Explore the vast range of titles available.

An unprecedented cold wave intruded into East Asia in early January 2021 and led to record-breaking or historical extreme low temperatures over vast regions. This study shows that a major stratospheric sudden warming (SSW) event at the beginning of January 2021 exerted an important influence on this cold wave. The major SSW event occurred on 2 January 2021 and subsequently led to the displacement of the stratospheric polar vortex to the East Asian side. Moreover, the SSW event induced the stratospheric warming signal to propagate downward to the mid-to-lower troposphere, which not only enhanced the blocking in the Urals–Siberia region and the negative phase of the Arctic Oscillation, but also shifted the tropospheric polar vortex off the pole. The displaced tropospheric polar vortex, Ural blocking, and another downstream blocking ridge over western North America formed a distinct inverted omega-shaped circulation pattern (IOCP) in the East Asia–North Pacific sector. This IOCP was the most direct and impactful atmospheric pattern causing the cold wave in East Asia. The IOCP triggered a meridional cell with an upward branch in East Asia and a downward branch in Siberia. The meridional cell intensified the Siberian high and low-level northerly winds, which also favored the invasion of the cold wave into East Asia. Hence, the SSW event and tropospheric circulations such as the IOCP, negative phase of Arctic Oscillation, Ural blocking, enhanced Siberian high, and eastward propagation of Rossby wave eventually induced the outbreak of an unprecedented cold wave in East Asia in early January 2021.

This is an extended editors’ commentary on the topical collection “Historical and recent change in extreme climate over East Asia”, which collects a total of 15 papers related to the change and variability of extreme climate events in East Asia over the last few hundreds years. The extreme climate events are broadly classified into three categories: temperature and extreme warmth/coldness, precipitation and floods/droughts and western North Pacific typhoons. This commentary briefly summarizes the main findings presented in each paper in this topical collection, and outlines the implications of these findings for monitoring, detecting and modeling of regional climate change and for studying climate change impacts and adaptability. It also assesses the uncertainties of these studies, as well as the remaining knowledge gaps that should be filled in the future. One solid conclusion we can draw from these studies is that there was a marked decadal to multi-decadal variability of extreme climate events in East Asia in recent history, and the extreme events as observed during the last decades of the instrumental era were still within the range of natural variability except for some of those related to temperature. More severe and enduring droughts occurred in the early 20 th century or the earlier periods of history, frequently leading to great famines in northern China. Uncertainties remain in reconstructing historical extreme climate events and analyzing the early instrumental records. Further research could focus on the improvement of methodology in proxy based reconstruction of multi-decadal variations of surface air temperature and precipitation/drought, the recovery, digitization, calibration and verification of the early instrumental records, and the mechanisms of the observed multi-decadal variability of extreme climate in the region.

By using instrumental surface air pressure (SAP) records for 1885–2017 at Hong Kong (HK) station, SAP data for 1951–2016 at 66 stations over mainland China and modern tropical cyclones (TCs) of 1951–2017 derived from the Best Tracks (BT) dataset over Northwest Pacific, an objective identification method (OIM) for TCs is developed. Taking HK station as an example, the general distance of detectable landing TCs and the SAP thresholds are determined by utilizing the correlation between the SAP metrics at HK station and those at each landing site for all 392 real modern TC processes during the period of 1951–2016. Then, a long series of TCs affecting HK station for 1885–2017 is reconstructed by applying the thresholds of daily mean SAP and 24-h SAP difference to observed SAP data during the whole stage. The misjudgment of this OIM is about 10%, and it provides a homogeneous series of TCs affecting HK area during 1885–2017. The reconstructed annual TC series shows a visible decreasing trend from 1885 to 2017, with a more obvious reduction occurring after the early 1960s. Specifically, the 10 years of 1994–2003 had the smallest number of TCs. This SAP-based method developed in this study is potentially applicable for other areas.

Home quarantine due to the global coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on children. Lifestyle changes have led to an increase in precocious puberty (PP) among girls, and the underlying risk factors for this remain unclear. Thus, we aimed to assess the influence of environmental, genetic, nutritional, and other lifestyle factors on the risk of PP in girls. We evaluated the incidence of new-onset PP in girls during home quarantine for COVID-19 and analyzed the potential risk factors. This was a retrospective questionnaire and medical record-based study involving 22 representative medical units from 13 cities in Henan Province, China. Girls with new-onset PP (central precocious puberty, 58; premature thelarche, 58; age, 5–9 years) between February 2020 and May 2020 were included, along with 124 healthy, age-matched controls. The number of new-onset PP cases reported during the study period was compared with that reported between February and May in 2018 and 2019. Patients’ families completed a questionnaire to assess potential risk factors. There was a 5.01- and 3.14-fold increase in the number of new-onset PP cases from 2018 to 2020 and from 2019 to 2020, respectively; the differences were statistically significant (p<0.01). High-risk factors for PP included longer time spent using electronic devices, decreased exercise time, higher body mass index, vitamin D deficiency, young age (<12 years) of mother during menarche, consumption of fried food and processed meat, residence in rural areas, and consumption of off-season fruits. Thus, we found that lifestyle changes caused due to the COVID-19 pandemic led to a significant increase in PP in girls. Management of the risk factors identified in this study may help in PP prevention.

Purpose Wiedemann–Steiner syndrome (WDSTS) is an autosomal dominant disorder with broad and variable phenotypes including short stature. This study aims to determine the long-term effect of recombinant human growth hormone (rhGH) treatment on WDSTS and summarize the phenotypes and genotypes of WDSTS. Methods We analyzed the clinical and genetic features of five patients with WDSTS, and comprehensively reviewed reported WDSTS diagnostic features. Results Four patients had short stature, one exhibited early puberty, and all exhibited distinctive facial features, intellectual disabilities, and hypertrichosis. Two patients had subnormal GH peaks. Three patients treated with rhGH for 1.5–4.9 years showed height gains (1.8, 1.1, and 1.9 standard deviations score [SDS]); patient 5 received rhGH and leuprolide for 1 year, with 0.2 SDS in height gain and controlled bone age. Five KMT2A gene variants were identified, four of which were novel. Our review (54 articles including 260 WDSTS cases) revealed that growth retardation, intellectual delay, distinctive facial features, and hirsutism are frequent findings of the condition. Among the 229 KMT2A gene variants described, frameshift variants were the most common (37.7%). Conclusion Our findings broaden the KMT2A gene variant, clinical, and molecular spectra used to diagnose and treat WDSTS, and highlight the crucial role of genetic testing in WDSTS diagnosis and the effectiveness of rhGH therapy.

Tropical cyclones (TCs) are among the most destructive weather systems affecting East Asia, with northern China particularly vulnerable to their associated systems. In recent decades, a poleward migration in the average latitude of TCs has been observed. However, the understanding of changes in precipitation in northern China associated with this shift remains poor. Thus, we investigate the variability of northward-migrating TCs (NTCs) during 1960–2024, coupled with an in-depth analysis of their associated precipitation changes. Results reveal that precipitation induced by NTCs shows robust upward trends, with TC-induced total precipitation (TCP) and extreme precipitation (TCEP) increasing by 0.83 (p<0.05) and 0.63 mm per decade, respectively. Both the rates of TCP and TCEP decadal intensification are notably higher in the early 21 st century compared to the entire study period. Seasonal analysis indicates that TCP is concentrated in the Bohai Bay during summer in the past 15 years (2010–2024), while in autumn, it is centered in northeastern China. Additionally, the upward trend of TCP over the Bohai Bay in the past 15 years is primarily driven by typhoons and super-typhoons, and that over northeastern China is driven by severe tropical storms and severe-typhoons. The pronounced amplification of TCP during 2010–2024 (compare to 2000–2009) is likely attributed to stronger NTCs, longer durations and slower translation speeds. These findings highlight the escalating hydrometeorological hazards posed by NTCs in northern China, particularly in northeastern China, where TCEP has greatly intensified. Addressing the aforementioned emerging features of TCP and TCEP is crucial for improving drought-flood forecasting, disaster mitigation, and adaptation in these regions.

Compound K is one of the active metabolites of Panaxnotoginseng saponins, which could attenuate the formation of atherosclerosis in mice modelsvia activating LXRα. We synthesized and evaluated a series of ginsenoside compound K derivatives modified with short chain fatty acids. All of the structures of this class of ginsenoside compound K derivative exhibited comparable or better biological activity than ginsenoside compound K. Especially structure 1 exhibited the best potency (cholesteryl ester content: 41.51%; expression of ABCA1 mRNA: 319%) and low cytotoxicity.

A digital current sharing control method leveraging a CAN bus is developed to inhibit the fluctuating current distributions of parallel converters in high-output oxidation power systems. When compared to conventional current sharing strategies, the proposed design significantly reduces circuit complexity without resorting to an analog current sharing bus, and is extremely robust in maintaining system functionality against one or multiple module failures. The digital control design also features anti-interference among high-power switching converters. In addition to detailing the operation principles and mathematical deductions of the state-space average model, the design of a current sharing controller and a current sharing scheme based on a CAN bus are presented to analyze the steady-state operation of parallel converters and dynamic-state operation. Based on these observations, a proof-of-concept prototype was developed that offers a maximum output power of nearly 400 kW with a current sharing error (CSE) below 2.1%. In addition, this system features outstanding anti-interference capability in intense electromagnetic fields.

Congenital hyperinsulinism (CHI) is the most common cause of severe, persistent hypoglycemia in neonates and infants. If the patient does not respond to medical treatment the currently available treatment is subtotal pancreatectomy, but some patients still experience severe hypoglycemia after surgery. Sirolimus, a mammalian target of rapamycin inhibitor has recently been reported to be effective in the treatment of insulinoma and CHI patients. Here we report a patient with CHI who had prolonged hypoglycemia after subtotal pancreatectomy. The patient had a heterozygous mutation in but was unresponsive to an optimal dose of diazoxide (15 mg/ kg/day) and octreotide (30 μg/kg/day). The patient subsequently had subtotal pancreatectomy but severe and persistent hypoglycemia continued post-operatively. Sirolimus was commenced. There was a remarkable improvement in glycemic control without major adverse events, although he required a small dose of octreotide to maintain euglycemia. Sirolimus therapy was discontinued when the patient was 15 months old. At the time of this report, at an age of three years and eight months, the patient continues to maintain good glycemic control. This report suggests that sirolimus may be an effective treatment option in patients with CHI resistant to established medical therapy or failure of ubtotal pancreatectomy. However, the long-term safety requires study in larger groups of very young patients.

Aims. To study the clinical features, genetic etiology, and the correlation between phenotype and genotype of neonatal diabetes mellitus (NDM) in Chinese patients. Methods. We reviewed the medical records of 25 NDM patients along with their follow-up details. Molecular genetic analysis was performed. We compared the HbA1c levels between PNDM group and infantile-onset T1DM patients. Results. Of 25 NDM patients, 18 (72.0%) were PNDM and 7 (28.0%) were TNDM. Among 18 PNDM cases, 6 (33.3%) had known KATP channel mutations (KATP-PNDM). There were six non-KATP mutations, five novel mutations, including INS, EIF2AK3 (n=2), GLIS3, and SLC19A2, one known EIF2AK3 mutation. There are two ABCC8 mutations in TNDM cases and one paternal UPD6q24. Five of the six KATP-PNDM patients were tried for glyburide transition, and 3 were successfully switched to glyburide. Mean HbA1c of PNDM was not significantly different from infantile onset T1DM (7.2% versus 7.4%, P=0.41). Conclusion. PNDM accounted for 72% of NDM patients. About one-third of PNDM and TNDM patients had KATP mutations. The genetic etiology could be determined in 50% of PNDM and 43% of TNDM cases. PNDM patients achieved good glycemic control with insulin or glyburide therapy. The etiology of NDM suggests polygenic inheritance.