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The economic trend and the health care landscape are rapidly evolving across Asia. Effective real-world data (RWD) for regulatory and clinical decision-making is a crucial milestone associated with this evolution. This necessitates a critical evaluation of RWD generation within distinct nations for the use of various RWD warehouses in the generation of real-world evidence (RWE). In this article, we outline the RWD generation trends for 2 contrasting nation archetypes: "Solo Scholars"-nations with relatively self-sufficient RWD research systems-and "Global Collaborators"-countries largely reliant on international infrastructures for RWD generation. The key trends and patterns in RWD generation, country-specific insights into the predominant databases used in each country to produce RWE, and insights into the broader landscape of RWD database use across these countries are discussed. Conclusively, the data point out the heterogeneous nature of RWD generation practices across 10 different Asian nations and advocate for strategic enhancements in data harmonization. The evidence highlights the imperative for improved database integration and the establishment of standardized protocols and infrastructure for leveraging electronic medical records (EMR) in streamlining RWD acquisition. The clinical data analysis and reporting system of Hong Kong is an excellent example of a successful EMR system that showcases the capacity of integrated robust EMR platforms to consolidate and produce diverse RWE. This, in turn, can potentially reduce the necessity for reliance on numerous condition-specific local and global registries or limited and largely unavailable medical insurance or claims databases in most Asian nations. Linking health technology assessment processes with open data initiatives such as the Observational Medical Outcomes Partnership Common Data Model and the Observational Health Data Sciences and Informatics could enable the leveraging of global data resources to inform local decision-making. Advancing such initiatives is crucial for reinforcing health care frameworks in resource-limited settings and advancing toward cohesive, evidence-driven health care policy and improved patient outcomes in the region.

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The genus Languidipes is currently represented by three species distributed in southeastern Asia, India, and Sri Lanka. Languidipes corporaali is the most widely distributed species, and both, male and female imagos, as well as nymphs, are known. In contrast, the other species, L. taprobanes and L. lithophagus, are only known from nymphs. Here, we describe a new species, Languidipes janae sp nov, based on male imagos collected from Borneo, Indonesia. This new species is characterized by the presence of ommation on mesonotum, and penis almost completely divided, with sub-quadrate base and a small outer projection basal to the long and slender distal arms. This constitutes the first record of the genus for Borneo. A cladistic analysis of the subfamily Asthenopodinae supports its taxonomic status.

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OBJECTIVE: To develop a predictive model for thiamine responsive disorders (TRDs) among infants and young children hospitalized with signs or symptoms suggestive of thiamine deficiency disorders (TDDs) based on response to therapeutic thiamine in a high-risk setting. STUDY DESIGN: Children aged 21 days to <18 months hospitalized with signs or symptoms suggestive of TDD in northern Lao People's Democratic Republic were treated with parenteral thiamine (100 mg daily) for ≥3 days in addition to routine care. Physical examinations and recovery assessments were conducted frequently for 72 hours after thiamine was initiated. Individual case reports were independently reviewed by three pediatricians who assigned a TRD status (TRD or non-TRD), which served as the dependent variable in logistic regression models to identify predictors of TRD. Model performance was quantified by empirical area under the receiver operating characteristic curve. RESULTS: A total of 449 children (median [Q1, Q3] 2.9 [1.7, 5.7] months old; 70.3% exclusively/predominantly breastfed) were enrolled; 60.8% had a TRD. Among 52 candidate variables, those most predictive of TRD were exclusive/predominant breastfeeding, hoarse voice/loss of voice, cyanosis, no eye contact, and no diarrhea in the previous 2 weeks. The area under the receiver operating characteristic curve (95% CI) was 0.82 (0.78, 0.86). CONCLUSIONS: In this study, the majority of children with signs or symptoms of TDD responded favorably to thiamine. While five specific features were predictive of TRD, the high prevalence of TRD suggests that thiamine should be administered to all infants and children presenting with any signs or symptoms consistent with TDD in similar high-risk settings. The usefulness of the predictive model in other contexts warrants further exploration and refinement. TRIAL REGISTRATION: Clinicaltrials.gov NCT03626337.

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Although the evolutionary history of anthropoid primates (monkeys, apes, and humans) appears relatively well-documented, there is limited data available regarding their origins and early evolution. We review and discuss here the earliest records of anthropoid primates from Asia, Africa, and South America. New fossils provide strong support for the Asian origin of anthropoid primates. However, the earliest recorded anthropoids from Africa and South America are still subject to debate, and the early evolution and dispersal of platyrhines to South America remain unclear. Because of the rarity and incomplete nature of many stem anthropoid taxa, establishing the phylogenetic relationships among the earliest anthropoids remains challenging. Nonetheless, by examining evidence from anthropoids and other mammalian groups, we demonstrate that several dispersal events occurred between South Asia and Afro-Arabia during the middle Eocene to the early Oligocene. It is possible that a microplate situated in the middle of the Neotethys Ocean significantly reduced the distance of overseas dispersal.

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BACKGROUND: The injection of illicit, non-regulated foreign materials may trigger an autoimmune autoinflammatory syndrome induced by adjuvants (ASIA). METHODS: A retrospective review of health records was performed to identify patients' epidemiological and clinical characteristics. The issues analyzed were age and gender of cases, occupation, the person who administered the substance, anatomical site, type and volume of the injected substance, time from injection to the onset of symptoms, chief complaint, measures taken to alleviate symptoms, local complications, systemic manifestations, and imaging method to aid in diagnosis. RESULTS: More than 70% of patients were female and dedicated to household activities; the mean age was 44 years for females and 40.7 years for males. One-quarter of patients reported some comorbidity. The most commonly reported substance was mineral oil, whereas the most frequent anatomical site was the gluteal region with volumes around one liter. Signs and symptoms occurred almost exclusively at a local level, pain (40%) and swelling (18%) being the predominant manifestations with a peak incidence after three years. Treatment was mainly medical; surgery, primarily en bloc resection, was performed in 20% of patients. CONCLUSIONS: A myriad of substances may induce autoimmune autoinflammatory syndrome induced by adjuvants (ASIA) when injected for cosmetic purposes. Since effective treatments are scarce, public policies should be enforced to alert the community and limit the consequences of this healthcare problem. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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Introducción: parte esencial del manejo y control de la pandemia por SARS-CoV-2 ha sido la vacunación. Sin embargo, las sales de aluminio usadas en las vacunas para potenciar el sistema inmune, pueden asociarse con el síndrome autoinmune/autoinflamatorio inducido por adyuvantes (ASIA). Esta condición se ha relacionado con otros factores, como agentes infecciosos, implantes de silicona e inoculación de aceites minerales. Hay poca información acerca de enfermedades endocrinas autoinmunes y ASIA después de la vacunación para SARS-CoV-2. Objetivo: reportar los casos relacionados con enfermedad tiroidea posterior a la vacunación para COVID-19, en pacientes que asistieron a la consulta de endocrinología en la clínica Imbanaco, Cali, Colombia, en 2021. Métodos: descripción clínica, de laboratorio e imágenes de 8 pacientes que acudieron a la consulta de endocrinología. Resultados y discusión: 87.5% eran de sexo femenino de 46.8 ± 10 años, el tiempo entre la aplicación de la vacuna y la aparición de los síntomas fue 13.8 días y la vacuna más relacionada fue Pfizer/BioNTech seguida por Sinovac-CoronaVac y AstraZeneca/AZD1222. La presentación de tiroiditis subaguda estuvo presente en el (37.5%), enfermedad de Graves (37.5%), tiroiditis silente (12.5%) e hipotiroidismo (12.5%). Los síntomas más comunes fueron mialgias y palpitaciones. El hallazgo ecográfico más común fue tiroiditis subaguda. Conclusiones: en esta seria de casos, reportamos una relación entre la vacunación y la aparición de enfermedad tiroidea por SARS-CoV-2. dado que estos eventos son motivo de controversia, serán necesarios otros estudios que ayuden a establecer si existe o no causalidad

Introduction: Vaccines have been an essential part of the SARS-CoV-2 pandemic management and control. However, aluminum salts in vaccines, used to enhance the immune response, may be associated with autoimmune/inflammatory syndrome induced by adjuvants (ASIA). This syndrome has been linked to other factors, such as infectious agents, silicone implants, and mineral oil inoculation. Data on autoimmune endocrine disorders and ASIA following SARS-CoV-2 vaccination is scant. Objective: to report cases of thyroid disorders following COVID-19 vaccination, in patients who attended the endocrinology clinic at Clínica Imbanaco, Cali, Colombia, in 2021. Methods: clinical, laboratory and imaging description of 8 patients who attended the endocrinology service. Results and discussion: 87.5% were females, aged 46.8 ± 10 years. Time between vaccine administration and symptoms onset was 13.8 days and the most related vaccine was the Pfizer/BioNTech vaccine followed by Sinovac-CoronaVac and AstraZeneca/AZD1222 vaccines. Subacute thyroiditis presented in 37.5%, Graves ́ disease in 37.5%, silent thyroiditis in 12.5% and hypothyroidism in 12.5%. Myalgias and palpitations were the most common symptoms. Subacute thyroiditis was the most common ultrasound finding. Conclusions: our case series evidences a relationship between thyroid disease and SARS-CoV-2 vaccination. Given controversy remains, further studies will be necessary to establish causality.

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ABSTRACT Objective: To identify predictors of stunting among children 0-24 months in Southeast Asia. Methods: This scoping review focused on articles with observational study design in English published from 2012 to 2023 from five international databases. The primary keyword used were: "stunting" OR "growth disorder" AND "newborn" AND "predict" AND "Southeast Asia". Results: Of the 27 articles selected for the final analysis there are thirteen predictors of stunting in seven Southeast Asia countries. The thirteen predictors include the child, mother, home, inadequate complementary feeding, inadequate breastfeeding, inadequate care, poor quality foods, food and water safety, infection, political economy, health and healthcare, water, sanitation, and environment, and social culture factor. Conclusion: All these predictors can lead to stunting in Southeast Asia. To prevent it, health service providers and other related sectors need to carry out health promotion and health prevention according to the predictors found.

RESUMO Objetivo: Identificar preditores de nanismo entre crianças de 0 a 24 meses no Sudeste Asiático. Métodos: Esta revisão de escopo se concentrou em artigos com desenho de estudo observacional em inglês publicados de 2012 a 2023 em cinco bases de dados internacionais. As palavras-chave primárias usadas foram: "stunting" (nanismo) OU "growth disorder" (distúrbio de crescimento) E "newborn" (recém-nascido) E "predict" (previsão) E "Southeast Asia" (Sudeste Asiático). Resultados: Dos 27 artigos selecionados para análise final, existem treze preditores de nanismo em sete países do Sudeste Asiático. Os treze preditores incluem a criança, a mãe, a casa, a alimentação complementar inadequada, a amamentação inadequada, os cuidados inadequados, os alimentos de má qualidade, a segurança alimentar e da água, a infeção, a economia política, a saúde e os cuidados de saúde, a água, o saneamento e o meio ambiente, e o fator cultura social. Conclusão: Todos estes preditores podem levar ao nanismo no Sudeste Asiático. Para preveni-lo, os prestadores de serviços de saúde e outros setores relacionados precisam realizar a promoção e a prevenção da saúde de acordo com os preditores encontrados.

RESUMEN Objetivo: Identificar indicadores de desnutrición crónica entre niños de 0 a 24 meses en el Sudeste Asiático. Métodos: Esta revisión de alcance se centró en artículos con diseño de estudio observacional publicados en inglés, entre los años 2012 y 2023 de cinco bases de datos internacionales. Las principales palabras clave utilizadas fueron: "stunting (Desnutrición crónica)" o "growth disorder (Desorden del crecimiento)", y "newborn (Recién nacido)", y "predict (Predecir)", y "Southeast Asia (Sudeste Asiático)". Resultados: De los 27 artículos seleccionados para el análisis final, se encontraron trece indicadores que influyen en la desnutrición crónica en siete países del Sudeste Asiático. Los trece indicadores incluyen el niño, la madre, el hogar, la alimentación inadequada complementaria, la lactancia materna inadecuada, la atención inadecuada, los alimentos de mala calidad, la seguridad de los alimentos y el agua, la infección, la economía política, la salud y la asistencia sanitaria, el agua, el saneamiento y el medio ambiente, y por último el factor sociocultural. Conclusión: Todos estos indicadores pueden provocar desnutrición crónica en niños del Sudeste Asiático. Para poder prevenirlo los prestadores de servicios de salud y otros sectores relacionados, necesitan realizar actividades de promoción y prevención de la salud de acuerdo con los indicadores encontrados en este artículo.

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Ha habido muchos casos de aparición de autoanticuerpos y síntomas de enfermedad después de la exposición a adyuvantes, no solo después del aumento de senos con implantes de silicona, sino también como un efecto secundario muy raro de la vacunación, como el síndrome de la guerra del Golfo o el síndrome de miofascitis macrofágica. Las enfermedades cuyos síntomas se desarrollaron después de dicha exposición adyuvante se denominan síndrome autoinmune/inflamatorio inducido por adyuvantes (ASIA). El grupo de adyuvantes incluye no solo implantes de silicona, sílice, escualeno y aluminio, sino también componentes de tinta utilizados para hacer tatuajes. Analizando los informes disponibles sobre la influencia de los adyuvantes en el desarrollo de enfermedades autoinmunes, se concluye que, además de la exposición prolongada a la silicona, también es necesaria la coexistencia de otros factores, como genéticos o ambientales. Los análisis claramente no confirman un mayor riesgo de desarrollar una enfermedad autoinmune después del aumento de senos con implantes de silicona o tatuajes, pero parece que entre estas pacientes hay un grupo que está más predestinado a desarrollar síntomas de la enfermedad. En la población general, los beneficios de la vacunación son obvios, y el riesgo de eventos adversos graves después de la inmunización es incomparablemente menor que el riesgo de desarrollar una enfermedad específica y sus complicaciones, también para pacientes con enfermedades autoinmunes diagnosticadas. Debido a la heterogeneidad de los datos en estudios previos y las dificultades para diagnosticar ASIA, parece necesario realizar más análisis de la influencia de los adyuvantes en el desarrollo de enfermedades autoinmunes y refinar los criterios de diagnóstico de ASIA, que ahora permiten un diagnóstico demasiado fácil de esta enfermedad. (provisto por Infomedic International)

There have been many cases of occurrence of autoantibodies and disease symptoms after adjuvant exposure, not only after breast augmentation with silicone implants, but also as a very rare side effect of vaccination, such as Gulf War syndrome or macrophagic myofasciitis syndrome. Diseases whose symptoms developed after such adjuvant exposure are called adjuvant-induced autoimmune/inflammatory syndrome (ASIA). The adjuvant group includes not only silicone, silica, squalene and aluminum implants, but also ink components used to make tattoos. Analyzing the available reports on the influence of adjuvants on the development of autoimmune diseases, it is concluded that, in addition to prolonged exposure to silicone, the coexistence of other factors, such as genetic or environmental, is also necessary. The analyses clearly do not confirm an increased risk of developing an autoimmune disease after breast augmentation with silicone implants or tattoos, but it seems that among these patients there is a group that is more predestined to develop symptoms of the disease. In the general population, the benefits of vaccination are obvious, and the risk of serious adverse events after immunization is incomparably lower than the risk of developing a specific disease and its complications, also for patients with diagnosed autoimmune diseases. Due to the heterogeneity of data in previous studies and the difficulties in diagnosing ASIA, further analysis of the influence of adjuvants on the development of autoimmune diseases and refinement of the diagnostic criteria for ASIA, which now allow too easy diagnosis of this disease, seems necessary. (provided by Infomedic International)

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Previous studies have found high levels of unintended pregnancy among female sex workers (FSW), but less attention has been paid to their abortion practices and outcomes. This study is the first to investigate abortion-related mortality among FSW across eight countries: Angola, Brazil, Democratic Republic of Congo (DRC), India, Indonesia, Kenya, Nigeria, and South Africa. The Community Knowledge Approach (CKA) was used to survey a convenience sample of FSW (n = 1280). Participants reported on the deaths of peer FSW in their social networks during group meetings convened by non-governmental organisations (n = 165 groups, conducted across 24 cities in 2019). Details on any peer FSW deaths in the preceding five years were recorded. The circumstances of abortion-related deaths are reported here. Of the 1320 maternal deaths reported, 750 (56.8%) were due to unsafe abortion. The number of abortion-related deaths reported was highest in DRC (304 deaths reported by 270 participants), Kenya (188 deaths reported by 175 participants), and Nigeria (216 deaths reported by 312 participants). Among the abortion-related deaths, mean gestational age was 4.6 months and 75% occurred outside hospital. Unsafe abortion methods varied by country, but consumption of traditional or unknown medicines was most common (37.9% and 29.9%, respectively). The 750 abortion-related deaths led to 1207 children being left motherless. The CKA successfully recorded a stigmatised practice among a marginalised population, identifying very high levels of abortion-related mortality. Urgent action is now needed to deliver comprehensive sexual and reproductive healthcare to this vulnerable population, including contraption, safe abortion, and post-abortion care.

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Case description: A 42-year-old woman with severe pulmonary and mediastinal inflammatory involvement, secondary to infiltration of a silicone-related allogenic material with systemic migration. Clinical findings: The patient developed esophageal and bronchial stenosis, recurrent infections, malnutrition, and respiratory deterioration, making surgical removal of the allogenic material impossible. Treatment and outcome: Clinical and radiological improvement was achieved after treatment with multiple intravenous and oral immunomodulators. Clinical relevance: Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a heterogeneous disease resulting from exposure to allogenic substances in a susceptible subject. These substances cause autoimmune or autoinflammatory phenomena. Since ASIA was described ten years ago, its diagnostic criteria are still under discussion, with an uncertain prognosis. The ideal therapy is based on eliminating the causative substance, but this is not always possible. Therefore, it is necessary to start an immunomodulatory treatment, using it in this patient, a scheme that had not been previously reported in the literature.

Descripción del caso: Mujer de 42 años con compromiso inflamatorio pulmonar y mediastinal severo, secundario a infiltración de un material alogénico relacionado con la silicona con migración sistémica. Hallazgos clínicos: La paciente desarrolló estenosis esofágica y bronquial, infecciones recurrentes, desnutrición y deterioro respiratorio, imposibilitando la extracción quirúrgica del material alogénico. Tratamiento y resultado: Mejoría clínica y radiológica lograda tras un tratamiento con múltiples inmunomoduladores intravenosos y orales. Relevancia clínica: El síndrome autoinmune / inflamatorio inducido por adyuvantes (ASIA) es una enfermedad heterogénea que resulta de la exposición a sustancias alógenas en un sujeto con susceptibilidad genética. Estas sustancias inducen fenómenos autoinmunitarios o autoinflamatorios. Desde que ASIA fue descrito hace 10 años, sus criterios diagnósticos continúan en discusión, con un pronóstico incierto. El tratamiento idóneo se basa en eliminar la sustancia causante, pero no siempre es posible, por lo cual se hace necesario iniciar un tratamiento inmunomodulador, empleándose en esta paciente un esquema que no había sido reportado previamente en la literatura.

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The vertiginous advance for identifying the genomic sequence of SARS-CoV-2 allowed the development of a vaccine including mRNA-based vaccines, inactivated viruses, protein subunits, and adenoviral vaccines such as Sputnik. This study aims to report on autoimmune disease manifestations that occurred following COVID-19 Sputnik vaccination. Patients and Methods: A retrospective study was conducted on patients with new-onset autoimmune diseases induced by a post-COVID-19 vaccine between March 2021 and December 2022, in two referral hospitals in Mexico City and Argentina. The study evaluated patients who received the Sputnik vaccine and developed recent-onset autoimmune diseases. Results: Twenty-eight patients developed recent-onset autoimmune diseases after Sputnik vaccine. The median age was 56.9 ± 21.7 years, with 14 females and 14 males. The autoimmune diseases observed were neurological in 13 patients (46%), hematological autoimmune manifestations occurred in 12 patients (42%), with thrombotic disease observed in 10 patients (28%), and autoimmune hemolytic anemia in two patients (7.1%). Rheumatological disorders were present in two patients (7.1%), and endocrine disorders in one patient (3.5%). Principio del formulario Conclusion: Although the COVID-19 Sputnik vaccine is generally safe, it can lead to adverse effects. Thrombosis and Guillain-Barre were the most frequent manifestations observed in our group of patients.

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INTRODUCTION: There are many studies showing that silicone breast implants may affect lactation, but few analyzed whether these implants affect placentation. We observed that many mothers with growth-restricted pregnancies had inflammatory conditions, such as silicone breast implants or giardiasis. METHODS: This single-center cohort study assessed the prevalence of inflammatory conditions in normotensive growth-restricted singleton pregnancies. Next, we stratified the patients according to the presence or absence of silicone breast implants, to determine whether these implants influence fetal growth restriction onset or severity. RESULTS: Twelve (32%) of the 38 participants underwent cosmetic breast augmentation 4-18 years before pregnancy. Half of the patients with and 38% without silicone breast implants had giardiasis. Half of the mothers with and 35% without silicone breast implants had autoantibodies. Silicone breast implants were associated with a 70% increased risk of fetal growth restriction before 32 weeks' gestation (95% confidence interval [CI], 1.2-2.5). Fetal growth restriction was diagnosed significantly earlier in mothers with than in those without silicone breast implants, respectively at 27 (95% CI, 25-30) and 30 weeks' gestation (95% CI, 29-32). Silicone breast implants also tripled the risk of fetuses being below the third percentile, but the difference was not significant. CONCLUSION: Our results suggest that the association of inflammatory conditions, such as silicone breast implants, giardiasis, and autoantibodies may contribute to placental insufficiency. Silicone breast implants older than four years increased the risk of early-onset fetal growth restriction. Studies with large samples are needed to validate our findings and define whether silicone-related fetal growth restriction should be included in autoimmune/inflammatory syndrome induced by adjuvants (ASIA) criteria. Key Points • Fetal growth restriction (FGR), responsible for 30% of stillbirths, is the most common cause of prematurity and intrapartum asphyxia. • In this study, including 38 mothers with normotensive FGR, all participants had 2-4 inflammatory conditions, such as giardiasis, sinusitis, candidiasis, dysbiosis, extreme fear or autoantibodies. • Silicone breast implants were associated with a 70% increased risk of fetal growth restriction before 32 weeks' gestation. • FGR was diagnosed at 27 weeks' gestation (95% CI, 25-30) in mothers with and at 30 weeks' gestation (95% CI, 29-32) in mothers without silicone breast implants.

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Records of element ratios obtained from the Maldives Inner Sea sediments provide a detailed view on how the Indian Monsoon System has varied at high-resolution time scales. Here, we present records from International Ocean Discovery Program (IODP) Site U1471 based on a refined chronology through the past 550,000 years. The record's high resolution and a proper approach to set the chronology allowed us to reconstruct changes in the Indian Monsoon System on a scale of anomalies and to verify their relationships with established records from the East Asian Monsoon System. On the basis of Fe/sum and Fe/Si records, it can be demonstrated that the Asia continental aridity tracks sea-level changes, while the intensity of winter monsoon winds responds to changes in Northern Hemisphere summer insolation. Furthermore, the anomalies of continental aridity and intensity of winter monsoon winds at millennial-scale events exhibit power in the precession band, nearly in antiphase with Northern Hemisphere summer insolation. These observations indicate that the insolation drove the anomalies in the Indian Summer Monsoon. The good correspondence between our record and the East Asian monsoon anomaly records suggests the occurrence of anomalous widespread arid events in Asia.

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The rapid rollout of vaccines to combat the coronavirus disease 2019 (COVID-19) pandemic over the past 2 years has resulted in the use of various vaccine platforms and regional differences in COVID-19 vaccine implementation strategies. The aim of this narrative review was to summarize evolving COVID-19 vaccine recommendations in countries in Latin America, Asia, and Africa and the Middle East across various vaccine platforms, age groups, and specific subpopulations. Nuances in primary and booster vaccination schedules were evaluated, and the preliminary impact of such diverse vaccination strategies are discussed, including key vaccine effectiveness data in the era of Omicron-lineage variants. Primary vaccination rates for included Latin American countries were 71-94% for adults and between 41% and 98% for adolescents and children; rates for first booster in adults were 36-85%. Primary vaccination rates for adults in the included Asian countries ranged from 64% in the Philippines to 98% in Malaysia, with corresponding booster rates varying from 9% in India to 78% in Singapore; for adolescents and children, primary vaccination rates ranged from 29% in the Philippines to 93% in Malaysia. Across included African and Middle Eastern countries, primary vaccination rates in adults varied widely from 32% in South Africa to 99% in the United Arab Emirates; booster rates ranged from 5% in South Africa to 60% in Bahrain. Evidence from the regions studied indicates preference of using an mRNA vaccine as a booster on the basis of safety and effectiveness of observed real-world data, especially during circulation of Omicron lineages. Vaccination against COVID-19 remains of paramount importance to reduce the burden of disease; strategies to overcome vaccine inequity, fatigue, hesitancy, and misinformation and to ensure adequate access and supply are also important.

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The chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) and autoimmune/inflammatory syndrome induced by adjuvants (ASIA) were described a decade ago. There are a limited number of reports and these diseases are still underdiagnosed. We presented a 35 years-old patient with clinical manifestations of cerebellum affection and enhancement in the MRI, with the influenza vaccine as the only triggering factor. Infectious diseases, malignancy, and additional systemic involvement were ruled out; therefore, on suspicion of CLIPPERS syndrome, the patient received corticosteroid therapy with an adequate response. The knowledge of CLIPPERS syndrome as an unusual ASIA presentation and high response to the corticosteroids may lead to a timely diagnosis, appropriate treatment, and follow up with better outcomes for patients.

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Case description: A 42-year-old woman with severe pulmonary and mediastinal inflammatory involvement, secondary to infiltration of a silicone-related allogenic material with systemic migration. Clinical findings: The patient developed esophageal and bronchial stenosis, recurrent infections, malnutrition, and respiratory deterioration, making surgical removal of the allogenic material impossible. Treatment and outcome: Clinical and radiological improvement was achieved after treatment with multiple intravenous and oral immunomodulators. Clinical relevance: Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a heterogeneous disease resulting from exposure to allogenic substances in a susceptible subject. These substances cause autoimmune or autoinflammatory phenomena. Since ASIA was described ten years ago, its diagnostic criteria are still under discussion, with an uncertain prognosis. The ideal therapy is based on eliminating the causative substance, but this is not always possible. Therefore, it is necessary to start an immunomodulatory treatment, using it in this patient, a scheme that had not been previously reported in the literature.

Descripción del caso: Mujer de 42 años con compromiso inflamatorio pulmonar y mediastinal severo, secundario a infiltración de un material alogénico relacionado con la silicona con migración sistémica. Hallazgos clínicos: La paciente desarrolló estenosis esofágica y bronquial, infecciones recurrentes, desnutrición y deterioro respiratorio, imposibilitando la extracción quirúrgica del material alogénico. Tratamiento y resultado: Mejoría clínica y radiológica lograda tras un tratamiento con múltiples inmunomoduladores intravenosos y orales. Relevancia clínica: El síndrome autoinmune / inflamatorio inducido por adyuvantes (ASIA) es una enfermedad heterogénea que resulta de la exposición a sustancias alógenas en un sujeto con susceptibilidad genética. Estas sustancias inducen fenómenos autoinmunitarios o autoinflamatorios. Desde que ASIA fue descrito hace 10 años, sus criterios diagnósticos continúan en discusión, con un pronóstico incierto. El tratamiento idóneo se basa en eliminar la sustancia causante, pero no siempre es posible, por lo cual se hace necesario iniciar un tratamiento inmunomodulador, empleándose en esta paciente un esquema que no había sido reportado previamente en la literatura.

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Poor hygiene might be a risk factor for early childhood development (ECD). This study investigated the associations of three hygiene practices ('wash hands before a meal,' 'wash hands after going to the toilet,' and 'brush teeth'), separately and combined, with ECD. Six thousand six hundred ninety-seven children (4 [0.8] years) from the East Asia-Pacific Early Child Development Scales validation study were included in this cross-sectional analysis. The hygiene variables were recoded to have comparable values as 'always,' 'sometimes,' and 'never.' These variables were then grouped to create combined categories. The binary outcome variables, poor ECD, were defined as a score < age-specific 25th centile. Modified Poisson regression models were used to analyse the associations. Data collection was performed between 2012 and 2014, and the analyses were conducted in April 2022. Compared with children who 'always' washed their hands before a meal, those who did it 'sometimes' (Prevalence Ratio [PR]: 1.30 [95% CI: 1.16-1.46]) or 'never' (PR: 1.35 [1.18-1.55]) had a higher likelihood of poorer overall development. Comparable results were identified for the other two hygiene practices and the other four domain-specific outcomes (p < 0.05). Compared with children who always followed the three hygiene practices, the likelihood of poor overall ECD increased as the combined hygiene practice decreased among children with poor hygiene practices (PRnever: 1.67 [1.40-2.00]; PRrarely: 1.49 [1.30-1.71]; PRsometimes: 1.30 [1.14-1.49]). Children who did not always follow good hygiene practices had a higher likelihood of poor ECD independently of sociodemographic factors. Considering these findings, future hygiene practice interventions and trials should consider including ECD outcomes.

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PURPOSE: Hepatocellular carcinoma (HCC) is one of the most prevalent types of cancers in Asia. Accumulating evidence suggests that ferroptosis is a non-apoptotic form of cell death, and has played an important role in cancer biology. METHODS: Based on the manually curated ferroptosis-related gene set and TCGA-LIHC dataset of Asian patients, we used DESeq2, Kaplan-Meier analysis, and univariate Cox regression to identify differentially expressed ferroptosis-related genes with significantly prognostic capacity. A risk signature was constructed based on the selected genes for predicting the survival of HCC patients in Asia. The survival prediction accuracy was confirmed by the time-dependent receiver operating characteristic (ROC) curve analysis. Gene set variation analysis (GSVA) was used to explore the functional associations of the signature. Ferroptosis potential index (FPI) and xCell algorithm was applied to quantify ferroptosis and immune cell infiltration, respectively. Two independent datasets from the GEO and the ICGC database were used for external validation. RESULTS: The ferroptosis-related signature could accurately predict the survival outcomes of HCC patients in Asian (p value < 0.0001). We showed that the signature was an independent factor and was beneficial in elevating risk stratification of current clinicopathologic features, such as the amount of alpha-fetoprotein (AFP) and residual tumor classification. Functional characterization showed that critical processes in tumorigenesis belonged to the high-risk groups, for example inflammatory response, which may be the main driver of HCC. The high-risk group had higher FPIs and infiltrations of macrophages and T-helper cells than the low-risk group. Furthermore, two independent cohorts confirmed the prognostic value of our signature. CONCLUSION: Overall, our results demonstrated potential application of ferroptosis-related genes as independent biomarkers in Asian HCC patients. Targeting ferroptosis may be clinically useful beyond known clinicopathological factors and provide benefit in immunotherapy.

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Coastal zones are usually composed of coastlines and coastal wetlands and are among the most productive and dynamic ecosystems. However, the deltas are seldom detected and compared in detail at the continental scale to investigate the spatiotemporal evolution of coastline migration and coastal wetlands. Here we detected and compared the spatiotemporal changes in coastlines, wetlands, and ecosystem services in major deltas in Asia, including the Yellow River Delta (YRD), Yangtze River Delta (YAD), Pearl River Delta (PRD), Red River Delta (RRD), Mekong River Delta (MERD), Chao Phraya River Delta (CPRD), Mahanadi River Delta (MARD), Krishna River Delta (KRD), and Indus River Delta (IRD). We used time series remote sensing images from 1990 to 2019 to derive coastline and wetland information for the nine coastal zones. The ecosystem service value coefficients were applied to explore the ecosystem services characteristics of wetland changes in coastal areas. We found that the coastlines of the deltas in the study area changed less in the bedrock and sandy coasts, while the coastlines in the silty delta coasts changed more from 1990 to 2019. The interannual dynamics of coastal wetland areas in nine major deltas over the nearly 30 years can be divided into three periods: decreasing variability (1990-2005), increasing variability (2005-2015), and increasing volatility (2015-2019). Ecosystem services had an overall downward trend. These findings complement the official database of coastal planning and have substantial guiding implications for adjusting coastal management regulation policies.

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Pinostrobin, marker compounds from Boesenbergia rotunda with various pharmacological activities, have been studied extensively, including synthesizing its derivatives, which have potent pharmacological activities. This study aims to describe research related to B. rotunda, pinostrobin, and their derivatives. Metadata information was collected from Scopus in August 2022, with three keywords searched for article titles, abstracts, and keywords. Analysis and research mapping were carried out with VOSviewer. The most widely used synonym for the plant name was "Boesenbergia rotunda", in which Norzulaani Khalid from the University of Malaya, Malaysia, mostly reported research with the keywords "Boesenbergia rotunda", "pinostrobin", and "derivative". The majority of researchers come from institutions in Southeast Asia, such as Malaysia, Thailand, and Indonesia. Interestingly, no Chinese researchers have reported studies on this topic. The journals and publishers that publish the most articles with these three keywords are Bioorganic and Medicinal Chemistry Letters and Elsevier, respectively. This information will make it easier for researchers on this topic to find partners for collaboration and determine journals to publish their research results.

La pinostrobina, compuesto de marcadores de Boesenbergia rotunda con diversas actividades farmacológicas, se ha estudiado ampliamente, incluida la síntesis de sus derivados que tienen potentes actividades farmacológicas. Este estudio tuvo como objetivo describir investigaciones relacionadas con B. rotunda, pinostrobina y sus derivados. La información de metadatos se recopiló de Scopus en agosto de 2022, con tres palabras clave buscadas para títulos de artículos, resúmenes y palabras clave. El análisis y el mapeo de la investigación se realizaron con VOSviewer. El sinónimo más utilizado para el nombre de la planta fue "Boesenbergia rotunda", en el que Norzulaani Khalid de la Universidad de Malaya, Malasia, informó principalmente sobre investigaciones con las palabras clave "Boesenbergia rotunda", "pinostrobina" y "derivado". La mayoría de los investigadores provienen de instituciones del sudeste asiático como Malasia, Tailandia e Indonesia. Curiosamente, ningún investigador chino ha informado de estudios sobre este tema. Las revistas y editoriales que más artículos publican con estas tres palabras clave son Bioorganic and Medicinal Chemistry Letters y Elsevier. Esta información facilitará a los investigadores sobre este tema encontrar colaboraciones y determinar las revistas para publicar los resultados de sus investigaciones.