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  1. The Effects of Safety-specific Transformational Leadership and Active Transactional Leadership on Mindful Safety Practices Adoption in the Chinese Petroleum Industry
    Shi H
    Int J Occup Saf Ergon, 2021 Jun 15.
    PMID: 34126878 DOI: 10.1080/10803548.2021.1943203
    AbstractPrevious studies have concentrated on the value of managerial leadership for the safety behavior conduction by the employees in the workplace. However, safety leadership styles concerning mindful safety practices have rarely been examined. The goal of this study is therefore to investigate the relationships between safety-specific leaderships (transformational and active transactional leadership) and the adoption of mindful safety practices among the first-line workers mediated by safety climate in the Chinese petroleum industry. Data were obtained from first-line workers in the two Chinese petroleum companies. PLS-SEM results have shown that transformational and active transactional leadership are positively related to safety climate, which in turn affect the mindful safety practices adoption in the Chinese petroleum industry. The results of the current study indicate that transformational and active transactional leadership in a safety-specific view offer a comprehensive leadership model for mindful safety practices conduction in the Chinese petroleum industry.
  2. Revision of the Oriental species of Calleida Latreille (sensu lato). Part 1: Introduction, groups of species, and species of six species groups (Coleoptera: Carabidae: Lebiini)
    Casale A, Shi H
    Zootaxa, 2018 Jun 29;4442(1):1-42.
    PMID: 30313981 DOI: 10.11646/zootaxa.4442.1.1
    This revision focuses on the genus Calleida Latreille, 1824 (in the widest sense) in the Oriental Region, previously treated as genus or subgenus Callidiola Jeannel, 1949. In the present contribution, as first part of a series of revisions of the Asiatic Calleida species, we define nine species groups including all known Asiatic species, based on external features and morphological characters of male and female genitalia. A key for the identification of all nine species groups is provided, along with diagnostic characters, included species, geographical distribution, and brief discussion on monophyly and relationships for each species group. In particular, the present contribution deals with species of six small species groups, including eleven species in total, for which keys to all known species, descriptions, distribution maps, habitus images and genitalia illustrations are provided.Five new species are described: Calleida gressittiana Casale Shi, sp. n. (type locality: Kinabalu, Sabah, Borneo), Calleida puncticollis Shi Casale, sp. n. (type locality: Zigui, Hubei), Calleida jelineki Casale Shi, sp. n. (type locality: Coimbatore, India), Calleida viet Casale Shi, sp. n. (type locality: Vung Tau, Vietnam), Calleida borneensis Shi Casale, sp. n. (type locality: Sabah, Borneo). Lectotypes for five taxa are designated. One synonymy is newly proposed: Calleida lieftincki Louwerens junior synonym of Calleida corporaali Andrewes, syn. nov.
  3. Effects of safety leadership and safety management practices on safety participation through a casual-chain mediators approach in the Chinese construction industry
    Shi H, Nadeem MA
    Int J Occup Saf Ergon, 2023 Dec;29(4):1383-1394.
    PMID: 36178706 DOI: 10.1080/10803548.2022.2131274
    Objectives. This article aims to prompt first-line workers to go beyond regular job roles and engage in more discretionary safety behavior-safety participation in the Chinese construction industry. The construction industry is a high-risk industry, and first-line workers are more likely to be exposed to workplace hazards. Once accidents happen, the negative consequences would come out. Therefore, employee voluntary safety behavior is focused on in this research. Methods. The present research framework examines the roles of safety leadership and safety management practices from the group and organizational perspectives in predicting the voluntary safety behavior (safety participation) of first-line workers in the Chinese construction industry through casual-chain mediators (safety climate and job satisfaction). In this study, partial least squares structural equation modeling (PLS-SEM) is adopted for data analysis and hypotheses testing. Results. After data analysis, the results show that safety leadership and safety management practices are significantly and positively associated with safety participation of first-line workers through safety climate and job satisfaction. Moreover, safety management practices have a more statistical effect on safety climate compared to safety leadership. Conclusions. These results provide some practical implications for facilitating the workers to conduct safety participation inthe construction industry.
  4. Fulltext Taxonomy and phylogeny of the genus Gastrocentrum Gorham (Coleoptera, Cleridae, Tillinae), with the description of five new species
    Yang G, Yang X, Shi H
    Zookeys, 2020;979:99-132.
    PMID: 33192133 DOI: 10.3897/zookeys.979.53765
    The genus Gastrocentrum Gorham, 1876 is revised to include nine species. Five new species are described in this genus: G. magnumsp. nov. (NE India), G. regularesp. nov. (Cameron Highlands, Malaysia), G. xiaodongisp. nov. (Gyirong, Xizang, China), G. zayuensesp. nov. (Zayü, Xizang, China), and G. gaoligongensesp. nov. (Fugong, Yunnan, China). Gastrocentrum nitidum Schenkling, 1916 is transferred to the genus Tillus as a new combination. All the species in this genus are described (except G. brevicolle), and a key is provided for their identification. Illustrations of male genitalia, female reproductive organs, and other important structures are provided. An interspecific phylogeny-estimate of Gastrocentrum is presented based on morphological data, with two main clades recognized: a clade containing G. unicolor and G. laterimaculatum, and a clade containing the remaining six species (the latter a polytomy consisting of G. magnumsp. nov., G. dux, and G. regularesp. nov., and a well-supported sub-clade representing the remaining species). Additionally, the taxonomic and phylogenetic importance of female reproductive organs is discussed.
  5. Facilitating Mindful Safety Practices among First Line Workers in Chinese Petroleum Industry through Safety Management Practices and Safety Motivation
    Shi H, Mohamed Zainal SR
    Int J Occup Saf Ergon, 2021 Mar 11.
    PMID: 33704011 DOI: 10.1080/10803548.2021.1902672
    Petroleum Industry belongs to the high-risk industry and operates under the social technical system. Therefore, safety behavior of employees need to be paid high attention. Thus, six dimensions of safety management practices are identified as independent variables to predict a special component of common safety behavior-mindful safety practices in Chinese Petroleum Industry. HRO (High Reliability Organization) theory is adopted as the underpinning theory. 255 first line workers from a Chinese petroleum company participated in this survey. The results reveal that safety training and safety communication and feedbacks are positively related to safety motivation. Moreover, workers' involvement and safety promotion policy have direct and positive impacts on mindful safety practices. Further, safety motivation is found to play a mediating role in the prediction of mindful safety practices in Chinese Petroleum Industry. These findings give new insights for petroleum companies on how to promote mindful safety practices in the workplace.
  6. Fulltext Development of MTH1-Binding Nucleotide Analogs Based on 7,8-Dihalogenated 7-Deaza-dG Derivatives
    Shi H, Ishikawa R, Heh CH, Sasaki S, Taniguchi Y
    Int J Mol Sci, 2021 Jan 28;22(3).
    PMID: 33525366 DOI: 10.3390/ijms22031274
    MTH1 is an enzyme that hydrolyzes 8-oxo-dGTP, which is an oxidatively damaged nucleobase, into 8-oxo-dGMP in nucleotide pools to prevent its mis-incorporation into genomic DNA. Selective and potent MTH1-binding molecules have potential as biological tools and drug candidates. We recently developed 8-halogenated 7-deaza-dGTP as an 8-oxo-dGTP mimic and found that it was not hydrolyzed, but inhibited enzyme activity. To further increase MTH1 binding, we herein designed and synthesized 7,8-dihalogenated 7-deaza-dG derivatives. We successfully synthesized multiple derivatives, including substituted nucleosides and nucleotides, using 7-deaza-dG as a starting material. Evaluations of the inhibition of MTH1 activity revealed the strong inhibitory effects on enzyme activity of the 7,8-dihalogenated 7-deaza-dG derivatives, particularly 7,8-dibromo 7-daza-dGTP. Based on the results obtained on kinetic parameters and from computational docking simulating studies, these nucleotide analogs interacted with the active site of MTH1 and competitively inhibited the substrate 8-oxodGTP. Therefore, novel properties of repair enzymes in cells may be elucidated using new compounds.
  7. Fulltext A modified method for genomic DNA extraction from the fish intestinal microflora
    Han Z, Sun J, Lv A, Sung Y, Sun X, Shi H, et al.
    AMB Express, 2018 Apr 02;8(1):52.
    PMID: 29610998 DOI: 10.1186/s13568-018-0578-3
    A modified genomic DNA extraction method named the combination of lysozyme and ultrasonic lysis (CLU) method was used to analyze the fish intestinal microflora. In this method, the physical disruption and chemical lysis steps were combined, and some parameters in the key steps were adjusted. In addition, the results obtained by this method were compared with the results obtained by the Zirmil-beating cell disruption method and the QIAamp Fast DNA Stool Mini Kit. The OD260/OD280ratio and concentration of the DNA extracted using the CLU method were 2.02 and 282.8 µg/µL, respectively; when the incubation temperatures for lysozyme and RNase were adjusted to 37 °C, those values were 2.08 and 309.8 µg/µL, respectively. On the agarose gel, a major high-intensity, discrete band of more than 10 kb was found for the CLU method. However, the smearing intensity of degraded DNA was lower when the incubation temperatures were 60 °C for lysozyme and 30 °C for RNase than when incubation temperatures of 37 °C for lysozyme and 37 °C for RNase were used. The V3 variable region of the prokaryotic 16S rDNA was amplified, and an approximately 600-bp fragment was observed when the DNA extracted using the CLU method was used as a template. The CLU method is simple and cost effective, and it yields high-quality, unsheared, high-molecular-weight DNA, which is comparable to that obtained with a commercially available kit. The extracted DNA has potential for applications in critical molecular biology techniques.
  8. Impact of DNA extraction methods on the observed microbial communities from the intestinal flora of the penaeid shrimp Litopenaeus vannamei
    Jiang B, Sun J, Lv A, Hu X, Shi H, Sung Y, et al.
    FEMS Microbiol Lett, 2019 05 01;366(9).
    PMID: 31074797 DOI: 10.1093/femsle/fnz099
    Two DNA extraction methods, the Zirmil-beating cell disruption method (ZBC) and the QIAamp fast DNA stool mini kit (QIA), were used to extract DNA from the intestinal flora of the penaeid shrimp Litopenaeus vannamei, and their microbial communities were analyzed using 16S rDNA high-throughput sequencing. Results were obtained in terms of the number of reads, alpha diversity indexes, beta diversity indexes and taxonomic composition. The alpha diversity indexes of the community, according to the ZBC method, were higher than those according to the QIA method. Furthermore, results from the three samples using the ZBC method were less consistent than those where the QIA method was used. Further, using the latter method led to substantive clustering. It is suggested that the QIA method is more stable and repeatable than the ZBC method. Although the two extraction methods shared the major abundant microflora based on 16S rDNA high-throughput sequencing, bias associated with diversity analysis indexes and certain species was observed.
  9. Synthesis of γ-N-modified 8-oxo-2'-deoxyguanosine triphosphate and its characterization
    Thavoncharoensub N, Maruyama K, Heh CH, Hoong Leong K, Shi H, Shigematsu Y, et al.
    Nucleosides Nucleotides Nucleic Acids, 2019;38(8):578-589.
    PMID: 30929604 DOI: 10.1080/15257770.2019.1586919
    8-OxodGTP is generated by the reaction between dGTP and reactive oxygen species and a considered mutagenic nucleotide. It can be incorporated into the duplex DNA during replication processes by the DNA polymerase, and thus the repair enzyme removes oxodGTP from the nucleotide pools in living cells. On the other hand, the γ-modified triphosphates show interesting properties for use as biological tools. Therefore, the γ-N-pyrenylalkyl-oxodGTP derivatives were synthesized and their effect on the enzymatic reactions were evaluated. The γ-N-pyrenylmethyl-oxodGTP was found to be accepted by the DNA polymerase just like oxodGTP, but showed a competitive inhibition property for the human oxodGTPase.
  10. Fulltext Protective effect of curcumin against ultraviolet A irradiation‑induced photoaging in human dermal fibroblasts
    Liu X, Zhang R, Shi H, Li X, Li Y, Taha A, et al.
    Mol Med Rep, 2018 05;17(5):7227-7237.
    PMID: 29568864 DOI: 10.3892/mmr.2018.8791
    Ultraviolet (UV) radiation induces DNA damage, oxidative stress, and inflammatory processes in skin, resulting in photoaging. Natural botanicals have gained considerable attention due to their beneficial protection against the harmful effects of UV irradiation. The present study aimed to evaluate the ability of curcumin (Cur) to protect human dermal fibroblasts (HDFs) against ultraviolet A (UVA)‑induced photoaging. HDFs were treated with 0‑10 µM Cur for 2 h and subsequently exposed to various intensities of UVA irradiation. The cell viability and apoptotic rate of HDFs were investigated by MTT and flow cytometry assays, respectively. The effect of UVA and Cur on the formation of reactive oxygen species (ROS), malondialdehyde levels, which are an indicator of ROS, and the levels/activity of antioxidative defense proteins, including glutathione, superoxide dismutase and catalase, were evaluated using 2',7'-dichlorofluorescin diacetate and commercial assay kits. Furthermore, western blotting was performed to determine the levels of proteins associated with endoplasmic reticulum (ER) stress, the apoptotic pathway, inflammation and the collagen synthesis pathway. The results demonstrated that Cur reduced the accumulation of ROS and restored the activity of antioxidant defense enzymes, indicating that Cur minimized the damage induced by UVA irradiation in HDFs. Furthermore, western blot analysis demonstrated that Cur may attenuate UVA‑induced ER stress, inflammation and apoptotic signaling by downregulating the protein expression of glucose‑regulated protein 78, C/EBP‑homologous protein, nuclear factor‑κB and cleaved caspase‑3, while upregulating the expression of Bcl‑2. Additionally, it was demonstrated that Cur may regulate collagen metabolism by decreasing the protein expression of matrix metalloproteinase (MMP)‑1 and MMP‑3, and may promote the repair of cells damaged as a result of UVA irradiation through increasing the protein expression of transforming growth factor‑β (TGF‑β) and Smad2/3, and decreasing the expression of the TGF‑β inhibitor, Smad7. In conclusion, the results of the present study indicate the potential benefits of Cur for the protection of HDFs against UVA‑induced photoaging and highlight the potential for the application of Cur in skin photoprotection.
  11. A Colorimetric/Fluorescent Dual-Mode Aptasensor for Salmonella Based on the Magnetic Separation of Aptamers and a DNA-Nanotriangle Programmed Multivalent Aptamer
    Ma N, Sun M, Shi H, Xue L, Zhang M, Yang W, et al.
    Foods, 2023 Oct 20;12(20).
    PMID: 37893744 DOI: 10.3390/foods12203853
    Salmonella infection has emerged as a global health threat, causing death, disability, and socioeconomic disruption worldwide. The rapid and sensitive detection of Salmonella is of great significance in guaranteeing food safety. Herein, we developed a colorimetric/fluorescent dual-mode method based on a DNA-nanotriangle programmed multivalent aptamer for the sensitive detection of Salmonella. In this system, aptamers are precisely controlled and assembled on a DNA nanotriangle structure to fabricate a multivalent aptamer (NTri-Multi-Apt) with enhanced binding affinity and specificity toward Salmonella. The NTri-Multi-Apt was designed to carry many streptavidin-HRPs for colorimetric read-outs and a large load of Sybr green I in the dsDNA scaffold for the output of a fluorescent signal. Therefore, combined with the magnetic separation of aptamers and the prefabricated NTri-Multi-Apt, the dual-mode approach achieved simple and sensitive detection, with LODs of 316 and 60 CFU/mL for colorimetric and fluorescent detection, respectively. Notably, the fluorescent mode provided a self-calibrated and fivefold-improved sensitivity over colorimetric detection. Systematic results also revealed that the proposed dual-mode method exhibited high specificity and applicability for milk, egg white, and chicken meat samples, serving as a promising tool for real bacterial sample testing. As a result, the innovative dual-mode detection method showed new insights for the detection of other pathogens.
  12. Factors associated with obesity: a case-control study of young adult Singaporean males
    Shi H, Jiang B, Wei Sim JD, Chum ZZ, Ali NB, Toh MH
    Mil Med, 2014 Oct;179(10):1158-65.
    PMID: 25269135 DOI: 10.7205/MILMED-D-14-00064
    A case-control study among Singapore Armed Forces' newly enlisted Servicemen was conducted to examine factors associated with male obesity. Four hundred and fifty-nine individuals from the Obese Basic Military Training program were selected as "cases" (average age: 19.5, body mass index: 30.4) and another 340 individuals were selected from the Normal Basic Military Training program as "controls" (average age: 19.3, body mass index: 21.4). Information such as family background, socioeconomic factors, and lifestyle practices were captured using facilitator-led questionnaires. Several variables were significantly associated with obesity after adjustments for possible confounders. These include childhood obesity (odds ratio [OR] = 2.06), less than an hour of exercise per day (OR = 2.97), Indian ethnicity (OR = 2.22), specific education backgrounds (especially that of Institute of Technical Education-OR = 2.75), father's employment at nonmanagerial/professional jobs (OR = 1.52), mother's employment at managerial/professional jobs (OR = 2.02), regular smoking (OR = 1.73) and alcohol consumption (OR = 2.26), 6 hours or less of sleep (OR = 3.73), obesity among family members (OR = 1.86 for mother; OR = 2.98 for siblings), parental history of diabetes mellitus (OR = 2.22 for father; OR = 2.70 for mother), and eating at inexpensive local food stalls (OR = 1.82). Our study found that a number of factors, ranging from personal and family backgrounds to lifestyle choices, were significantly associated with obesity among male youths.
  13. Fulltext Assessing the Foodshed and Food Self-Sufficiency of the Pearl River Delta Megacity Region in China
    Wang Y, Shi H, Zhang Y, Li X, Zhao M, Sun B
    Foods, 2023 Nov 22;12(23).
    PMID: 38231600 DOI: 10.3390/foods12234210
    Food self-sufficiency has long been regarded as essential for understanding and managing urban and regional food systems; however, few studies have examined the food self-sufficiency of megacity regions within a comprehensive framework that distinguishes different types of agricultural land (i.e., arable land, horticultural landscapes, and waters). To fill these gaps, we took the Pearl River Delta as a case study and quantified the foodsheds of different types of agricultural land by calculating the land footprint of food consumption. On this basis, food self-sufficiency is defined as the ratio of available and required agricultural area for regional food demand. The results indicated that the self-sufficiency level provided by the arable land in the Pearl River Delta is low and cannot realize self-sufficiency at the regional and urban levels. The horticultural landscapes can provide self-sufficiency at the regional level, whereas the regions with water cannot, as their foodsheds extend over the boundary of the Pearl River Delta. For arable land, establishing a localized regional food system requires expanding the foodshed size. These findings provide evidence that megacity regions may face increasing difficulties in achieving self-sufficiency in the near future. This research can improve policymakers' understanding of the sustainability and resilience of regional food systems in megacity regions.
  14. Dual-Functional Tetrahedron Multivalent Aptamer Assisted Amplification-Free CRISPR/Cas12a Assay for Sensitive Detection of Salmonella
    Qiao Z, Xue L, Sun M, Ma N, Shi H, Yang W, et al.
    J Agric Food Chem, 2024 Jan 10;72(1):857-864.
    PMID: 38134022 DOI: 10.1021/acs.jafc.3c07582
    Salmonellosis continues to impose a significant economic burden globally. Rapid and sensitive detection of Salmonella is crucial to preventing the outbreaks of foodborne illnesses, yet it remains a formidable challenge. Herein, a dual-functional tetrahedron multivalent aptamer assisted amplification-free CRISPR/Cas12a assay was developed for Salmonella detection. In the system, the aptamer was programmatically assembled on the tetrahedral DNA nanostructure to fabricate a multivalent aptamer (TDN-multiApt), which displayed a 3.5-fold enhanced avidity over the monovalent aptamer and possessed four CRISPR/Cas12a targeting fragments to amplify signal. Therefore, TDN-multiApt could directly activate Cas12a to achieve the second signal amplification without any nucleic acid amplification. By virtue of the synergism of high avidity and cascaded signal amplifications, the proposed method allowed the ultrasensitive detection of Salmonella as low as 7 cfu mL-1. Meanwhile, this novel platform also exhibited excellent specificity against target bacteria and performed well in the detection of various samples, indicating its potential application in real samples.
  15. Fulltext A Matrilineal Genetic Perspective of Hanging Coffin Custom in Southern China and Northern Thailand
    Zhang X, Li C, Zhou Y, Huang J, Yu T, Liu X, et al.
    iScience, 2020 Apr 24;23(4):101032.
    PMID: 32304863 DOI: 10.1016/j.isci.2020.101032
    Hanging Coffin is a unique and ancient burial custom that has been practiced in southern China, Southeast Asia, and near Oceania regions for more than 3,000 years. Here, we conducted mitochondrial whole-genome analyses of 41 human remains sampled from 13 Hanging Coffin sites in southern China and northern Thailand, which were dated between ∼2,500 and 660 years before present. We found that there were genetic connections between the Hanging Coffin people living in different geographic regions. Notably, the matrilineal genetic diversity of the Hanging Coffin people from southern China is much higher than those from northern Thailand, consistent with the hypothesized single origin of the Hanging Coffin custom in southern China about 3,600 years ago, followed by its dispersal in southern China through demic diffusion, whereas the major dispersal pattern in Southeast Asia is cultural assimilation in the past 2,000 years.
  16. Fulltext The hidden risk of microplastic-associated pathogens in aquatic environments
    Zhong H, Wu M, Sonne C, Lam SS, Kwong RWM, Jiang Y, et al.
    Eco Environ Health, 2023 Sep;2(3):142-151.
    PMID: 38074987 DOI: 10.1016/j.eehl.2023.07.004
    Increasing studies of plastisphere have raised public concern about microplastics (MPs) as vectors for pathogens, especially in aquatic environments. However, the extent to which pathogens affect human health through MPs remains unclear, as controversies persist regarding the distinct pathogen colonization on MPs as well as the transmission routes and infection probability of MP-associated pathogens from water to humans. In this review, we critically discuss whether and how pathogens approach humans via MPs, shedding light on the potential health risks involved. Drawing on cutting-edge multidisciplinary research, we show that some MPs may facilitate the growth and long-range transmission of specific pathogens in aquatic environments, ultimately increasing the risk of infection in humans. We identify MP- and pathogen-rich settings, such as wastewater treatment plants, aquaculture farms, and swimming pools, as possible sites for human exposure to MP-associated pathogens. This review emphasizes the need for further research and targeted interventions to better understand and mitigate the potential health risks associated with MP-mediated pathogen transmission.
  17. Current diagnosis and management of mucopolysaccharidosis VI in the Asia-Pacific region
    Hwu WL, Okuyama T, But WM, Estrada S, Gu X, Hui J, et al.
    Mol Genet Metab, 2012 Sep;107(1-2):136-44.
    PMID: 22864057 DOI: 10.1016/j.ymgme.2012.07.019
    Mucopolysaccharidosis (MPS) type VI (Maroteaux-Lamy syndrome) is a clinically heterogeneous lysosomal storage disorder. It presents significant diagnostic and treatment challenges due to the rarity of the disease and complexity of the phenotype. As information about MPS VI in Asia-Pacific countries is limited, a survey was conducted to assess current practices for diagnosis and management of MPS VI in this region. The participants were selected based on their experience in diagnosing and managing MPS patients.
  18. Fulltext Immunity and clinical efficacy of an inactivated enterovirus 71 vaccine in healthy Chinese children: a report of further observations
    Liu L, Mo Z, Liang Z, Zhang Y, Li R, Ong KC, et al.
    BMC Med, 2015;13:226.
    PMID: 26381232 DOI: 10.1186/s12916-015-0448-7
    To investigate the long-term effects on immunity of an inactivated enterovirus 71 (EV71) vaccine and its protective efficacy.
  19. Fulltext Asia-Pacific consensus on long-term and sequential therapy for osteoporosis
    Tai TW, Chen HY, Shih CA, Huang CF, McCloskey E, Lee JK, et al.
    Osteoporos Sarcopenia, 2024 Mar;10(1):3-10.
    PMID: 38690538 DOI: 10.1016/j.afos.2024.02.001
    OBJECTIVES: This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition. The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach.

    METHODS: A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and antiresorptive agents in sequential therapy approaches.

    RESULTS: The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to antiresorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for individuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment.

    CONCLUSIONS: This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.

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