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Background: Upper limb lymphedema (ULL) is a common and deliberating complication for breast cancer survivors (BCSs). Breast cancer survivors with ULL reported a wide range of symptoms. However, little is known about symptom patterns and interrelationships among them. This study was designed to explore symptom clusters and construct symptom networks of ULL-related symptoms among BCSs and to identify the core symptoms., Methods: This study is a secondary data analysis using datasets from three cross-sectional studies of BCSs in China. A total of 341 participants with maximum interlimb circumference ≥2 cm and complete responses in Part I of the Breast Cancer and Lymphedema Symptom Experience Index were included. Symptom clusters were identified through principal component analysis, and multiple linear regression analysis was employed to explore factors associated with severity of overall ULL-related symptoms. A contemporaneous network with 20 frequently reported symptoms were constructed after controlling for covariates., Results: Three symptom clusters, including lymph stasis symptom cluster, nerve symptom cluster, and movement limitation symptom cluster, were identified. Postsurgery time, axillary lymph node dissection, and radiotherapy were associated with the severity of ULL-related symptoms. Tightness (r s = 1.379; r scov = 1.097), tingling (r s = 1.264; r scov = 0.925), and firmness (r s = 1.170; r scov = 0.923) were the most central symptoms in both networks with and without covariates., Conclusions: Breast cancer survivors with ULL experienced severe symptom burden. Tightness, tingling, and firmness were core symptoms of ULL among BCSs. Our findings demonstrated that the assessment and targeted intervention of specific core symptoms might help to relive effectively the burden of ULL-related symptom among BCSs., (© 2024. Society of Surgical Oncology.)

Satellite-derived chlorophyll-a concentration (Chl-a) is essential for assessing environmental conditions, yet its application in the optically complex waters of the eastern Yellow Sea (EYS) is challenged. This study refines the Chl-a algorithm for the EYS employing a switching approach based on normalized water-leaving radiance at 555 nm wavelength according to turbidity conditions to investigate phytoplankton bloom patterns in the EYS. The refined Chl-a algorithm (EYS algorithm) outperforms prior algorithms, exhibiting a strong alignment with in situ Chl-a. Employing the EYS algorithm, seasonal and bloom patterns of Chl-a are detailed for the offshore and nearshore EYS areas. Distinct seasonal Chl-a patterns and factors influencing bloom initiation differed between the areas, and the peak Chl-a during the bloom period from 2018 to 2020 was significantly lower than the average year in both areas. Specifically, bimodal and unimodal peak patterns in Chl-a were observed in the offshore and nearshore areas, respectively. By investigating the relationships between environmental factors and bloom parameters, we identified that major controlling factors governing bloom initiation were mixed layer depth (MLD) and suspended particulate matter (SPM) in the offshore and nearshore areas, respectively. Additionally, this study proposed that the recent decrease in the peak Chl-a might be caused by rapid environmental changes such as the warming trend of sea surface temperature (SST) and the limitation of nutrients. For example, external forcing, phytoplankton growth, and nutrient dynamics can change due to increased SST and limitation of nutrients, which can lead to a decrease in Chl-a. This study contributes to understanding phytoplankton dynamics in the EYS, highlighting the importance of region-specific considerations in comprehending Chl-a patterns and bloom dynamics., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The biogeographical range shift of insect pests is primarily governed by temperature. However, the range shift of seasonal long-distance migratory insects may be very different from that of sedentary insects. Nilaparvata lugens (BPH), a serious rice pest, can only overwinter in tropical-to-subtropical regions, and some populations migrate seasonally to temperate zones with the aid of low-level jet stream air currents. This study utilized the CLIMEX model to project the overwintering area under the climate change scenarios of RCP2.6 and RCP8.5, both in 2030s and 2080s. The overwintering boundary is predicted to expand poleward and new overwintering areas are predicted in the mid-latitude regions of central-to-eastern China and mid-to-southern Australia. With climate change, the habitable areas remained similar, but suitability decreased substantially, especially in the near-equatorial regions, owing to increasing heat stress. The range shift is similar between RCP2.6-2030s, RCP2.6-2080s, and RCP8.5-2030s, but extreme changes are projected under RCP8.5-2080s with marginal areas increasing from 27.2 to 38.8% and very favorable areas dropping from 27.5 to 3.6% compared to the current climate. These findings indicate that climate change will drive range shifts in BPH and alter regional risks differently. Therefore, international monitoring programs are needed to effectively manage these emerging challenges., (© 2024. The Author(s).)

The complexity around the dynamic markets for new psychoactive substances (NPS) forces researchers to develop and apply innovative analytical strategies to detect and identify them in influent urban wastewater. In this work a comprehensive suspect screening workflow following liquid chromatography - high resolution mass spectrometry analysis was established utilising the open-source InSpectra data processing platform and the HighResNPS library. In total, 278 urban influent wastewater samples from 47 sites in 16 countries were collected to investigate the presence of NPS and other drugs of abuse. A total of 50 compounds were detected in samples from at least one site. Most compounds found were prescription drugs such as gabapentin (detection frequency 79%), codeine (40%) and pregabalin (15%). However, cocaine was the most found illicit drug (83%), in all countries where samples were collected apart from the Republic of Korea and China. Eight NPS were also identified with this protocol: 3-methylmethcathinone 11%), eutylone (6%), etizolam (2%), 3-chloromethcathinone (4%), mitragynine (6%), phenibut (2%), 25I-NBOH (2%) and trimethoxyamphetamine (2%). The latter three have not previously been reported in municipal wastewater samples. The workflow employed allowed the prioritisation of features to be further investigated, reducing processing time and gaining in confidence in their identification., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Various numerical experiments using WRF (Weather Research & Forecasting Model) and CMAQ (Community Multiscale Air Quality Modeling System) were performed to analyze the phenomenon of rapidly high concentration PM 2.5 after the passage of a cold front in an area with limited local emissions. The episode period was from January 14 to 23, 2018, and analysis was conducted by dividing it into two stages according to the characteristics of changes in PM 2.5 concentrations during the period. Through the analysis of observational data during the episode period, we confirmed meteorological impacts (decrease in temperature, increase in wind speed and relative humidity) and an increase in air pollution (PM 10 and PM 2.5 ) attributed to the passage of a cold front. Using CMAQ's IPR (Integrated Process Rate) analysis, the contribution of the horizontal advection process was observed in transporting PM 2.5 to Gangneung at higher altitudes, and the PM 2.5 concentrations at the surface increased because the vertical advection process was influenced by the terrain. Notably, in Stage 2 (64 μg·m -3 ), a higher contribution of the vertical advection process compared to Stage 1 (35 μg·m -3 ) was observed, which is attributed to the differences in synoptic patterns following the passage of the cold front. During Stage 2, following the cold front, atmospheric stability (dominance of high-pressure system) led to air subsidence and the presence of a temperature inversion layer, creating favorable meteorological conditions for the accumulation of air pollutants. This study offers the mechanisms of air pollution over the Korean Peninsula under non-stationary meteorological conditions, particularly in relation to the passage of the cold front (low-pressure system). Notably, the influence of a cold front can vary according to the synoptic patterns that develop following its passage., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Soon-Hwan Lee reports financial support was provided by South Korea Ministry of Science and ICT. Soon-Hwan Lee reports financial support was provided by South Korea Ministry of Education. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Evidence of the relationship between greenness and sleep is limited, and, given the worsening sleep insufficiency worldwide, this relationship needs elucidation. In this study, we investigated the association of greenness with sleep deprivation using nationwide survey data., Methods: This study included 1,727,273 participants in the Korea Community Health Survey who resided in all 229 districts of South Korea from 2011 to 2018. Sleep deprivation variables were defined as strong deprivation or mild deprivation, based on average daily sleep duration of <5 or 5-6 h, respectively. District-specific annual average of satellite-derived enhanced vegetation index (EVI) was used as a green space exposure. A logistic regression with complex survey weights was used to estimate the association between greenness and sleep deprivation, and it was further examined by sex, age group, educational status, income level, and population density. The regression analysis was performed annually, and the annual estimates were pooled by a combined data analysis., Results: A higher level of greenness was associated (odds ratio [95 % confidence interval]) with strong and mild sleep deprivation (0.96 [0.93-0.99] and 0.96 [0.95-0.97]), respectively, and males and the younger age group (<65 years) showed a more prominent association with greenness than in females and the elderly group (65 years or older). In addition, only high-population-density areas showed evident associations of greenness with both strong and mild sleep deprivation., Conclusions: This large population-based study provides important epidemiological evidence for improving sleep quantity through an increase in greenness exposure and supports policymakers in establishing strategies for urban planning., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Priority water pollutants comprising six plasticizers, 18 volatile organic compounds (VOCs), total petroleum hydrocarbon (TPH), 1,4-dioxane, epichlorohydrin, formaldehyde, acrylamide, and cyanides were determined in surface river sediments to assess their distribution patterns and ecological risks. Among these, di (2-ethylhexyl) phthalate (DEHP), toluene, TPH, and acrylamide were frequently found in sediments. The industrial sites had higher concentrations of ∑plasticizers (median 628 ng/g dry weight (dw)), ∑VOCs (median 3.35 ng/g dw), acrylamide (median 0.966 ng/g dw), and TPH (median 152 μg/g dw) in sediments than the mixed and non-industrial areas. The other pollutants did not show the significant differences in levels according to site types because of their relatively low detection frequencies. Volatile and soluble substances as well as hydrophobic pollutants were predominantly detected in surface sediments from industrial areas. Sediment contamination patterns were affected by the size and composition of the industrial zones around the sampling sites. The ecological risks determined using the sediment quality guidelines (DEHP, VOCs, and TPH) and the mean probable effect level quotients (DEHP) were mostly acceptable. However, the two most representative industrial regions (the largest industrial area and the first industrial city) showed risks of concern for DEHP and TPH., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Objective: Health management of children during early childhood requires substantial information. Multicultural families find it difficult to obtain and use parenting-relevant information for their young children. This study aimed to develop, implement, and evaluate a tailored Health parenting program and lay-health workers' support to improve children's health in multicultural families in Korea., Methods: In this study, we employed the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model as the conceptual framework, guiding the creation of a tailored mHealth application supplemented by a lay-health worker support module. The efficacy of the program was assessed through an experimental three-arm cluster randomized controlled trial. A total of 101 participants were stratified into three distinct groups as follows: (1) Experimental Group A, which received the mHealth program alongside the lay-health worker support component; (2) Experimental Group B, exposed solely to the mHealth program; and (3) Control Group, devoid of any intervention. Within these groups, 101 marriage migrant women hailing from Vietnam, the Philippines, and China were incorporated, with each group comprising 33, 30, and 38 participants, respectively. The study's primary endpoint encompassed a comprehensive assessment of health-promoting behaviors, proficiency in eHealth literacy, and the family strength., Results: The analysis revealed noteworthy interactions among the three distinct groups over the course of time, with implications for health-promotion behaviors ( p  = 0.041), eHealth literacy ( p  = 0.037), and family strength ( p  = 0.044). Specifically, the experimental groups exhibited substantially elevated levels of the specified outcome variables when contrasted with the control group. Notably, the positive effects persisted even up to 12 weeks subsequent to the conclusion of the intervention, underscoring the program's capacity to foster enduring improvements in the observed metrics., Conclusion: This study highlights the benefits of offering contextually appropriate information to target groups constrained by challenges in information access, evaluation, and utilization. Notably, drawing from their positive experiences in this process, we underscore the importance of employing lay health workers. These workers play a crucial role in fostering and ensuring sustained behavioral changes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Son and Han.)

Hand-foot-mouth disease (HFMD) is a viral disease that occurs primarily in children. Meteorological factors have a significant impact on its popularity annually in Korea. This study proposes a new HFMD prediction model using a dual-attention-based recurrent neural network (DA-RNN) and important weather factors for HFMD in Korea. First, suspected cases of HFMD in each state were predicted using meteorological factors from the DA-RNN. Second, the weather factors were divided into six categories: temperature, wind, rainfall, day length, humidity, and air pollution to conduct sensitivity analysis. Because of this prediction, the proposed model showed the best performance in predicting the number of suspected HFMD cases in a week compared with other RNN methods. Sensitivity analysis showed that air pollution and rainfall play an important role in HFMD in Korea. This model provides information for HFMD prevention and control and can be extended to predict other infectious diseases., (© 2023. Springer Nature Limited.)

The new velocity fields based on the Generalized Ekman (GE) theory to trace floating algae were derived and verified by drifter observations and compared to reanalysis datasets in the Yellow Sea (YS). Two velocity fields using diagnostic approaches and two velocity fields from reanalysis datasets were examined. The results revealed that the diagnostic velocity fields had comparable accuracy to the reanalysis datasets, even locally better. Then, we applied each velocity field to trace green algae, Ulva prolifera, in July 2011 and brown algae, Sargassum horneri, in May 2017 using particle tracking experiments. In addition, drifter trajectories were simulated, and error accumulation speed was estimated for each velocity field. Simulation results using the diagnostic velocity fields consistently showed better agreement with satellite images and in situ observations than those using reanalysis datasets, demonstrating that the diagnostic velocity could be a superior tool for simulating surface-floating substances and organisms. The approach to derive diagnostic velocity fields can be easily applied instead of relying on heavy computing numerical models., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Along with bisphenol-A (BPA), conventional phthalate esters (PAEs) have been reported as environmental hormones, despite their functional usefulness as plasticizers. Nevertheless, they are frequently found in various products, including children's utensils and toys made of poly (vinyl chloride). This is tremendously important because PAEs are harmful to infants. In addition, gel/slime-type toys made of poly (vinyl alcohol) are currently popular for developing infant' tactile senses. In this study, we developed a method to qualitatively and quantitatively detect PAEs in gel/slime-type toys mimicking, infants playing with them in a bathtub. As a result, 1,2-cyclohexanedicarboxylic acid diisononyl ester (DINCH), one of the PAE alternatives, transferred into the water from the toys and was detected most commonly (108-719 μg g -1 ; 0.01-0.07 wt%) among PAEs. The detected DINCH levels were below the universally accepted levels for PAEs (0.1 wt%). However, the amount of DINCH detected could still be toxic, in accordance with toxicity tests using water fleas. Furthermore, unpleasant odors were emitted when the toys containing toxic volatile organic compounds were unpacked. This is the first study to develop a method to analyze PAE in gel/slime-type toys and determine that alternatives to conventional PAEs cannot be unconditionally regarded as safe chemicals. Therefore, the revised standards for regulating PAEs and their alternatives must be reconsidered., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

In this study, the levels and distributions of short chain chlorinated paraffins (SCCPs) and organophosphate flame retardants (OPFRs) were determined in 10-88 aged human serum/hair and their paired multiple exposure sources, including one-day composite food, drinking water, and house dust. The average concentration of SCCPs and OPFRs were respectively 6313 and 176 ng/g lipid weight (lw) in serum, 1008 and 108 ng/g dry weight (dw) in hair, 1131 and 27.2 ng/g dw in food, not detected and 45.1 ng/L in drinking water, and 2405 and 864 ng/g in house dust. The levels of SCCPs in serum of adults were significantly higher than those of juvenile (Mann-Whitney U test, p < 0.05), whereas gender showed no statistically significant difference in SCCPs and OPFRs levels. In addition, there were significant relationships of OPFR concentrations between serum and drinking water as well as hair and food using the multiple linear regression analysis, whereas no correlation was observed for SCCPs. Based on the estimated daily intake, the major exposure pathway for SCCPs was food, while for OPFRs, it was food and drinking water with three order magnitude safety margin., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Carbon compensation is an effective way of reducing carbon emissions. However, previous studies in this field have been limited and have not examined high-precision scientific carbon compensation under regional inequity. The present study examined initial carbon compensation in the grid and developed a new equitable carbon compensation model. Additionally, it modified the carbon compensation value for each province and analysed how land-use change affected carbon compensation. The results show that, after the modification, the entire carbon deficit reached 17.34 × 10 8  t C in 2015, representing a decrease of 14% compared with the initial carbon deficit. The area with negative carbon deficit values accounted for 36% of the whole area, concentrated mainly in the south, southwest and northwest. Without modification, the initial carbon compensation reached 537 × 10 8 USD, and only Yunnan, Sichuan and Hainan provinces being eligible to receive compensation. The final modified carbon compensation was approximately 20% of the initial values, and 11 provinces were eligible to obtain compensation. The other provinces responsible for paying the carbon compensation costs were typically concentrated in Central and Eastern China. Land-use changes in 2015 led to increases in the initial carbon compensation and modified carbon compensation of 3.74 × 10 8 and 0.13 × 10 8 USD, respectively. The per-unit land-use change caused greater increases in carbon emissions in China's big cities and the provinces in Central and East China. Some policies, such as macro-control by the central government, diversified forms and patterns of compensation, and auxiliary measures should be formulated/proposed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier Ltd.)

Background and Aim: The associations between COVID-19 transmission and meteorological factors are scientifically debated. Several studies have been conducted worldwide, with inconsistent findings. However, often these studies had methodological issues, e.g., did not exclude important confounding factors, or had limited geographic or temporal resolution. Our aim was to quantify associations between temporal variations in COVID-19 incidence and meteorological variables globally., Methods: We analysed data from 455 cities across 20 countries from 3 February to 31 October 2020. We used a time-series analysis that assumes a quasi-Poisson distribution of the cases and incorporates distributed lag non-linear modelling for the exposure associations at the city-level while considering effects of autocorrelation, long-term trends, and day of the week. The confounding by governmental measures was accounted for by incorporating the Oxford Governmental Stringency Index. The effects of daily mean air temperature, relative and absolute humidity, and UV radiation were estimated by applying a meta-regression of local estimates with multi-level random effects for location, country, and climatic zone., Results: We found that air temperature and absolute humidity influenced the spread of COVID-19 over a lag period of 15 days. Pooling the estimates globally showed that overall low temperatures (7.5 °C compared to 17.0 °C) and low absolute humidity (6.0 g/m 3 compared to 11.0 g/m 3 ) were associated with higher COVID-19 incidence (RR temp =1.33 with 95%CI: 1.08; 1.64 and RR AH =1.33 with 95%CI: 1.12; 1.57). RH revealed no significant trend and for UV some evidence of a positive association was found. These results were robust to sensitivity analysis. However, the study results also emphasise the heterogeneity of these associations in different countries., Conclusion: Globally, our results suggest that comparatively low temperatures and low absolute humidity were associated with increased risks of COVID-19 incidence. However, this study underlines regional heterogeneity of weather-related effects on COVID-19 transmission., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Although the particle phase state is an important property, there is scant information on it, especially, for real-world aerosols. To explore the phase state of fine mode aerosols (PM 2.5 ) in two megacities, Seoul and Beijing, we collected PM 2.5 filter samples daily from Dec 2020 to Jan 2021. Using optical microscopy combined with the poke-and-flow technique, the phase states of the bulk of PM 2.5 as a function of relative humidity (RH) were determined and compared to the ambient RH ranges in the two cities. PM 2.5 was found to be liquid to semisolid in Seoul but mostly semisolid to solid in Beijing. The liquid state was dominant on polluted days, while a semisolid state was dominant on clean days in Seoul. These findings can be explained by the aerosol liquid water content related to the chemical compositions of the aerosols at ambient RH; the water content of PM 2.5 was much higher in Seoul than in Beijing. Furthermore, the overall phase states of PM 2.5 observed in Seoul and Beijing were interrelated with the particle size distribution. The results of this study aid in a better understanding of the fundamental physical properties of aerosols and in examining how these are linked to PM 2.5 in polluted urban atmospheres.

This study investigated the effect of the concentration of ambient fine particulate matter (PM2.5), a transboundary air pollutant, on the livability of neighboring areas of China and South Korea with the aim of informing common policy development. Grey relational analysis (GRA) and panel regression analysis were performed to examine the effect of PM2.5 concentration on various livability indicators. The results revealed that urban living infrastructure was an indicator of effect in both South Korea and China. Based on the high correlation between urban living infrastructure and PM2.5 concentration, it can be seen that PM2.5 clearly affects livability, shown by panel regression analysis. Other key livability indicators were traffic safety, culture and leisure, and climate indicators. Spatial analysis of the livability index revealed that from 2015 to 2019, livability improved in both South Korea and China, but there was a clear difference in the spatial distribution in China. High-vulnerability areas showed potential risks that can reduce livability in the long run. In South Korea and China, areas surrounding large cities were found to be highly vulnerable. The findings of this research can guide the establishment of policies grading PM2.5 pollution at the regional or city macro-level.

While promoting the economic growth, energy has also brought pollution problems to the world environment, which has gradually become a bottleneck impeding sustainable economic development. In view of the rapid evolution of urbanization and industrialization, economic growth is increasingly dependent on the energy consumption, the development of the two is difficult to coordinate, and the internal contradictions are becoming increasingly serious, which hinders the sustainable development of economic growth. This study establishes the relationship between energy consumption and economic growth according to the energy Kuznets curve and studies the future trend of China's sustainable development through the comparative analysis of the energy Kuznets curve of the United States and Germany. The results show that, at the turning point of energy consumption, China's energy economic rate is higher than that of Germany and the United States. In addition, in terms of urbanization rate and industrial structure, although China's tertiary industry has made a breakthrough, it is still lower than that of the United States and Germany, but the level of urbanization rate has made significant progress. In short, China has obvious advantages in future economic development and has a late developing advantage compared with the United States and Germany. This paper makes an empirical analysis of the relationship between energy consumption and economic growth in OECD countries and finds out the turning point of energy consumption, so as to provide a theoretical basis for coordinating China's energy consumption and economic growth., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Liuyi Dai et al.)

Dissimilatory nitrate reduction to ammonium (DNRA) is an essential intermediate step in the nitrogen cycle, and different sediment physicochemical properties can affect the DNRA process. But the detailed research on the environmental nitrogen cycling in urban river networks based on DNRA communities and the functional gene nrfA is lacking. In this study, the flow line of the Huangpu River in Shanghai was analyzed using isotope tracer, quantitative real-time PCR, and high-throughput sequencing techniques to evaluate the role of DNRA on the stability of the river network and marine. The significant positive correlation between the rate of DNRA and sediment organic carbon was identified. At the genus level, Anaeromyxobacter is the most dominant. Notably, both heterotrophic and autotrophic DNRA species were discovered. This study added diversity to the scope of urban freshwater river network ecosystem studies by investigating the distribution of DNRA bacteria along the Huangpu River. It provided new insights into the biological nitrogen cycle of typical urban inland rivers in eastern China., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Northeast Asia has been suffering from dramatic increases of particulate matter (PM) since the late 1990s, and it still continues to undergo haze despite various abating regulations. In this study, we investigated aerosol-cloud-precipitation (ACP) interactions with the varied PM, and the impact of long-range transport (LRT) process on ACP in springtime was assessed in Northeast Asia. Our long-term (1995-2019) analysis of PM 10 exhibited the correlation with decreases of both sunshine duration and drizzle occurrences that can be interpreted as direct and indirect aerosol effects, while cloud cover induced by the varied PM 10 was found only in more than 90% cloud cover (9/10-10/10 category). The online WRF-Chem with wind-blown dust simulation indicated that cloud water was affected by secondary inorganic aerosol (SIA) formation near the surface in upwind areas dominantly, whereas, along the LRT pathway, cloud water perturbation altitudes were increased quasi-linearly toward downward between 1 and 3 km. The gas-to-particle conversion ratios of sulfur ([SO 4 2- ]/[SO 2  + SO 4 2- ]) and nitrogen ([NO 3 - ]/[NO 2  + NO 3 - ]) both remain aloft long at the same vertical levels of most perturbed cloud altitude enough to be transported over long distance in springtime. Formations of sulfate and nitrate showed different ACP interaction timing; distinctive shifts in the ratios observed at the exit (Shanghai-Yellow Sea) by nitrate, and entrance areas (Seoul-Tokyo) by sulfate along the LRT pathway, respectively, with higher ratios of 0.8 or more in springtime. Our results indicate that ACP processes have been enhanced at a LRT-related altitude with different SIA production timings that can be considered in species-specific springtime PM abatements over Northeast Asia., (© 2022. The Author(s).)

In this study, eggs of black-tailed gull (Larus crassirostris), a top trophic level predator of marine ecosystem were, for the first time, monitored to assess the temporal and spatial trends of emerging pollutants in South Korea. Two Island regions, namely, Baekryeong-do (Site A) and Hong-do (Site B) were investigated from 2012 to 2018, and the total levels of short chain chlorinated paraffins (SCCPs), medium chain CPs (MCCPs), and organophosphate flame retardants (OPFRs) for both Site A and B were 1180-2931 and 694-2023 ng/g lipid weight (lw), 1287-4898 and 1034-3075 ng/g lw, and 203-499 and 233-409 ng/g lw, respectively. The time-trends of the concentration of pollutants showed an increasing tendency from 2012 to 2018, with the levels predicted to be doubled within three years, following the results of regression analysis. A shift in temporal-trends from shorter to longer chain CPs was noted, suggesting the effect of industrial-related contamination. Especially, significantly high levels of CPs and OPFRs were found in the site adjacent to China, which is reasonable as China is the largest producer and consumer of FRs and plasticizers worldwide. This study is valuable to understand the temporal increment of emerging pollutants as the alternatives of phased-out FRs and plasticizers, while raising the need for continuous environmental management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Skin cancer is the most common human malignancy worldwide and solar ultraviolet (UV) radiation is known to serve an important role in its pathogenesis. Natural candidate compounds with antioxidant, photoprotective and anti‑melanogenic effects were investigated against the background of skin photoprotective and anti‑melanogenic properties. Gomisin D, J and O are dibenzocyclooctadiene lignans present in Kadsura medicinal plants and possess several pharmacological activities. In this study, the functions and mechanisms underlying the effects of gomisin D, J and O in UVA‑and UVB‑irradiated keratinocytes and α‑melanocyte stimulating hormone (α‑MSH)‑stimulated melanocytes were explored. Following UVA and UVB irradiation, keratinocytes were treated with gomisin D, J and O, and keratinocyte viability, lactate dehydrogenase (LDH) release, intracellular reactive oxygen species (ROS) production and apoptosis were examined. The results demonstrated that gomisin D and J improved keratinocyte viability and reduced LDH release under UVA and UVB irradiation. Intracellular ROS production induced by UVA and UVB irradiation was suppressed by gomisin D and J. In addition, Annexin V and TUNEL staining analysis indicated that gomisin D and J have significant anti‑apoptotic effects on UVA‑and UVB‑irradiated keratinocytes. After α‑MSH stimulation, melanocytes were treated with gomisin D, J and O, and the changes in melanocyte viability, intracellular melanin content, intracellular tyrosinase activity, and mechanisms underlying these changes were examined. Gomisin D markedly inhibited the α‑MSH‑induced increase in intracellular melanin content and tyrosinase activity. Mechanistically, gomisin D reduced the protein and mRNA expression levels of microphthalmia‑associated transcription factor (MITF), tyrosinase, tyrosinase‑related protein (TRP)‑1 and TRP‑2 in α‑MSH‑stimulated melanocytes. In addition, gomisin D markedly downregulated α‑MSH‑induced phosphorylation of protein kinase A and cAMP response element binding protein, which are known to be present upstream of the MITF, tyrosinase, TRP‑1 and TRP‑2 genes. Overall, gomisin D has photoprotective and anti‑melanogenic effects; these findings provide a basis for the production of potential brightening and photoprotective agents using natural compounds such as gomisin D.

A single-particle mass spectrometer (SPMS) with laser ionization was constructed to determine the chemical composition of single particles in real time. The technique was evaluated using various polystyrene latex particles with different sizes (125 nm, 300 nm, 700 nm, and 1000 nm); NaCl, KCl, MgCO 3 , CaCO 3 , and Al 2 O 3 particles with different chemical compositions; an internal mixture of NaCl and KCl; and an internal mixture of NaCl, KCl, and MgCl 2 with different mixing states. The results show that the SPMS can be useful for the determination of chemical characteristics and mixing states of single particles in real time. The SPMS was then applied to obtain the chemical signatures of various combustion aerosols (diesel engine exhaust, biomass burning (rice straw), coal burning, and cooking (pork)) based on their single-particle mass spectra. Elemental carbon (EC)-rich and EC-organic carbon (OC) particles were the predominant particle types identified in diesel engine exhaust, while K-rich and EC-OC-K particles were observed among rice straw burning emissions. Only one particle type (ash-rich particles) was detected among coal burning emissions. EC-rich and EC-OC particles were observed among pork burning particles. The single-particle mass spectra of the EC or OC types of particles differed among various combustion sources. The observed chemical signatures could be useful for rapidly identifying sources of atmospheric fine particles. In addition, the detected chemical signatures of the fine particles may be used to estimate their toxicity and to better understand their effects on human health.

The COVID-19 pandemic caused disruptions of public life and imposed lockdown measures in 2020 resulted in considerable reductions of anthropogenic aerosol emissions. It still remains unclear how the associated short-term changes in atmospheric chemistry influenced weather and climate on regional scales. To understand the underlying physical mechanisms, we conduct ensemble aerosol perturbation experiments with the Community Earth System Model, version 2. In the simulations reduced anthropogenic aerosol emissions in February generate anomalous surface warming and warm-moist air advection which promotes low-level cloud formation over China. Although the simulated response is weak, it is detectable in some areas, in qualitative agreement with the observations. The negative dynamical cloud feedback offsets the effect from reduced cloud condensation nuclei. Additional perturbation experiments with strongly amplified air pollution over China reveal a nonlinear sensitivity of regional atmospheric conditions to chemical/radiative perturbations. COVID-19-related changes in anthropogenic aerosol emissions provide an excellent testbed to elucidate the interaction between air pollution and climate., (© 2021. The Author(s).)

During the outbreak of the coronavirus disease 2019 (COVID-19) in China in January and February 2020, production and living activities were drastically reduced to impede the spread of the virus, which also caused a strong reduction of the emission of primary pollutants. However, as a major species of secondary air pollutant, tropospheric ozone did not reduce synchronously, but instead rose in some region. Furthermore, higher concentrations of ozone may potentially promote the rates of COVID-19 infections, causing extra risk to human health. Thus, the variation of ozone should be evaluated widely. This paper presents ozone profiles and tropospheric ozone columns from ultraviolet radiances detected by TROPOospheric Monitoring Instrument (TROPOMI) onboard Sentinel 5 Precursor (S5P) satellite based on the principle of optimal estimation method. We compare our TROPOMI retrievals with global ozonesonde observations, Fourier Transform Spectrometry (FTS) observation at Hefei (117.17°E, 31.7°N) and Global Positioning System (GPS) ozonesonde sensor (GPSO 3 ) ozonesonde profiles at Beijing (116.46°E, 39.80°N). The integrated Tropospheric Ozone Column (TOC) and Stratospheric Ozone Column (SOC) show excellent agreement with validation data. We use the retrieved TOC combining with tropospheric vertical column density (TVCD) of NO 2 and HCHO from TROPOMI to assess the changes of tropospheric ozone during the outbreak of COVID-19 in China. Although NO 2 TVCD decreased by 63%, the retrieved TOC over east China increase by 10% from the 20-day averaged before the lockdown on January 23, 2020 to 20-day averaged after it. Because the production of ozone in winter is controlled by volatile organic compounds (VOCs) indicated by monitored HCHO, which did not present evident change during the lockdown, the production of ozone did not decrease significantly. Besides, the decrease of NO x emission weakened the titration of ozone, causing an increase of ozone., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Management of water-quality in a river ecosystem needs to be focused on susceptible regions to eutrophication based on proper measurements. The stress-response relationships between nutrients and primary productivity of phytoplankton allow the derivation of ecologically acceptable thresholds of stressors under field conditions. However, spatio-temporal variations in heterogeneous environmental conditions have hindered the development of locally applicable criteria. To address these issues, we utilized a combination of a geographically specialized artificial neural network (Geo-SOM, geo-self-organizing map) and linear mixed-effect models (LMMs). The model was applied to a 24-month dataset of 54 stations that spanned a wide spatial gradient in the Nakdong River basin. The Geo-SOM classified 1286 observations in the basin into 13 clusters that were regionally and seasonally distinct. Inclusion of the random effects of Geo-SOM clustering improved the performance of each LMM, which suggests that there were significant spatio-temporal variations in the Chla-stressor relationships. These variations arise owing to differences in background seasonality and the effects of local pollutant variables and land-use patterns. Among the 16 environmental variables, the major stressors for Chla were total phosphate (TP) as a nutrient and biological oxygen demand (BOD) as a non-nutrient according to the results of both Geo-SOM and LMM analyses. Based on LMMs with the random effect of the Geo-SOM clusters on the intercept and the slope, we can propose recommended thresholds for TP (18.5 μg L -1 ) and BOD (1.6 mg L -1 ) in the Nakdong River. The combined method of LMM and Geo-SOM will be useful in guiding appropriate local water-quality-management strategies and in the global development of large-scale nutrient criteria., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020. Published by Elsevier Ltd.)

ABSTRACT As another wave of COVID-19 outbreak has approached in July 2020, a larger scale COVID-19 pediatric Asian cohort summarizing the clinical observations is warranted. Children confirmed with COVID-19 infection from the Republic of Korea, the Hong Kong Special Administrative Region (HKSAR) and Wuhan, China, during their first waves of local outbreaks were included. Their clinical characteristics and the temporal sequences of the first waves of local paediatric outbreaks were compared. Four hundred and twenty three children with COVID-19 were analyzed. Wuhan had the earliest peak, followed by Korea and HKSAR. Compared with Korea and Wuhan, patients in HKSAR were significantly older (mean age: 12.9 vs. 10.8 vs. 6.6 years, p  < 0.001, respectively) and had more imported cases (87.5% vs. 16.5% vs. 0%, p  < 0.001, respectively). The imported cases were also older (13.4 vs. 7.6 years, p  < 0.001). More cases in HKSAR were asymptomatic compared to Korea and Wuhan (45.5% vs. 22.0% vs. 20.9%, p  < 0.001, respectively), and significantly more patients from Wuhan developed fever (40.6% vs. 29.7% vs. 21.6%, p =0.003, respectively). There were significantly less imported cases than domestic cases developing fever after adjusting for age and region of origin ( p  = 0.046). 5.4% to 10.8% of patients reported anosmia and ageusia. None developed pediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PMIS-TS). In general, adolescents were more likely to be asymptomatic and less likely to develop fever, but required longer hospital stays. In conclusion, majority patients in this pediatric Asian cohort had a mild disease. None developed PIMS-TS. Their clinical characteristics were influenced by travel history and age.

In this study, the fate of organophosphate esters (OPEs) in conventional and advanced drinking water treatment plants (DWTPs) was investigated in field scale. In addition, the risk of OPEs by drinking water was assessed. The average total OPE concentrations in raw and treated water were lower in the rainy season (94.3 and 57.1 ng/L, respectively) than dry season (163 and 84.2 ng/L, respectively). Advanced DWTPs showed better removal efficiencies of major OPEs rather than those in conventional DWTPs. The average removal rates for two chlorinated OPEs, including tris(2-chloroethyl)phosphate (TCEP) and tris(1-chloro-2-propyl)phosphate (TCIPP), were negative (TCEP: -87%, TCIPP: -41%) for a conventional DWTP but positive (TCEP: 46%, TCIPP: 49%) for advanced DWTPs using granular activated carbon filtration. The average removal rates for advanced DWTPs were statistically higher for the alkyl/aryl OPEs, tri-n-butyl phosphate (TNBP: 67%) and tris(2-butoxyethyl) phosphate (TBOEP: 63%), than those for the conventional DWTPs (TNBP: 21%, TBOEP: 25%). The hazardous quotient (HQ) of major OPEs were lower for advanced DWTPs and water irrigated from upstream sties/reservoir compared to that of conventional DWTPs and water irrigated from downstream sites. We believe that this is the first comparison of OPE removal efficiencies achieved in conventional and advanced DWTPs., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020. Published by Elsevier Ltd.)

Arising with increasing security issues in highly aggregated tourist crowds (HATCs), widespread attention has been dedicated to security status. Assessing and forecasting the security status of HATCs in various situations related to tourist destinations is an important strategy of security management. Thus, this study constructed a system dynamic flow diagram for the security evaluation of HATCs. The relevant data were collected on perceptions of crowded tourists through questionnaires at Tianyou Peak during China's National Day (Golden Week Holiday). Additionally, efforts were made to conduct online surveys at Shanghai Disney Park and Shilin Night Market in Taipei, since crowding always occurs in these two areas. Empirical results based on Vensim software suggest that HATC status is the result of the coupling of various influencing factors and the result of the benign coupling of the three subsystems: multi-source pressure, state variation, and management response. HATC security presents a changing trend of "increase-decrease-recovery". Differences exist in the changes of HATC security status in different spaces and at different time nodes. The findings also indicated that HATCs that appear in the daytime are more stable than HATCs that appear at special time nodes. This study highlighted that the security management of HATCs should focus on systematization, differentiation, and precision management., Competing Interests: The authors have declared that no competing interests exist

Background: Depression is a serious and common psychiatric disorder generally affecting more women than men. A woman's risk of developing depression increases steadily with age, and higher incidence is associated with the onset of menopause. Here we evaluated the antidepressant properties of Asparagus cochinchinensis (AC) extract and investigated its underlying mechanisms in a rat menopausal depression model., Methods: To model this menopausal depression, we induced a menopause-like state in rats via ovariectomy and exposed them to chronic unpredictable mild stress (CUMS) for 6 weeks, which promotes the development of depression-like symptoms. During the final 4 weeks of CUMS, rats were treated with either AC extract (1000 or 2000 mg/kg, PO), which has been reported to provide antidepressant effects, or with the tricyclic antidepressant imipramine (10 mg/kg, IP)., Results: We report that CUMS promotes depression-like behavior and significantly increases serum corticosterone and inflammatory cytokine levels in the serum of ovariectomized (OVX) rats. We also found that CUMS decreases the expression of brain-derived neurotrophic factor (BDNF) and its primary receptor, tropomyosin receptor kinase B (TrkB), in OVX rats, and treatment with AC extract rescues both BDNF and TrkB expression levels., Conclusion: These results suggest that AC extract exerts antidepressant effects, possibly via modulation of the BDNF-TrkB pathway, in a rat model of menopausal depression.

Short-chain chlorinated paraffin (SCCP) concentrations in 419 food samples (from 59 species) from Republic of Korea were determined. The SCCP concentrations and lipid contents in whole foods positively correlated and the highest SCCP concentration (891 ng/g wet weight) was observed in fats and oils. The SCCP concentrations were higher in benthic fish/shellfish and demersal fish than other fish and shellfish. The SCCP concentrations were higher in duck meat and eggs than meat and eggs of other species. The chlorine-based congener group patterns were related to the lipid contents of the foods. SCCPs in eggs (high lipid content) were dominated by more-chlorinated SCCPs (particularly Cl 8 -SCCPs, which contributed 43% of the total) but SCCPs in seaweed (low lipid content) were dominated by less-chlorinated SCCPs (particularly Cl 6 -SCCPs, which contributed 46%). Dietary SCCP intakes were calculated using the median SCCP concentrations and estimated 888 and 781 ng/kg/d for male and female Korean adults, respectively. The predominant contributing foods to SCCP dietary exposure differed according to sex and age. Dairy products contributed most (about 50%) for infants/children (1-5 y old), but meat and dairy products contributed most for adult males and females, respectively. Grain contributed most for ≥65 y old., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Although postoperative chylothorax following congenital heart surgery occurs rarely, it is associated with substantial morbidity and mortality. The incidence of postoperative chylothorax has been reported as 2% to 5%. Therefore, we aimed to evaluate the incidence of postoperative chylothorax at our center and compared our results with those of other studies., Methods: Between January 2009 and December 2018, there were 2,515 congenital heart repair surgeries performed at our center. Thirty-six patients with postoperative chylothorax were enrolled in this study, and their medical records retrospectively were reviewed. We calculated the overall and surgery-specific incidences. We compared the data of the medical management group with those of the surgical management group., Results: The overall incidence of postoperative chylothorax was 1.4%. The incidence was highest for patients who underwent vascular ring repair (3/32). Moreover, the incidence was higher for single ventricle-related procedure than bi-ventricle-related procedures (5.6% versus 1.0%, P < .0001). Chylothorax was predominantly found on the left side (20/36). Among these cases, six patients died; three of these six were in the surgical management group., Conclusions: The postoperative chylothorax incidence at our center was comparable to those of other centers. However, a reasonable protocol for postoperative chylothorax management to improve outcomes is necessary.

In December 2019, numerous coronavirus disease 2019 (COVID-19) cases were reported in Wuhan, China, which has since spread throughout the world. However, its impact on rheumatoid arthritis (RA) patients is unknown. Herein, we report a case of COVID-19 pneumonia in a 61-year-old female RA patient who was receiving conventional disease-modifying antirheumatic drugs (cDMARDs). The patient presented with a 4-day history of myalgia and febrile sensation. COVID-19 was confirmed by real-time polymerase chain reaction (PCR). Chest X-ray showed increased opacity on the right lower lung area, and C-reactive protein level was slightly elevated. The patient was treated with antiviral agents (lopinavir/ritonavir), and treatment with cDMARDs was discontinued except hydroxychloroquine. Her symptoms and laboratory results gradually improved. Three weeks later, real-time PCR for COVID-19 showed negative conversion, and the patient was discharged without any complications.

Introduction: The zinc finger homeobox 4 (ZFHX4) protein is a crucial molecular regulator of tumor-initiating stem cell-like functions. Objective: This study aimed to determine the role of ZFHX4 in the progression of ovarian serous cystadenocarcinoma (OSC). Methods: Differential gene expression ZFHX4 among low-stage (stages I and II), high-stage (stages III and IV), low-grade (grades I and II), and high-grade (grades III and IV) OSC patients was identified using four independent cohorts from the Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO). We compared ZFHX4 expression as a prognostic factor using Kaplan-Meier survival curves, multivariate analysis, the time-dependent area under the curve (AUC) of Uno's C-index, and the AUC of the receiver operating characteristics at 4 years post diagnosis. Results: ZFHX4 gene expression in high-stage tumors is significantly higher than in low-stage tumors (TCGA, p  = 0.007; GSE9891, p  = 0.001). A Kaplan-Meier analysis revealed that elevated expression of ZFHX4 was associated with a poor prognosis in OSC patients for all cohorts, regardless of stage and grade (TCGA, p  = 1e-04; GSE9891, p  = 0.0044; GSE13876, p  = 0.00078; GSE26712, p  = 0.039). Analysis of C-indices and the area under the receiver operating characteristic curve further supported this result (C-index: TCGA, 0.599; GSE9891, 0.642; GSE13876, 0.585; GSE26712, 0.597). Moreover, univariate and multivariate Cox hazards analyses confirmed the prognostic significance of ZFHX4 levels. Conclusion: Collectively, these findings suggest that ZFHX4 is a prognostic factor for OSC.

Background: Several studies on clinical practice for Duchenne muscular dystrophy (DMD) have been conducted in Western countries. However, there have been only a few similar studies in Asia and Oceania. Here, we investigate the steroid therapy-related clinical practice for DMD among the local experts. In 2015, we conducted a DMD expert survey in Asia and Oceania to acquire information regarding patients with DMD and to assess current clinical practice with the cooperation of Asian and Oceanian Myology Centre, a neuromuscular disease research network., Results: We obtained survey responses from 87 out of 148 clinicians (62%) from 13 countries and regions. In China, 1385 DMD patients were followed-up by 5 respondent neurologists, and 84% were between 0 and 9 years of age (15% were 10-19 years, 1% > 19 years). While in Japan, 1032 patients were followed-up by 20 clinicians, and the age distribution was similar between the 3 groups (27% were 0-9 years, 35% were 10-19 years, 38% were >19 years). Most respondent clinicians (91%) were aware of DMD standard of care recommendations. Daily prednisolone/prednisone administration was used most frequently at initiation (N = 45, 64%). Inconsistent opinion on steroid therapy after loss of ambulation and medication for bone protection was observed., Conclusions: Rare disease research infrastructures have been underdeveloped in many of Asian and Oceanian countries. In this situation, our results show the snapshots of current medical situation and clinical practice in DMD. For further epidemiological studies, expansion of DMD registries is necessary., (Copyright © 2020 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Total suspended particulate matter (TSP) was collected during the summer and winter in five cities in China (Shenyang, Beijing, and Shanghai), Russia (Vladivostok), and Korea (Busan) from 1997 to 2014. Nine polycyclic aromatic hydrocarbons (PAHs) with four to six rings, including pyrene (Pyr) and benzo[ a ]pyrene (BaP), were determined using high-performance liquid chromatography with fluorescence detection. Two nitropolycyclic aromatic hydrocarbons (NPAHs), 1-nitropyrene (1-NP) and 6-nitrobenzo[ a ]pyrene (6-NBaP), were also determined using high-performance liquid chromatography with online reduction/chemiluminescence detection. Two Chinese cities, Beijing and Shenyang, showed very high concentrations of total PAHs (ΣPAH) and total NPAHs (ΣNPAH) with a large seasonal difference (winter > summer), although the concentrations decreased over time. In both cities, maximum mean concentrations of ΣPAH over 200 ng m -3 were observed in the winter. In Beijing, an increase in the ΣPAH concentration was observed in the winter of 2010, which was after the 2008 Beijing Olympic Games. The [1-NP]/[Pyr] ratio, a diagnostic parameter for source, was smaller in the winter than in the summer over the monitoring period, suggesting a large contribution of coal heating systems in the winter. In Vladivostok, concentrations of ΣPAH and ΣNPAH were lower than in the above two Chinese cities. The [1-NP]/[Pyr] ratio was larger than in the above Chinese cities even in the winter, suggesting that the contribution of coal combustion facilities, such as power plants for heating, was not very large. In Shanghai and Busan, concentrations of ΣPAH and ΣNPAH were much lower than in the above three cities. At the beginning of the monitoring periods, the [1-NP]/[Pyr] ratios, which were as large as those of Japanese commercial cities, suggested a large contribution from automobiles. After that, the contribution of automobiles decreased gradually. However, BaP concentrations were still over 1 ng m -3 in all cities monitored in China, Russia, and Korea, suggesting that the urban air pollution of PAHs and NPAHs in these regions should not be ignored., Competing Interests: The authors declare no conflict of interest.

Objective: To evaluate the efficacy and safety of tadalafil in Asian men with both lower urinary tract symptoms associated with benign prostatic hyperplasia and erectile dysfunction., Methods: The present phase 3, randomized, double-blind, parallel, placebo- and tamsulosin-controlled study was carried out at 40 study centers in the Asia-Pacific region (mainland China, Taiwan and Korea; NCT01937871). Participants were randomized to receive a placebo (n = 361), tadalafil 5 mg (n = 362) or tamsulosin 0.2 mg (n = 185) in a 2:2:1 ratio for 12 weeks., Results: A total of 909 Asian men were randomized into three groups. After 12 weeks of treatment, a statistically significant improvement in least squares mean change from baseline in total International Prostate Symptom Score was observed in the tadalafil versus the placebo group (-5.49 vs -4.08, respectively; P < 0.001). A statistically significant improvement in the change from baseline for the International Index of Erectile Function-Erectile Function domain score, was observed in tadalafil compared with the placebo at 12 weeks (5.24 vs 1.88, respectively; P < 0.001). A significant improvement was observed in the change from baseline in the percentage of "Yes" responses to Sexual Encounter Profile questions 2 and 3 in the tadalafil versus placebo group at 12 weeks (23.87% vs 10.90%; P < 0.001 and 36.62% vs 15.96%; P < 0.001, respectively). Safety results were consistent with the known tadalafil safety profile., Conclusions: Tadalafil is efficacious and well tolerated in the treatment of Asian men with both lower urinary tract symptoms associated with benign prostatic hyperplasia and erectile dysfunction., (© 2018 The Japanese Urological Association.)

Objectives: An Asia-Pacific regional collaboration group conducted its first multi-country research project to determine whether or not European quality indicators (QIs) for psychosocial care in dementia could be implemented as a valid tool in residential aged care across seven Asia-Pacific sites (Australia, Hong Kong Special Administrative Region, Mainland China, Malaysia, Singapore, South Korea, and Thailand)., Method: Following the European QI protocol, auditing and data extraction of medical records of consenting residents with dementia were conducted by trained auditors with relevant health care backgrounds. Detailed field notes by the auditors were also obtained to describe the characteristics of the participating care facilities, as well as key issues and challenges encountered, for each of the 12 QIs., Results: Sixteen residential care facilities in the seven Asia-Pacific sites participated in this study. Data from 275 residents' records revealed each of the 12 Qis' endorsement varied widely within and between the study sites (0%-100%). Quality of the medical records, family and cultural differences, definitions and scoring of certain indicators, and time-consuming nature of the QI administration were main concerns for implementation., Conclusion: Several items in the European QIs in the current format were deemed problematic when used to measure the quality of psychosocial care in the residential aged care settings in participating Asia-Pacific countries. We propose refinements of the European QIs for the Asian-Pacific context, taking into account multiple factors identified in this study. Our findings provide crucial insights for future research and implementation of psychosocial dementia care QIs in this region.

Background: CTX-M-55 extended-spectrum beta-lactamases are being rapidly disseminated and transmitted in clinical practices around the world. The genetic contexts of the transferable plasmid-mediated bla CTX-M-55 gene in Enterobacteriaceae were detected and characterized in this study., Methods: Isolates were obtained from the First Affiliated Hospital of Zhengzhou University between September 2015 and March 2016. Based on polymerase chain reaction and BLAST analysis, resistance genes and genetic context of the bla CTX-M-55 gene were investigated. Conjugation experiments and multilocus sequence typing were performed to demonstrate plasmid-mediated bla CTX-M-55 transmission., Results: Thirteen bla CTX-M-55 -positive isolates of Enterobacteriaceae were obtained. Seven isolates were Escherichia coli, 3 were Klebsiella pneumoniae, 1 was Citrobacter freundii, 1 was Morganella morganii and 1 was Serratia marcescens. The bla CTX-M-55 gene has not previously been identified from C. freundii and M. morganii. Four different bla CTX-M-55 genetic contexts were identified, and all of them harbored ISEcp1 in the region upstream of bla CTX-M-55 (in two cases, ISEcp1 was truncated by IS26, and in one case, it was truncated by IS1294), whereas ORF477 was detected downstream of the bla CTX-M-55 gene from 12 of 13 strains. The novel genetic context of ISEcp1∆-bla CTX-M-55 -∆IS903 was firstly detected the IS903 element which was identified downstream of bla CTX-M-55 . A conjugation assay revealed that all bla CTX-M-55 plasmids were quickly and easily transferable to recipient E. coli, which then presented resistance to multiple antibiotics., Conclusions: Numerous bla CTX-M-55 -positive strains were isolated in a short period of 7 months. The findings indicate that bla CTX-M-55 was rapidly disseminated. The genetic context and conjugative transfer found in this study demonstrate that there is active transmission of bla CTX-M-55 among strains of Enterobacteriaceae in China, which could give rise to an urgent global public health threat.

Background: Mucopolysaccharidosis I (MPS I) is an autosomal recessive lysosomal storage disorder caused by a lack of the lysosomal enzyme α-L-iduronidase (IDUA). To date, more than 200 IDUA mutations have been reported. However, only a few types of mutations are recurrent and the frequencies of mutations differ from country to country., Methods: We performed the IDUA mutation analysis in seven patients who were biochemically diagnosed with MPS I in the Department of Pediatrics, Samsung Medical Center, from 2009 to 2014. Here, we describe the results of the IDUA mutation analysis in seven patients with MPS I and the IDUA mutational spectrum in Korean patients with MPS I, including previous data., Results: The IDUA mutations were found in all 14 alleles of 7 patients, and 11 kinds of IDUA mutations were identified. The detected mutations were five missense mutations (p.A79V, p.L346R, p.T388K, p.P496R, and p.C577Y), two nonsense mutations (p.Y618* and p.R628*), two deletions (c.683delC and c.1591delC), one splice site mutation (c.972+1G>A), and one duplication (c.613&#95;617dup). Among these, p.T388K, p.C577Y, c.683delC, c.1591delC, and c.972+1G>A were novel mutations that have not previously been reported. After taking everything into consideration, including IDUA mutation analysis of the previously reported 10 unrelated Korean patients with MPS I, p.L346R and c.704ins5 were most commonly found in Korean patients with MPS I. However, p.W402* and p.Q70*, which have mainly been found in Caucasian patients, were not found., Conclusion: As a result, p.L346R and c.704ins5, which were the most common in Korea, which is geographically situated midway between China and Japan, were some of the most common mutations in China and Japan, respectively. These results are especially worthy of notice.

Background and Aim: Approximately one-third of patients with hepatitis C virus (HCV) genotype (GT) 1 infection live in East Asia. This study evaluated the efficacy, pharmacokinetics, safety, and tolerability of simeprevir plus peginterferon alpha-2a and ribavirin (PR) in HCV GT1-infected, treatment-naïve, Asian patients with compensated liver disease., Methods: This phase III, randomized study (NCT01725529) was conducted in China and South Korea. Patients received simeprevir 150 mg once daily (QD), simeprevir 100 mg QD, or placebo, in combination with PR for 12 weeks. Patients in the simeprevir groups received PR alone for a further 12 or 36 weeks based on response-guided treatment criteria. Patients in the placebo group received a further 36 weeks of PR alone. The primary efficacy endpoint was sustained virologic response 12 weeks after planned end of treatment (SVR12). Secondary endpoints were safety, pharmacokinetics, tolerability, and patient-reported outcomes., Results: Overall, 457 patients were treated; the majority had GT1b infection (452/457 [99%]) and IL28B CC GT (364/457 [80%]). Of the 454 patients who had liver biopsy, 26 had cirrhosis (6%). SVR12 rates were superior for both the simeprevir 100 mg (89%; P = 0.003) and 150 mg (91%; P < 0.001) groups versus placebo (76%). Adverse events were mainly grade 1/2 and occurred at a similar incidence across all treatment groups. Overall, eight patients (2%) discontinued simeprevir or placebo treatment because of adverse events., Conclusions: Both simeprevir (100 mg and 150 mg QD) plus PR achieved superiority in SVR12 versus placebo plus PR in treatment-naïve, HCV GT1-infected, Asian patients and were well tolerated., (© 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Purpose: High mobility group box 1 (HMGB1) plays a central role in the pathogenesis of sepsis and multiple organ dysfunction syndromes. We investigated the associations of a single nucleotide polymorphism (SNP; rs1045411) in HMGB1 with various clinical parameters, severity, and prognosis in patients with sepsis, severe sepsis, or septic shock., Materials and Methods: We enrolled 212 adult patients followed for 28 days. All patients were genotyped for rs1045411, and the serum levels of HMGB1 and several cytokines were measured., Results: The proportions of patients according to genotype were GG (71.2%), GA (26.4%), and AA (2.4%). Among patients with chronic lung disease comorbidity, patients with a variant A allele had higher positive blood culture rates and higher levels of various cytokines [interleukin (IL)-1β, IL-6, IL-10, IL-17, and tumor necrosis factor-α] than those with the GG genotype. In the analysis of those with diabetes as a comorbidity, patients with a variant A allele had higher blood culture and Gram-negative culture rates than those with GG genotypes; these patients also had a higher levels of IL-17. In the analysis of those with sepsis caused by a respiratory tract infection, patients with a variant A allele had higher levels of IL-10 and IL-17 (all p<0.05). This polymorphism had no significant impact on patient survival., Conclusion: The variant A allele of rs1045411 appears to be associated with a more severe inflammatory response than the GG genotype under specific conditions.

The purpose of this study was to compare the effects of Korean mindfulness-based stress reduction (K-MBSR), walking, and patient education regarding diabetes mellitus (DM) on stress response, glycemic control, and vascular inflammation in patients with diabetes mellitus. A cluster randomized trial including 56 adults with diabetes mellitus (K-MBSR group = 21, walking group = 18, patient education group = 17) was conducted between 13 July and 14 September 2012. The questionnaire included the Diabetes Distress Scale and Perceived Stress Response Inventory. Fasting blood samples were used to measure levels of cortisol, blood glucose, plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (t-PA). There were no statistically significant differences between the effects of K-MBSR, walking, and patient education on stress, glycemic control, or vascular inflammation. However, in the K-MBSR and walking groups, significant reductions in the levels of serum cortisol and PAI-1 were observed. A significant reduction in psychological responses to stress was observed in the walking and patient education groups. Longitudinal studies could provide better insight into the impact of K-MBSR, walking, and patient education on health outcomes in adults with diabetes mellitus., (© 2015 Wiley Publishing Asia Pty Ltd.)

Background: The purpose of this study was to assess the efficacy, safety, and pharmacokinetics of cisplatin-based chemotherapy plus cetuximab as first-line treatment in Chinese and Korean patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN)., Methods: Patients (n = 68) received cetuximab weekly plus 3-week cycles of cisplatin/5-fluorouracil (5-FU) chemotherapy for up to 6 cycles. The primary endpoint was overall response rate., Results: The overall response rate was 55.9%, including 2 complete responses (CRs). Median overall survival (OS) was 12.6 months and median progression-free survival (PFS) was 6.6 months. Grade 3/4 adverse events (AEs) were reported in 41 (60.3%) patients. The safety profile was in line with previous clinical experience. The pharmacokinetic profile was in line with that observed with cetuximab in white and Japanese patients., Conclusion: The efficacy, safety, and pharmacokinetic findings from this study support the use of first-line platinum-based chemotherapy plus cetuximab in Chinese and Korean patients with recurrent and/or metastatic SCCHN (ClinicalTrials.gov NCT01177956)., (© 2014 Wiley Periodicals, Inc.)

Aim: To investigate the efficacy of premedication with pronase, a proteolytic enzyme, in improving image quality during magnifying endoscopy., Methods: The study was of a blinded, randomized, prospective design. Patients were assigned to groups administered oral premedication of either pronase and simethicone (Group A) or simethicone alone (Group B). First, the gastric mucosal visibility grade (1-4) was determined during conventional endoscopy, and then a magnifying endoscopic examination was conducted. The quality of images obtained by magnifying endoscopy at the stomach and the esophagus was scored from 1 to 3, with a lower score indicating better visibility. The endoscopist used water flushes as needed to obtain satisfactory magnifying endoscopic views. The main study outcomes were the visibility scores during magnifying endoscopy and the number of water flushes., Results: A total of 144 patients were enrolled, and data from 143 patients (M:F=90:53, mean age 57.5 years) were analyzed. The visibility score was significantly higher in the stomach following premedication with pronase (73% with a score of 1 in Group A vs 49% in Group B, P<0.05), but there was no difference in the esophagus visibility scores (67% with a score of 1 in Group A vs 58% in Group B). Fewer water flushes [mean 0.7±0.9 times (range: 0-3 times) in Group A vs 1.9±1.5 times (range: 0-6 times) in Group B, P<0.05] in the pronase premedication group did not affect the endoscopic procedure times [mean 766 s (range: 647-866 s) for Group A vs 760 s (range: 678-854 s) for Group B, P=0.88]. The total gastric mucosal visibility score was also lower in Group A (4.9±1.5 vs 8.3±1.8 in Group B, P<0.01)., Conclusion: The addition of pronase to simethicone premedication resulted in clearer images during magnifying endoscopy and reduced the need for water flushes.

The isoflavone diversity (44 varieties) of the soybean, Glycine max (L.) Merrill, from China, Japan, and Korea was examined by high-performance liquid chromatography. The profiles of 12 isoflavones identified from the grains were subjected to data-mining processes, including partial least-squares discriminant analysis (PLS-DA), Pearson's correlation analysis, and hierarchical clustering analysis (HCA). Although PLS-DA did not reveal significant differences among extracts of soybean from 3 countries, the results clearly show that the variation between varieties was low. The CS02554 variety was separate from the others in the first 2 principal components of PLS-DA. HCA of these phytochemicals resulted in clusters derived from closely related biochemical pathways. Daidzin, genistin, and glycitin contents were significantly correlated with their respective malonyl glycoside contents. Daidzein content correlated positively with genistein content (r=0.8189, P<0.0001). The CS02554 variety appears to be a good candidate for future breeding programs, as it contains high levels of isoflavone compounds. These results demonstrate the use of metabolite profiling combined with chemometrics as a tool for assessing the quality of food and identifying metabolic links in biological systems., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

In response to increasing trends in sulfur deposition in Northeast Asia, three countries in the region (China, Japan, and Korea) agreed to devise abatement strategies. The concepts of critical loads and source-receptor (S-R) relationships provide guidance for formulating such strategies. Based on the Long-range Transboundary Air Pollutants in Northeast Asia (LTP) project, this study analyzes sulfur deposition data in order to optimize acidic loads over the three countries. The three groups involved in this study carried out a full year (2002) of sulfur deposition modeling over the geographic region spanning the three countries, using three air quality models: MM5-CMAQ, MM5-RAQM, and RAMS-CADM, employed by Chinese, Japanese, and Korean modeling groups, respectively. Each model employed its own meteorological numerical model and model parameters. Only the emission rates for SO(2) and NO(x) obtained from the LTP project were the common parameter used in the three models. Three models revealed some bias from dry to wet deposition, particularly the latter because of the bias in annual precipitation. This finding points to the need for further sensitivity tests of the wet removal rates in association with underlying cloud-precipitation physics and parameterizations. Despite this bias, the annual total (dry plus wet) sulfur deposition predicted by the models were surprisingly very similar. The ensemble average annual total deposition was 7,203.6 ± 370 kt S with a minimal mean fractional error (MFE) of 8.95 ± 5.24 % and a pattern correlation (PC) of 0.89-0.93 between the models. This exercise revealed that despite rather poor error scores in comparison with observations, these consistent total deposition values across the three models, based on LTP group's input data assumptions, suggest a plausible S-R relationship that can be applied to the next task of designing cost-effective emission abatement strategies.

Growth hormone receptor gene (GHR) is one of the likely candidates for determining morphological traits, because GH is a key regulator of bone growth. The genetic association of GHR in exon 10 with mandibular ramus height has been found in different populations, Japanese and Chinese. On the other hand, two common isoforms of GHR, one full-length (fl-GHR) and the other lacking the extracellular domain encoded by exon 3 (d3-GHR), are associated with differences in responsiveness to GH. The purpose of this study involving 159 Korean subjects was to study the associations between a GHR polymorphism (d3/fl-GHR) that results in genomic deletion of exon 3 and craniofacial morphology, and to study the associations between GHR genotypes in exon 10 and craniofacial morphology. Moreover, the allelic frequencies in a multi-ethnic population (24 Han Chinese, 24 African-Americans, 24 European-Americans, and 24 Hispanics) in a GHR polymorphism (d3/fl-GHR) were compared in this study. The five craniofacial linear measurements (cranial base length, maxillary length, overall mandibular length, mandibular corpus length, and mandibular ramus height) obtained from lateral cephalograms were examined as craniofacial morphology. We found that the d3/fl-GHR polymorphism had no association for any measurements, and a statistically significant association (P=0.024) between the GHR polymorphisms P561T and C422F in exon 10 and mandibular ramus height. Neither SNPs besides P561T and C422F polymorphisms in exon 10 nor the measurements besides mandibular ramus height have statistically significances. Both derived alleles at P561T and C422F SNPs were highly associated with only one haplotype, haplotype-4 in Korean population. As quantitative haplotype association, the results showed a significant difference in mandibular ramus height between individuals having one haplotype-4 and others without haplotype-4 (P=0.028). Moreover, we found that the d3/fl-GHR polymorphism showed diverse frequency in different population. Regarding GHR genotypes in exon 10, the present study mostly reflected the results obtained for a Japanese population, although our current study does not replicate the correlation between the I526L polymorphism of GHR and mandibular ramus height as was reported in a previous study of Han Chinese. The results of the present study suggest that the GHR exon 10 SNPs, not d3/fl-GHR, contribute to changes in the mandibular ramus height of Koreans.