The Global Energy and Water Exchanges(GEWEX)Project in Central Asia:The Case for a Regional Hydroclimate Project

Central Asia consists of the former Soviet Republics,Kazakhstan,Kyrgyz Republic,Tajikistan,Turkmenistan,and Uzbekistan.The region’s climate is continental,mostly semi-arid to arid.Agriculture is a significant part of the region’s economy.By its nature of intensive water use,agriculture is extremely vulnerable to climate change.Population growth and irrigation development have significantly increased the demand for water in the region.Major climate change issues include melting glaciers and a shrinking snowpack,which are the foundation of the region’s water resources,and a changing precipitation regime.Most glaciers are located in Kyrgyzstan and Tajikistan,leading to transboundary water resource issues.Summer already has extremely high temperatures.Analyses indicate that Central Asia has been warming and precipitation might be increasing.The warming is expected to increase,but its spatial and temporal distribution depends upon specific global scenarios.Projections of future precipitation show significant uncertainties in type,amount,and distribution.Regional Hydroclimate Projects(RHPs)are an approach to studying these issues.Initial steps to develop an RHP began in 2021 with a widely distributed online survey about these climate issues.It was followed up with an online workshop and then,in 2023,an in-person workshop,held in Tashkent,Uzbekistan.Priorities for the Global Energy and Water Exchanges(GEWEX)project for the region include both observations and modeling,as well as development of better and additional precipitation observations,all of which are topics for the next workshop.A well-designed RHP should lead to reductions in critical climate uncertainties in policy-relevant timeframes that can influence decisions on necessary investments in climate adaptation.

Central Asia revealed as a key area in evolution of Eremurus (Asphodelaceae)

Eremurus was described at the beginning of the 19th century.However,due to limited sampling and the small number of gene markers to date,its phylogeny and evolution are largely unknown.In this study,we analyzed plastomes from 27 species belonging to 2 subgenera and 3 sections of Eremurus,which are found in Central Asia(its center of diversity)and China.We also analyzed nuclear DNA ITS of 33 species,encompassing all subgenera and sections of the genus in Central Asia,southwest Asia and China.Our findings revealed that the genus was monophyletic,although both subgenera Eremurus and Henningia were found to be paraphyletic.Both plastome and nrDNA-based phylogenetic trees had three clades that did not reflect the current taxonomy of the genus.Our biogeographical and time-calibrated trees suggest that Eremurus originated in the ancient Tethyan area in the second half of the Eocene.Diversification of Eremurus occurred from the early Oligocene to the late Miocene.Paratethys Sea retreat and several orogenetic events,such as the progressive uplift of the Qinghai-Tibet Plateau and surrounding mountain belts(Altai,Pamir,Tian Shan),caused serious topographic and climate(aridification)changes in Central Asia that may have triggered a split of clades and speciation.In this transformed Central Asia,speciation proceeded rapidly driven mainly by vicariance caused by numerous mountain chains and specialization to a variety of climatic,topographic and soil conditions that exist in this region.

Leading Pattern of Spring Drought Variability over East Asia and Associated Drivers

Drought events have become more frequent and intense over East Asia in recent decades,leading to huge socioeconomic impacts.Although the droughts have been studied extensively by cases or for individual regions,their leading variability and associated causes remain unclear.Based on the Standardized Precipitation Evapotranspiration Index(SPEI)and ERA5 reanalysis product from 1979 to 2020,this study evealuates the severity of spring droughts in East Asia and investigates their variations and associated drivers.The results indicate that North China and Mongolia have experienced remarkable trends toward dryness during spring in recent decades,while southwestern China has witnessed an opposite trend toward wetness.The first Empirical Orthogonal Function mode of SPEI variability reveals a similar seesawing pattern,with more severe dryness in northwestern China,Mongolia,North China,South Korea,and Japan but increased wetness in Southwestern China and southeast Asia.Further investigation reveals that the anomalously dry(wet)surface in North(Southwestern)China is significantly associated with anomalously high(low)temperature,less(more)precipitation,and reduced(increased)soil moisture during the previous winter and early spring,regulated by an anomalous anticyclone(cyclone)and thus reduced(increased)water vapor convergence.The spring dry-wet pattern in East Asia is also linked to cold sea surface temperature anomalies in the central-eastern Pacific.The findings of this study have important implications for improving the prediction of spring drought events in East Asia.

The Unprecedented Extreme Anticyclonic Anomaly over Northeast Asia in July 2021 and Its Climatic Impacts

This study investigates the evolution of an extreme anomalous anticyclone(AA)event over Northeast Asia,which was one of the dominant circulation systems responsible for the catastrophic extreme precipitation event in July 2021 in Henan,and further explores the significant impact of this AA on surface temperatures beneath it.The results indicate that this AA event over Northeast Asia was unprecedented in terms of intensity and duration.The AA was very persistent and extremely strong for 10 consecutive days from 13 to 22 July 2021.This long-lived and unprecedented AA led to the persistence of warmer surface temperatures beyond the temporal span of the pronounced 500-hPa anticyclonic signature as the surface air temperatures over land in Northeast Asia remained extremely warm through 29 July 2021.Moreover,the sea surface temperatures in the Sea of Japan/East Sea were extremely high for 30 consecutive days from 13 July to 11 August 2021,persisting well after the weakening or departure of this AA.These results emphasize the extreme nature of this AA over Northeast Asia in July 2021 and its role in multiple extreme climate events,even over remote regions.Furthermore,possible reasons for this long-lasting AA are explored,and it is suggested to be a byproduct of a teleconnection pattern over extratropical Eurasia during the first half of its life cycle,and of the Pacific-Japan teleconnection pattern during the latter half.

Deep structure of the Southeast Asian curved subduction system and its dynamic process

The deep structure,material circulation,and dynamic processes in the Southeast Asia have long been an elusive scientific puzzle due to the lack of systematic scientific observations and recognized theoretical models.Based on the deep seismic tomography using long-period natural earthquake data,in this study,the deep structure and material circulation of the curved subduction system in Southeast Asia was studied,and the dynamic processes since 100 million years ago was reconstructed.It is pointed out that challenges still exist in the precise reconstruction of deep mantle structures of the study area,the influence of multi-stage subduction on deep material exchange and shallow magma activity,as well as the spatiotemporal evolution and coupling mechanism of multi-plate convergence.Future work should focus on high-resolution land-sea joint 3-D seismic tomography imaging of the curved subduction system in the Southeast Asia,combined with geochemical analysis and geodynamic modelling works.

Performance validation of High Mountain Asia 8-meter Digital Elevation Model using ICESat-2 geolocated photons

High Mountain Asia(HMA),recognized as a third pole,needs regular and intense studies as it is susceptible to climate change.An accurate and high-resolution Digital Elevation Model(DEM)for this region enables us to analyze it in a 3D environment and understand its intricate role as the Water Tower of Asia.The science teams of NASA realized an 8-m DEM using satellite stereo imagery for HMA,termed HMA 8-m DEM.In this research,we assessed the vertical accuracy of HMA 8-m DEM using reference elevations from ICESat-2 geolocated photons at three test sites of varied topography and land covers.Inferences were made from statistical quantifiers and elevation profiles.For the world’s highest mountain,Mount Everest,and its surroundings,Root Mean Squared Error(RMSE)and Mean Absolute Error(MAE)resulted in 1.94 m and 1.66 m,respectively;however,a uniform positive bias observed in the elevation profiles indicates the seasonal snow cover change will dent the accurate estimation of the elevation in this sort of test sites.The second test site containing gentle slopes with forest patches has exhibited the Digital Surface Model(DSM)features with RMSE and MAE of 0.58 m and 0.52 m,respectively.The third test site,situated in the Zanda County of the Qinghai-Tibet,is a relatively flat terrain bed,mostly bare earth with sudden river cuts,and has minimal errors with RMSE and MAE of 0.32 m and 0.29 m,respectively,and with a negligible bias.Additionally,in one more test site,the feasibility of detecting the glacial lakes was tested,which resulted in exhibiting a flat surface over the surface of the lakes,indicating the potential of HMA 8-m DEM for deriving the hydrological parameters.The results accrued in this investigation confirm that the HMA 8-m DEM has the best vertical accuracy and should be of high use for analyzing natural hazards and monitoring glacier surfaces.

IMpower210:A phase Ⅲ study of second-line atezolizumab vs. docetaxel in East Asian patients with non-small cell lung cancer

Objective: IMpower210(NCT02813785) explored the efficacy and safety of single-agent atezolizumab vs.docetaxel as second-line treatment for advanced non-small cell lung cancer(NSCLC) in East Asian patients.Methods: Key eligibility criteria for this phase Ⅲ, open-label, randomized study included age ≥18 years;histologically documented advanced NSCLC per the Union for International Cancer Control/American Joint Committee on Cancer staging system(7th edition);Eastern Cooperative Oncology Group performance status of 0 or 1;and disease progression following platinum-based chemotherapy for advanced or metastatic NSCLC. Patients were randomized 2:1 to receive either atezolizumab(1,200 mg) or docetaxel(75 mg/m^(2)). The primary study endpoint was overall survival(OS) in the intention-to-treat(ITT) population with wild-type epidermal growth factor receptor expression(ITT EGFR-WT) and in the overall ITT population.Results: Median OS in the ITT EGFR-WT population(n=467) was 12.3 [95% confidence interval(95% CI),10.3-13.8] months in the atezolizumab arm(n=312) and 9.9(95% CI, 7.8-13.9) months in the docetaxel arm[n=155;stratified hazard ratio(HR), 0.82;95% CI, 0.66-1.03]. Median OS in the overall ITT population was 12.5(95% CI, 10.8-13.8) months with atezolizumab treatment and 11.1(95% CI, 8.4-14.2) months(n=377) with docetaxel treatment(n=188;stratified HR, 0.87;95% CI, 0.71-1.08). Grade 3/4 treatment-related adverse events(TRAEs) occurred in 18.4% of patients in the atezolizumab arm and 50.0% of patients in the docetaxel arm.Conclusions: IMpower210 did not meet its primary efficacy endpoint of OS in the ITT EGFR-WT or overall ITT populations. Atezolizumab was comparatively more tolerable than docetaxel, with a lower incidence of grade3/4 TRAEs.

Linkage Between European and East Asian Heatwaves on Synoptic Scales

Concurrent extreme weather events in geographically distant areas potentially cause high-end risks for societies.By using network analysis,the present study managed to identify significant nearly-simultaneous occurrences of heatwaves between the grid cells in East Asia and Eastern Europe,even though they are geographically far away from each other.By further composite analysis,this study revealed that hot events first occurred in Eastern Europe,typically with a time lag of3-4 days before the East Asian heatwave events.An eastward propagating atmospheric wave train,known as the circumglobal teleconnection(CGT)pattern,bridged the sequent occurrences of extreme events in these two remote regions.Atmospheric blockings,amplified by surface warming over Eastern Europe,not only enhanced local heat extremes but also excited a CGT-like pattern characterized by alternative anomalies of high and low pressures.Subsequent downstream anticyclones in the middle and upper troposphere reduced local cloud cover and increased downward solar radiation,thereby facilitating the formation of heatwaves over East Asia.Nearly half of East Asian heatwave events were preceded by Eastern European heatwave events in the 10-day time range before East Asian heatwave events.This investigation of heatwave teleconnection in the two distant regions exhibits strong potential to improve the prediction accuracy of East Asian heatwaves.

Groundwater and environmental challenges in Asia

Asia stands out as the most populous and geographically diverse region globally.The pressing issues of water resource development and the resulting ecological impacts are exacerbated by the region's rapid population growth and economic expansion.Groundwater,a vital source of water in Asia,faces significant disparities in distribution and suffers from unsustainable exploitation practices.This study applies groundwater system theory and categorizes Asia into 11 primary groundwater systems and 36 secondary ones,based on intercontinental geological structures,climate,terrain,and hydrogeological characteristics.As of the end of 2010,Asia's assessed groundwater resources totalled 4.677×10^(9) m^(3)/a,with exploitable resources amounting to 3.274×10^(9) m^(3)/a.By considering the geological environmental impacts of groundwater development and the distinctive characteristics of terrain and landforms,six categories of effect zones with varying distribution patterns are identified.The current research on Asia's groundwater resources,environmental dynamics,and human impacts aims to provide a theoretical foundation for sustainable groundwater management and environmental conservation in the region.

North Atlantic Abrupt Climate Signals during the Last Glacial Period in Central Asia：Evidences from Aeolian Loess Sediments

Objective Climate fluctuations over suborbital or millennial timescale display significant instability during the last glacial period,which are often superimposed upon the orbital periodicity.They triggered some abrupt climate events,

Subseasonal Prediction of Early-summer Northeast Asian Cut-off Lows by BCC-CSM2-HR and GloSea5

Northeast Asian cut-off lows are crucial cyclonic systems that can bring temperature and precipitation extremes over large areas.Skillful subseasonal forecasting of Northeast Asian cut-off lows is of great importance.Using two dynamical forecasting systems,one from the Beijing Climate Center(BCC-CSM2-HR)and the other from the Met Office(GloSea5),this study assesses simulation ability and subseasonal prediction skill for early-summer Northeast Asian cut-off lows.Both models are shown to have good ability in representing the spatial structure of cut-off lows,but they underestimate the intensity.The skillful prediction time scales for cut-off low intensity are about 10.2 days for BCC-CSM2-HR and 11.4 days for GloSea5 in advance.Further examination shows that both models can essentially capture the initial Rossby wave train,rapid growth and decay processes responsible for the evolution of cut-off lows,but the models show weaker amplitudes for the three-stage processes.The underestimated simulated strength of both the Eurasian midlatitude and East Asian subtropical jets may lead to the weaker local eddy-mean flow interaction responsible for the cut-off low evolution.

The Relationship between Model Biases in East Asian Summer Monsoon Rainfall and Land Evaporation

The East Asian Summer Monsoon(EASM)provides the majority of annual rainfall to countries in East Asia.Although state-of-the-art models broadly project increased EASM rainfall,the spread of projections is large and simulations of present-day rainfall show significant climatological biases.Systematic evapotranspiration biases occur locally over East Asia,and globally over land,in simulations both with and without a coupled ocean.This study explores the relationship between evapotranspiration and EASM precipitation biases.First,idealized model simulations are presented in which the parameterization of land evaporation is modified,while sea surface temperature is fixed.The results suggest a feedback whereby excessive evapotranspiration over East Asia results in cooling of land,a weakened monsoon low,and a shift of rainfall from the Philippine Sea to China,further fueling evapotranspiration.Cross-model regressions against evapotranspiration over China indicate a similar pattern of behavior in Atmospheric Model Intercomparison Project(AMIP)simulations.Possible causes of this pattern are investigated.The feedback is not explained by an overly intense global hydrological cycle or by differences in radiative processes.Analysis of land-only simulations indicates that evapotranspiration biases are present even when models are forced with prescribed rainfall.These are strengthened when coupled to the atmosphere,suggesting a role for land-model errors in driving atmospheric biases.Coupled atmosphere-ocean models are shown to have similar evapotranspiration biases to those in AMIP over China,but different precipitation biases,including a northward shift in the ITCZ over the Pacific and Atlantic Oceans.

Interannual Meridional Displacement of the Upper-Tropospheric Westerly Jet over Western East Asia in Summer

The interannual meridional displacement of the upper-tropospheric westerly jet over the eastern portion of East Asia in summer has been well documented.This study,however,investigates the interannual meridional displacement of the westerly jet over the western portion of East Asia in summer,which is distinct from its eastern counterpart.The results show that the meridional displacement of the western East Asian jet shows a clear asymmetric feature;that is,there are remarkable differences between the southward and northward displacement of the jet.The southward displacement of the jet corresponds to suppressed convection in the tropical western North Pacific and Maritime Continent and enhanced convection in the equatorial Pacific,which can be explained by the warmer sea surfaces found in the northern Indian Ocean and equatorial eastern Pacific.These tropical anomalies somewhat resemble those associated with the eastern East Asian jet variability.However,the northward displacement of the western East Asian jet does not correspond to significant convection and SST anomalies in the entire tropics;instead,the northward displacement of the jet corresponds well to the positive phase of the Arctic Oscillation.Furthermore,the meridional displacement of the western jet has asymmetric impacts on rainfall and surface air temperatures in East Asia.When the western jet shifts northward,more precipitation is found over South China and Northeast China,and higher temperatures appear in northern China.By contrast,when the jet shifts southward,more precipitation appears over the East Asian rainy belt,including the Yangtze River valley,South Korea,and southern and central Japan and warmer temperatures are found South and Southeast Asia.

The combined effects of North Atlantic Oscillation and Western Pacific teleconnection on winter temperature in Eastern Asia during 1980−2021

As important atmospheric circulation patterns in Northern Hemisphere(NH),the North Atlantic Oscillation(NAO)and the Western Pacific teleconnection(WP)affect the winter climate in Eurasia.In order to explore the combined effects of NAO and WP on East Asian(EA)temperature,the NAO and WP indices are divided into four phases from 1980−2021:the positive NAO and WP phase(NAO+/WP+),the negative NAO and WP phase(NAO−/WP−),the positive NAO and negative WP phase(NAO+/WP−),the negative NAO and positive WP phase(NAO−/WP+).In the phase of NAO+/WP+,the low geopotential height(GH)stays in north of EA at 50°−80°N;the surface air temperature anomaly(SATA)is 0.8−1℃lower than Southern Asian.In the phase of NAO−/WP−,the center of high temperature and GH locate in the northeast of EA;the cold air spreads to Southern Asia,causing the SATA decreases 1−1.5℃.In the phase of NAO+/WP−,the high GH belt is formed at 55°−80°N.Meanwhile,the center of high SATA locates in the north of Asia that increases 0.8−1.1℃.The cold airflow causes temperature dropping 0.5−1℃in the south of EA.The SATA improves 0.5−1.5℃in south of EA in the phase of NAO−/WP+.The belt of high GH is formed at 25°−50°N,and blocks the cold air which from Siberia.The NAO and WP generate two warped plate pressure structures in NH,and affect the temperature by different pressure configurations.NAO and WP form different GH,and GH acts to block and push airflow by affecting the air pressure,then causes the temperature to be different from the north and south of EA.Finally,the multiple linear regression result shows that NAO and WP are weakened by each other such as the phase of NAO+/WP+and NAO−/WP−.

Spatiotemporal characteristics and influencing factors of ecosystem services in Central Asia

Land use/land cover(LULC)change and climate change are two major factors affecting the provision of ecosystem services which are closely related to human well-being.However,a clear understanding of the relationships between these two factors and ecosystem services in Central Asia is still lacking.This study aimed to comprehensively assess ecosystem services in Central Asia and analyze how they are impacted by changes in LULC and climate.The spatiotemporal patterns of three ecosystem services during the period of 2000-2015,namely the net primary productivity(NPP),water yield,and soil retention,were quantified and mapped by the Carnegie-Ames-Stanford Approach(CASA)model,Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST)model,and Revised Universal Soil Loss Equation(RUSLE).Scenarios were used to determine the relative importance and combined effect of LULC change and climate change on ecosystem services.Then,the relationships between climate factors(precipitation and temperature)and ecosystem services,as well as between LULC change and ecosystem services,were further discussed.The results showed that the high values of ecosystem services appeared in the southeast of Central Asia.Among the six biomes(alpine forest region(AFR),alpine meadow region(AMR),typical steppe region(TSR),desert steppe region(DSR),desert region(DR),and lake region(LR)),the values of ecosystem services followed the order of AFR>AMR>TSR>DSR>DR>LR.In addition,the values of ecosystem services fluctuated during the period of 2000-2015,with the most significant decreases observed in the southeast mountainous area and northwest of Central Asia.LULC change had a greater impact on the NPP,while climate change had a stronger influence on the water yield and soil retention.The combined LULC change and climate change exhibited a significant synergistic effect on ecosystem services in most of Central Asia.Moreover,ecosystem services were more strongly and positively correlated with precipitation than with temperature.The greening of desert areas and forest land expansion could improve ecosystem services,but unreasonable development of cropland and urbanization have had an adverse impact on ecosystem services.According to the results,ecological stability in Central Asia can be achieved through the natural vegetation protection,reasonable urbanization,and ecological agriculture development.

Projection of precipitation extremes over South Asia from CMIP6 GCMs

Extreme precipitation events are one of the most dangerous hydrometeorological disasters,often resulting in significant human and socio-economic losses worldwide.It is therefore important to use current global climate models to project future changes in precipitation extremes.The present study aims to assess the future changes in precipitation extremes over South Asia from the Coupled Model Intercomparison Project Phase 6(CMIP6)Global Climate Models(GCMs).The results were derived using the modified Mann-Kendall test,Sen's slope estimator,student's t-test,and probability density function approach.Eight extreme precipitation indices were assessed,including wet days(RR1mm),heavy precipitation days(RR10mm),very heavy precipitation days(RR20mm),severe precipitation days(RR50mm),consecutive wet days(CWD),consecutive dry days(CDD),maximum 5-day precipitation amount(RX5day),and simple daily intensity index(SDII).The future changes were estimated in two time periods for the 21^(st) century(i.e.,near future(NF;2021-2060)and far future(FF;2061-2100))under two Shared Socioeconomic Pathway(SSP)scenarios(SSP2-4.5 and SSP5-8.5).The results suggest increases in the frequency and intensity of extreme precipitation indices under the SSP5-8.5 scenario towards the end of the 21^(st) century(2061-2100).Moreover,from the results of multimodel ensemble means(MMEMs),extreme precipitation indices of RR1mm,RR10mm,RR20mm,CWD,and SDII demonstrate remarkable increases in the FF period under the SSP5-8.5 scenario.The spatial distribution of extreme precipitation indices shows intensification over the eastern part of South Asia compared to the western part.The probability density function of extreme precipitation indices suggests a frequent(intense)occurrence of precipitation extremes in the FF period under the SSP5-8.5 scenario,with values up to 35.00 d for RR1mm and 25.00-35.00 d for CWD.The potential impacts of heavy precipitation can pose serious challenges to the study area regarding flooding,soil erosion,water resource management,food security,and agriculture development.

Seasonal Prediction Skill and Biases in GloSea5 Relating to the East Asia Winter Monsoon

The simulation and prediction of the climatology and interannual variability of the East Asia winter monsoon(EAWM),as well as the associated atmospheric circulation,was investigated using the hindcast data from Global Seasonal Forecast System version 5(GloSea5),with a focus on the evolution of model bias among different forecast lead times.While GloSea5 reproduces the climatological means of large-scale circulation systems related to the EAWM well,systematic biases exist,including a cold bias for most of China’s mainland,especially for North and Northeast China.GloSea5 shows robust skill in predicting the EAWM intensity index two months ahead,which can be attributed to the performance in representing the leading modes of surface air temperature and associated background circulation.GloSea5 realistically reproduces the synergistic effect of El Niño–Southern Oscillation(ENSO)and the Arctic Oscillation(AO)on the EAWM,especially for the western North Pacific anticyclone(WNPAC).Compared with the North Pacific and North America,the representation of circulation anomalies over Eurasia is poor,especially for sea level pressure(SLP),which limits the prediction skill for surface air temperature over East Asia.The representation of SLP anomalies might be associated with the model performance in simulating the interaction between atmospheric circulations and underlying surface conditions.

Paediatric gastrointestinal endoscopy in the Asian-Pacific region:Recent advances in diagnostic and therapeutic techniques

There has been a rapid expansion in the knowledge of paediatric gastroenterology over the recent decade,with a fast-growing repertoire of diagnostic techniques and management strategies for a wide spectrum of childhood gastrointestinal(GI)diseases.Paediatric GI endoscopy is a core competency every paediatric gastroenterologist should possess,and represents one of the most common procedures performed in children for both diagnostic and therapeutic purposes.Yet there remains a dearth of literature on the utility and outcomes of paediatric GI endoscopy in the Asia-Pacific region.Data on the diagnostic value of paediatric GI endoscopy would be an important aspect of discussion,with the emergence of inflammatory bowel disease(IBD)and eosinophilic GI disease as increasingly common endoscopic diagnoses.Time-based trends in paediatric GI endoscopy do point towards more IBD and gastroesophageal reflux disease-related complications being diagnosed,with a declining incidence of GI bleeding.However,the real-world diagnostic value of endoscopy in Asia must be contextualised to the region-specific prevalence of paediatric GI diseases.Helicobacter pylori infection,particularly that of multidrug-resistant strains,remains a highly prevalent problem in specific regions.Paediatric functional GI disorders still account for the majority of childhood GI complaints in most centres,hence the diagnostic yield of endoscopy should be critically evaluated in the absence of alarm symptoms.GI therapeutic endoscopy is also occasionally required for children with ingested foreign bodies,intestinal polyposis or oesophageal strictures requiring dilation.Endoscopic haemostasis is a potentially life-saving skill in cases of massive GI bleeding typically from varices or peptic ulcers.Advanced endoscopic techniques such as capsule endoscopy and balloon-assisted enteroscopy have found traction,particularly in East Asian centres,as invaluable diagnostic and therapeutic tools in the management of IBD,obscure GI bleeding and intestinal polyposis.State of the art endoscopic diagnostics and therapeutics,including the use of artificial intelligence-aided endoscopy algorithms,real-time confocal laser endomicroscopy and peroral endoscopic myotomy,are expected to gain more utility in paediatrics.As paediatric gastroenterology matures as a subspecialty in Asia,it is essential current paediatric endoscopists and future trainees adhere to minimum practice standards,and keep abreast of the evolving trends in the diagnostic and therapeutic value of endoscopy.This review discusses the available published literature on the utility of paediatric GI endoscopy in Asia Pacific,with the relevant clinical outcomes.

Genomic analysis of indigenous goats in Southwest Asia reveals evidence of ancient adaptive introgression related to desert climate

Understanding how evolutionary pressures related to climate change have shaped the current genetic background of domestic animals is a fundamental pursuit of biology. Here, we generated wholegenome sequencing data from native goat populations in Iraq and Pakistan. Combined with previously published data on modern, ancient(Late Neolithic to Medieval periods), and wild Capra species worldwide, we explored the genetic population structure, ancestry components, and signatures of natural positive selection in native goat populations in Southwest Asia(SWA). Results revealed that the genetic structure of SWA goats was deeply influenced by gene flow from the eastern Mediterranean during the Chalcolithic period, which may reflect adaptation to gradual warming and aridity in the region. Furthermore, comparative genomic analysis revealed adaptive introgression of the KITLG locus from the Nubian ibex(C. nubiana) into African and SWA goats. The frequency of the selected allele at this locus was significantly higher among goat populations located near northeastern Africa. These results provide new insights into the genetic composition and history of goat populations in the SWA region.

Views of South Asian Physicians on Climate Related Health Effects: A Multinational Cross-Sectional Pilot Study

Background: South Asian populations are vulnerable to poor health outcomes associated with climate due to the region’s complex topography, poverty, lack of education, and population density. Physicians, being highly trusted members of society, can help mitigate climate change effects in their countries. Objectives: The present study assessed perceptions of physicians from four South Asian countries (Bangladesh, Bhutan, India, and Pakistan). We hypothesized that physicians from these countries will be aware and knowledgeable about health effects of climate change. Methods: We conducted a cross-sectional online survey of physicians between March and July 2022. Data of 201 physicians was analyzed using the Kruskal-Wallis test and Dunn’s post hoc method. Results: Physicians from four South Asian countries were attuned to the health risks associated with climate change. A majority of physicians (86.6%) believed that climate change would make health conditions in their countries more severe or frequent (Bangladesh 83.3%;Bhutan 70%;India 91% and Pakistan 90.8%). The most common health effect related to climate change was illnesses related to reduced outdoor air quality (54.3%). Common barriers to discuss climate change with patients from all four countries were physicians’ lack of knowledge (strongly agree, 13.8%;agree 47.7%) in how to approach the issue with patients, lack of time (strongly agree, 12%;agree, 48%) and their perception that patients were not interested in knowing about climate change (strongly agree, 8.6%;agree, 42.6%). More than half (56.2%) of the physicians reported no training (Bangladesh, 51.7%;Bhutan, 80%;India, 44.6%;Pakistan, 63.1%) and approximately 30% reported less than 20 hours of training (Bangladesh, 28.3%;Bhutan, 15.0%;India, 39.3%;Pakistan, 27.7%) in climate-change-related health effects. Conclusion: While additional large-scale research is needed to understand the trends observed in our pilot study, our findings identify the need to introduce interventions to improve physicians’ knowledge of the health impacts of climate crisis.