Background/Objectives: Casein glycomacropeptide (cGMP) has been modified to enable its suitability as a low phenylalanine (Phe) protein substitute (PS) in phenylketonuria (PKU). No data is available about its global usage. Methods: A 60-item multiple choice and short answer/extended response questionnaire examining the use of modified cGMP in PKU was distributed globally to dietitians and physicians via web-based professional inherited metabolic disorder groups. Results: Respondents (n = 208) from 45 countries across 6 continents completed the questionnaire. Of these, 83.7% (n = 174) were dietitians/nutritionists, 14.9% (n = 31) medical doctors/physicians and 1.4% (n = 3) other health professionals, caring for both paediatric and adult patients (59.1%), paediatrics only (25.0%) or adults only (15.9%). cGMP PS were reported as not available in their centre/hospital by 19.7% (n = 41), mostly in Africa, South America, and southern and western Asia. The main reasons included lack of regulatory approval (65.8%), not promoted by manufacturers (41.5%), and cost (29.3%). An estimated 25% of represented patients globally were using cGMP PS; 78.4% (n = 163) following refusal/poor adherence with Phe-free amino acids and 54.8% (n = 114) for adult patients recommencing dietary treatment. There were concerns about the residual Phe in cGMP negatively impacting blood Phe levels in children <12y (66.3%), adolescents (48.0%), adults (34.6%), and the first trimester of pregnancy (53.1%). Sixty nine percent (n = 145) adjusted dietary Phe prescription according to the cGMP Phe content, particularly in regions with a higher percentage of severe PKU variants. Commonly perceived clinical advantages with cGMP were improved taste/palatability (93.2%, n = 194) and fewer gastrointestinal symptoms (55.8%, n = 116). Perceived clinical disadvantages were residual Phe (72.1%, n = 150), lack of data in children < 3 years (48.1%, n = 100), and the high energy content of some brands (45.2%, n = 94). There were concerns that cGMP PS were too high in sugar (34.1%, n = 71) and dissatisfaction or uncertainty about the adequacy of its Phe (66.3%) and amino acid (34.1%) content. Conclusions: There is global inconsistency in access to cGMP PS suitable for PKU, and in the interpretation of evidence-based research. Some professionals have significant concerns about its nutritional composition particularly residual Phe, limiting its estimated use to approximately 25% of PKU patients globally.

Non-invasive prenatal testing (NIPT) can determine fetal chromosomal sex early in pregnancy, raising the possibility of sex selection. However, current evidence regarding this practice is limited. Our objective was to assess the sex ratio at birth (SRB) among a cohort of infants born following NIPT from a single laboratory provider in Victoria, Australia (2014-2018). The NIPT dataset was linked with Victorian birth records. SRB and estimated relative risk of the birth of a male infant based on maternal major region of birth, parity and maternal age were calculated. An SRB was considered outside the natural range if the point estimate and 95% confidence interval were outside 1.04-1.06. The final dataset for analysis contained n = 43,665 NIPT records. The majority (88.5%, n=38,631) were linked with a birth record. The overall SRB was within the natural range (1.05, 95% CI 1.029-1.071). Confidence intervals for all maternal major regions of birth, parities, and maternal age categories overlapped with the natural range. There was an increased estimated relative risk of a male birth for mothers born in Southern and Central Asia compared with mothers born in Australia (RR: 1.049, 95% CI 1.005-1.096, p=0.03). We did not find evidence of an overall skewed SRB among a cohort of Australian NIPT users. However, our findings warrant larger studies on NIPT use and possible sex selection practices.

Cytogenetic findings are critical for determining prognosis, therapy and risk assessment in acute lymphoblastic leukaemia (ALL). Data on the epidemiology of cytogenetic findings in ALL from southern Asia is limited. This report documents the cytogenetic changes in ALL seen at a referral hospital in southern India and compares it with the literature. Clinical profiling and conventional cytogenetic analysis (CCA) of all patients with reverse-transcription polymerase chain reaction (RT-PCR) for detection of cryptic t(12;21). Of 1968 ALL, 1,819 (92.4%) patients, age 0.3-84 years, (median 17) had successful CCA. There were 979 children (<18 years) and 840 adults. Abnormal karyotypes were found in 1368 (75.2%), B-ALL-78% and T-ALL-69%. Favorable-risk group included high hyperdiploidy (HeH, 17.4%), t(12;21) (9.8%), and t(1;19) (4.3%), with > 80% of HeH and t(12;21) in children. The unfavorable-risk group included t(9;22) (11.2%, 80% adults), hypodiploidy (8.0%), MYC (8q24) translocations (2.3%), and KMT2A/MLL(11q23) translocations (1.6%). In children, the frequency of HeH (26.8%) was lower than the West (30.7%) but higher than S.E. Asia (15.5%) while t(9;22) (4.2%) was higher than the West (2%) but lower than S.E. Asia (6.8%). In adults, frequencies again differed from S.E. Asia (HeH, 6.4% vs. 2.7% and t(9;22), 19.4% vs. 29.3%) but were comparable to the West. CCA effectively provides diagnostic information in over 90% of ALL cases. While the spectrum of cytogenetic changes is similar to global data, there are significant regional variations in the frequencies of specific abnormalities.

The genus Hexarthrius Hope, 1842, a prominent member of the family Lucanidae, is widely distributed across southern Asia and includes some of the largest stag beetle species in the world. This study presents the first mitogenomic phylogeny for Hexarthrius and its related genera, using complete mitogenomes from all recognized Hexarthrius species and representatives of all known related genera; 23 mitogenomes are reported here for the first time. We identified two novel mitochondrial gene rearrangements in Hexarthrius and its relative genus Rhaetulus Westwood, 1871, with implications for mitogenome evolution in Lucanidae. Phylogenetic inference and molecular dating recover Hexarthrius as monophyletic and subdivided into two well-supported clades: a Himalayan clade and a Tropical clade, which diverged approximately 8.9 million years ago. Rhaetus Parry, 1864 is inferred as the sister group to Hexarthrius , whereas Rhaetulus occupies a basal position within the larger Hexarthrius clade. Ancestral-area and morphological reconstructions indicate a complex history of vicariance and dispersal associated with uplift of the Hengduan–Himalayan region and subsequent island isolations. These results clarify species relationships, biogeography, and morphological evolution within this emblematic beetle lineage.

Gender at the crossroads of mental health and climate change: A scoping review.

Achieving "remediating while producing" on arsenic contaminated soil by constructing interplanting systems based on medicinal crops and Pteris vittata L․.

The paper provides a description of a new species of Astagalus L. section Dissitiflori DC. (Fabaceae) from Kyrgyzstan. Section Dissitiflori (= sect. Xiphidium) is a difficult taxonomic group distributed from Southern, Central and Eastern Europe to Altai and Siberia and from Western to Middle, Central and Southern Asia, includes near 200 species, with hotspots in Iran and Middle Asia. Astagalus ketmentubensis, sp. nov., belongs to the affinity of A. vassilczenkoanus Golosk. and A. fedtschenkoanus Lipsky. First of them is a narrow endemic to Kyrgyz Mt. Ridge and second one is distributed from Chu-Ili mountains (Kazakhstan) to northern Pamir-Alai (Alai and Turkestan Mt. Ridges), while A. ketmentubensis is a rare plant of vicinity of Ketmen-Tyube Depression (Western Tian Shan).

Piper betle L., commonly referred to as Betel, is extensively cultivated in southern and southeast Asia. Historically, the residents of Southeast Asia were enthusiastic consumers of betel leaf, which held significant significance in their traditional healing practices and cultural rituals. This study aimed to examine the roles of betel leaf in the traditional medicinal practices of the Mualang Dayak community. The research objective was to develop a model that could determine the correlation between the use of betel leaf in traditional healing and cultural behaviours. A qualitative approach was employed in this study, utilising face-to-face interviews with key informants such as shamans, community leaders, and elderly individuals. The findings revealed that betel-chewing was a common practice among the Mualang Dayaks, who believed that betel leaf possessed therapeutic properties for treating ailments like najam and nipu darah in conventional healing. Within the realm of ethnomedicine, the Mualang Dayaks attributed a sacred status to betel leaf and incorporated it into their traditional healing practices. In conclusion, the established model illustrates that betel leaf is more closely associated with the integration of magicoreligious beliefs in the treatment of illnesses, rather than being supported by scientifically proven medicinal properties.

Oral squamous cell carcinoma (OSCC) is one of the most common malignancies in Southern and Southeastern Asia, and in the Hunan region of China, where betel nut chewing is prevalent. The prognosis of OSCC with oral submucous fibrosis (OSF), caused by areca nut use, remains debated. This study aimed to determine whether OSCC associated with OSF exhibits distinct tumor biological behaviors compared to OSCC without OSF, and to explore the tumor immune microenvironment, specifically focusing on the expression of Th17/Treg cells and the PD-1/PD-L1 axis. OSCC patients with and without OSF (Jan 2013-Oct 2023) were recruited from Xiangya Stomatological Hospital, grouped by history and clinical features. Patients were followed every 3months for recurrence and complications. SPSS 27 was used for descriptive and inferential statistics (Kaplan-Meier, Cox regression, χ2-test); survival/log survival/hazard functions were plotted to compare survival probabilities, stratified by sex, age, tumor location, stage (early/advanced, TNM), and habits (betel quid, smoking, alcohol). A subgroup of 88 patients (44 each) had immunohistochemical analysis for Th17/Treg and PD-1/PD-L1 expression. OSCC with OSF primarily affected the tongue and buccal mucosa, occurring in younger patients (median age 48 vs. 55years). Recurrence was higher in OSF-associated OSCC (27.56% vs. 19.73%). Overall Survival (OS) rates for OSCC with OSF were 94.25% (1-year OS), 49.82% (3-year OS), and 41.23% (5-year OS), compared to 94.82% (1-year OS), 56.58% (3-year OS), and 47.92% (5-year OS) in non-OSF cases. A subgroup of 88 patients (44 each) had immunohistochemical analysis for the expression of IL-17 (a marker of Th17 cells) and Foxp3 (a marker of Treg cells), as well as PD-1/PD-L. Immune profiling showed elevated IL-17, Treg cells, PD-L1, and PD-1 in OSF-associated OSCC. OSCC with OSF displays more aggressive tumor biological behavior and worse prognosis, which contributed by a more suppressive immune microenvironment marked by elevated levels of IL-17, Treg cells, and PD-1/PD-L1 expression. These results highlight the need for tailored treatment approaches in managing OSCC in patients with OSF.

Samples collected in intertidal and shallow subtidal localities along the coast of Kuwait and Saudi Arabia yielded five species of the genus Armandia Filippi, 1861 (Annelida, Opheliidae) that are newly reported in the Arabian Gulf: Armandia bipapillata Hartmann-Schröder, 1974, Armandia aff. dolio Parapar &amp; Moreira, 2015, Armandia melanura Gravier, 1905, Armandia sinaitica Amoureux, 1983 and Armandia aff. weissenbornii Kükenthal, 1887. All species are fully described, illustrated, and compared with similar species and those previously reported in the area. A key for species of Armandia in the Indo-Pacific, Southern Asia, Indo-Malay Archipelago and Australia, is also provided.

Newcastle Disease (ND) remains a major threat to poultry production worldwide, particularly in regions where it is endemic, like Southern Asia. The disease is caused by virulent forms of avian paramyxovirus-1, commonly termed Newcastle Disease Virus (NDV), a highly contagious virus with significant genetic diversity and evolving pathogenicity. This study aimed to molecularly characterize NDV isolates obtained from chickens and pheasants during the 2020/21 ND outbreaks in Nepal, to understand their genetic makeup, phylogenetic relationships, and implications for control strategies. Necropsy samples, including trachea, liver, intestine, spleen, lungs, heart, and proventriculus were collected from ten birds. Isolates from five clinical samples were typed as NDV by hemagglutination and hemagglutination inhibition (HA/HI) assays and were subjected to whole genome sequencing (WGS). Full genomes of 15,192 nucleotides were recovered from each isolate. Fusion (F) gene sequence analysis revealed the presence of multi-basic cleavage site motif 112RRQKRF117 in all isolates, indicative of virulent strain and suggesting a potentially velogenic or mesogenic phenotype. Phylogenetic analyses consistently classified all isolates within genotype VII.2 of class II NDV. Further comparative analysis indicated a close genetic relationship between the Nepalese isolates and strains reported from India and Bangladesh, and BEAST analysis suggested Southern Asia as the likely source of introduction into Nepal. These viral genomes provide additional insight into contemporary NDV circulating in an area of endemicity.

Sub-Saharan Africa is still the region having the highest burden of under-five mortality rate in the world. Of 4.8 million under-five deaths in 2023, more than 80 percent of under-five death reported from Sub-Saharan Africa and Southern Asia. While previous studies have examined the determinants of under-five mortality in individual countries, there is limited evidence on its spatial distribution and multilevel determinants across the region. This study aimed to examine the spatial pattern and identify significant factors of under-five mortality in Sub-Saharan African countries. This study explored the Demographic and Health Survey (DHS) data from nine Sub-Saharan African countries conducted between 2016 and 2022, and used a total of 115,335 live births for analysis. The multilevel logistic regression model was considered and several nested models were compared using the likelihood ratio test, AIC and BIC criteria. Significant predictors of under-five mortality were reported using adjusted odds ratios (AOR) with 95% Confidence Intervals (CI) and p-values < 0.05. The spatial distribution of under-five mortality in Sub-Saharan Africa was significantly clustered, as indicated by Moran's Index of 0.552 (p < 0.001). High mortality rates were observed in Burundi (58.5 per 1,000 live births) and low rates in Kenya (33.9), with an overall rate of 48.9 per 1,000 live births. Increased risk was associated with low maternal education (AOR = 1.57, 95% CI: 1.28-1.91), large family size (AOR = 2.60, 95% CI: 2.41-2.81), and multiple births (AOR = 5.73, 95% CI: 5.01-6.36). On the other hand, a lower risk was observed among children born to employed mothers (AOR = 0.90, 95% CI: 0.84-0.97), whose mothers used contraceptives (AOR = 0.59, 95% CI: 0.55-0.63), and those delivered at health facilities (AOR = 0.83, 95% CI: 0.77-0.90). The study reveals a significant spatial clustering of under-five mortality across Sub-Saharan Africa, with an overall rate that exceeds the Sustainable Development Goal (SDG) target of 25 deaths per 1,000 live births by 2030. Family planning, maternal education, and safe delivery practices would be essential in reducing under-five mortality in Sub-Saharan African countries. Empowering women through education and promoting family planning, safe delivery, and income-generating programs are vital to reduce child mortality. Regional collaboration and sharing best practices can further advance child survival across Sub-Saharan Africa.

EP3.4, e-Poster Terminal 3, September 4, 2025, 11:35 - 13:00AimWe investigated the prevalence of diabetes among different groups of migrants in Australia and their sociodemographic characteristics to guide health planning.MethodsWe used whole population data from 2021 Australian census and analysed data from people aged ≥30. Age-standardised prevalence (ASP) and age-standardised prevalence ratio (ASPR) of diabetes were calculated. Among those with diabetes, we reported sociodemographic characteristics and comorbidities.Results41% of the population with diabetes were migrants. Of those, 40% were born in Europe. The prevalence of diabetes ranged from 5.3% (migrants from Northeast Asia) to 14.4% (migrants from Oceania) and was higher among males and people aged 70-85. ASP was higher than Australian-born (ASPR:1.4-2.2) among migrants from Southeast Asia, North Africa and Middle East, Southern and Central Asia, and Oceania.Among migrants with diabetes, a range of 10.4% (migrants from Northeast Asia) to 32% (migrants from North-West Europe) had ≥3 long-term health conditions. Percentage of people with <10 years ago arrival ranged from 0.6% (migrants from Southern and Eastern Europe) to 14.9% (migrants from Northeast Asia). The highest percentage of low English proficiency was observed among migrants from Northeast Asia (55.2%). A range of 0.4% (migrants from North-West Europe) to 13.3% (migrants from North Africa and Middle East) did not go to school, and 38.5% (migrants from Sub-Sahara Africa) to 66.2% (migrants from Southern and Eastern Europe) had <$500 weekly income. Among groups with ASPR >1 who had low English language proficiency, a range of 8% (born in Oceania) to 29% (born in North Africa and Middle East) had <$500 weekly income, and 2% (born in Oceania) to 10% (born in North Africa and Middle East) did not go to school.ConclusionThe prevalence of diabetes and sociodemographic characteristics of those with diabetes vary among migrant groups. Considering intersectionality can improve diabetes-related outcomes among migrants.

Geographical and climatic influences on olive oil fatty acid composition: a comparative review across hemispheres.

The genus Leucas R.Br. (Lamiaceae) is widely distributed throughout Africa, southern Asia, and northeastern Australia. Leucas zeylanica (L.) W.T.Aiton and Leucas marrubioides Desf. are two species occurring in Sri Lanka that are extensively employed in traditional medicine. This study reports, for the first time, the chemical composition of the essential oils obtained from the wild aerial parts of these species collected in Sri Lanka. GC–MS analysis revealed that the essential oils of L. zeylanica (Lz) and L. marrubioides (Lm) are characterised by high contents of sesquiterpene hydrocarbons, with β-selinene (30.0%) and β-caryophyllene (25.6%) identified as the predominant constituents, respectively. The chemical profiles are discussed in comparison with previously published data on essential oils from other Leucas species. Furthermore, a comprehensive review of the volatile constituents reported to date for the genus Leucas is presented.

Abstract. Natural and agricultural soils are important sources of nitrogen oxides (NOx), accounting for about 10 %–20 % of the global NOx emissions. The increased application of nitrogen (N) fertilizer in agriculture has strongly enhanced the N availability of soils in the last several decades, leading to higher soil NOx emissions. However, the magnitude of the N fertilizer-induced soil NOx emissions remains poorly constrained due to limited field observations, resulting in divergent estimates. Here we integrate the results from meta-analyses of field manipulation experiments, emission inventories, atmospheric chemistry modelling and terrestrial biosphere modelling to investigate these uncertainties and the associated impacts on ground-level ozone and methane. The estimated present-day global soil NOx emissions induced by N fertilizer application vary substantially (0.84–2.2 Tg N yr−1) among different approaches with different spatial patterns. Simulations with the 3-D global chemical transport model GEOS-Chem demonstrate that N fertilization enhances global surface ozone concentrations during summertime in agricultural hotspots, such as North America, western Europe and eastern and southern Asia by 0.1 to 3.3 ppbv (0.2 %–7.0 %). Our results show that such spreads in soil NOx emissions also affect atmospheric methane concentrations, reducing the global mean by 6.7 (0.4 %) ppbv to 16.6 (0.9 %) ppbv as an indirect consequence of enhanced N fertilizer application. These results highlight the urgent need to improve the predictive understanding of soil NOx emission responses to fertilizer N inputs and its representation in atmospheric chemistry modelling.

ABSTRACT Southeastern and Southern Asian countries endure high the issue of carbon curse, which necessitates them to become environmentally sustainable by overcoming this curse in due course. Hence, considering 12 countries from these two Asian regions, this study explores whether geopolitical dispute settlement enables them to improve their carbon curse situations. Notably, this study considers an external conflict resolution‐based measure of geopolitical dispute settlement and assesses its impacts on a holistic carbon curse index that emphasizes reductions in carbon emission growth rates and intensity levels. The analysis period ranges from 2000 to 2022 and uses (non)parametric panel data estimators. Accordingly, findings affirm that geopolitical dispute settlement directly reduces the carbon curse, especially across Southeast Asia and in relatively less developed and low carbon curse‐experiencing countries. Additionally, geopolitical dispute settlement indirectly offsets the carbon curse‐exacerbating impacts of natural resources. Additionally, renewable energy consumption fails to lessen the carbon curse, irrespective of regional location, development status, and the severity of the curses faced. Besides, foreign direct investment inflow worsens carbon curse situations, irrespective of the development status, and particularly in countries facing moderate to high degrees of carbon curse. Moreover, energy optimization exacerbates carbon curses, especially across South Asia and in the relatively more developed and low carbon curse‐facing countries. Furthermore, financial development does not influence carbon curse as a whole, but it reduces the curse in relatively wealthier countries. Finally, corruption control efforts fail to lessen the curse, irrespective of the existing carbon curse‐facing level. Therefore, the above findings have critical policy implications in terms of overcoming the carbon curse issue throughout Southeast and South Asia.

Ovine babesiosis caused by Babesia ovis is a tick-borne disease that affects sheep in enzootic regions of Southern Europe, Middle East, and Asia, resulting in significant economic loss. Despite its clinical relevance, only a few useful serological markers are available for accurate diagnosis. In the present study, we characterized the B. ovis spherical body protein 4 (SBP4) using in silico, molecular, and immunological approaches, and evaluated its preliminary activity with sera naturally infected sheep, suggesting its potential for future serodiagnostic application. The full-length sbp4 gene was identified via genome analysis, revealing a 984 bp intronless open reading frame encoding a 327-amino acid protein with a predicted signal peptide. Codon-optimized for expression in Escherichia coli, the sbp4 gene was cloned and inserted into the pET-29b(+) vector. Expression in Escherichia coli C43(DE3) produced soluble recombinant rBoSBP4 protein, which was purified via affinity chromatography. The ~ 37 kDa protein was confirmed by SDS‒PAGE and recognized by anti-His antibodies. Western blot and indirect ELISA using sera from naturally B. ovis-infected sheep demonstrated that rBoSBP4 is specifically recognized during infection, whereas negative control sera showed no reactivity. The immunization of rabbits with rBoSBP4 also induced a strong antibody response, as determined by ELISA. These results indicate that rBoSBP4 is both immunogenic and antigenically specific, supporting its potential utility in the development of serological diagnostic assays for ovine babesiosis.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-28444-1.

Urban flooding poses an escalating threat to riverine cities in Southern Asia’s tropical regions, primarily driven by rapid urban expansion. This study develops future projections of Intensity–Duration–Frequency (IDF) curves for major urban centers in Punjab, Pakistan, utilizing downscaled satellite-derived precipitation data. Baseline IDF curves were established using historical rainfall records from multiple meteorological stations. Among eight General Circulation Models (GCMs) assessed, EC-Earth3-Veg-LR demonstrated the highest skill in capturing extreme rainfall patterns relevant to the region. Future precipitation projections from this model were downscaled using the Equidistant Quantile Matching (EQM) technique and applied to generate IDF curves under two CMIP6 scenarios: SSP2-4.5 and SSP5-8.5. The results reveal a substantial increase in extreme rainfall intensities, particularly under the SSP5-8.5 scenario, with projected 100-year return period rainfall intensities rising by approximately 30–55% across key cities. The downscaled projections reveal more pronounced variations than the raw GCM outputs, emphasizing the importance of high-resolution climate data for accurate regional hydrological risk evaluation and effective urban flood resilience planning.

Abstract. Water vapor in the upper troposphere and lower stratosphere plays a crucial role for climate, affecting radiation, chemistry, and atmospheric dynamics. This study applies a simplified Lagrangian method to reconstruct stratospheric water vapor based on satellite observations from the Stratospheric Aerosol and Gas Experiment III on the International Space Station (SAGE III/ISS) and the Aura Microwave Limb Sounder (MLS). The objective is to improve understanding of moisture enhancements in the Asian and North American monsoons and to identify the key factors contributing to reconstruction biases. The performance of Lagrangian reconstructions significantly improves with the size of trajectory ensembles but exhibits a general dry bias. The reconstruction represents the summertime local water vapor maximum well in the Asian monsoon, particularly above the tropopause, but not in the North American monsoon. The main dehydration region diagnosed from trajectories indicates that water vapor in the Asian monsoon is predominantly controlled by local tropopause temperatures. The dry bias in reconstructions below the tropopause over the Asian monsoon shows a positive correlation with convection intensity, particularly in the western part of the monsoon region, suggesting that underestimated moistening from convection may contribute to this bias. Water vapor mixing ratios in the North American monsoon are largely influenced by long-range transport from dehydrated regions over southern Asia and additional local moistening. The limited performance of reconstructions in the North American monsoon is therefore likely linked to underestimation of local convection or uncertainties in long-range transport.