East Asia Research Articles

Modeling of the modern climatic range of <i>Cydalima perspectalis</i> (Lepidoptera, Crambidae) in Eurasia

Modeling of the modern climatic range of a dangerous plant pest of the genus Buxus L. box tree moth Cydalima perspectalis (Walker, 1859) is carried out in order to determine possible territories of its further expansion in Eurasia. Information on the loci of actual C. perspectalis detection both in native (East and South Asia) and invasive (Europe and West Asia) parts of the range was collected from various sources (species distribution databases and publications). Six bioclimatic (three temperature and three humidity) parameters are used as distribution predictors. Original methods for determining the number of pseudo-absence points and their selective generation are developed and applied. The final classification and partitioning of the space of bioclimatic factors is carried out using gradient boosting. The modern Eurasian climatic range of the box tree moth is calculated and mapped. It is shown that the invasion has not yet reached its limits and there are a number of territories in Eurasia where climatic conditions are favorable for the emergence of C. perspectalis populations both in the native part of the range (certain southern and eastern regions of China, the DPRK, the southern foothills of the Himalayas) and in its invasive part (Northern and Eastern Europe, Caucasus, and Turkey). A comparative assessment of the importance of different climatic factors in determining the box tree moth distribution area is given. It has been found out that the sum of the driest month precipitation is of greatest importance for constructing a model of the C. perspectalis climatic range (47.6%). A significant difference in climatic conditions between the native and invasive parts of the range is revealed and assumptions about the possible causes of its occurrence are made.

Dry soil moisture on the Tibetan plateau drives synchronous extreme heatwaves in Europe and East Asia

Dry soil moisture on the Tibetan plateau drives synchronous extreme heatwaves in Europe and East Asia

Understanding the Best Nutritional Management for Creutzfeldt–Jakob Disease Patients: A Comparison Between East Asian and Western Experiences

(1) Background: Creutzfeldt–Jakob disease (CJD) is a rare and fatal neurodegenerative disorder caused by the accumulation of an altered prion protein, which usually leads to death within one year after clinical onset. CJD patients usually present with rapid cognitive impairment associated with declines in cerebellar, motor, visual, behavioral, and swallowing functions. Moreover, CJD patients lose their ability to eat and take medications orally very early on in treatment; nevertheless, there are no specific nutritional guidelines for this disease shared worldwide. (2) Methods: This review aims to describe the nutritional outcomes of CJD patients in Western countries to compare them with those described in East Asian countries and then aims to explore the most recent trends in the nutritional management of CJD patients, including some dietary compounds that present neuroprotective effects. (3) Results: In Japan’s, Taiwan’s, and China’s healthcare systems, CJD patients receive intensive life-sustaining treatment that prolongs their survival (i.e., artificial feeding); conversely, in Western countries, intensive life-sustaining treatments like tube feeding are not commonly provided to CJD patients. (4) Conclusions: It is difficult to pinpoint the reasons for these discrepancies around CJD palliative care supply, but it is clear that specific nutritional guidelines may directly improve the nutritional management of CJD patients and thus allow their families and caregivers to ensure the best end-of-life care for these patients.

New Late Cretaceous Paleomagnetic Results From the Eastern Qiangtang Terrane: Implications for the Postcollisional Extrusion and Convergence of the Southeastern Tibetan Plateau

AbstractTo refine the postcollisional extrusion and convergence history of the southeastern Tibetan Plateau, we report a quality paleomagnetic data set from Upper Cretaceous redbeds of the eastern Qiangtang Terrane (QT), where is situated at the front edge of eastern Himalayan Syntaxis. The 32 site‐mean directions provide a mean pole at 75.4°N, 176.8°E (A95 = 2.4°) and a paleolatitude of 31.8 ± 2.4°N for the Mangkang area. Comparison with reliable Late Cretaceous paleomagnetic data from the eastern QT and East Asia indicates that the eastern QT experienced a southward extrusion of 940 ± 310 km after the Late Cretaceous. Comparing Late Cretaceous paleolatitudes estimated from the eastern QT and Lhasa terrane (LT) reveals a paleolatitude difference of 2,390 ± 620 km. Such a great latitudinal convergence can be attributed to the fact that some continental terranes originally located between the eastern LT and QT were laterally extruded after the Late Cretaceous.

Evaluating Performance and Agreement of Coronary Heart Disease Polygenic Risk Scores.

Polygenic risk scores (PRSs) for coronary heart disease (CHD) are a growing clinical and commercial reality. Whether existing scores provide similar individual-level assessments of disease susceptibility remains incompletely characterized. To characterize the individual-level agreement of CHD PRSs that perform similarly at the population level. Cross-sectional study of participants from diverse backgrounds enrolled in the All of Us Research Program (AOU), Penn Medicine BioBank (PMBB), and University of California, Los Angeles (UCLA) ATLAS Precision Health Biobank with electronic health record and genotyping data. Polygenic risk for CHD from published PRSs and new PRSs developed separately from testing samples. PRSs that performed population-level prediction similarly were identified by comparing calibration and discrimination of models of prevalent CHD. Individual-level agreement was tested with intraclass correlation coefficient (ICC) and Light κ. A total of 48 PRSs were calculated for 171 095 AOU participants. The mean (SD) age was 56.4 (16.8) years. A total of 104 947 participants (61.3%) were female. A total of 35 590 participants (20.8%) were most genetically similar to an African reference population, 29 801 (17.4%) to an admixed American reference population, 100 493 (58.7%) to a European reference population, and the remaining to Central/South Asian, East Asian, and Middle Eastern reference populations. There were 17 589 participants (10.3%) with and 153 506 participants without (89.7%) CHD. When included in a model of prevalent CHD, 46 scores had practically equivalent Brier scores and area under the receiver operator curves (region of practical equivalence ±0.02). Twenty percent of participants had at least 1 score in both the top and bottom 5% of risk. Continuous agreement of individual predictions was poor (ICC, 0.373 [95% CI, 0.372-0.375]). Light κ, used to evaluate consistency of risk assignment, did not exceed 0.56. Analysis among 41 193 PMBB and 53 092 ATLAS participants yielded different sets of equivalent scores, which also lacked individual-level agreement. CHD PRSs that performed similarly at the population level demonstrated highly variable individual-level estimates of risk. Recognizing that CHD PRSs may generate incongruent individual-level risk estimates, effective clinical implementation will require refined statistical methods to quantify uncertainty and new strategies to communicate this uncertainty to patients and clinicians.

Identification of Genetic Loci Associated with Bolting Time in Radish (Raphanus sativus L.) by QTL Mapping and GWAS

Bolting time is a critical trait that affects crop yield, adaptability, and overall productivity, making its regulation vital for agricultural success. In this study, we explored the genetic mechanisms controlling flowering time in radish (Raphanus sativus) via a combination of quantitative trait locus (QTL) analysis and genome-wide association study (GWAS). By developing an F2 population from a cross between the relatively late-bolting variety ‘L432’ and the early-bolting variety ‘L285’, we identified 12 QTLs associated with bolting time. Furthermore, a GWAS performed on 60 East Asian radish accessions revealed 14 candidate genes potentially involved in flowering and bolting regulation. FLOWERING LOCUS C (FLC2) was the major candidate gene explaining the early and late bolting types. One locus was commonly detected from QTL and GWAS on chromosome 4, where CONSTANS-like (COL4) is located. To validate these findings, SNP markers were designed and applied to F2 populations, revealing a correlation between marker presence and bolting phenotypes. These results offer valuable insights into the molecular control of bolting time in radish and identify candidate genes for use in marker-assisted breeding. These findings could enhance breeding efforts for optimizing bolting time in various radish markets.

Proportion of Gleason Score ≥8 Prostate Cancer on Biopsy and Tumor Aggressiveness in Matched Cohorts of East Asian and Non-East Asian Men.

Historically, Asia had a lower prostate cancer (PCa) incidence and mortality compared with Western countries, but the gap is narrowing. Paradoxically, Asians have been reported to present with more advanced disease though more favorable outcomes. Despite PCa becoming an emerging health priority in East Asia, our knowledge remains limited. We compared the prevalence of high-grade PCa on biopsy and disease progression after radical prostatectomy (RP) in East Asian men from Asia and non-East Asian men from Western countries. This retrospective cohort study included men who underwent prostate biopsy and RP at academic centers in Shanghai, China, and Toronto, Canada (2014-2019). The expanded RP cohort included East Asian men from Singapore (n=282) and non-East Asians from Paris (n=192). Primary endpoints included the proportion of men with Gleason score (GS) ≥8 on biopsy and metastasis-free survival (MFS) after RP for GS ≥8. Multivariable logistic regression and Cox proportional hazard models were performed. Propensity score matching was used to reduce imbalances between cohorts. PCa was found on biopsy in 2,343 of 4,905 (48%) East Asians and 2,317 of 3,482 (67%) non-East Asians (P<.001). Prostate-specific antigen (PSA) levels at presentation and the proportion of men with GS ≥8 were higher in East Asians than non-East Asians (12.4 vs 6.6 ng/mL and 15.0% vs 8.8%, respectively; both P<.001). On multivariable analysis, there was no difference in the proportion of men with GS ≥8 between matched cohorts with PSA <20 ng/mL (n=3,572; odds ratio, 1.05 [95% CI, 0.77-1.43]; P=.76). No difference in MFS was found after RP between matched cohorts (hazard ratio, 0.97 [95% CI, 0.55-1.70]; P=.92). This contemporary study demonstrates that East Asian men are equally as likely to harbor aggressive PCa on biopsy as non-East Asian men at PSA levels observed in screening programs, with no difference in disease aggressiveness after RP. The assumption that unfavorable PCa at diagnosis is more common but less aggressive in East Asians should be revisited and viewed in the context of the expected increase in the PCa burden worldwide.

Earlier Seasonal March of the East Asian Summer Monsoon in the Mid-Pliocene

Abstract The mid-Pliocene (∼3.3–3 million years ago) has been considered as a potential analog for future climate, but the seasonal march of the East Asian summer monsoon (EASM)—a distinctive feature of the modern EASM characterized by a northward migration of the monsoon circulation and rainband from early to late summer—remains unclear in this regard. Here, based on model simulations mainly from the Pliocene Model Intercomparison Project Phase 2, we find that the seasonal march of the mid-Pliocene EASM is about two pentads earlier than today. It is accompanied by a northward shift of the monsoon circulation and rainband in July, resulting from both extratropical and tropical processes. For the extratropical path, greener vegetation in the midlatitudes enhances the surface warming, which reduces the meridional temperature gradient. The subsequent weakening and northward shift of the subtropical westerly jet lead to weaker zonal topographic Rossby waves, resulting in an anticyclone over East Asia. For the tropical path, exposure of the Sunda and Sahul shelves weakens the Walker circulation, which suppresses the Maritime Continent convection. The subsequent weakening of the local Hadley circulation increases precipitation in the tropical western North Pacific, which excites a Pacific–Japan meridional teleconnection with anticyclonic circulation over northern East Asia. These processes lead to a northward shift of the western Pacific subtropical high and hence the monsoon rainband. Our results unravel the dominant roles of vegetation and geography in the earlier seasonal march of the mid-Pliocene EASM, and its implications for potential future changes in the EASM’s seasonal march are discussed.

Book Review: Shadow Education in the Middle East

Since the 1990s, private supplementary tutoring has become increasingly prevalent across the globe. Such form of tutoring is often referred to as ‘shadow education’ because it ‘mimics schooling’ (p. 4). As such, ‘as the curriculum changes in the schools, so it changes in the shadow; and as the school systems expand, so do shadow systems’ (p. 4). This has inspired numerous scholars to explore its contributing factors and their implications for education policymaking, social mobility, and equity. Shadow Education in the Middle East: Private supplementary tutoring and its policy implications, co-authored by Mark Bray and Anas Hajar, is the latest addition the study of shadow education as a global phenomenon. It builds on Mark Bray and others’ existing works on mapping the global landscape of shadow education, including post-Soviet states (Silova et al., 2006), the Mediterranean (Bray et al., 2013), East Asia (Zhang and Yamato, 2018), South Asia (Joshi, 2021), and Africa (Bray, 2021).

Disentangling regional climate change: assessing the contribution of global- and regional-scale anthropogenic factors to observed regional warming

Abstract While the influence of uniformly-distributed well-mixed greenhouse gas emissions on global warming is well-documented and robustly attributed through multiple lines of evidence, regional attribution remains more challenging and dependent on the performance and resolution of climate models. This study investigates the extent to which observed regional temperature trends are attributable to global-scale anthropogenic factors, mainly the direct effects of CO2, aiming to differentiate the portion of the change attributable to regional-scale drivers and local feedback mechanisms. To quantify the contribution of global- and regional-scale climate drivers to observed temperature change, I conducted regression analyses using the observed temperature change in HadCRUT4 and the global warming index derived from global radiative forcing series. Results indicate that in certain regions—specifically West Asia, East N. America, West Africa, and the Amazon— 62 ± 7%, 61 ± 13%, 58 ± 7%, and 61 ± 10% of the warming observed over 1991–2020 can be attributed to global anthropogenic warming, primarily the direct effects of CO2. The remaining portion, which represents 22 ± 8%, 21 ± 16%, 27 ± 9%, 23 ± 14% of the observed warming, is attributable to regional drivers. The Mediterranean showcases high sensitivity, with regional drivers contributing 31 ± 13% of the observed 1.2 ∘ C warming, amplifying the warming attributed to global anthropogenic drivers, estimated at 55 ± 10%. The Arctic Ocean along with the Russian-Arctic region exhibits a substantial contribution from regional drivers and local feedback mechanisms (the indirect effects of CO2) to the observed warming amplification, quantified at 43 ± 15% of the 3 ∘C warming over 1991–2020. Regional cooling drivers, however, are significant in East Asia and the Tibetan Plateau, with the latter experiencing a cooling contribution of − 42 ± 17%. By breaking down the contributions of climate drivers into global and regional-scale components, we gain valuable insights into the local climate mechanisms responsible for the observed regional warming, which is a crucial factor that affects agriculture, ecosystems and societies.

A genome-wide cross-trait analysis identifying shared genetic basis and causal relationships between Hunner-type interstitial cystitis and autoimmune diseases in East Asian populations

PurposeEpidemiological studies have demonstrated the clinical link between Hunner interstitial cystitis (HIC) and autoimmune diseases (ADs), suggesting potential shared genetic bases for their comorbidity. We aimed to investigate the shared genetic architecture and causal relationships between HIC and ADs.MethodsWe conducted a genome-wide cross-trait study with ~170000 individuals of East Asian ancestry to investigate the shared architecture between HIC and ADs. Bidirectional Mendelian randomization (MR) was used to assess potential causal relationships and a multi-trait analysis of GWAS (MTAG) was conducted to identify their associated pleiotropic loci. Fine-mapping analysis narrowed candidate gene susceptibility loci and colocalization analysis was performed to identify shared variants at specific locus. Lastly, transcriptome-wide association (TWAS) and functional analysis were utilized to explore potential shared gene-tissue associations.ResultsThrough bidirectional MR analysis, we observed a positive causal effect of AIH(ORIVW=1.09, PIVW=1.00×10-3) and RA (ORIVW=1.47, PIVW&amp;lt;1.00×10-4) on HIC and a negative causal effect of UC on HIC (ORIVW=0.89, PIVW&amp;lt; 1.00×10-4). Furthermore, we unveiled a robust positive causal effect of HIC on T1D(ORConMix=1.05, PConMix=1.77×10-3). Cross-trait meta-analysis identified a total of 64 independent SNPs associated with HIC and ADs. Functional analysis revealed that the identified variants regulated gene expression in major tissues belonging to the autoimmune system.ConclusionsOur findings might offer insights into the shared underlying etiology of HIC and ADs.

A review on ethnobotany, phytochemistry, and pharmacology of the genus Duhaldea DC

The botanical drugs of genus Duhaldea DC. have been traditionally utilized in folk medicine for the treatment of a wide array of illnesses, encompassing fractures, bone wounds, carbuncles and poisoning, bronchitis, bruises, giddy with hypertension of qi, and lung deficiency cough. The genus Duhaldea DC. comprises 15 species widespread in Central, East, and Southeast Asia and 7 species (2 endemic) in China. The review aims to provide a systematic overview of ethnopharmacology, phytochemistry, and pharmacology of Duhaldea DC. and to explore the future therapeutic potential and scientific potential of this genus. The data were systematically collected from books and scientific databases such as PubMed, Web of Science, Google Scholar, CNKI, and doctoral and master’s theses. To date, a total of 352 metabolites have been isolated from this genus, and terpenoids, flavonoids, phenylpropanoids, and inositol angelates are the primary contributors to the pharmacological activities of Duhaldea DC. The crude extracts and isolated phytochemical metabolites from this genus have been shown to exhibit various pharmacological activities, including anti-inflammatory, antimicrobial, anti-osteoporotic, anticancer, and antioxidant activities. Despite notable advancements in our understanding of the chemical constituents and pharmacological properties of Duhaldea DC., it is absolutely crucial to conduct additional research into the pharmacology and toxicology of these species to definitively ascertain their safety, efficacy, and quality.

Status Hierarchies and Stigma Shifting in International Relations

Abstract How do states as social actors cope with stigma-induced status anxiety? I propose the concept of “stigma shifting” as a way in which status-anxious states overcompensate for their stigma-induced inferiority and reaffirm their place in the world: by seeking identification with higher-status states and differentiation from lower-status states. In identifying with the desired group of states, stigmatized states engage in approval-seeking behavior and reaffirm their in-group status in areas where they feel discredited. In differentiating themselves from the undesired group, stigmatized states engage in distinction-seeking behavior, claiming their superiority over this “lesser” group in areas that gave rise to their status anxiety in the first place. Stigma shifting, in other words, allows a stigmatized state to take the role of a stigmatizer. To demonstrate the concept's depth and analytical utility, I draw on the case of East Asia in three disparate issue areas: colonial redress, nuclear disaster, and international order making. Japan, stigmatized in all three areas, has reaffirmed its status by shifting the stigma onto its significant but “lesser” others: China and Korea. Ultimately, stigma shifting solidifies status hierarchies in the world—not just the hierarchy as represented by the “Western” dominance of international society but also the regional hierarchies of the non-Western world.

Should mathematicians worry with PISA and TIMSS math results?

Since the end of last century, international large-scale assessment studies have been providing systematic information about countries’ education results. The news they convey regarding European education are not at all reassuring and have worsened with school closures and the disruption due to the recent Covid-19 pandemic. The size of the education losses and the distance of most European countries to other areas of the world, namely South East Asia, are often overlooked. A simple statistical analysis shows most European students are about one to two school years behind their peers in most advanced countries and regions, and the gap is increasing. These facts will negatively impact European workforce, economic competitiveness, and development. They will most likely also negatively impact mathematics higher education and research in our continent. To recognise the problem is the first step to cope with it. [1]

The Development of Overseas Corporate Culture of Chinese Bank in the Qing Dynasty: A Case Study of Heshengyuan

The Heshengyuan (合盛元) Bank is a paradigmatic example of the Shanxi merchants (晋商) during the Qing Dynasty. Established in the early 19th century, the bank actively expands its domestic operations and takes the initiative to extend its services eastward. It establishes branches and subsidiaries in Korea and Japan, engaging in financial transactions. During its overseas expansion, the firm develops an innovative corporate culture that includes the following elements: a proactive approach to business expansion and the exploration of international financial territories; an astute awareness of customer demands, with a business strategy oriented towards market needs; and a policy of prioritizing the employment of young executives and the hiring of expatriate personnel. These culturally open and progressive corporate values facilitate Heshengyuan&amp;rsquo;s significant commercial influence within the East Asian region and bequeath a legacy of corporate ethos that serves as a valuable reference for subsequent generations.

Chromosome-level genome assembly of the smallscale yellowfin (Plagiognathops microlepis).

The small-scale yellowfin (Plagiognathops microlepis) is a highly valued species in East Asian aquaculture due to its adaptability and high yield. However, the lack of genomic data has impeded genetic research and breeding efforts. In this study, we utilize PacBio Hifi long-read sequencing and Hi-C technologies to construct a highly detailed genome of P. microlepis at the chromosomal level. The assembly encompasses 976.41 Mb, with an exceptional 99.84% distribution across 24 chromosomes. Notably, the contig N50 was 34.41 Mb and scaffold N50 was 38.38 Mb. The completeness of the P. microlepis genome assembly is underscored by a BUSCO score of 98.08%. A total of 25,389 protein-coding genes were identified, with a BUSCO score of 96.98%, and 99.85% of these genes were functionally annotated. Synteny relationships at the chromosome level with Danio rerio and Chanodichthys erythropterus genomes uncover small-scale chromosomal rearrangements. This high-fidelity genome assembly serves as a pivotal resource for forthcoming endeavors such as the genome structure, functional elements, comparative genomics, and evolutionary characteristics of P. microlepis and its relative species.

Complex chromosomal rearrangements in female carriers experiencing recurrent pregnancy loss or poor obstetric history and literature review.

Complex chromosomal rearrangements (CCRs) often remain unidentified as they are rarely observed in the general population. Females with CCRs are generally recognized on the identification of an affected child with multiple congenital anomalies (MCA) or having a history of repeated pregnancy loss/bad obstetric history (RPL/BOH). In contrast, males with CCRs are diagnosed primarily due to infertility. This study aimed to carry out a systematic epidemiological analysis of CCRs in one of the largest series from the Indian population. In addition, a review of the literature on female CCR carriers experiencing RPL/BOH has been compiled in an attempt to identify the genomic landscape of breakpoints, commonly involved chromosomes, and the breakpoint regions. A total of 8560 healthy individuals with normal physical and mental well-being and had no history of any obvious genetic disorder at the time of presentation were referred for chromosome analysis in view of RPL/BOH between 1994 and 2024. Of them, 8158 had a normal chromosome complement whereas, 402 (4.7%) showed chromosomal aberrations. CCRs were detected in seven individuals, i.e., one partner in each of seven couples with structural rearrangements, all of whom were females. Comprehensive characterization of CCR was carried out using various molecular cytogenetic techniques. Seven CCR carriers had a total of 25 pregnancies: 20 leading to miscarriages (80%), one leading to the birth of an abnormal child (4%), two medically terminated pregnancies (8%) due to abnormal antenatal findings, and the remaining two were healthy (8%). A total of 13 different chromosomes with 24 non-recurring breakpoints were identified in these cases. Chromosome (#) 2 showed four breaks (16.7%), followed by #1, #4, #6, and #13 with three breaks each (12.5% each), while one break each (4.2% each) was seen on the remaining eight chromosomes (#3, #5, #8, #11, #14, #15, #17, and #21). Type I and type IV CCRs were observed in five (71.4%) and one case (14.3%), respectively, along with a "not a true" CCR (14.3%) in the present study group. Overall, the prevalence of CCRs in couples with RPL/BOH was 0.16%. To the best of our knowledge, this is the first study on the epidemiology of CCRs in couples with RPL/BOH of Indian origin. The incidence of CCRs in couples experiencing RPL/BOH in the present cohort was found to be 0.16% with type I CCR being the most predominant of all types, which is congruent with observations from non-Hispanic white and South East Asian populations. The uniqueness and rarity of each CCR pose a challenge in genetic and reproductive counseling.

Global, regional and country-specific burden of patella, tibia or fibula, or ankle fractures and its prediction to 2035: findings from global burden of disease study 2019.

Bone fractures are a global public health issue and a major source of significant illness and financial hardship. However, to date, there is limited research on patella, tibia or fibula, or ankle fractures (FPTFA) disease burden. Using the framework of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we conducted temporal trends of disease burden, effects of sex and socio-demographic index (SDI) on age standardized prevalence rate (ASPR) and age-period-cohort model. Machine learning models were built to predict the ASPR of FPTFA in 2035. In 1990 and 2019, the top three of all fractures with the highest ASPR was FPTFA. Globally, in 2019, there were 13529.45million (95%UI: 11811.02, 15642.25), 9198.67million (95%UI: 8518.9, 10009.91) and 77.54million (95%UI: 34.09, 149.9) prevalent cases of fracture attributable to fall, transport injury and mechanical external force, respectively. The number of fracture prevalence and years lived with disability (YLDs), and ASPR were higher in males than in females. From 1990 to 2019, most of GBD regions showed a downward trend in average annual percent change (AAPC) of ASPR attributable to transport injuries, High-income Asia Pacific had the highest decline (AAPC= -1.81%, 95%CI: -1.89% to -1.74%). However, an upward trend in East Asia was observed (AAPC = 1.60%, 95%CI: 1.48-1.73%). With increasing SDI, the ASPR for FPTFA attributed to the fall and mechanical external force slowly increased and then turned downward, especially in high-income and high-SDI countries. The longitudinal age curve suggested that the attributed rate was increased for the three sites of lower limb fractures. The best predictive models for FPTFA caused by falls, transport injuries and mechanical external force were autoregressive integrated moving average model (ARIMA) (0,2,1), ARIMA (2,0,1) and ARIMA (0,2,2), with R2 of 0.96, 0.78 and 0.94, respectively. By 2035, ASPR for the fall-related FPTFA will continue to rise rapidly, whereas the ASPR of the transport injury-related FPTFA will gradually decrease. FPTFA attributed to the falls is the dominant type and the burden and trends of the fall-related FPTFA are substantial. Fall prevention and access to treatment are crucial for reducing FPTFA burden.

Molecular profiling reveals novel therapeutic targets and clonal evolution in ovarian clear cell carcinoma.

Ovarian clear cell carcinoma (OCCC) has a disproportionately high incidence among women in East Asia. Patients diagnosed with OCCC tend to experience worse clinical outcomes than those with high-grade serous carcinoma (HGSC) at advanced stages. The unfavorable prognosis of OCCC can be partly attributed to its frequent resistance to conventional chemotherapy. Within a precision medicine framework, we sought to provide a comprehensive molecular characterization of OCCC using whole-exome sequencing to uncover potential molecular targets that may inform novel therapeutic strategies. We performed whole-exome sequencing analysis on tumor-normal paired samples from 102 OCCC patients. This comprehensive genomic characterization of a substantial cohort of OCCC specimens was coupled with an analysis of clonal progression. On analyzing 102 OCCC samples, ARID1A (67%) and PIK3CA (49%) emerged as the most frequently mutated driver genes. We identified tier 1 or 2 clinically actionable molecular targets in 40% of cases. This included DNA mismatch repair deficiency (n = 1), as well as BRCA2 (n = 1), PIK3CA (n = 36), KRASG12C (n = 1), and ATM (n = 4) mutations. Furthermore, 45% of OCCC samples displayed ARID1A biallelic loss. Interestingly, we identified previously unreported mutations in the 5' untranslated region of the TERT gene that harbored an adverse prognostic significance. Clock-like mutational processes and activated APOBECs were major drivers of somatic point mutations. Mutations arising from DNA mismatch repair deficiency were uncommon. Reconstruction of clonal evolution revealed that early genetic events likely driving tumorigenesis included mutations in the ARID1A, PIK3CA, TERT, KRAS, and TP53 genes. Our study provides a comprehensive characterization of the genomic landscape and clonal evolution in OCCC within a substantial cohort. These findings unveil potentially actionable molecular alterations that could be leveraged to develop targeted therapies.

Body mass index and breast cancer risk in premenopausal and postmenopausal East Asian women: a pooled analysis of 13 cohort studies.

It has been suggested that the association between body mass index and breast cancer risk differs between Asian women and Western women. We aimed to assess the associations between body mass index and breast cancer incidence in East Asian women. Pooled analyses were performed using individual participant data of 319,189 women from 13 cohort studies in Japan, Korea, and China. Participants' height and weight were obtained by measurement or self-reports at cohort baseline. Breast cancer was defined as code C50.0-C50.9 according to the International Classification. Using a Cox proportional hazards model, hazard ratios of breast cancer were estimated for each body mass index category, with the reference group set as the group with a body mass index of 21 to < 23 kg/m2. The hazard ratio for a 5kg/m2 increase in body mass index was also calculated. During a mean 16.6 years of follow-up, 4819 women developed breast cancer. Similar to Westerners, a steady increase in breast cancer risk with increasing body mass index was observed in postmenopausal women, but the slope of the risk increase appeared to slow at a body mass index of 26-28 kg/m2. In premenopausal women, the inverse association seen in Westerners was not observed. The risk of developing breast cancer after 50 years of age increased slightly with increasing body mass index, which was more pronounced in the older birth cohort. There was no significant association between body mass index and the risk of developing breast cancer before 50 years of age, but the risk estimates changed from positive to negative as the birth cohort got younger. In East Asia, the role of body mass index in breast cancer in premenopausal women may be changing along with the increase in obesity and breast cancer. The increased risk of postmenopausal breast cancer with a higher body mass index was as robust as that of Western women.