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Disease phenotype of pediatric inflammatory bowel disease (PIBD) in children from the Asia-Pacific region differs from that of children from the West. Many parts of Asia are endemic for tuberculosis, making diagnosis and management of pediatric Crohn's disease a challenge. Current available guidelines, mainly from Europe and North America, may not be completely applicable to clinicians caring for children with PIBD in Asia due to differences in disease characteristics and regional resource constraints. This position paper is an initiative from the Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (APPSPGHAN) that aims to provide an up-to-date, evidence-based approach to PIBD in the Asia-Pacific region. A group of pediatric gastroenterologists with a special interest in PIBD performed an extensive literature search covering epidemiology, disease characteristics and natural history, management, and monitoring. Attention was paid to publications from the region with special consideration to a resource-limited setting. This current position paper deals with surgical management, disease monitoring, immunization, bone health, and nutritional issues of PIBD in Asia. A special section on differentiating pediatric Crohn's disease from tuberculosis in children is included. This position paper provides a useful guide to clinicians in the surgical management, disease monitoring, and various health issues in children with IBD in Asia-Pacific region., (© 2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Background: Mantle cell lymphoma (MCL) is a B cell malignancy that can be aggressive and with a poor prognosis; the clinical course is heterogeneous. The epidemiology of MCL in Asia is not well documented but appears to comprise 2-6% of all lymphoma cases based on available data, with variation observed between countries. Although international guidelines are available for the treatment of MCL, there is a lack of published data or guidance on the clinical characteristics and management of MCL in patient populations from Asia. This paper aims to review the available treatment and, where clinical gaps exist, provide expert consensus from the Asian Lymphoma Study Group (ALSG) on appropriate MCL management in Asia. BODY: Management strategies for MCL are patient- and disease stage-specific and aim to achieve balance between efficacy outcomes and toxicity. For asymptomatic patients with clearly indolent disease, observation may be an appropriate strategy. For stage I/II disease, following international guidelines is appropriate, which include either a short course of conventional chemotherapy followed by consolidated radiotherapy, less aggressive chemotherapy regimens, or a combination of these approaches. For advanced disease, the approach is based on the age and fitness of the patient. For young, fit patients, the current practice for induction therapy differs across Asia, with cytarabine having an important role in this setting. Hematopoietic stem cell transplantation (HSCT) may be justified in selected patients because of the high relapse risk. In elderly patients, specific chemoimmunotherapy regimens available in each country/region are a treatment option. For maintenance therapy after first-line treatment, the choice of approach should be individualized, with cost being an important consideration within Asia. For relapsed/refractory disease, ibrutinib should be considered as well as other follow-on compounds, if available., Conclusion: Asian patient-specific data for the treatment of MCL are lacking, and the availability of treatment options differs between country/region within Asia. Therefore, there is no clear one-size-fits-all approach and further investigation on the most appropriate sequence of treatment that should be considered for this heterogeneous disease.

Rabies is a lethal zoonotic encephalomyelitis that causes an estimated 59,000 human deaths yearly worldwide. Although developing countries of Asia and Africa bear the heaviest burden, surveillance and disease detection in these countries is often hampered by the absence of local laboratories able to diagnose rabies and/or the difficulties of sample shipment from low-access areas to national reference laboratories. Filter papers offer a convenient cost-effective alternative for the sampling, shipment, and storage of biological materials for the diagnosis of many pathogens including rabies virus, yet the properties of diagnostic tests using this support have not been evaluated thoroughly. Sensitivity and specificity of molecular diagnosis of rabies infection using a reverse transcription followed by a hemi-nested polymerase chain reaction (RT-hn-PCR) either directly on brain tissue or using brain tissue dried on filter paper were assessed on 113 suspected field animal samples in comparison to the direct fluorescent antibody test (FAT) recommended by the World Health Organization as one of the reference tests for rabies diagnosis. Impact of the duration of the storage was also evaluated. The sensitivity and the specificity of RT-hn-PCR i) on brain tissue were 96.6% (95% CI: [88.1-99.6]) and 92.7% (95% CI: [82.4-98.0]) respectively and ii) on brain tissue dried on filter paper 100% (95% CI: [93.8-100.0]) and 90.9% (95% CI: [80.0-97.0]) respectively. No loss of sensitivity of RT-hn-PCR on samples of brain tissue dried on filter paper left 7 days at ambient temperature was detected indicating that this method would enable analyzing impregnated filter papers sent to the national reference laboratory at ambient temperature within a 1-week shipment time. It could therefore be an effective alternative to facilitate storage and shipment of samples from low-access areas to enhance and expand rabies surveillance., Competing Interests: The authors have declared that no competing interests exist.

In past decades, we have seen several epidemics of respiratory infections from newly emerging viruses, most of which originated in animals. These emerging infections, including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and the pandemic influenza A(H1N1) and avian influenza (AI) viruses, have seriously threatened global health and the economy. In particular, MERS-CoV and AI A(H7N9) are still causing infections in several areas, and some clustering of cases of A(H5N1) and A(H7N9) may imply future possible pandemics. Additionally, given the inappropriate use of antibiotics and international travel, the spread of carbapenem-resistant Gram-negative bacteria is also a significant concern. These infections with epidemic or pandemic potential present a persistent threat to public health and a huge burden on healthcare services in the Asia-Pacific region. Therefore, to enable efficient infection prevention and control, more effective international surveillance and collaboration systems, in the context of the 'One Health' approach, are necessary., (© 2019 Asian Pacific Society of Respirology.)

A longer life brings opportunities for older adults and their families as well as for their communities. Commercial businesses can be successful in innovating on these opportunities and achieving business expansion when they better understand the market dynamics and spectrum of older adults as consumers and view them more as assets rather than as burdens to society. While there is no "typical" older adult consumer, some traits, characteristics, and physical realities may be more common, including those related to family and community, the shopping experience, brand marketing and packaging, food and nutrition, and health. The opportunities of longer life are impacted by health and underscore the importance of positive, healthy aging-related behaviors like good nutrition and active lifestyles. Healthy aging also requires a sustained commitment and action from country leaders to formulate evidence-based polices--like systematic nutrition screening and intervention-and healthcare workforce training and education that can strengthen and support an active aging population. In addition, governments should consider engaging commercial businesses to help set sustainable policies that can advance products for older adults. Finally, governments should set national and local goals to incentivize commercial business development and investment in public-private partnerships to improve quality of care, promote healthy aging, and impact outcomes for noncommunicable diseases, ultimately benefitting population health for Asia-Pacific Economic Cooperation (APEC) countries.

Background: Little is known about the time course of mortality reduction following smoking cessation in Asians who have smoking behaviours distinct from their Western counterparts. We evaluated the level of reduction in all-cause, cardiovascular disease (CVD) and lung cancer mortality by years since quitting smoking, in Asia., Methods: Using Cox regression, we analysed individual participant data (n = 709 151) from 16 prospective cohorts conducted in China, Japan, Korea/Singapore, and India/Bangladesh, separately by cohorts. Cohort-specific hazard ratios (HRs) were combined using a random-effects meta-analysis., Results: During a mean follow-up of 12.0 years, 108 287 deaths were ascertained-35 658 from CVD and 7546 from lung cancer. Among Asian men, a dose-response relationship of risk reduction in deaths from all causes, CVD and lung cancer was observed with an increase in years after smoking cessation. Compared with never smokers, however, all-cause and CVD mortality among former smokers remained elevated 10-14 years after quitting [multivariable-adjusted HR (95% confidence interval (CI) = 1.25 (1.13-1.37) and 1.20 (1.02-1.41), respectively]. Lung cancer mortality stayed almost 2-fold higher than among never smokers 15-19 years after smoking cessation [1.97 (1.41-2.73)], particularly among former heavy smokers [2.62 (1.71-4.00)]. Women who quitted for ≥5 years retained a significantly elevated mortality from all causes, CVD and lung cancer. Overall patterns of the cessation-mortality associations were similar across countries., Conclusions: Our findings suggest that adverse effects of tobacco smoking persist for an extended time period, even for more than two decades, which is beyond the time windows defined in current clinical guidelines for risk assessment of lung cancer and CVD., (© The Author(s) 2021; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Purpose: Local allergic rhinitis (LAR) is characterized by a localized nasal allergic response without evidence of systemic atopy. LAR is an underdiagnosed entity and is a diagnostic and therapeutic challenge for clinicians. This study aimed to investigate the prevalence and clinical characteristics of patients with LAR to house dust mites (LAR-HDM) in Korea., Methods: We performed a retrospective chart review of 336 adult patients with rhinitis symptoms who visited the Rhinologic Clinic at Korea University Guro Hospital from October 2019 to April 2021. Using results of the skin prick test, serologic test, and nasal provocation test, patients were classified as allergic rhinitis (AR) to HDM (AR-HDM), AR to other allergens, non-allergic rhinitis (NAR), or LAR-HDM. We excluded patients with AR to other allergens and compared the clinical characteristics of the remaining three groups. Patient demographic data were reviewed, and patients' nasal symptoms, olfactory function, serum total IgE, and severity of accompanying rhinosinusitis were evaluated., Results: In total, 336 patients were examined. AR-HDM was diagnosed in 138 (41.1%) patients, AR to other allergens in 36 (10.7%) patients, NAR in 21 (42.0%) patients, and LAR-HDM in 21 (6.3%) patients. The mean age of patients with LAR-HDM was significantly higher than that of patients with AR-HDM. There were no significant differences in sex, smoking history, asthma, and family history of allergic diseases between the groups. Compared to NAR patients, there were significantly more patients with LAR-HDM who had persistent nasal symptoms. The frequency of nasal itching and sneezing was significantly higher in the LAR-HDM group than in the NAR group. The olfactory function score in the LAR-HDM group was significantly worse than that in the AR-HDM group, and the Lund-Mackay score was significantly higher in the LAR-HDM group than in the other groups., Conclusion: Clinical history and nasal symptoms are very similar in LAR-HDM and AR-HDM. Clinicians should take more care to differentiate them. LAR-HDM should also be considered in patients with persistent and severe nasal symptoms without systemic atopy., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The existing scholarly discourse surrounding the energy transition has long operated on the assumption of perfect displacement of non-renewable energy. However, an evolving set of studies highlights an intricate web of inefficiencies and complexities that prevent the perfect displacement of fossil fuel energy with renewable energy production. Since this could carry serious implications for the environmental targets of several economies, it is crucial to accurately and continuously measure the actual extent of fossil fuel displacement. Within this framework, this study empirically investigates the extent of non-renewable energy displacement by renewable energy for a balanced panel of seven Asia-Pacific (APAC) countries between 1989 and 2015. The outcome function also controls for globalisation, real GDP per capita, and crude oil prices. After implementing the necessary diagnostics, the panel cointegration establishes a significant long-run relationship among the selected variables. The PMG-ARDL estimation indicates that renewable energy production and globalisation significantly reduce the fossil fuel energy production, whereas real GDP per capita and crude oil prices induce it positively. However, the coefficient of renewable energy production is only - 0.39, indicating that more than 2.5 units of renewable electricity are necessary to displace a unit of non-renewable energy. As such, this study concludes that the current energy transition in Asia-Pacific region is not perfect. These results are robust to the usage of the FGLS estimation technique. The study suggests the adoption of a new energy transition that allows greater displacement of fossil fuel energy as well as gradual reduction in overall energy use., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This paper aims to measure the impact of environmental provisions in free-trade agreements on pollution levels in 40 Asian economies for the period 1990-2019. Following the failure of WTO negotiations, there has been a rapid proliferation of preferential trade agreements incorporating various types of environmental clauses. We exploit such changes to assess their influence on pollution emissions. We use a DOLS approach that considers the potential endogeneity of environmental clauses. Further, panel vector error correction models (VECM) are employed for examining the presence of a cointegration relationship among the variables studied. Overall, our findings indicate that these environmental clauses have heterogenous effects on CO 2 emissions. We do not find significant effects of environmental clauses on pollution. However, this result is driven by environmental provisions that are not legally enforceable. We do find a positive effect of environmental clauses with a higher level of legalism on the environmental quality. These results show that the inclusion of environmental provisions in trade agreements is not sufficient by itself. Such provisions should incorporate a legally enforceable framework to effectively address environmental concerns. These findings have significant policy implications for Asian countries., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The main hurdle in deploying renewable energy projects is the high initial cost, making it difficult for businesses and individuals to afford it. The fragility of the financial sector and human resource management further slows the pace of renewable energy demand. Therefore, we aim to investigate the impact of financial fragility and human resource management on renewable energy consumption over time horizon 1997-2020. To that end, the analysis employed the ARDL-PMG model. For Asia as a whole and all other sub-regions, including South East Asia, East Asia, South Asia, and Western Asia, the estimates for bank non-performing loans are notably negative. In general, these findings imply that a rise in financial fragility significantly reduces renewable energy consumption in the long run. In the short run, the estimates attached to both bank non-performing loans and bank costs are negatively significant in Asia and sub-regions of Western Asia only. The results for the human resources show that it exerts a significant and positive influence on renewable energy demand in Asia as a whole, South Asia, East Asia, and Western Asia. The estimates attached to human resources are statistically insignificant in all models in the short run. In the end, some important public strategies and their implementations have been discussed., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study investigates a modified version of the Okun's Law that incorporates energy consumption and temperature for five Central Asian countries, while it employs the ARDL methodology, spanning the period 1995-2018. While the original Okun's Law is not supported, the analysis does find support for the modified Law, suggesting the importance of regional specific factors. The results document the presence of a negative association between unemployment and real GNP both in the short and in the long run. The impact of energy consumption on unemployment is positive in the long run, while the temperature impacts unemployment both in the short and in the long run., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The timing, sequence, and scale of uplift of the Himalayan-Tibetan Orogen (HTO) are controversially debated. Many geoscientific studies assume paleoelevations close to present-day elevations and the existence of alpine environments across the HTO already in the late Paleogene, contradicting fossil data. Using molecular genetic data of ground beetles, we aim to reconstruct the paleoenvironmental history of the HTO, focusing on its southern margin (Himalayas, South Tibet). Based on a comprehensive sampling of extratropical Carabus, and ~ 10,000 bp of mitochondrial and nuclear DNA we applied Bayesian and Maximum likelihood methods to infer the phylogenetic relationships. We show that Carabus arrived in the HTO at the Oligocene-Miocene boundary. During the early Miocene, five lineages diversified in different parts of the HTO, initially in its southern center and on its eastern margin. Evolution of alpine taxa occurred during the late Miocene. There were apparently no habitats for Carabus before the late Oligocene. Until the Late Oligocene elevations must have been low throughout the HTO. Temperate forests emerged in South Tibet in the late Oligocene at the earliest. Alpine environments developed in the HTO from the late Miocene and, in large scale, during the Pliocene-Quaternary. Findings are consistent with fossil records but contrast with uplift models recovered from stable isotope paleoaltimetry., (© 2023. Springer Nature Limited.)

The reduction of carbon emissions has become an important climate issue worldwide. However, the diversity of carbon trading systems and the differentiation policy may generate incomparable carbon abatement costs across regions and countries. Based on the nonparametric model, this paper investigates the shadow price of carbon emissions and energy structure in 38 Asian countries from 1991 to 2019. The main findings of this paper are as follows: (1) The annual average shadow price of carbon emissions experienced a fluctuating decline for Asian countries during the period 1991-2000, followed by a continuous rise and then a fluctuating decline. (2) Industrialization may lead to a decline in carbon shadow price, while urbanization may lead to a rise in the opportunity cost of carbon reduction. (3) The carbon shadow price in countries of Asia-Pacific Economic Cooperation (APEC) is lower than that in non-APEC countries. (4) The structure of energy consumption is negatively related to marginal abatement costs, while on the contrary, the coefficients of the level of human resources are significantly positive. We also derive corresponding policy measures to promote intra-regional emission reduction., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

One of the greatest challenges facing humanity in the current millennium is the need to mitigate climate change, and one of the most viable options to overcome this challenge is to invest in renewable energy. The study dynamically examines the links between renewable energy consumption, non-renewable energy consumption, climate change, and economic growth in five emerging Asian countries during the period 1975-2020. Variables selected in the model have long-term cointegration, as explored by the Pedroni cointegration test and the Westerlund cointegration test. The long-term estimated parameters of the augmented mean group (AMG) method show that renewable energy consumption significantly reduces climate change, while non-renewable energy consumption significantly promotes climate change. The results also show that GDP, investment in transport infrastructure, and urbanization can significantly contribute to climate change in selected emerging Asian countries. Moreover, the results validate the inverted U-shaped EKC hypothesis for emerging Asian economies. Country-specific analysis results using AMG estimates shows that renewable energy consumption reduces climate change in selected emerging Asian countries. Non-renewable energy consumption and investment in transport infrastructure have had significant progressive impacts on climate change in all countries. Urbanization contributes significantly to climate change, with the exception of Japan, which does not have any significant impact on climate change. GDP contributes significantly to climate change in all countries; however, GDP2 has significant adverse effects on climate change in India, China, Japan, and Korea, validating the inverted U-shaped EKC assumption for all countries except Bangladesh. Moreover, the Dumitrescu and Hurlin causality test confirmed a pairwise causal relationship between non-renewable energy consumption and GDP, supporting the feedback hypothesis. The results suggest that the best option for climate change mitigation in selected emerging Asian countries is to transition from non-renewable to renewable energy sources., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The present paper investigates the influence of renewable energy consumption (REC), economic growth (GDP), financial development index (FDI), z-score (ZS) and control of corruption (CC) on carbon dioxide (CO2) emissions, for eighteen different APEC economies over the period 2000-2019 using the Pooled Mean Group-Autoregressive Distributed Lags (PMG-ARDL) approach and Granger causality tests. The outcomes of the empirical study confirm that the variables are cointegration using Pedroni tests. The long-run estimates revealed that economic growth and renewable energy contribute to the huge of carbon emissions, while financial development, ZS and CC lead to decrease carbon emissions. Granger causality shows that, in the long-run, there is bidirectional causality between CO2 emissions, economic growth, and financial development. In the short-run and for basic variables, Granger shows a unidirectional causality from CO2 emissions and economic growth to REC and; unidirectional causality from financial development, ZC and CC to CO2 emissions. A comprehensive approach is needed in APEC countries to effectively reduce CO2 emissions and promote sustainable development, including encouraging green financial products, reinforcing financial regulations, transitioning to a low-carbon economy, enhancing renewable energy usage, and improving governance and institutional quality, while considering the distinctive characteristics of each country., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Allergic diseases such as asthma, atopic dermatitis, and food allergies are a burgeoning health challenge in the Asia-Pacific region. Compounding this, the region has become increasingly susceptible to the impacts of climate change. The region has weathered extreme precipitation, intense heat waves, and dust storms over the recent decades. While the effects of environmental and genetic factors on allergic diseases are well understood, prevailing gaps in understanding the complex interactions between climate change and these factors remain. We aim to provide insights into the various pathways by which climate change influences allergic diseases in the Asia-Pacific population. We outline practical steps that allergists can take to reduce the carbon footprint of their practice on both a systemic and patient-specific level. We recommend that allergists optimize disease control to reduce the resources required for each patient's care, which contributes to reducing greenhouse gas emissions. We encourage the responsible prescription of metered dose inhalers by promoting the switch to dry powder inhalers for certain patients, at each clinician's discretion. We also recommend the utilization of virtual consultations to reduce patient travel while ensuring that evidence-based guidelines for rational allergy management are closely adhered to. Finally, eliminating unnecessary testing and medications will also reduce greenhouse gas emissions in many areas of medical care., (© 2024 The Author(s). Pediatric Allergy and Immunology published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

As resource shortages and environmental problems keep coming up, economies urgently need renewable energies as the new driving force for development. As one of the representatives of renewable energy, the photovoltaic (PV)'s trade has received much attention from all walks of life. Based on bilateral PV trade data, complex network methods and exponential random graph models (ERGM), this paper constructs global PV trade networks (PVTNs) during 2000-2019, describes detailed evolution features and verifies the influencing factors of the PVTNs. We find that (1) PVTNs have obvious characteristics of the small-world network, accompanied by disassortativity and low reciprocity. (2) Asia, North America, and Europe are the top 3 leading regions in the PVTNs. (3) China is the largest exporter, and the US is the leading recipient. Germany is an essential importer as well as exporter of PVTNs. (4) The formation and evolution of the PVTNs are significantly affected by transitivity, reciprocity, and stability. PV trade is more possible when economy-pairs are WTO members, located on the same continent, or with asymmetrical urbanization rates, industrialization rates, technological level or environmental supervision strength. Specifically, economies with higher industrialization rates, technological levels, stricter environmental regulations or lower urbanization rates are more likely to import PV. Economies with higher economic development, larger area, and greater trade openness are more inclined to trade PV. Besides, economic partners that share a religion or language, have common historical colonial ties or geographic borders or sign regional trade agreements are more likely to trade PV., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Within the last decade, declining son preference in Asia has given rise to gender-equitable fertility preferences. These include daughter preference, gender indifference, and gender balance. Using five rounds of the India National Family Health Surveys, I investigate the sources of the trends in shifting parental preferences for the gender of their children. Over more than a quarter-century period (1992-1993 to 2019-2021), I find a significant decline in son preference from 40 to 18 percent and an increase in gender-equitable preferences among most subpopulations. Multivariate analysis shows that for all survey years, education and frequent exposure to television significantly increased the odds of gender-equitable preferences. In the last decade, community norms supporting women's employment are also associated with gender-equitable preferences. In addition, decomposition analysis shows that compared to compositional change, social norm change accounts for two-thirds of the rise in gender-equitable preferences. These findings suggest that rising norms of gender equality have the potential to dismantle gender-biased preferences in India., (© 2023 The Population Council, Inc.)

Balanced and sustainable development is one of the Belt and Road Initiative (BRI) objectives. Therefore, considering the role of urbanization and human capital as critical elements for sustainable development, we analyzed the moderating effect of human capital on the relationship between urbanization and CO 2 emissions in Asian member countries of the Belt and Road Initiative. In doing so, we used the STIRPAT framework and the environmental Kuznets curve (EKC) hypothesis. We also employed the pooled OLS estimator with the Driscoll-Kraay's robust standard errors, the feasible generalized least squares (FGLS), and the two-stage least square (2SLS) estimators in the case of 30 BRI countries for the period 1980-2019. The relationship between urbanization, human capital, and carbon dioxide emissions were examined first by showing a positive correlation between urbanization and carbon dioxide emissions. Secondly, we showed that human capital mitigated the positive effect of urbanization on CO 2 emissions. Next, we demonstrated that human capital had an inverted U-shaped effect on CO 2 emissions. Specifically, a 1% increase in urbanization rose CO 2 emissions by 0.756%, 0.943%, and 0.592% following the Driscoll-Kraay's OLS, the FGLS, and the 2SLS estimators, respectively. A 1% increase in the combination of human capital and urbanization reduced CO 2 by 0.751%, 0.834%, and 0.682%, respectively. Finally, a 1% increase in the square of human capital decreased CO 2 emissions by 1.061%, 1.045%, and 0.878%, respectively. Accordingly, we provide policy implications on the conditional influence of human capital in the urbanization-CO 2 emission nexus for sustainable development in these countries., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Environmental degradation has attained much attention from researchers and policymakers at national and global levels. The ever-increasing energy use in production methods is considered one of the fundamental reasons for environmental degradation. The concept of environmental efficiency in the wake of sustainable growth evolved in the last three decades. The present study has been designed to estimate environmental efficiency using the Malmquist-Luenberger productivity index (MLI) using annual data from 43 Asian countries from 1990 to 2019. The MLI is an established econometric approach to estimate cases where input variables are used to get output variables in desirable and undesirable forms. Labor, capital, and energy consumption are input variables, while carbon dioxide (CO 2 ) emissions (undesirable variable) and gross domestic product (undesirable variable) are taken as output variables. The results suggested that, on average, environmental efficiency has decreased by 0.3% over the period in selected Asian countries. Cambodia, Turkey, and Nepal have the highest total factor productivity (TFP) output growth rate on average among 43 Asian countries. These countries are excellent examples of sustainable development that balances environmental protection and efficiency. On the other hand, Kuwait, Mongolia, and Yemen showed the least TFP growth. The study also employed unconditional and convergence tests where the countries' conditional convergence is based on foreign direct investment, population density, inflation, industrialization, and globalization. Some policy implications for Asian countries are also discussed at the end of the study., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This research is an endeavor to improve the literature on information and communication technology (ICT)-financial development-environmental sustainability nexus by conducting an aggregated and disaggregated analysis on the role of financial development and technological progress in attaining a sustainable environment. By employing a unique and comprehensive set of financial development and ICT indicators, this study offers an in-depth analysis of the role of financial development, ICT, and especially their interactions in maintaining environmental sustainability in 30 Asian economies from 2006 to 2020. Results from the two-step system generalized method of moments indicate that separately, both financial development and ICT are detrimental but together, their joint effects are beneficial to the environment. Several policy implications and recommendations are made to help policymakers to craft, design, and implement appropriate policies to improve environmental quality., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The effects of renewable energy, tourism, foreign direct investment, and income on environmental degradation have attracted the attention of many researchers, but to date, no researcher has examined the concurrent effects of these variables on CO 2 emissions for the Association of Southeast Asian Nations (ASEAN) countries. Motivated by this gap in the literature, this study aims to analyze the determinants of carbon dioxide (CO 2 ) emissions under the environmental Kuznets curve (EKC) hypothesis for six ASEAN countries. To this end, the study utilizes the panel ARDL estimator and the Dumitrescu-Hurlin panel causality test from 1995 to 2018. The results show that (i) tourism and foreign direct investment increase CO 2 emissions. (ii) Real income and trade openness reduce environmental degradation. (iii) Since the long-run income elasticity is lower than the short-run, the EKC hypothesis is valid. (iv) Renewable energy reduces carbon emissions only in the short term and has no effect on environmental quality in the long term. There is also no causal relationship between renewable energy and environmental degradation. This could be due to the ineffective deployment of renewable energy in ASEAN countries. Based on these results, this study suggests that ASEAN countries should effectively use renewable energy, reduce the amount of fossil energy in the tourism sector, and support economic development to achieve a sustainable environment., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

To identify perceptions and attitudes among people with obesity (PwO) and healthcare professionals (HCPs) toward obesity and its management in nine Asia-Pacific (APAC) countries, a cross-sectional online survey was conducted among adult PwO with self-reported body mass index of ≥25 kg/m 2 (≥27 kg/m 2 , Singapore), and HCPs involved in direct patient care. In total, 10 429 PwO and 1901 HCPs completed the survey. Most PwO (68%) and HCPs (84%) agreed that obesity is a disease; however, a significant proportion of PwO (63%) and HCPs (41%) believed weight loss was the complete responsibility of PwO and only 43% of PwO discussed weight with an HCP in the prior 5 years. Most respondents acknowledged that weight loss would be extremely beneficial to PwO's overall health (PwO 76%, HCPs 85%), although nearly half (45%) of PwO misperceived themselves as overweight or of normal weight. Obesity was perceived by PwO (58%) and HCPs (53%) to negatively impact PwO forming romantic relationships. HCPs cited PwOs' lack of interest (41%) and poor motivation (37%) to lose weight as top reasons for not discussing weight. Most PwO (65%) preferred lifestyle changes over medications to lose weight. PwO and HCPs agreed that lack of exercise and unhealthy eating habits were the major barriers to weight loss. Our data highlights a discordance between the understanding of obesity as a disease and the actual behaviour and preferred approaches to manage it among PwO and HCPs. The study addresses a need to align these gaps to deliver optimal care for PwO., (© 2024 The Authors. Clinical Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Hyperkalaemia is an electrolyte imbalance that impairs muscle function and myocardial excitability, and can potentially lead to fatal arrhythmias and sudden cardiac death. The prevalence of hyperkalaemia is estimated to be 6%-7% worldwide and 7%-10% in Asia. Hyperkalaemia frequently affects patients with chronic kidney disease, heart failure, and diabetes mellitus, particularly those receiving treatment with renin-angiotensin-aldosterone system (RAAS) inhibitors. Both hyperkalaemia and interruption of RAAS inhibitor therapy are associated with increased risks for cardiovascular events, hospitalisations, and death, highlighting a clinical dilemma in high-risk patients. Conventional potassium-binding resins are widely used for the treatment of hyperkalaemia; however, caveats such as the unpalatable taste and the risk of gastrointestinal side effects limit their chronic use. Recent evidence suggests that, with a rapid onset of action and improved gastrointestinal tolerability, novel oral potassium binders (e.g., patiromer and sodium zirconium cyclosilicate) are alternative treatment options for both acute and chronic hyperkalaemia. To optimise the care for patients with hyperkalaemia in the Asia-Pacific region, a multidisciplinary expert panel was convened to review published literature, share clinical experiences, and ultimately formulate 25 consensus statements, covering three clinical areas: (i) risk factors of hyperkalaemia and risk stratification in susceptible patients; (ii) prevention of hyperkalaemia for at-risk individuals; and (iii) correction of hyperkalaemia for at-risk individuals with cardiorenal disease. These statements were expected to serve as useful guidance in the management of hyperkalaemia for health care providers in the region., (© 2024 The Authors. Nephrology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Nephrology.)

Biased technological progress is the act of energy conservation and emission reduction by changing the marginal rate of substitution. In this study, we introduced renewable energy into a production function, and proposed a method of identifying biased characteristics of technological progress, based on marginal productivity theory. A panel dataset for the Asia-Pacific Economic Cooperation (APEC) economies from 2000 to 2017 was analyzed to explore the effect of biased technological progress in reducing particulate matter (PM 2.5 ). We found that input biased technological progress tended to use more non-renewable energy. Input biased technological progress aggravated haze pollution; however, this effect decreased as the PM 2.5 concentration increased. Output biased technological progress significantly reduced haze pollution in high-income economies, but increased it in low-income economies. The effect of neutral technological progress on haze pollution was the opposite of the effect from output biased technological progress. We also found that increasing renewable energy consumption and reducing energy intensity were separate effective paths for input and output biased technological progress, respectively, to mitigate haze pollution. For neutral technological progress, improving total factor productivity was an important way to mitigate haze pollution. Finally, several policy recommendations are proposed to mitigate haze pollution in APEC economies., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study aims to analyze the impact of ICT, renewable energy consumption, and financial development on CO 2 emissions in selected developing countries of East and South Asia. Using panel data spanning 1985-2020, Pooled Mean Group (PMG) estimator is used to analyze the short-run and long-run effects. Results suggest that ICT and financial development positively contribute to the degradation of the environment in the long run, while their impact on CO 2 emissions is insignificant in the short run. On the other hand, renewable energy consumption affects environmental quality positively in both the long run and short run. It is also examined that economic growth affects CO 2 emissions positively but the squared economic growth reduces CO 2 emissions which validates inverted U-shaped EKC hypothesis. The empirical findings of the Granger Causality test suggest unidirectional causality from ICT and financial development to CO 2 emissions, while a bi-directional relationship is found among renewable energy and CO 2 emissions. Results imply that governments in these countries need to invest in renewable energy to control environmental degradation., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This two-dimensional study makes significant incursions into the health-environment literature by interrogating whether non-renewable energy moderates the impact of environmental degradation on mortality rates. It further aligns with the 2030 United Nations Sustainable Development Goals and 11, which aim to ensure healthy lives and promote well-being for all at all ages and make cities and human settlements inclusive, safe, resilient and sustainable. It contributes to the health-environment literature by investigating the intrinsic relationships among mortality rates, carbon emissions (environmental degradation), and non-renewable energy consumption. The study uses an unbalanced sample of 42 Asia and Pacific countries to determine (1) whether carbon emissions exaggerate the incidence of mortality rates and (2) if the interaction of non-renewable energy with carbon emissions enhances or alters the impact of carbon emissions on mortality rates. Consistent findings from the panel spatial correlation consistent least-squares dummy variables (PSCC-LSDV) and two-step system generalized method of moments (GMM) techniques reveal that (i) carbon emissions exacerbate mortality rates; (ii) non-renewable energy consumption exhibit mortality-reducing properties; (iii) non-renewable energy attenuates the impact of carbon emissions on mortality rates, (iv) persistency in mortalities occurs; and (v) the health-environment-energy dynamics differ across income groups. The paper's conjecture is expected to channel a new line of discourse on how non-renewable energy influences the environment and health outcomes., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The precise estimation of cases with significant fibrosis (SF) is an unmet goal in non-alcoholic fatty liver disease (NAFLD/MASLD)., Aims: We evaluated the performance of machine learning (ML) and non-patented scores for ruling out SF among NAFLD/MASLD patients., Methods: Twenty-one ML models were trained (N = 1153), tested (N = 283), and validated (N = 220) on clinical and biochemical parameters of histologically-proven NAFLD/MASLD patients (N = 1656) collected across 14 centres in 8 Asian countries. Their performance for detecting histological-SF (≥F2fibrosis) were evaluated with APRI, FIB4, NFS, BARD, and SAFE (NPV/F1-score as model-selection criteria)., Results: Patients aged 47 years (median), 54.6% males, 73.7% with metabolic syndrome, and 32.9% with histological-SF were included in the study. Patients with SFvs.no-SF had higher age, aminotransferases, fasting plasma glucose, metabolic syndrome, uncontrolled diabetes, and NAFLD activity score (p < 0.001, each). ML models showed 7%-12% better discrimination than FIB-4 to detect SF. Optimised random forest (RF) yielded best NPV/F1 in overall set (0.947/0.754), test set (0.798/0.588) and validation set (0.852/0.559), as compared to FIB4 in overall set (0.744/0.499), test set (0.722/0.456), and validation set (0.806/0.507). Compared to FIB-4, RF could pick 10 times more patients with SF, reduce unnecessary referrals by 28%, and prevent missed referrals by 78%. Age, AST, ALT fasting plasma glucose, and platelet count were top features determining the SF. Sequential use of SAFE < 140 and FIB4 < 1.2 (when SAFE > 140) was next best in ruling out SF (NPV of 0.757, 0.724 and 0.827 in overall, test and validation set)., Conclusions: ML with clinical, anthropometric data and simple blood investigations perform better than FIB-4 for ruling out SF in biopsy-proven Asian NAFLD/MASLD patients., (© 2024 John Wiley & Sons Ltd.)

Adopting renewable energy consumption is one of the most important aspects of international efforts to combat climate change, improve energy security, and encourage the shift to a more robust and sustainable energy system. Therefore, the empirics and policymakers worldwide are searching for factors that can promote renewable energy consumption. This analysis intends to investigate the role of financial globalization and tourism on renewable energy consumption in Asia and sub-regions such as Central Asia, East Asia, South Asia, Southeast Asia, and West Asia. The analysis utilized the linear and nonlinear CS-ARDL methods. Long-run outcomes of the linear and nonlinear models confirm that a rise in financial globalization and tourism promotes renewable energy consumption in Asia and all sub-regions. However, the nonlinear model highlights that a fall in financial globalization hurts renewable energy consumption in Central and South Asian regions, and tourism only hurts renewable energy consumption in Asia. In addition, ICT, GDP, and GHG emissions help promote renewable energy consumption. These results suggest that Asian policymakers must increase collaboration in the financial sectors and promote sustainable tourism in the regions to promote renewable energy consumption., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The renewable energy product trade is critically important to global economic prospects and its rapid development, making it a key issue in international economics of much interest to scholars. Previous studies have paid attention to bilateral trade, yet we still know little about the patterns of renewable energy product trade and its evolution from the whole industry perspective. Based on bilateral trade data, complex network, as well as ERGM and TERGM, we build global renewable energy trade networks (GRETNs) during 2000-2018 and explore the patterns and determinants. The results show that (1) the GRETNs expand during 2000-2018, characterized by a small-world, reciprocity, degree disassortative, and export volume heterogeneity. (2) The GRETNs form four communities, and the community patterns greatly fluctuate over time. (3) Economies in North America, Europe, and Asia play dominant roles, while the USA, Germany, and China are the cores of the GRETNs. (4) Endogenous structure of reciprocity, structural embeddedness, and out-degree popularity are essential parts of the evolving patterns of GRETNs. Most trade relationships are developed between economies located within the same continent, participating in APEC or WTO, or having similar areas. There is heterophily in GDP and per capita income, and Matthew effects in GDP, urbanization, and industrialization rate. Countries that share a common geographic border, language, religion, or currency, being former colonies of the same colonialists, and having signed regional trade agreements are more likely to trade in renewable energy products., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and Aim: Greenhouse gas emissions are the fundamental cause of global warming, with CO 2 being the most contributive. Carbon reduction has been widely advocated to mitigate the climate crisis. The endoscopy unit is the third highest waste-generating department in a hospital. The awareness and acceptance of the practice of green endoscopy among healthcare workers is unclear., Method: An online survey was conducted over a 5-week period from July to August 2023 in the Asia-Pacific region, which targeted endoscopists, nurses, and other healthcare professionals of the endoscopy unit. The primary outcome was the agreement to adopt green endoscopy. The secondary outcomes included views on sustainable practices, factors associated with increased acceptance of green endoscopy, the acceptance of different carbon reduction measures, and the perceived barriers to implementation., Results: A total of 259 valid responses were received. Overall, 79.5% of participants agreed to incorporate green endoscopy into their practice. Nevertheless, existing green policies were only reported by 12.7% of respondents. The level of understanding of green endoscopy is the only significant factor associated with its acceptance (odds ratio 3.10, P < 0.007). Potential barriers to implementation include healthcare cost increment, infection risk, inadequate awareness, and lack of policy and industrial support., Conclusion: Green endoscopy is well accepted among healthcare workers but not widely implemented. The level of understanding is highly associated with its acceptance, highlighting the importance of education. A reliable assessment tool is needed to quantify the environmental impact of endoscopy. Further studies are needed to ascertain its benefit and cost effectiveness., (© 2023 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

While climate change is having serious impacts on agriculture and may require ongoing adaptation, short-run threats to global food security are also crucial for developing countries. We use dynamic and asymmetric panel autoregressive distributed lag estimators to investigate how the effects of climate change on agricultural productivity vary depending upon the short run and long run in Asia over the period of 1980-2016. The results confirmed that there is a long-run relationship between agricultural productivity and climate change variables; however, only CO 2 emissions could be linked to agricultural productivity in the short run. Moreover, while the direction of this effect is positive for the short run, it turns into negative in the long run confirming that carbon fertilization in the atmosphere can to some extent have a positive effect on agricultural productivity., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Freshwater mussels cannot spread through oceanic barriers and represent a suitable model to test the continental drift patterns. Here, we reconstruct the diversification of Oriental freshwater mussels (Unionidae) and revise their taxonomy. We show that the Indian Subcontinent harbors a rather taxonomically poor fauna, containing 25 freshwater mussel species from one subfamily (Parreysiinae). This subfamily most likely originated in East Gondwana in the Jurassic and its representatives arrived to Asia on two Gondwanan fragments (Indian Plate and Burma Terrane). We propose that the Burma Terrane was connected with the Indian Plate through the Greater India up to the terminal Cretaceous. Later on, during the entire Paleogene epoch, these blocks have served as isolated evolutionary hotspots for freshwater mussels. The Burma Terrane collided with mainland Asia in the Late Eocene, leading to the origin of the Mekong's Indochinellini radiation. Our findings indicate that the Burma Terrane had played a major role as a Gondwanan "biotic ferry" alongside with the Indian Plate., (© 2022. The Author(s).)

This study explores the influence of financial development (FD) on CO 2 emissions in five South Asian economies including energy consumption (ENC) and per capita income (PCI) as control variables. Using annual panel data for the period 1980-2018, this study applies the second-generation unit root and cointegration tests, panel pooled generalized least square (GLS) estimate, pooled mean group (PMG) estimation, and Dumitrescu-Hurlin panel causality test to accomplish the study. Westerlund cointegration test confirms a long-run relationship among the variables. The GLS estimation results reveal that FD, ENC, and PCI have significant impacts on environmental pollution. The relationship between FD and CO 2 emissions is linear, and thus, FD causes environmental pollution positively; an increasing level of FD does not reduce the latter. PCI and ENC affect environmental quality negatively. However, the existence of the EKC hypothesis is validated, as, at a rising level of PCI, pollution starts declining, taking an inverse U-shape. The PMG estimators also provide similar outcomes and validate the robustness of the panel GLS estimation. The D-H causality test supports the GSL findings and further reveals a feedback relationship between PCI and CO 2 emissions, ENC causes CO 2 emissions, bidirectional causality exists between FD and ENC, PCI causes both ENC and FD, and CO 2 emissions cause FD. The outcomes have implications for the policymakers to encourage firms and stakeholders to invest in renewable energy projects, and the financial intermediaries to the extent and subsidize loans for such investment projects. This is likely to induce investments in renewable energy sources, which will boost the energy portfolios, reduce CO 2 emissions, and produce a moderately cleaner environment., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The fact is that output volatility and carbon dioxide (CO2) emissions move together over the period. This empirical study examines the dynamic effect of output volatility on CO2 emissions using the advance nonlinear panel autoregressive distributed lag (ARDL) approach. The empirical analysis is executed for ten high emitters Asian countries covering the period from 1990 to 2019. The findings reveal that positive change in output volatility increases CO2 emissions and negative change in output volatility decreases CO2 emissions in the long run in Asia. The results also show that digitization also positively impacts environmental quality in Asia due to green globalization. The findings are also robust and similar in an alternative indicator of the environment. An important policy is that reducing volatility in output is a suitable way of environmental sustainability, particularly for Asian countries., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Air pollution brings uncountable serious influences on human life during the last decade. This study is an attempt to compare economic liberalism with economic federalism in examining the problem of air pollution in the Asia-Pacific region. Economic analysts have different views with one school of thought arguing that air pollution is the cause of the failure of a free economy rather than the failure of government regulations, while another supports liberal economics and vice versa. After developing a conceptual framework, the study uses the technique of fuzzy set qualitative comparative analysis (fsQCA) to examine how the rule of law, the size of government, regulatory efficiency, and the openness of the market influence air pollution in countries across the region. The analysis identifies two solutions with government size being found to be a necessary and core condition that influences air pollution. The study thus provides insights and suggests that government spending, taxation, and other financial health policies can be used as key sources to control air pollution in the Asia-Pacific region., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Continuous economic growth and the rise in energy consumption are linked with environmental pollution. Demand for health care expenditure increased after the COVID-19 pandemic. This study is interesting in modeling the nexus between public and private health expenditure, carbon dioxide emissions, and economic growth. To this end, the present study analyzed the nexus between public and private health care expenditure, economic growth, and environmental pollution for 36 Asian countries for the period 1991-2017. FMOLS, GMM, and quantile regression analysis confirm the EKC hypothesis in Asia. Besides, FMOLS and quantile regressions reached the reducing effects of government and private health expenditures on CO 2 emissions. While quantile regression results show that public and private health expenditures can mitigate CO 2 emissions; however, these results differ for various levels of CO 2 . Findings of quantile regression show a significant impact of both public and private health expenditures in reducing CO 2 at the 50 th and 75 th quantiles but results are insignificant for the 25 th quantile. Overall, the paper concludes that both government and private health sectors' expenditures caused CO 2 emissions to decrease in Asia and that the negative impact of the private health sector on CO 2 emissions is greater than that of the government health sector. The concluding remark is that the higher the health spending, the higher the environmental quality will be in Asia. Hence, the health administrators need to increase public and private health expenditures with an effective cost-service and energy-efficient management approach to reach sustainable health services and a sustainable environment in Asia., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This paper examines the effect of ICT and FDI on environmental pollution in major Asia Pacific countries during the year 1990-2018. We use Pooled Mean Group (PMG) and Dumitrescu-Hurlin Panel Causality for the estimation of the results. Our results suggest that ICT and FDI affect the carbon emissions or environmental pollution negatively. This implies that with the rise in ICT infrastructure and FDI inflows, environmental pollution decreases significantly in the long run. The Dumitrescu-Hurlin causality results suggest the existence of bidirectional causality among ICT and FDI which implies that increase in foreign investment leads to increase in ICT infrastructure and also, with increasing ICT infrastructure, the foreign investment increases in the Asia Pacific countries. On the policy forefront, the main focus should be targeted towards promoting FDI and ICT infrastructure in order to facilitate sustainable economic development in the Asia Pacific countries., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The aim of this paper is to investigate the nexus between natural resources, gross capital formation, globalization, and economic growth in the developing countries from European, Asian, African, and American continents. It adopted the panel vector autoregression (PVAR) approach to test this relationship for the period from 1980 to 2018. Results suggest that natural resources and globalization have a positive impact on economic growth in European, Asian, and American countries, while capital formation negatively affects growth. In African countries, the effect of globalization and gross capital formation is positive, but natural resources have a negative impact on GDP. Evidence from all continents illustrate that there is bidirectional causality between globalization and economic growth. Also, there is bidirectional causality detected between capital formation and growth in Europe and Asia and between natural resources and growth in Asia and America, while there is unidirectional causality from GDP to natural resources in Europe, from capital formation to GDP in Africa and America, from GDP to natural resources in Europe, and from natural resources to GDP in America. Based on these results, it can be said that new growth models can no longer be independent of natural resource rents and globalization., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)