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Caenorhabditis diversity on Pohnpei, Micronesia, provides evidence that the Elegans Supergroup has its roots in the Americas and diversified in the Pacific en route to Asia.

The microscopic nematode Caenorhabditis elegans stands unrivaled as a model for developmental biology, neurobiology, and genetics, but fundamental aspects of its ecology, biogeography, and natural history remain unknown. Leveraging recent findings that place its center of diversity in the cool, high-elevation forests of Hawaii, we performed an intensive survey of the Caenorhabditis fauna of Pohnpei, a high island in Micronesia that is home to the largest patch of high-elevation forest between Hawaii and East Asia. We found nine species of Caenorhabditis, five of them new, but not C. elegans. Most species were limited to the hot lowlands but three spanned the elevational range and one was found only in the cloudforest. Using the distribution of Caenorhabditis nematodes among habitat patches - individual rotting fruits or flowers - we parameterized simple models that capture key aspects of the population biology of these animals. We generated transcriptomes for the new species and inferred a phylogeny for 70 species of Caenorhabditis, based on 2955 genes. This phylogeny allowed us to perform the first quantitative biogeographic analysis for the group. Our analysis suggests that the deep ancestors of the Elegans Supergroup of species lived in the Americas, and that the Supergroup's subsequent diversification occurred in Remote Oceania. The ancestors of the Supergroup gave rise to a diverse Oceanian fauna and ultimately to multiple lineages that moved into Asia, Africa, Australasia, and back into the Americas. Though biogeographic inferences are limited by the lack of information from key regions of the southwest Pacific, the data are consistent with a model of trans-Pacific migration, with the islands of Oceania serving as sources rather than sinks for biodiversity.

Caenorhabditis

Acedapsone in the prevention of leprosy: field trial in three high prevalence villages in Micronesia.

The 1,659 non-leprous people in a Micronesian population experiencing an annual leprosy incidence rate of about 7/1,000 were offered 15 acedapsone (DADDS) injections during 1967--1970 for leprosy prevention purposes. Subsequent annual surveillance showed an initial cessation of new cases during the 3-year DADDS campaign, followed by a resumption of cases thereafter at a yearly level of about 2/1,000 with a longer pause and slower rise among those who received the full regimen. A secondary wave of cases that has occurred since 1973 among children born after 1968 shows that post-campaign transmission occurred, probably principally from relapsing multibacillary cases with onset before the campaign. Recommendations are made for a balanced, long-term control program with DADDS preventive treatment limited to contacts of multibacillary cases.

Acedapsone

Prevalence of antibody to hepatitis A and hepatitis B viruses in selected populations of the South Pacific.

Five island populations representing the three major cultural groups of the South Pacific--Polynesia, Micronesia, Melanesia--were studied for prevalence of antibody to hepatitis A virus (anti-HAV) and of antibody to the core antigen of hepatitis B virus (anti-HBc). Sera were collected in the late 1950s and early 1960s, selected where possible for appropriate age and sex distributions, and were tested by radioimmunoassay. Rather marked differences in prevalence were observed. Anti-HBc patterns confirmed that HBV is endemic in the Pacific populations. Furthermore, the patterns differed somewhat from each other and did not correlate with ethnogeographic area. Prevalence of anti-HAV was high in all populations studied. A Unique pattern was found for the island of Ponape (Micronesia): In a Ponape population bled in 1963, anti-HAV was not detected in any individual under 20 years of age, but almost all individuals over that age were found to be seropositive. On testing a second group of sera collected in 1975, all individuals aged 14--21 years were found to be antibody positive, indicating that HAV had returned to Ponape sometime prior to 1975. There was no significant difference in the prevalence of HAV or HBV infection between males and females in any of the populations studied.

Adolescent

Adolescent health across Asia Pacific, 2000-23: a systematic analysis for the Global Burden of Disease Study 2023.

BACKGROUND: The Asia Pacific region is home to more than half of the world's 1·93 billion adolescents (aged 10-24 years). Addressing adolescent health in this region is of global importance, but to date a systematic analysis of key contributors to disease in adolescents has not been done, which is a barrier to responsive action. This systematic analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 aims to provide a comprehensive assessment of adolescent health across the Asia Pacific region, at both the subregional and national levels, encompassing burden of disease, mortality, and prevalence of adolescent risk factors. METHODS: As part of GBD 2023, we obtained estimates for cause-specific mortality, disability-adjusted life-years (DALYs), and risk factor prevalence by sex for adolescents aged 10-24 years and 5-year age groups (10-14 years, 15-19 years, and 20-24 years) across 44 countries and territories (hereafter referred to collectively as Asia Pacific), grouped by seven UN subregions, from 2000 to 2023. We extracted GBD 2023 population counts and estimates of number and rate (per 100 000 population) for mortality and disease burden (DALYs). Risk prevalence estimates were obtained directly from the Institute for Health Metrics and Evaluation, and binge drinking estimates were sourced from WHO. Estimates are reported with 95% uncertainty intervals (UIs) where possible. UIs were estimated by running 250 draws of the posterior distribution, ordering the draws, and selecting the 2·5th and 97·5th percentiles for each metric. FINDINGS: In 2023, in adolescents across Asia Pacific, there were 637 496 deaths and a total disease burden of 115·8 million DALYs, representing 34·1% of global adolescent deaths and 40·6% of the global adolescent burden of disease. Non-communicable diseases (NCDs; particularly mental disorders) were the leading causes of disease burden and mortality (64·8% of DALYs and 43·9% of deaths). Unintentional and transport injuries were also leading causes of death (14·7% of deaths due to transport injury and 13·3% of deaths due to unintentional injury) and leading causes of disease burden particularly among males in south-eastern Asia. In Melanesia, Micronesia, and some parts of south-eastern Asia (Cambodia, Indonesia, Laos, the Philippines, and Timor-Leste), respiratory infections and tuberculosis remained important contributors. Southern Asia had the largest reduction (1·5% per year) in all-cause DALYs over the study period, and Australia and New Zealand (0·2% per year) had the smallest, with females in Australia and New Zealand showing a slight increase contrary to regional trends. Eastern Asia had the largest reduction (2·8% per year) in all-cause mortality rate and Melanesia (0·8% per year) the smallest. Risk factors generally had between-subregion and within-subregion variation; however, some regional trends stood out, with overweight and obesity increasing in all countries across the region, and binge drinking increasing in more countries than not. In 2023, prevalence of smoking in males exceeded that in females in every country, from 40% difference in Timor-Leste to less than 1% difference in Australia. Anaemia prevalence is decreasing in all countries, but female prevalence was higher and reducing at a slower rate than in males. Bullying prevalence was slightly higher in Polynesia, Micronesia, and Melanesia combined, Australia and New Zealand, and eastern Asia compared with southern and south-eastern Asian subregions. INTERPRETATION: Several patterns were consistent across the region: the dominance of mental disorders and NCDs, the universal rise in overweight and obesity (particularly high in Oceanic countries but increasing rapidly in south and south-eastern Asia), and persistent sex-specific challenges across subregions: unintentional injuries and smoking in males, and anaemia in females. Actions to tackle shared risk factors (while accounting for context-specific local health profiles, workforce deficits, cultural factors, and health system capacity) should not be forgone due to local variation. Future research could focus on subnational variation, intersecting inequalities, and multi-sectoral interventions targeting shared risk factors. Priority actions should include regional investment in adolescent mental health services and obesity prevention, targeted injury reduction strategies for high-risk populations, and sex-specific approaches to smoking cessation and anaemia reduction, delivered through local health systems with the capacity and cultural responsiveness to meet local needs. FUNDING: Gates Foundation and Australian Government.

Humans

The high prevalence of diabetes mellitus on a Central Pacific Island.

A diabetes prevalence study on an isolated urbanized Central Pacific Island has established a prevalence rate of 34.4% in individuals aged 15 years and over. Of these, 10.4% had previously known diabetes; in the others the diagnosis was made on the basis of a plasma glucose level of at least 160 mg/100 ml 2h after a 75 gm oral glucose load. A further 11.3% of the subjects had borderline diabetes as judged by a 2-h plasma glucose of between 140 and 159 mg/100 ml. Of the diabetics, 72% had a positive family history of diabetes. The high prevalence rate appears to be related to a number of factors including a diabetic genotype, urbanization, and obesity.

Adolescent

Nutrient intakes in an urbanized Micronesian population with a high diabetes prevalence.

Dietary data was obtained from 77 adult Micronesian (Nauruan) subjects during a diabetes epidemiological survey. The life-style of this isolated Pacific population is almost completely Westernized and they have been shown to have a very high diabetes prevalence rate. Nearly all food consumed by the islanders is imported from Australia. The main caloric intake of both males and females was at least twice those recommended for Western or developing Pacific populations. The diet meets or exceeds the Australian National Health and Medical Research Council recommended allowance for calories, protein, fat, and ascorbic acid, but thiamin intake was inadequate. The percentage of fat in the diet was lower than that consumer by Western populations. Obesity is a pronounced feature of this population and the high caloric intake coupled with reduced physical activity would appear to be a major factor in relation to this. This Micronesian group has a genetic susceptibility to diabetes which may have been unmasked by the change from traditional to Western life-style. This problem may not be unique to Nauru and, with progressive Westernization, many other Polynesian and Micronesian populations may be at risk.

Adolescent

Ventilatory lung function studies in Pacific Island Micronesians.

In the first study of ventilatory lung function in people of the Micronesian race, observations in 182 normal subjects (117 males and 65 females) between the ages of 15 and 80 years were used to calculate regression equations for FVC, FEV1, and FEV1%. Mean values of FVC and FEV1 were found to be lower than those reported for Caucasians and Polynesians, but similar to Melanesians, Negroes and Chinese. Values of FEV1% were comparable among all races. The three Oceanic races showed a smaller reduction of FVC and a larger reduction of FEV1% with increasing age than did Caucasians. Although the biological significance of this variability of ventilatory function in different races is uncertain, the definition of racial norms is already proving useful in studies of pulmonary airway disease among Oceanic peoples.

Adolescent

The effect of westernization on native populations. Studies on a Micronesian community with a high diabetes prevalence.

A diabetes prevalence study in 1975 on an isolated urbanized Central Pacific island (Nauru) showed rates comparable to the American Pima Indians--the highest yet recorded in the world literature. This paper reports the results of a follow-up study and the high prevalence has been confirmed. In this survey of 417 people aged ten years and over, 9.8% were known diabetics. With a plasma glucose of 160 mg/100 ml or over at two hours after a 75 gram oral glucose load as the criterion of diagnosis, , diabetes was detected in a further 19.2%, making a total diabetic population of 29% in the population studied. The prevalence of diabetes was 44% in people aged 20 years and over. A further 7% had borderline diabetes on the basis of a two-hour plasma glucose of 140--159 mg/100 ml. Parity did not appear to be a causative factor in relation to the high diabetes prevalence. However, obesity is common in this community and is more marked than that seen in other Pacific or Caucasian communities. The high prevalence of diabetes in this population appears to be related to the inter-action of environmental factors, such as obesity, with a diabetic genotype. The results confirm the possible detrimental effects of westernization on native populations.

Adolescent