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Background and Objectives: Securing an adequate blood supply relies on accurate knowledge of blood donors and donation practices. As published evidence on Asian populations is sparse, this study aims to gather up-to-date information on blood donors and donation practices in Asia to assist planning and strategy development., Materials and Methods: Ten blood collection agencies (BCAs) provided 12 months' data on donors who met eligibility criteria or were deferred, as well as details of their donation practices. Body mass index and blood volumes were calculated and analysed., Results: Data on 9,599,613 donations and 154,834 deferrals from six national and four regional BCAs revealed varied donation eligibility and collection practices. Seven used haemoglobin (Hb) criteria below the World Health Organization anaemia threshold. Seven accepted donors weighing <50 kg. Data collection on the weight and height of donors and on deferrals was inconsistent, often not routine. Deferred donors appear to weigh less, with corresponding lower estimated blood volume., Conclusion: The diversity in eligibility criteria and donation practices reflects each BCA's strategy for balancing donor health with securing an adequate blood supply. Use of lower Hb criteria substantiate their appropriateness in Asia and indicate the need to define Hb reference intervals relevant to each population. We encourage routine gathering of donor weight and height data to enable blood volume estimation and local optimization of donation volumes. Blood volume estimation formulae specific for the Asian phenotype is needed. Information from this study would be useful for tailoring donation criteria of Asian donors around the world., (© 2023 The Authors. Vox Sanguinis published by John Wiley & Sons Ltd on behalf of International Society of Blood Transfusion.)

Background: Hepatocellular carcinoma is the sixth most common malignancy in the world. Major hepatectomy (resection of greater than or equal to three liver segments) is needed if a tumour is large or close to major blood vessels. Despite low mortality, open major hepatectomy is associated with high rates of tumour recurrence that limits survival. Laparoscopic major hepatectomy has been proposed as an alternative approach with potential oncological benefits. This study compares laparoscopic major hepatectomy with open major hepatectomy for hepatocellular carcinoma in a randomized trial., Methods: The Asia-Pacific multicentre randomized trial of laparoscopic versus open major hepatectomy for hepatocellular carcinoma (AP-LAPO trial) is an open-labelled multicentre randomized trial to be conducted in five centres in the Asia-Pacific region. The study will test the hypothesis that laparoscopic major hepatectomy for hepatocellular carcinoma is associated with less tumour recurrence and better survival compared with open major hepatectomy; the primary outcome being 2-year recurrence-free survival. Secondary outcomes include hospital mortality, postoperative complications according to the Clavien-Dindo classification, time to functional recovery, quality of life, long-term survival, and postoperative serum surgical stress-related cytokines., Results and Conclusion: The AP-LAPO trial will determine whether laparoscopic major hepatectomy offers oncological benefits to patients with hepatocellular carcinoma compared with open major hepatectomy., Registration Number: NCT04852211 (http://www.clinicaltrials.gov) registered on 21 April 2021., Protocol Version: AP-LAPO trial version 01 (1 December 2021)., (© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.)

The root of Angelica sinensis is known throughout Asia for its traditional efficacy in invigorating and promoting blood circulation. The wild germplasm resources of A. sinensis was in short supply, and most of the commercial medicinal materials come from cultivation. To obtain the differences in the transcriptional levels of wild and cultivated of A. sinensis, the full-length transcriptome of A. sinensis was analyzed using PacBio SMRT three-generation high-throughput sequencing technology. Using the high-throughput sequencing platform Illumina HiSeq X Ten PE150, a root transcriptome dataset of wild and cultivated A.sinensis was obtained. The transcriptome sequencing analyses obtained 16.5 Gb database in wild and cultivated A.sinensis, after assembly steps, we obtain 113 906 transcript sequences(insfroms) with an average length of 1 466 nt. BLAST analysis indicated that 109 113(accounting for 95.79% of the total insfroms), 93 276(81.89%),60 638(53.24%),48 928(42.95%),42 876(37.64%)isofroms were successfully annotated in the NR, Swiss-port, GO, KO and KOG databases, respectively. The annotation information can be classified into three categories of biological processes, cellular components and molecular functions of GO classification, involving 128 KEGG standard metabolic pathways. Analysis of 25 463 differential insfroms, 15 090 higher expression in wild A. sinensis, and 10 373 higher in cultivated A. sinensis. In the enrichment analysis of GO and KEGG, differential insfroms were concentrated on the pathway of plant-pathogen interaction, MAPK signaling pathway-plant and plant hormone signal transduction. In this study, high-throughput sequencing was used to obtain the full-length transcription information of A. sinensis, and the overall characteristics of A. sinensis genetic information were clarified. By comparing the differential expression of wild and cultivated A. sinensis at the genetic level, it provides basic information for further screening and breeding of A. sinensis germplasm resources, resistance research and secondary metabolic pathway analysis.

Background: To compare the power to predict the 5-year conditional disease-specific survival (CS5) between the 7th and 8th editions of the TNM for gastric cancer (GC) patients., Method: This retrospective study recruited 20,548 patients who underwent GC surgery from the databases of the Surveillance, Epidemiology, End Results and a center in Asia. The CS5 was evaluated with the 7th and 8th TNM classification., Results: A two-step model showed that at the 3-5th postoperative years, the 8th staging remained an independent risk factor, whereas there was no significant difference for 7th -edition staging. Further analysis of the ability to predict CS5 indicated that there were significant differences in the CS5 of 7th -edition stages IIb and IIIa at baseline and at the postoperative 1-4th years (all p < 0.05, Cohen's d > 0.5). However, the CS5 of the fifth year was similar between them (p = 0.307, Cohen's d = 0.35). Meanwhile, the results indicated that the 8th -edition staging could effectively determine the CS5 among stages Ⅰa, Ⅰb, Ⅱa, Ⅱb, Ⅲa, and Ⅲb at baseline and at the postoperative 1-5th years (all p < 0.05). However, neither the 7th - nor the 8th -edition staging could predict the CS5 for stages Ⅲb and Ⅲc from the postoperative third to fifth years (all p > 0.05)., Conclusions: For patients with stages IIB and IIIA GC, the 8th TNM has a higher discriminatory value than the 7th edition for CS5 after the postoperative fourth year. However, a more detailed classification system is still needed to predict conditional survival for GC., (Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)

Background: Primary angle closure glaucoma (PACG) is higher in Asians than Europeans and Africans, with over 80% of PACG worldwide in Asia. Previous estimates of PACG were based largely on early studies, mostly using inappropriate case definitions. Therefore, we did a systematic review and meta-analysis to estimate the prevalence of PACG in adult Asian populations and to quantify its association with age, gender, and region., Methods: All primary reports of population-based studies that reported the prevalence of PACG in adult Asian populations were identified. PACG case definition was compatible with the ISGEO definition. Twenty-nine population-based studies were included. The overall pooled prevalence estimates were calculated using a random effect model, and ethnicity-, age- and gender-specific pooled prevalence estimates were also calculated., Results: The overall pooled prevalence of PACG in those of adult Asians was 0.75% (95% CI, 0.58, 0.96). Ethnicity-specific pooled prevalence estimates were 0.97% (0.22, 4.27) in Middle East group, 0.66% (0.23, 1.86) in South East Asia group, 0.46% (0.32, 0.64) in India group, 1.10% (0.85, 1.44) in China group, and 1.19% (0.35, 3.98) in Japan group, respectively. Age-specific prevalence was 0.21% (0.12, 0.37) for those 40-49 years, 0.54% (0.34, 0.85) for those 50-59 years, 1.26% (0.93, 1.71) for those 60-69 years, and 2.32% (1.74, 3.08) for those 70 years or above. The overall female to male ratio of the PACG prevalence was 1.51∶1 (95% CI 1.01, 2.28)., Conclusions: PACG affects approximately 0.75% adult Asians, increasing double per decade, and 60% of cases being female. The prevalence rates vary greatly by ethnic region.

Background: Genotype I (GI) Japanese encephalitis virus (JEV) that replaced GIII virus has become the dominant circulating virus in Asia. Currently, all registered live and inactivated JEV vaccines are derived from genotype III viruses. In Taiwan, the compulsory JEV vaccination policy recommends that children receives four doses of formalin-inactivated Nakayama (GIII) JEV vaccine., Methodology/principal Findings: To evaluate the influence of genotype replacement on the post-vaccination viral neutralizing ability by GIII and GI viruses, the small panel of vaccinated-children serum specimens was assembled, and the reciprocal 50% plaque-reduction neutralizing antibody titers (PRNT(50)) were measured against Nakayama vaccine strain, CJN GIII human brain isolate and TC2009-1 GI mosquito isolate. The seropositivity rate (PRNT(50) ≥ 1:10) and geometric mean titers (GMT) against the TC2009-1 virus were the lowest among the three viruses. The protective threshold against the CJN and TC2009-1 viruses could only be achieved when the GMT against Nakayama virus was ≥ 1:20 or ≥ 1:80, respectively. Using undiluted vaccinees' sera, the enhancement of JEV infection in K562 cells was observed in some low or non-neutralizing serum specimens., Conclusions/significance: Our preliminary study has shown that neutralizing antibodies, elicited by the mouse brain-derived and formalin-inactivated JEV Nakayama vaccine among a limited number of vaccinees, have reduced neutralizing capacity against circulating GI virus, but more detailed studies are needed to address the potential impact on the future vaccine policy.

Background: The national health insurance (NHI) in Taiwan covers almost the entire population and controls medical costs. However, there is increasing patient admission and shortage of inpatient care staff. The hospitalist system may be a solution., Objective: To study the efficiency of the hospitalist system under the NHI in Taiwan., Design: Prospective observational study., Methods: Under the NHI, a hospitalist-run ward (HW) was set-up in a medical referral center for patients admitted from the emergency department. The cohort was observed and compared to the internist-run wards (IWs) in terms of performance., Results: From November 2009 to January 2010, 377 patients admitted to the HW and 433 to the IWs were enrolled. Patients in the HW were older and had poorer functional status and more underlying comorbidities. The HW group also had lower admission costs and shorter lengths of hospital stay (LOS) than the IW group. Due to different demographics, propensity analysis was performed on 101 matched pairs of patients, which showed significantly lower cost and shorter LOS in HW patients despite similar mortality and readmission rates., Conclusions: The hospitalist system has higher efficiency than the internist-run general wards under the NHI system in terms of costs and length of hospitalization. It may serve as an alternative model to address rising admissions and staff shortages., (Copyright © 2011 Society of Hospital Medicine.)

Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in many Asian countries. Recent emergence of community-associated (CA) MRSA worldwide has added another serious concern to the epidemiology of S. aureus infections. To understand the changing epidemiology of S. aureus infections in Asian countries, we performed a prospective, multinational surveillance study with molecular typing analysis., Methods: We evaluated the prevalence of methicillin resistance in S. aureus isolates in CA and healthcare-associated (HA) infections, and performed molecular characterization and antimicrobial susceptibility tests of MRSA isolates., Results: MRSA accounted for 25.5% of CA S. aureus infections and 67.4% of HA infections. Predominant clones of CA-MRSA isolates were ST59-MRSA-SCCmec type IV-spa type t437, ST30-MRSA-SCCmec type IV-spa type t019 and ST72-MRSA-SCCmec type IV-spa type t324. Previously established nosocomial MRSA strains including sequence type (ST) 239 and ST5 clones were found among CA-MRSA isolates from patients without any risk factors for HA-MRSA infection. CA-MRSA clones such as ST59, ST30 and ST72 were also isolated from patients with HA infections., Conclusions: Our findings confirmed that MRSA infections in the community have been increasing in Asian countries. Data also suggest that various MRSA clones have spread between the community and hospitals as well as between countries.

Appropriate antimicrobial treatment of community-acquired pneumonia (CAP) should be based on the distribution of aetiological pathogens, antimicrobial resistance of major pathogens, clinical characteristics and outcomes. We performed a prospective observational study of 955 cases of adult CAP in 14 hospitals in eight Asian countries. Microbiological evaluation to determine etiological pathogens as well as clinical evaluation was performed. Bronchopulmonary disease (29.9%) was the most frequent underlying disease, followed by cardiovascular diseases (19.9%), malignancy (11.7%) and neurological disorder (8.2%). Streptococcus pneumoniae (29.2%) was the most common isolate, followed by Klebsiella pneumoniae (15.4%) and Haemophilus influenzae (15.1%). Serological tests were positive for Mycoplasma pneumoniae (11.0%) and Chlamydia pneumoniae (13.4%). Only 1.1% was positive for Legionella pneumophila by urinary antigen test. Of the pneumococcal isolates, 56.1% were resistant to erythromycin and 52.6% were not susceptible to penicillin. Seventeen percent of CAP had mixed infection, especially S. pneumoniae with C. pneumoniae. The overall mortality rate was 7.3%, and nursing home residence, mechanical ventilation, malignancy, cardiovascular diseases, respiratory rate>30/min and hyponatraemia were significant independent risk factors for mortality by multivariate analysis (P<0.05). The current data provide relevant information about pathogen distribution and antimicrobial resistance of major pathogens of CAP as well as clinical outcomes of illness in Asian countries.