Asian Subregions Research Articles

Burden of Gastrointestinal Tumors in Asian Countries, 1990-2021: An Analysis for the Global Burden of Disease Study 2021.

Gastrointestinal tumors represent a significant component of the cancer burden in Asia. This study aims to evaluate the burden of gastrointestinal tumors in Asia from 1990 to 2021 using data from the Global Burden of Disease Study 2021 (GBD 2021). The absolute incidence, mortality, and disability adjusted life years (DALYs) number and rate of six gastrointestinal tumors(colon and rectum cancer (CRC), stomach cancer (SC), pancreatic cancer (PC), esophageal cancer (EC), liver cancer (LC) and gallbladder and biliary tract cancer (GBTC)) in 48 Asian countries were extracted from GBD 2021. Differences were analyzed based on gender, age, year, location and socio-demographic index (SDI). In 2021, SC accounted for the highest disease burden in Asia (DALYs=16.41million [95% UI: 13.70, 19.62]). From 1990 to 2021, the age-standardized incidence rates of EC, LC, and SC in Asia declined, while the incidence rates of CRC and PC increased significantly, with CRC showing the largest rise (AAPC=1.08 [95% CI: 1.02 to 1.12]). Gastrointestinal tumors DALY rates peaked at age 70 and above, with males generally exhibiting higher rates than females. Furthermore, East Asia bears a higher burden compared to other Asian subregions. A higher SDI correlates with increased DALY rates for PC, but no linear relationship was observed for other gastrointestinal tumors. The burden of gastrointestinal tumors in Asia remains high and may continue to increase. Therefore, effective prevention and treatment measures are essential to address the challenge posed by gastrointestinal tumors.

Predicting the potential risk of Caragana shrub encroachment in the Eurasian steppe under anthropogenic climate change

Climate change and human activities drive widespread shrub encroachment in global grassland ecosystems, particularly in the Eurasian steppe. Caragana shrubs, the primary contributors to shrub encroachment in this region, play a crucial role in shaping the ecosystem's structure and function. Future changes in the suitable distribution range of Caragana species will directly affect the ecological security and sustainable socio-economic development of the Eurasian steppe ecosystem. We used an ensemble modeling approach to predict Caragana shrub-dominated plant communities' current and future distribution in three major steppe subregions: the Black Sea-Kazakhstan steppe, the Tibetan Plateau steppe, and the Central Asian steppe. We assessed the potential risk of Caragana shrub encroachment by predicting changes in the suitable distribution area of 19 Caragana shrub species under future climate changes. Our research findings suggest that the expansion of Caragana species in different subregions of the Eurasian steppe is influenced by the effects of climate change in various ways. The distribution of Caragana species is primarily influenced by precipitation and temperature, and the global human modification (ghm) has a significant impact on the Central Asian and Tibetan Plateau subregions. Minimal changes are expected in the Black Sea-Kazakhstan subregion, a slight increase on the Tibetan Plateau, and a substantial rise in the Central Asian subregion, which suggests a higher potential risk of Caragana species shrub encroachment in that area. Our research provides valuable insights into the response of Caragana shrub encroachment to changing climates and human activities. It also has implications for the sustainable management of different areas of the vast Eurasian steppe ecosystem.

Predicted changes in distribution and grazing value of Stipa-based plant communities across the Eurasian steppe

The Eurasian steppe is one of the world's largest continuous areas of grassland and has an important role in supporting livestock grazing, the most ubiquitous land use on Earth. However, the Eurasian steppe is under threat, from irrational grazing utilization, climate change, and resource exploitation. We used an ensemble modeling approach to predict the current and future distribution of Stipa-dominated plant communities in three important steppe subregions; the Tibetan Alpine, Central Asian, and Black Sea-Kazakhstan subregions. We combined this with an assessment of the grazing value of 22 Stipa species, the dominant grassland species in the area, to predict how grazing value might change under future climate change predictions. We found that the effects of changing climates on grazing values differed across the three subregions. Grazing values increased in the Tibetan alpine steppe and to a lesser extent in Central Asia, but there were few changes in the Black Sea-Kazakhstan subregion. The response of different species to changing climates varied with environmental variables. Finally, our trait-based assessment of Stipa species revealed variations in grazing value, and this had major effects on the overall grazing value of the region. Our results reinforce the importance of trait-based characteristics of steppe plant species, how these traits affect grazing value, and how grazing values will change across different areas of the Eurasian steppe. Our work provides valuable insights into how different species will respond to changing climates and grazing, with important implications for sustainable management of different areas of the vast Eurasian steppe ecosystem.

Asia’s four regionalisms (Southeast Asia, South Asia, Central Asia and East Asia): a view from multilateral treaties of the United Nations

This study presents a quantitative framework to analyze the engagement of four Asian sub-regions with global issues through their participation in multilateral treaties across various policy areas. The research addresses key questions regarding the speed of Asian states’ involvement in multilateral treaties and their adaptation to these treaties within the United Nations system over time. The approach combines empirical data and conceptualization to ensure a robust evidentiary basis. A dataset comprising 600 major multilateral treaties deposited in the United Nations system, covering diverse global issues, was collected. Additionally, ratification actions from twenty-eight Asian countries were categorized into four sub-regions: East Asia, South Asia, Southeast Asia, and Central Asia. To quantitatively measure states’ engagement with multilateral treaties, the study developed and calculated the Treaty Participation Index for each Asian country and sub-group. In an area predominantly characterized by qualitative research, this paper contributes to the existing literature by providing quantitative and metric findings for comparative analyses of multilateral treaty participation among the four Asian sub-regions, as well as comparisons between Asia and the rest of the world. By analyzing the results, the paper offers an evidence-based assessment of the feasibility of these four regionalisms in Asia, particularly in the context of the transition from international politics to the paradigm of global politics.

How are green finance, carbon emissions, and energy resources related in Asian sub-regions?

In this research, by employing the STIRPAT (Stochastic Impacts by Regression on Population, Affluence, and Technology) framework, for the case studies of five Asian regions and data from 2010 to 2021, the impacts of green finance and renewable resource deployment on CO2 emissions are evaluated. The results confirmed that the effect of green financial development and expansion of renewable energies on carbon dioxide emissions does not have the same pattern in Asia. In Central and South Asia, the development of green finance, patents, and the expansion of renewable energies do not significantly affect carbon dioxide emissions. In contrast, in East Asia, green financial development, exploitation of renewable energies, and patents will reduce carbon dioxide emissions in the short and long term. Accelerating the operationalization of ongoing green projects, promoting FinTech green financing tools, increasing green facilities, implementing tax exemptions, and supporting green research and development are suggested as effective practical policies.

Burden of Common Neurologic Diseases in Asian Countries, 1990-2019: An Analysis for the Global Burden of Disease Study 2019.

Background and objectivesBased on the Global Burden of Diseases, Injuries, and Risk Factors (GBD) study, neurological disorders are a major cause of morbidity and mortality worldwide. However, there has been no comprehensive assessment of neurological disorders in Asia. Data from the GBD 1990-2019 study were investigated to provide new details for neurological disorders in Asia.MethodsThe burden of common neurological disorders in Asia was calculated for 1990 and 2019 as incidence, prevalence, deaths, and disability-adjusted life-years (DALYs). 13 common neurological disorders were analyzed. Data are presented as totals and by sex, age, year, location, risk factors and socio-demographic index (SDI) and shown as counts and rates.ResultsIn 2019, the most burdensome neurological disorders in Asia with respect to the absolute number of DALYs were stroke (98.8 million [95% UI, 91.0∼107.0]), migraine (24.6 million [95% UI, 3.4∼56.4]), Alzheimer's disease (AD) and other dementias (13.5 million [95% UI, 5.9∼29.8]). From 1990 to 2019, the absolute number of DALYs and deaths caused by combined neurological disorders (deaths by 60.7% and DALYs by 17.6%) increased, but the age-standardised rates (deaths by 34.1% and DALYs by 36.3%) decreased. The burden of neurological disorders peaked among individuals aged 65-74 years and was higher among males than among females; moreover, this burden varied considerably across Asian subregions and countries. Risk-attributable DALYs accounted for 86.9%, 28.5%, and 11.1% of DALYs for stroke, AD and other dementias and multiple sclerosis (MS), respectively. For communicable neurological disorders, the crude rates of all metrics were moderately to strongly negatively correlated with the SDI, while the crude rate of stroke prevalence was moderately positively correlated with the SDI.ConclusionNeurological disorders were the leading cause of DALYs and the second leading cause of deaths in Asia in 2019, and the burden may likely increase with the growth and aging of the Asian population. Urgent measures are needed for prevention, treatment, rehabilitation, and support services for common neurological disorders regionally and nationally.

Tackling Blindness from the Scourge of Glaucoma

Glaucoma is a global public health concern and in Pakistan we need an effective country wide response to ensure our residents receive the care they deserve. The term glaucoma or more precisely the glaucomas, refers to a group of disorders which have in common an intraocular pressure (IOP) sensitive optic neuropathy in association with ganglion cell loss and visual field defects.1In comparison to other Asian subregions, South Central Asia is expected to have the largest growth in glaucoma cases from 2013 to 2040, from 17.06 million to 32.90 million.2

Complex Epidemiology of Prostate Cancer in Asian Countries

The incidence of prostate cancer (PCa) has increased worldwide in recent years along with the recommendation for prostate-specific antigen testing, and mortality has been declining owing to advances in fragmented and simplified access to treatment care. However, GLOBOCAN (Global Cancer Observatory) data show that this result is not true for all countries. It has been reported that the degree of PCa progression at diagnosis and survival rates differ among racial groups. Based on various comparisons between Caucasians and Asians, it was inferred that survival rates were higher in Asians despite the higher degree of progression at diagnosis, suggesting a better prognosis for life compared with Caucasians. The survey among Asian countries did not reveal any obvious differences among Asian subregions; rather, it inferred that the impact of the level of development among the countries was significant. The development of healthcare systems and medical care could improve PCa survival in developing countries.

Climate change and food security nexus in Asia: A regional comparison

Global climatic conditions are expected to become more variable in the future, which will have far-reaching impacts on food production. In Asia, many of these impacts have been measured, but a comprehensive analysis of the effects of climate change on food production at the regional scale is limited. In this study, two key issues were addressed. First, we estimated the actual trends in temperature and precipitation across 12 Asian countries in Southern, South-Eastern, Western, and Eastern Asia between 1970 and 2018 and examined their implications on food production. Second, we deployed robust estimation techniques and examined how climatic conditions influence food production across Asian sub-regions. The results show that annual temperature across Asian regions trends positively. However, a cross-country analysis reveals varied trends in annual rainfall. The regional results indicate that temperature significantly induces food production in all regions except South-Eastern Asia, where the effect is negligible. Rainfall promotes food production in Southern, South-Eastern, and Western Asia but is not favourable to food production in Eastern Asia. The findings also show that the impacts of climatic variables on food production differ significantly from country to country. Our results are robust and suggest that substantial investments in agricultural extension, research programmes, and improved irrigation infrastructure are critical to enhancing food production and security in Asia.

Spatiotemporal Characteristics of Drought in Central Asia from 1981 to 2020

Drought is a meteorological phenomenon that threatens ecosystems, agricultural production, and living conditions. Central Asia is highly vulnerable to drought due to its special geographic location, water resource shortages, and extreme weather conditions, and poor management of water resources and reliance on irrigated agriculture exacerbate the effects of drought. In this study, the latest version of the Global Land Data Assimilation System was employed to calculate the Standardized Precipitation Evapotranspiration Index at different time scales during the period from 1981 to 2020. The varimax Rotated Empirical Orthogonal Function was applied for subregional delineation of drought patterns in Central Asia, and various methods were employed for a comparative analysis of the spatiotemporal characteristics of drought in these Central Asian subregions. The results show that drought patterns vary considerably in the Central Asian subregions. Over the past 40 years, alternating wet and dry conditions occurred in Central Asia. North Kazakhstan experienced more drought events with lower severity. East and west differences appear after 2001, the west becoming drier and the east becoming wetter. Some regions near lakes, such as Balkhash, Issyk-Kul, and the Aral Sea, suffer from droughts of long duration and high severity. In the Tianshan region, droughts in the northern slopes occur more frequently, with shorter durations and higher intensity and peaks. Northwestern China and western Mongolia have extensive agricultural land and grasslands with highly fragile ecosystems that have become progressively drier since 2001.

Effective COVID-19 Control: A Comparative Analysis of the Stringency and Timeliness of Government Responses in Asia.

Aim: Many governments in East and Southeast Asia responded promptly and effectively at the onset of the COVID-19 pandemic. Synthesizing and analyzing these responses is vital for disease control evidence-based policymaking. Methods: An extensive review of COVID-19 control measures was conducted in selected Asian countries and subregions, including Mainland China, Hong Kong, Taiwan, South Korea, Singapore, Japan, and Vietnam from 1 January to 30 May 2020. Control measures were categorized into administrative, public health, and health system measures. To evaluate the stringency and timeliness of responses, we developed two indices: the Initial Response Index (IRI) and the Modified Stringency Index (MSI), which builds on the Oxford COVID-19 Government Response Tracker (OxCGRT). Results: Comprehensive administrative, public health, and health system control measures were implemented at the onset of the outbreak. Despite variations in package components, the stringency of control measures across the study sites increased with the acceleration of the outbreak, with public health control measures implemented the most stringently. Variations in daily average MSI scores are observed, with Mainland China scoring the highest (74.2), followed by Singapore (67.4), Vietnam (66.8), Hong Kong (66.2), South Korea (62.3), Taiwan (52.1), and Japan (50.3). Variations in IRI scores depicting timeliness were higher: Hong Kong, Taiwan, Vietnam, and Singapore acted faster (IRI > 50.0), while Japan (42.4) and Mainland China (4.2) followed. Conclusions: Timely setting of stringency of the control measures, especially public health measures, at dynamically high levels is key to optimally controlling outbreaks.

Assessment of the Inherent in-vitro Antioxidant Potential of Commelina benghalensis Leaf Extract

Commelina benghalensis is a troublesome but exotic weed native to the African and Asian subregions used traditionally for the treatment and management of various disorders. The aim of this study was to investigate the potential antioxidant activity of the methanolic leaf extract of Commelina benghalensis using various in vitro models. This was done by investigating the ability of the extract to scavenge hydrogen peroxide and hydroxyl radical. Other activities assessed were the reducing ability, ability to inhibit erythrocyte damage and reduce ferrous-ascorbate induced lipid peroxidation on bovine liver and egg yolk homogenates. The results revealed that the plant extract possessed significant hydrogen peroxide and hydroxyl radical scavenging abilities. The extract also possessed significant ability to reduce ferric ions and molybdate VI. The methanolic extract also significantly inhibited hydrogen peroxide-induced erythrocyte hemolysis and lipid peroxidation. Lipid peroxidation in bovine liver and egg yolk homogenates induced by the ferrous-ascorbate system was also reduced by the extract. In many instances, the effect of the extract was concentration-dependent. (p < 0.05). This antioxidant activity of the extract is ascribed to the phytochemicals which probably acted in synergy thus the Commelina benghalensis leaves could be exploited both nutraceutically and pharmacologically.

Effective COVID-19 Control: A Systematic and Comparative Analysis of the Stringency and Timeliness of Government Responses of Selected Countries and Subregions in Asia

Background: Many governments in East and Southeast Asia responded promptly and effectively at the onset of the COVID-19 pandemic. Systematically synthesizing these responses is vital for disease control evidence-based policy making.Methods: An extensive review of COVID-19 control measures was conducted in selected Asian countries and subregions, including Mainland China, Hong Kong, Taiwan, South Korea, Singapore, Japan, and Vietnam from January 1 to May 30, 2020. Control measures were categorized into administrative, public health, and health system measures. To evaluate the stringency and timeliness of responses, we developed two indices: the Initial Response Index (IRI) and the Modified Stringency Index (MSI), which builds on the Oxford COVID-19 Government Response Tracker (OxCGRT).Findings: Comprehensive administrative, public health, and health system control measures were implemented at the onset of the outbreak. Despite variations in package components, the stringency of control measures across the study sites increased with the acceleration of the outbreak, with public health control measures implemented the most stringently. Variations in daily average MSI scores are observed, with Mainland China scoring the highest (74·2), followed by Singapore (67·4), Vietnam (66·8), Hong Kong (66·2), South Korea (62·3), Taiwan (52·1), and Japan (50·3). Variations in IRI scores depicting timeliness were higher: Hong Kong, Taiwan, Vietnam, and Singapore acted faster (IRI>50·0), while Japan (42·4) and Mainland China (4·2) followed.Interpretation: Timely setting of stringency of the control measures, especially public health measures, at dynamically high levels is key to optimally controlling outbreaks.Funding: Saudi Ministry of Finance; Duke Global Health Institute.Declaration of Interests: The authors declare no conflict of interests.

Classification of tall-forb vegetation in the Pamir-Alai and western Tian Shan Mountains (Tajikistan and Kyrgyzstan, Middle Asia)

Aims: To complete the syntaxonomic scheme for tall-forb vegetation of the montane and alpine belts in the Pamir-Alai and western Tian Shan Mountains in Tajikistan and Kyrgyzstan with some remarks on its environmental predictors. Study area: Middle Asia: Tajikistan and Kyrgyzstan. Methods: A total of 244 relevés were sampled in 2013–2019 using the seven-degree cover-abundance scale of the Braun-Blanquet approach. These were classified with a modified TWINSPAN algorithm with pseudospecies cut-levels 0%, 5% and 25%, and total inertia as a measure of cluster heterogeneity. Diagnostic species were identified using the phi coefficient as a fidelity measure. NMDS was used to explore the relationships between the distinguished groups. Results: Our classification revealed 19 clusters of tall-forb vegetation in Middle Asia. Among others we found forb communities typical for Tian Shan, western Pamir-Alai, forb-scree vegetation of Pamir-Alai, dry tall-forbs and typical forbs of the alpine belt. A total of eight new tall-forb associations and five communities were distinguished. The forb vegetation of Middle Asia has been assigned to the class Prangetea ulopterae Klein. The main factors differentiating the species composition of the researched vegetation are elevation, mean annual temperature, sum of annual precipitation and inclination of the slope. Conclusions: The paper presents the first insight into the comprehensive classification of the alpine forb vegetation in Middle Asia and fosters progress in explaining the relationship of boreo-temperate and Mediterranean-like (Irano-Turanian) vegetation in western Asian and central Asian subregions of the Irano-Turanian phytogeographical region. Taxonomic references: The nomenclature of the vascular plants follows generally Cherepanov (1995) and for Bromus spp. The Plant List (2020) Version 1.1. http://www.theplantlist.org/. Syntaxonomic references: The names of syntaxa are used in accordance with Ermakov (2012), Gadghiev et al. (2002) and Nowak et al. (2018). Abbreviation: NMDS = Non-metric Multidimensional Scaling.

Moisture Source–Receptor Network of the East Asian Summer Monsoon Land Regions and the Associated Atmospheric Steerings

AbstractThis study aims to construct a novel source–receptor (SR) network to study the atmospheric water cycle associated with the East Asian summer monsoon (EASM) circulation. Using a dynamical recycling model (DRM), 68%–74% of the wet season (April–September) precipitation in six EASM land regions is attributed. The results reveal that terrestrial sources can be equally or more competitive than oceans for several sink regions downwind in East Asia. Terrestrial sources, such as the Indian subcontinent, Indochina, Southwest China, and the eastern Tibetan Plateau, are sustained by southwesterly monsoons and contribute to appreciable fractions of precipitation in the East Asian subregions downwind. Further, southwesterly and southeasterly sources for a sink region alternately dominate the moisture supply in the early and late wet season, respectively, referred to as the “SW–SE source swing.” The SR network is found to be largely governed by the zonal oscillation of the western North Pacific subtropical high and tropical cyclones. Knowledge about the coupled circulations might promise more predictability of the strength of the affected SR pairs. Notably, enhanced moisture supplies from regions such as the Indian subcontinent and Tibetan Plateau are well correlated with an upper-level wave train from western Russia. Finally, the preceding wintertime El Niño may favor (suppress) the moisture contribution of southwesterly (southeasterly) sources in the following wet season. The findings offer insights into the EASM water cycle and the governing circulations, and also accentuate the role of upwind terrestrial sources in the downwind precipitation and freshwater resources.

Environmental Kuznets curve revisited: An analysis using ecological and material footprint

• The relationship between economic growth and ecological and material footprint has been analyzed. • Panel data of Asian countries and sub-panel of Asian countries have been taken. • PMG, DOLS and GMM model has been applied for log-run estimates. • EKC in ecological footprint exist in case of whole panel with Central-and East Asian sub- panel. • EKC in material footprint exist in case of whole and sub-panel except for central Asian panel. The study employed ecological and material footprint from the consumption perspective as a holistic measure of human pressure on the environment to examine the environment-economic growth nexus. Particularly, Environmental Kuznets curve hypothesis has been tested for the group of thirty-seven Asian countries. These are further analyzed into five Asian sub-regions, namely; West-, Central-, South-, East-and Southeast Asian countries over the period of 1991 to 2017. Panel cointegration, Pooled mean group, dynamic ordinary least square and differenced panel generalized methods of moments have been applied. The analysis reveals a mixture of results for the presence of EKC when using ecological footprint. EKC exists for Central-and East Asian countries, but not in case of West-, South-and Southeast Asian countries. Whereas results support EKC when we used material footprint indicator except central Asia. Energy consumption increases the ecological and material footprint. In addition, overall globalization and urbanization enhances ecological and material footprint. From the outcome of this empirical work, a number of policy recommendations have been discussed.

Introduction: Democratic Hopes and Challenges

Western liberal democracy is in crisis. At the same time, since the end of the Cold War, new regions of the world and actors have risen to prominence. Contemporary discourse emphasizes, in particular, the rise of East Asia (including the Northeast and Southeast Asian sub-regions) and the empowerment of middle powers. This Special Issue of Asian Affairs: An American Review looks at the extent to which mid-sized East Asian states with significant democratic heritage embody hope for the liberal democratic project, and also the challenges they face. Furthermore, it considers how the analysis of the mode of interaction between state, economy and society allows a determination of the democratic conditions of any given country. The articles in this Special Issue originate from a project supported by the Asia Pacific department of the Friedrich Ebert Stiftung (FES) exploring regional interdependencies of democratization in Asia. This introduction explores the theoretical framework of the project and elaborates further on case selection.

Bangladesh's Trade with Asia: What Do Gravity Models Tell Us?

External trade has played a crucial role in Bangladesh’s strong economic growth and structural transformation, in the backdrop of rising prosperity in Asia as a whole. This paper examines the effect of national incomes and trade costs of three key Asian sub-regions—which “powered” the overall growth and prosperity in Asia as a whole—on Bangladesh’s external trade. The paper used the gravity model of international trade to test its validity in explaining Bangladesh’s trade with the sub-regions. Alternative empirical specifications of the model were econometrically estimated. The parameter estimates indicate that the central hypothesis of the gravity model is valid, i.e., trade between any two countries is directly proportional to their national incomes and inversely proportional to their trade costs. In line with these predictions, Bangladesh’s trade with the three key Asian sub-regions were found to be positively related to their GDPs and inversely related to trade costs. The predictive power of the estimated gravity models is also high. The statistical tests relevant to the econometric estimation of the specified model and the data used were conducted to ensure that the parameter estimates were robust. The model thus provides a solid basis for forecasting medium-term trade growth with the key Asian sub-regions, and hence it has a value to Bangladesh’s planners and policymakers. The results also imply that Bangladesh should pay greater attention to reviving trade (and industry) reforms to benefit from growing prosperity in its continental neighbourhood.

Ambient Particulate Matter Exposure and Under-Five and Maternal Deaths in Asia.

The Asian region is one of the major emission sources of air pollution. Although ambient PM2.5 has been linked to several health risks in high-, low-, and middle-income countries, the further analysis of type impact is still rare but significant. The PM2.5 distribution retrieved from MODIS (Moderate Resolution Imaging Spectroradiometer) aerosol optical depth products within 16 years thus explored the associations between under-five and maternal mortality for 45 countries in Asia. Both the nonparametric (Generalized Additive Mixed-Effect) and parametric (Generalized Linear Mixed-Effect) models were employed to analyze the collected datasets. The results show that the levels of PM2.5 in Asian sub-regions were higher than the Global Air Quality Standards. Biomass PM2.5 concentrations was associated with increased the rate of under-five (Incidence Rate Ratio, IRR = 1.29, 95% CI, 1.13–1.47) and maternal (IRR = 1.09, 95% CI: 1.08–1.10) deaths in Asia. Anthropogenic PM2.5 was associated with increased rate of under-five deaths in Asia by 12%. The nonparametric method revealed that dust PM2.5 was positively associated with the under-five (β = 0.04, p < 0.001) and maternal (β = 0.07, p < 0.001) deaths in Asia. The rate of maternal deaths was increased by biomass/dust (IRR = 1.64, 95% CI: 1.63–1.65) and anthropogenic/dust (IRR = 1.22, 95% CI: 1.19–1.26) mixture types. In summary, long-term exposure to different types of ambient PM2.5 in high concentration increased the rate of under-five and maternal deaths, suggesting that policies focusing on preventive and control measures is imperative for developing an improved maternal, newborn, and child health in Asia.

Effects of bicuspid extractions and incisor retraction on upper airway of Asian adults and late adolescents: A systematic review.

ObjectivesThis systematic review aimed to assess the effects of bicuspid extractions and incisor retraction on airway dimension, hyoid position and breathing of adults and late adolescents.MethodsThe review was conducted according to PRISMA guidelines. Eight databases including PubMed, EMBASE, Web of Science and Scopus were searched to August 2018. Minimum age of participants was 16 years. The intervention was dual‐arch bicuspid extractions with incisor retraction. Outcomes were airway dimension, hyoid position and breathing assessment.ResultsAll nine publications meeting inclusion criteria were from Asia. They were divided into three Asian subregions. All East Asian lateral cephalometric studies reported anteroposterior airway narrowing at the oropharynx and sometimes the hypopharynx. However, the narrowing was small, comparable to measurement errors, and highly variable. Two out of three East Asian computed tomography (CT) studies described reductions in airway dimensions. The single functional breathing study showed increased simulated flow resistance after incisor retraction in East Asians. South Asian studies had mixed findings, with some reporting significant airway narrowing. The single study from West Asia found no significant airway or hyoid changes.ConclusionsAirway response to bicuspid extractions and incisor retraction varied substantially when assessed with cephalometry. CT measurements present larger effect sizes and smaller variations, providing stronger evidence of airway narrowing. Orthodontic extractions for incisor retraction may be more frequently indicated in Asia, and East Asians seem particularly susceptible to airway narrowing and postero‐inferior hyoid movement with incisor retraction. Better designed CT studies are needed for confirmation due to small effect size and large variability.