verification, ethics, corporate information and content distribution in the most widely consumed news sites across Europe, the Americas, Asia Pacific and Africa. What is discovered is that there are no more evolved trends in some regions than in others. Nevertheless, European and American sites offer a broader range of options compared to their African and Asian counterparts.

Rationale and protocol paper for the Asia Pacific Network for inherited eye diseases

PurposeThere are major gaps in our knowledge of hereditary ocular conditions in the Asia-Pacific population, which comprises approximately 60% of the world's population. Therefore, a concerted regional effort is urgently needed to close this critical knowledge gap and apply precision medicine technology to improve the quality of lives of these patients in the Asia-Pacific region. DesignMulti-national, multi-center collaborative network. MethodsThe Research Standing Committee of the Asia-Pacific Academy of Ophthalmology and the Asia-Pacific Society of Eye Genetics fostered this research collaboration, which brings together renowned institutions and experts for inherited eye diseases in the Asia-Pacific region. The immediate priority of the network will be inherited retinal diseases (IRDs), where there is a lack of detailed characterization of these conditions and in the number of established registries. ResultsThe network comprises 55 members from 35 centers, spanning 12 countries and regions, including Australia, China, India, Indonesia, Japan, South Korea, Malaysia, Nepal, Philippines, Singapore, Taiwan, and Thailand. The steering committee comprises ophthalmologists with experience in consortia for eye diseases in the Asia-Pacific region, leading ophthalmologists and vision scientists in the field of IRDs internationally, and ophthalmic geneticists. ConclusionsThe Asia Pacific Inherited Eye Disease (APIED) network aims to (1) improve genotyping capabilities and expertise to increase early and accurate genetic diagnosis of IRDs, (2) harmonise deep phenotyping practices and utilization of ontological terms, and (3) establish high-quality, multi-user, federated disease registries that will facilitate patient care, genetic counseling, and research of IRDs regionally and internationally.

Abstract B090: Breast cancer incidence rates by neighborhood socioeconomic status and ethnic enclaves among Asian American, Native Hawaiian, and Pacific Islander females in California

Abstract Background—Among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) females in the U.S., breast cancer incidence has steadily increased1. Of note, California has the largest population of AANHPI residents in the United States2. Few studies have examined whether the incidence rates of breast cancer among AANHPI populations differ by the neighborhood social environment. Thus, we examined the incidence of invasive breast cancer by AANHPI ethnic enclave (ethnically distinct neighborhoods) and neighborhood socioeconomic status (nSES) among AANHPI females in California. Methods— With 14,738 AANHPI females diagnosed with invasive breast cancer from 2008 through 2012 from the California Cancer Registry, we calculated the incidence rates of breast cancer. The 2007 to 2011 American Community Survey (ACS) data was used to assess AANHPI ethnic enclave index and nSES at the census tract level. Incidence rate ratios (IRRs) were analyzed by statewide quintiles of AANHPI ethnic enclave index and nSES. For analyses of AANHPI ethnic enclave index and nSES combined, low and high levels were defined as quintiles 1-3 and quintiles 4-5, respectively, and IRRs were calculated for joint AANHPI and nSES as low-low, low-high, high-low, and high-high. IRR associations of ethnic enclave and nSES by stage (localized vs. advanced (regional/distant)) were also assessed. Results— Overall, neighborhoods of lower AANHPI ethnic enclave index had higher incidence rates of breast cancer for AANHPI females in California. The incidence rate of breast cancer among AANHPI living in low ethnic enclave neighborhoods were 1.16 times that of AANHPI females living high ethnic enclave neighborhoods (95% CI 1.12 to 1.20; p<0.001). In addition, AANHPI females living in higher SES neighborhoods had higher incidence rates of breast cancer (IRR = 1.16 comparing highest to lowest nSES quintile, 95% CI 1.12 to 1.20). The incidence rate of breast cancer among AANHPI females living in low ethnic enclave+high SES neighborhoods was 1.32 times that of AANHPI females living in high ethnic enclave+low SES neighborhoods (95% CI 1.25 to 1.39; p<0.001). Similar patterns of associations were observed for localized and advanced stages of the disease. Conclusion—For AANHPI females in California, incidence rates of breast cancer differed by nSES, ethnic enclave, and jointly. Impact— Future studies should examine whether the impact of these neighborhood-level factors on breast cancer incidence rates differ across specific AANHPI ethnic groups and investigate the pathways through which they contribute to breast cancer risk. Citation Format: Alya Truong, Mi-Ok Kim, Meg Mckinley, Scarlett L. Gomez, Salma Shariff-Marco, Iona Cheng. Breast cancer incidence rates by neighborhood socioeconomic status and ethnic enclaves among Asian American, Native Hawaiian, and Pacific Islander females in California [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B090.

Abstract B007: Racial and ethnic disparities in receipt of guideline concordant care among ovarian cancer patients

Abstract Background: Black women experience the worst survival after an ovarian cancer diagnosis, compared to any racial and ethnic group, and the mortality gap between non-Hispanic Black (NHB) and non-Hispanic White (NHW) women has continued to widen over the years. Standard of care for ovarian cancer has historically included surgical cytoreduction followed by platinum and taxane-based chemotherapy, with some minor variations over the years in the recommendations for agents, dosing patterns, and treatment sequence, which may affect disparities in adherence to treatment guidelines. The most drastic changes in National Comprehensive Cancer Network (NCCN) guidelines were released in 2016, with the incorporation of histotype in decision trees to guide care. Our study aimed to evaluate racial and ethnic differences in receipt of guideline concordant care in an integrated health system. Methods: This analysis included 4,197 California residents in the KP ROCS (Kaiser Permanente Research on Ovarian Cancer Survival) Study, age 18 years or older when diagnosed between 2000 and 2018 with invasive ovarian, fallopian or peritoneal cancer at Kaiser Permanente Northern California, and with available key information to assess guideline concordant care. Detailed surgery and chemotherapy data, as well as clinical characteristics (e.g., grade, stage, histotype), were obtained from electronic medical records. We evaluated concordance with year-specific NCCN guidelines for surgery and chemotherapy according to the year of diagnosis, with independent consideration of recommendations for neoadjuvant and adjuvant therapies. Results: Our study included 2,822 NHW women, 231 NHB women, 558 Asian American and Pacific Islander (AAPI) women, 512 Hispanic women, and 74 women of other races. Overall, we found that NHB women were less likely to receive guideline concordant care than any other groups (37.2% compared to 44.6% for NHW, 55.4% for NHA, and 48.6% for Hispanic women). NHB women were less like to receive surgery, and guideline concordant chemotherapy, including having early discontinuation. Annual trends also revealed persistently lower receipt of guideline treatment among NHB compared with all other groups over time. We also observed for all groups, except AAPI women a lower percentage of concordant care after 2016, most pronounced for NHB women, at 33%, when histotype was incorporated into NCCN guidelines. Conclusions: We found that in a setting with similar insurance coverage, treatment disparities persisted. Our next step will be to further explore the reasons for these treatment differences, including neighborhood context and geographic medical accessibility, as well as other patient characteristics (e.g., comorbidity burden, biological factors), that may also have an impact in disease progression and mortality outcomes. Citation Format: Elisa V. Bandera, Lindsay J. Collin, Valerie Lee, Juraj Kavecansky, Christine Garcia, Carola Sanchez Diaz, Farzin Khosrow-Khavar, Jennifer A. Doherty, Scarlett Lin Gomez, Lawrence H. Kushi. Racial and ethnic disparities in receipt of guideline concordant care among ovarian cancer patients [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B007.

Cognitive Assessment for Tagalog Speakers (CATS): A pilot study

AbstractBackgroundAs the US population of Asian Americans and Pacific Islanders (AAPI) over the age of 65 increases, the incidence of Alzheimer’s disease and related disorders (ADRD) in this group is expected to triple between 2008 and 2030. This group includes over 4 million Filipino Americans, who comprise the largest AAPI population in California and 10 other states. Although there is scarce literature detailing the prevalence of dementia among AAPI subgroups, one study found that Filipino Americans had the highest incidence rate of dementia (Mayeda et al., 2017). Despite the expected increase in the number of Filipino Americans with ADRD, no studies to‐date have validated neuropsychological measures in the United States for speakers of Tagalog (Filipino), one of the major languages spoken by Filipino Americans and the 4th most widely spoken language in the US. A major barrier to dementia care and diagnosis is the lack of linguistically and socioculturally appropriate cognitive tasks for Tagalog speakers. To address this need, we developed and piloted the Cognitive Assessment for Tagalog Speakers (CATS), the first neuropsychological battery for the detection of ADRD in Filipino American Tagalog speakers.MethodWe translated, adapted, and constructed de novo to measure performance across four main cognitive domains: visual/verbal memory, visuospatial functioning, speech and language, and frontal/executive functioning. Tasks were developed with a team of bilingual English/Tagalog and bicultural Filipino American/Canadian experts, including a neurologist, speech‐language pathologist, linguist, and neuropsychologist.ResultTo‐date, the CATS battery has been administered to 15 healthy control participants (age 61.8 ± 5.4 yrs, 5M/10F) at the University of California, San Francisco. These preliminary results show the feasibility of the measures but also demonstrated the need to consider effects of bilingualism, language typology, and cultural factors in the interpretation of results.ConclusionThis project will lay the groundwork for norming and validation studies and will help solidify connections to a population that has been underrepresented in ADRD research. As we move towards treatment and cure of ADRD, linguistically and culturally appropriate cognitive tests become even more important for equitable care.

Model sensitivity of Tibetan Plateau surface potential vorticity and the Asian summer monsoon system to Asian orographic perturbation in FGOALS-f2

The thermodynamic forcing of the Tibetan Plateau (TP) is important for the regulation of the Asian summer monsoon (ASM). However, the monsoon responses to orographic perturbation simulations show controversial results in previously published literature. One reason for this is that the monsoon responses to orographic forcing differ among climate models. Another reason is that the quantitative changes in the TP thermodynamic forcing remain unknown when the orography is modified. Therefore, the relationship between the TP forcing and the ASM may be different among climate models. In this paper, the surface potential vorticity (SPV) is used to quantify the surface thermodynamic forcing on the TP in the FGOALS-f2 climate model for both the standard Atmospheric Model Intercomparison Project (AMIP) and Coupled Model Intercomparison Project (CMIP) experiments with a modified orography, and various aspects of the ASM responses are also examined. Finally, their relationships with TP-SPV changes are quantitively estimated. The results indicate that the intensity of TP-SPV is reduced by nearly 100% in the AMIP runs, while it is reduced by 68% in the CMIP runs when the Asian mountains are removed. Overall, the responses of the monsoon system are more sensitive when air-sea interactions are considered. When the mountains are removed, the precipitation over the southern slope of the TP decreases by 73% and increases by nearly 30% over the tropical Indian Ocean in the CMIP runs. Moreover, the precipitation responses exhibit the largest difference between the AMIP and CMIP runs over the East Asian and Western Pacific regions. The precipitation over the Western Pacific remains almost unchanged when the orography is removed in the AMIP runs but is reduced by 20% in the CMIP runs. We propose that the calculation of SPV over the TP is helpful for understanding the TP orographic forcing and monsoon dynamics in the future.

Health and social experiences of Asian American and Pacific Islanders in the U.S. military.

Health and social experiences of Asian American and Pacific Islanders in the U.S. military.

Preface

Pandemic COVID-19 has hardly impacted global fisheries and aquaculture, as FAO reported in the 34th session of the Committee on Fisheries (COFI) in February 2021. FOA further suggest that this pandemic impact catalyzes the fisheries sector to be more innovative, socially, and environmentally responsible. Fish and fisheries product are well-known healthy food. It contains high quality and quantity of protein and provide essential vitamins and minerals to maintain human health status. The innovation of science and technology in the fisheries sector is a crucial point to improve and assure the efficiency and sustainability of the production and utilization of the resource. Research activities and development should be synergically conducted to implement technologies that benefit the communities.Department of Fisheries, Faculty of Agriculture, Universitas Gadjah Mada, holds a biennially international symposium to provide access and exchange of research data and fisheries experience to support the transfer of knowledge and technology to strengthen the world’s fisheries sector. The 5th International Symposium on Marine and Fisheries Research (The 5th ISMFR) aims to bring together academic scientists, researcher, government institutions, private parties, and stakeholders to share and exchange progress information, experiences, and research results in all aspects of marine and fisheries sciences. The 5th ISMFR theme was “Transformative Adaptation: An Approach in Building Resilience into Sustainable Fisheries”. It covered a broad spectrum of fisheries-related topics, including aquaculture, fish disease, fish genetics, biotechnology, marine natural product, seafood processing technology, seafood safety, fisheries biology, fisheries resources management, fisheries socio-economics, oceanography, climate sciences, and marine ecotoxicology. The 5th ISMFR was held on July 24nd 2023 at Grand Rohan Hotel, Yogyakarta. The seminar’s organizing committee was located in the Department of Fisheries, Faculty of Agriculture, Universitas Gadjah Mada, Yogyakarta, Indonesia. Management of symposium was carried out using the website (https://ismfrugm.faperta.ugm.ac.id/) and for the proceeding submission using the Morresier platform.The symposium consists of plenary session and parallel presentation sessions. The plenary session presented four keynote speakers, namely Professor Dr. Rockmin Dahuri the Head of Indonesian Aquaculture Society (Indonesia), Professor Dr. Sc. Amir Husni form Department of Fisheries, Universitas Gadjah Mada, Indonesia (Indonesia), Noranizan Mohd Adzahan, Ph.D from Universiti Putra Malaysia (Malaysia), and Dr. Krishna R. Salin the President World Aquaculture Society Asia Pacific Chapter (India). A total of six parallel class was conducted with 7 invited speakers and presenters from five countries, namely Egypt, USA, Thailand, Japan, and Malaysia. Presentations in each parallel class were divided into presentation panels consisting of approximately five presenters. Each presenter was given 12 minutes for presentation and discussion. A total of 144 scientific papers has been presented at the 5th ISMFR. The 5th ISMFR was attended by 136 participants. Presenters and attendances join the symposium in person at Grand Rohan Hotel, Yogyakarta. Presenters and attendances who were unable to attend in person took part in symposium virtually via Zoom Meeting platform.This proceeding provides an opportunity for readers to gain more information from the reviewed papers that have been presented in the 5th ISMFR. The articles published in this proceeding were selected gorm the papers presented in the symposium. The reviewed from four countries (Austria, Japan, Malaysia, and Indonesia) and editors from four countries (Malaysia, Thailand, Austria, and Indonesia) have participated in the abstract screening, improving, and finalizing the manuscript. The proceedings divided into three sections, namely aquaculture, aquatic resource management, dan fish product technology. From this proceeding, readers will find recent research finding on broad aspect of fisheries and marine sciences to come up with new knowledge and idea to promote sustainable fisheries through technology and research innovation for a healthy community.We want to thank all parties for the success of the 5th ISMFR. Our gratitude is presented to organizing committee, keynote and invited speakers, reviewers, editors, and editing staff for the dedication, hard work, and tireless efforts in implementing the symposium and publication process. We express our acknowledgment to the Rector of Universitas Gadjah Mada, the Dean of the Faculty of Agriculture, the Head of Fisheries Department, and the Publication Agency of Universitas Gadjah Mada, who provided continuous support on the symposium. Our thank you also conveyed to the speakers and participants, who have given their best effort to disseminate, discuss, and publish papers. We also thank to all parties who have contributed to the success of the 5th ISMFR and the publication. We sincerely hope readers will be find notable pieces of knowledge on fisheries and marine science from different points of view.Chief EditorList of committees of the 5th ISMFR, Documentation of the 5th ISMFR are available in this pdf.

Forced Migration in the Asia Pacific Region: A History of Predictable Crises

Summary The focus of this article is on how forced migration is regulated in the Asia Pacific region. While each new case of mass migration is widely characterised as an unprecedented crisis, history shows that much about these ‘crises’ was perfectly predictable. Resort to what Charlesworth identifies as ‘crisis mode’ short-circuits historical perspectives and obscures structural injustice. If we step back from the language of crisis, we can turn our focus to what the legal and institutional contexts in which forced migration occurs and that make it such a devastating experience.

Temporal trends of thyroid cancer between 2010 and 2019 in Asian countries by geographical region and SDI, comparison with global data.

This study aims to describe temporal trends of thyroid cancer (ThC) from 2010 to 2019, in Asian countries by geographical region and sociodemographic index, compared with global data. Annual case data and age-standardized rates (ASRs) of epidemiological indicators of ThC cancer data were collected from the 2019 Global Burden of Disease (GBD) study from 2010 to 2019 in 49 countries and territories in Asia. The relative difference (%) between years was used to show comparative variations of ASRs for the indicators studied. The female/male ratio was calculated by dividing female ASRs by male ASRs. Also, these rates were compared between the age group ≥70 years old and younger age groups. In 2019, more than 50% of ThC cases and deaths occurred in Asian countries. A total of 53% of ThC patients lived in Asia and more than 60% of the global burden of ThC was imposed on Asian countries. From 2010 to 2019, incidences, deaths, prevalence cases, and DALYs number of ThC cancer increased over 1.28-, 1.26-, 1.3-, and 1.2-fold, in Asia, respectively. During this period, the age-standardized incidence rate (ASIR) and the age-standardized prevalence rate (ASPR) of ThC cancer increased by 5% and 8%, respectively, while the age-standardized death rate (ASDR) and the age-standardized DALYs rate (DALYs ASR) of ThC cancer decreased by 6% and 4%, respectively. These trends are different from what happens in other continents. In 2019, age-specific incidence, death, prevalence, and DALY cases of ThC cancer were peaking at 50-54, 75-79, 50-54, and 55-59 years, respectively. In 2019, the highest ASIR and ASPR of ThC cancer was observed in high-income Asia Pacific countries and the highest ASDR and DALYs ASR in Southeast Asia countries. Only high-income Asia Pacific countries experienced a decreasing trend in ASIR and ASPR from 2010 to 2019. ASDR and DALYs ASR have the highest decreasing trend in high-income Asia Pacific. In 2019, among high SDI Asian countries, the Republic of Korea had the highest ASIR and ASPR, and Brunei Darussalam had the highest ASDR and DALYs ASR. The highest ASIR, ASDR, ASPR, and DALY ASR of ThC cancer was found in Lebanon and Malaysia (high-middle SDIs), Vietnam (middle SDIs), and Cambodia and Palestine (low-middle SDIs). Among low SDI Asian countries, Pakistan had the highest ASIR, ASDR, ASPR, and DALY ASR of ThC cancer. All indicators for most countries were higher in women than men. More than half of the burden of thyroid cancer is imposed on the residents of the Asian continent. Although the incidence and prevalence of this cancer in Asian countries is lower than that of the world, America, and Europe, the highest rate of death from thyroid cancer occurs in Asia and they witness the highest burden of the disease. Therefore, it seems that implementing early detection strategies and increasing access to treatment facilities in Asia is one of the necessities of thyroid cancer control in its residents.

Population Trends in the World and the Asia Pacific Region

This presentation explores the population trends in both the global and Asia-Pacific regions, examining the underlying factors that influence population growth and population age structure. The presentation highlights the importance of understanding fertility rates and their implications to population ageing, particularly in the context of the Asia-Pacific region. Fertility rates have declined in all regions of the world, however there is still substantial diversity across the globe. In high- and middle-income countries, fertility is now at low levels, some at extremely low levels. In low-income countries, the levels of fertility are more variable, with some countries seeing substantial decline, while others have declined, but at a slower rate. Because of low fertility, some countries have seen substantial population ageing in recent decades, and in the absence of migration, are experiencing depopulation. Other countries, buoyed by their migration policies, are ageing at a slower rate, and do not face the implications of a declining population. In the Asia-Pacific region there are substantial demographic shifts underway. The population has been declining in Japan for over 10 years, and is also declining in South Korea and most recently, China. All populations have very low fertility rates, with South Korea the lowest in the world, at 0.8 in 2021. Japan and South Korea also have very low immigration rates. In 2023, India overtook China as the world’s most populous country. While most regions of the world now have low population growth, populations in Africa are still growing rapidly, fuelled by a young population structure. This provides the region with a potential ‘demographic dividend’ which can contribute to economic opportunities. By outlining the drivers of population change, their implications, policy responses, and future challenges, this presentation will provide insights into the complexities of demographic shifts in today’s world.

Total Wrist Replacement Outcomes in the Asian Pacific Population - A Single-Centre Result.

Background: Total wrist replacement (TWR) is rarely done in the Asia-Pacific region. The aim of this study is to report the surgical outcomes and experience of TWR in patients with advanced arthritis. Methods: This is a retrospective review of all TWR patients in the Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong, which is a university tertiary centre, from January 2004 to March 2023. Recorded demographic parameters include gender, age upon surgery, pathology, types of implants and follow-up period. The surgical outcome parameters include range of motion, grip strength, wrist function assessment, radiological and clinical complications and any related secondary operations. Postoperative X-ray and clinical notes were reviewed. All wrist function assessments were performed by specialised occupational therapists according to protocol. Results: The study included a total of 12 wrists of 10 patients, all Chinese-Asian, with a mean age of 61.4 years at surgery. Larsen grade V arthritis constituted 50% and grade IV 16.7% of the patients, amongst which 33% had volar subluxation. The mean follow-up period was 97.4 months (21-205 months). The mean grip strength was 64.2% of the unaffected side. The mean postoperative Disabilities of Arm, Shoulder and Hand (DASH) score was 41.12% and patient-rated wrist/hand evaluation (PRWE) score 18.0. Complication incidence was 16.67% for loosening, 8.3% for metallosis and 8.3% for infection. One patient required conversion to total wrist arthrodesis due to metallosis. No patient suffered from dislocation, periprosthetic fracture and infection. Conclusions: TWR is an effective and safe alternative to total wrist arthrodesis with comparable outcomes. Our series outcomes are satisfactory and in line with literature. With meticulous soft tissue release and balancing, volar subluxation can also be corrected and may not be a contraindication. Level of Evidence: Level IV (Therapeutic).

Abstract C036: Investigating the phenotypic changes in in vitro and in vivo cancer models expressing isocitrate dehydrogenase 1 (IDH1) mutations R132H and R132Q

Abstract According to the National Cancer Institute, there were 25,050 new brain cancer cases in 2022, representing 1.3% of all cancer incidents in the United States. In the same year, the estimated death was 18,280 cases, representing 3.0% of all cancer deaths. Relative survival statistics between 2017 and 2018 showed that only 32.5% of patients would survive five years or more. Disparities in cancer incidence and outcomes, including brain cancers, can be due to biological, socioeconomic, and care access factors that often have roots in structural racism. Research shows lower three years survival rates of glioblastoma in the African American population by 28.8% compared to the Asian Pacific Islanders at 36.6% and Hispanic at 32.3%. Mutant isocitrate dehydrogenase 1 (IDH1) can lead to brain cancer, including > 80% of lower-grade gliomas and secondary glioblastomas. Mutant IDH1 catalyzes the NADPH-dependent conversion of α-ketoglutarate to D2-hydroxyglutarate (D2HG), an oncometabolite linked to many cancer types. IDH1 mutation occurs primarily at residue 132, and our lab has shown that the catalytic activity differs based on the amino acid substituted at that location. There is a lack of information describing the relation of D2HG produced to cancer cells’ phenotype severity. Understanding IDH1 mutation will clarify cancer progression, patients’ prognosis, and treatment responses. Here, we hypothesize that the toxic effect of D2HG will impair the viability of cells expressing mutant IDH1 and will cause a reduction in ROS and NADPH cellular levels. This work examines D2HG production efficiency in vivo and in vitro and the metabolic consequences of this oncometabolite. We created cell lines stably overexpressing IDH1-R132Q and IDH1-R132H to conduct this work. Our results showed higher levels of D2HG in cells expressing IDH1-R132Q compared to DH1-wild type and IDH1-R132H, supportive of our previous finding that IDH1-R132Q mutation has higher catalytic activities (higher efficiency in producing mutant IDH1). These higher D2HG levels caused cells to proliferate and migrate at lower rates. D2HG interferes with DNA demethylation by inhibiting the TET enzyme, and we observed higher levels of histone protein expression in IDH1-R132Q compared to the other modified cells. In in vivo studies, we identified elevated D2HG levels in mouse xenografts expressing IDH1-R132Q that affected tumor growth. Citation Format: Mowaffaq A.A. Adam, Mikella Robinson, An Hoang, Grace A. Wells, David A. Scott, Olga Zagnitko, Carrie House, Christal D. Sohl. Investigating the phenotypic changes in in vitro and in vivo cancer models expressing isocitrate dehydrogenase 1 (IDH1) mutations R132H and R132Q [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C036.

A Multicenter Retrospective Study to Understand the Clinical Characteristics, Treatment Patterns, and Resource Utilization for Patients with Chronic Lymphocytic Leukemia: CREEK Study

Abstract Introduction: The ever-growing array of treatments available for chronic lymphocytic leukemia (CLL) led to a significant change in CLL management over the last few years. However, information about managing CLL is scattered across various regions, resulting in significant disparities in treatment approaches and patient outcomes between countries. The CREEK study aimed to describe the disease characteristics, treatment patterns, and overall survival (OS) among CLL-treated (CLL-Tx) patients and CLL treatment-naïve (CLL-N) patients in different regions. Methods: Data from 1009 patients were collected retrospectively from June 2016 to March 2023. This observational study included 886 CLL-Tx patients from 17 countries in the Middle East and Africa (MEA), Asia Pacific (AP), and Latin America (LA); and a pilot cohort of 123 CLL-N patients from the Gulf Cooperation Council (GCC) countries. Patients' demographics, disease characteristics, laboratory assessments, comorbidities, treatment patterns, treatment-related adverse events (AEs), OS, and medical resource utilization (MRU) data were recorded. Results: The average age for both cohorts was 63 years. Most patients were males, 66.7% in CLL-Tx and 69.9% in CLL-N. The mean duration from clinical manifestation until diagnosis was 21.37 months for CLL-Tx and 1.46 months for CLL-N patients (p<0.0001). For CLL-Tx, almost 62% of the patients in MEA, 59.3% in AP, and 68.8% in LA had an Eastern Cooperative Oncology Group (ECOG) score of 0 or 1, and similarly for CLL-N patients (56.1%). Total leucocytic count, lymphocytes, and platelets showed a significant difference (p<0.05) between CLL-Tx and CLL-N patients. As per the Cumulative Illness Rating Scale (CIRS), musculoskeletal (p<0.0008) and endocrine-metabolic (p<0.0001) comorbidities were more frequent in the CLL-Tx group. Regarding the CLL-Tx patients, 69.7%, 62.9%, and 41.1% had extremely severe hematological problems (CIRS score 4) in MEA, LA, and AP, respectively. At diagnosis, patients from the MEA region presented with the highest prevalence of advanced disease staging, with 44.8% and 35.3% based on Rai and Binet Staging Scores, respectively; moreover, CLL-Tx patients exhibited a more advanced staging compared to CLL-N based on the same scores (p <0.0001). FISH testing for disease prognosis was not performed in about 59% of the patients across all regions. The testing rates for cytogenetic abnormalities, IGHV mutation status, and TP53 aberrations were relatively low in all regions. The percentage of unmutated IGHV was considerably higher (p=0.0001) in CLL-Tx (15.6%) patients, with the highest percentage in LA (21.0%), compared to CLL-N (10.6%). Cytogenetic abnormalities did not show significant differences between CLL-Tx and CLL-N patients (p>0.05), while TP53 aberrations differ significantly (p<0.05) (Table 1). Most patients, 76.0%, 81.8%, and 69.4%, received chemo-immunotherapies as 1 st line therapy, while 18.3%, 17.1%, and 30.1% received targeted therapy in MEA, AP, and LA, respectively. The percentage of patients with AEs who received 1 st line chemo-immunotherapies was higher than those who received targeted therapy (25.6% vs. 7.3%). The mean OS was 153.89 months in the treated study population (Table 2). The mean number of inpatient hospitalizations was 1.9 times for chemo-immunotherapy and 0.8 times for targeted therapy. The mean lengths of stay of 14.9 and 13.9 days, respectively; mean emergency room visits were 0.5 and 0.7, and blood transfusions were received by 16.7% and 9.2% of patients, respectively. Conclusions: This study highlights the variable disease characteristics between CLL-Tx and CLL-N patients and provides insight into the regional variations in treatment patterns and OS for CLL-Tx patients. A considerable number of patients had advanced disease staging at diagnosis; however, the study showed relatively low genetic testing rates, indicating the need for adequate clinical watchfulness. Despite being in the era of approved targeted therapy, the utilization of chemo-immunotherapy continues to be higher than that of targeted therapy in the first line, probably due to the lower access to targeted therapies. Keywords: Chronic Lymphocytic Leukemia (CLL), Genetic Testing, Treatment Patterns, Targeted Therapy, Chemo-immunotherapy, Real World Data.

Weak in ability but still follow what the headquarters asks: a legitimacy‐based view of MNC employees' adoption of English

This paper advances a legitimacy‐based view on what factors determine multinational corporation (MNC) employees' adoption of English at work. We posit that legitimacy judgment represents an alternative mechanism, other than language ability, for explaining MNC employees' response to headquarters' corporate language policy. The hypotheses were confirmed in two studies with mixed‐methods (experiments; semi‐structured interviews), involving MNC employees in China. Our findings verified that corporate language policy increases positive legitimacy judgment, which in turn enhances employees' adoption of English at work. Further analysis showed that language ability moderates the mediating effect of legitimacy judgment, such that this effect is stronger for employees with lower language ability. Semi‐structured interviews confirmed the experimental findings and brought more insight into why and how Chinese employees adopt English in daily work. This paper contributes to the research on corporate language policy, legitimacy judgment, and cross‐border management in Asia Pacific.

1803. Analysis of National Policies and Antimicrobial Resistance Burden: An Ecological Study of 114 Countries

Abstract Background The rise of antimicrobial resistance (AMR) is a top public health concern. The drivers of AMR are complex, with antimicrobial misuse, lack of coordinated policies and inter-country data cooperation playing key roles. The growing burden of AMR is not shared proportionally across countries and there’s marked heterogeneity of national-level policies to tackle AMR. Our aim was to evaluate whether stronger national policies correlate with reduced burden 3rd generation cephalosporin (3GC) resistant Escherichia coli utilizing two recently published estimates. Methods We used 2019 estimates of deaths and Disability Adjusted Life Years (DALYs) due to 3GC resistant E. coli published by Murray et al. We matched these estimates to the governance score produced by Patel et al, which analyzed National Action Plans (NAP) through a governance framework, assigning a “governance score” to countries based on 54 indicators across 3 domains (Table 1). We describe the relationship between the burden of 3GC resistant E. coli and governance score across six WHO regions: Africa, Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific. Results A total of 114 countries with both governance score and 3GC resistant E. coli data available were included. A multivariate log-linear regression model adjusted for region showed a relative risk reduction in the mortality of 3GC resistant E. coli of 2.8% (CI 1% –4.6%; p-value 0.002) for every increase in point of governance score (Figure 1). When looking at DALYs as a measure of AMR burden, using a multivariate log-linear regression model adjusted for regions, we find a relative risk reduction of 4.7% (CI 1.8% - 6.2%; P value < 0.001) for every increase in point of governance score (Figure 2). Conclusion We show that countries with high governance scores had overall lower burden of 3GC resistant E. coli. Additional time series analysis as well as evaluating specific aspects of NAPs against AMR burden would be an important next step. Disclosures All Authors: No reported disclosures