Search Results (299)

Objectives: To confirm a conjecture from year 2020 of the SARS-CoV-2 (COVID-19) pandemic suggesting policy alternatives to substantially reduce mortality burden. Methods: Data from a global COVID-19 database comparing different countries on cumulative mortality and vaccination were analyzed in conjunction with surveys of seropositivity. Predictions of final mortality burden under an alternate policy scenario for Japan were calculated and the COVID-19 outcomes for China were assessed. Results: By 2025, Western countries (US, UK, Brazil and Italy) had cumulative mortality rates in the range of 3339–3548 deaths per million, about 6-fold higher than East Asian and New Zealand ‘zero-COVID’ countries. Moderate virus suppression in Japan produced the lowest cumulative mortality of the countries analyzed; if earlier policies had been maintained, the predicted cumulative mortality rate by 2025 would be one-tenth that of the US, UK, Brazil and Italy and one-half to one-third that of other zero-COVID countries. For China, transitioning from a zero-COVID policy in 2022–2023, the estimated 2025 cumulative mortality was 1607/million, half that of Western countries. Conclusions: To minimize COVID-19 mortality would require: (1) Innovation on systematic sampling of ambient airborne virus exposure to sustain low but non-zero virus levels across entire populations, and (2) seropositivity assessment (instead of mass PCR testing for new cases) for calibrating exposure management, and tracking and protecting high-risk populations. Full article

Background/Objectives: Childhood stunting remains a critical public health issue in low- and middle-income countries. Despite Malaysia’s economic growth, there is limited large-scale evidence on the determinants of stunting among children from infancy to primary school age. This cross-sectional study, part of South East Asian Nutrition Surveys II (SEANUTS II), aimed to determine sociodemographic and environmental risk factors for stunting among 2989 children aged 0.5–12 years. Methods: Children were recruited from four regions in Peninsular Malaysia (Central, East Coast, 2022–2030Northern, Southern). Standing height or recumbent length was measured, and stunting was classified based on WHO criteria (height-for-age Z-score below −2 standard deviations). Parents reported information on socioeconomic status, sanitation facilities, and hygiene practices. Multivariate binary logistic regression was used to determine the determinants of stunting. Results: Stunting prevalence was 8.9%, with infants (aOR = 2.92, 95%CI:1.14–7.52) and young children (aOR = 2.92, 95%CI:1.80–4.76) having higher odds than school-aged children. Key biological predictors included low birth weight (aOR = 2.41; 95%CI:1.40–4.13) and maternal height <150 cm (aOR = 2.24; 95%CI:1.36–3.70). Chinese (aOR = 0.56; 95%CI:0.35–0.88) and Indian children (aOR = 0.16; 95%CI:0.05–0.52) had a lower risk of stunting compared to Malays. Conclusions: This study highlights the ongoing challenge of childhood stunting in Malaysia, with age, birth weight, ethnicity, and maternal height identified as key determinants. These findings call for early identification of at-risk households and targeted support, especially through education and financial aid to foster healthy child growth. Full article

It has been more than a decade since anti-PD-1 and anti-CTLA-4 antibodies were first introduced for the treatment of unresectable melanoma. The advent of these immunotherapies has dramatically transformed the treatment landscape. In recent years, anti-PD-1 antibodies have become the cornerstone of melanoma therapy, and the development of new treatment regimens has advanced rapidly in both Eastern and Western countries. However, clinical practice has revealed lower response rates in East Asian melanoma patients compared to Caucasian populations. This discrepancy may be partially attributed to T cell immune exhaustion within the tumor microenvironment, although the detailed mechanisms remain unclear. Moreover, there is currently no established treatment for BRAF wild-type melanoma that is resistant to anti-PD-1 antibodies. This review discusses the currently available therapeutic strategies for advanced melanoma and addresses the aforementioned challenges, highlighting recent efforts in both Eastern and Western regions. Full article

Accurate species identification of small aquatic insects remains challenging due to their morphological similarities. This study addresses this issue by developing a DNA barcode reference library for the globally distributed Brillia (Diptera: Chironomidae). We analyzed cytochrome c oxidase subunit I (COI) sequences of 241 specimens belonging to 13 Brillia species from 18 countries, including 56 newly generated and 185 publicly available COI barcodes. Our integrated approach included genetic distance analysis, haplotype network construction, and ecological niche modeling. The results revealed remarkable cryptic diversity, with sequences clustering into 30 Barcode Index Numbers and 158 unique haplotypes, most being region-specific. Notably, East Asian and North American populations showed complete genetic distinctness, suggesting long-term isolation. Environmental factors, particularly temperature and precipitation gradients, were identified as key drivers of this diversification. The study also corrected several misidentifications in existing databases. These findings significantly advance our understanding of Brillia diversity and provide a reliable molecular tool for freshwater ecosystem monitoring, with important implications for biodiversity conservation and environmental assessment. Full article

Climate change is a pressing global issue with severe consequences for the planet and human health. The Earth’s temperature has risen by 2 °C from 1901 to 2023, and this warming trend is expected to continue, causing potentially dangerous shifts in climate. Climate change impacts are already visible, with more frequent and severe heat waves, droughts, intense rain, and floods becoming increasingly common. Therefore, hydropower can contribute to addressing the global climate change issue and help to achieve global energy transition and stabilize global energy security. A Long Short-Term Memory (LSTM)-based model implemented in Python for global and regional hydropower forecasting was developed for a study period of 2023 to 2060 by taking the input data from 1980 to 2022. The results revealed that Asian countries have greater hydropower potential, which is expected to increase from 1926.51 TWh in 2023 to 2318.78 TWh in 2030, 2772.06 TWh in 2040, 2811.41 TWh in 2050, and 3195.79 TWh in 2060, as compared with the other regions of the world like the Middle East, Africa, Asia, Common Wealth of Independent State (CIS), Europe, North America, and South and Central America. The global hydropower potential is also expected to increase from 4350.12 TWh in 2023 to 4806.26 TWh in 2030, 5393.80 TWh in 2040, 6003.53 TWh in 2050, and 6644.06 TWh in 2060, which is sufficient for achieving energy transition and energy security goals. Furthermore, the performance and accuracy of the LSTM-based model were found to be 98%. This study will help in the efficient scheduling and management of hydropower resources, reducing uncertainties caused by environmental variability such as precipitation and runoff. The proposed model contributes to the energy transition and security that is needed to meet the global climate targets. Full article

Sheep pox (SP) is a contagious viral disease affecting sheep, characterized by fever, respiratory distress, hypogalactia, and skin lesions. In response to a series of outbreaks of pox-like lesions with morbidity (75%) and mortality (37%) rates among sheep in the Upper East Region of Ghana, nasal samples were obtained from affected sheep for diagnosis and characterization. The DNA extracted from these samples was tested using quantitative PCR (qPCR). Positive samples were subjected to further analysis for poxvirus marker genes using conventional PCR. Positive amplicons were sequenced, and phylogenetic analysis was conducted. The characterization and comparison of RPO30, GPCR, EEV glycoprotein, and B22R genes with other isolates demonstrated a close genetic relationship with sheep poxviruses (SPVs) identified in other African and Asian countries. This study represents the first comprehensive characterization of SPV in Ghana, and the data generated will be of significant interest to national and regional veterinary authorities. Full article

Background: The incidence of esophagogastric junction cancer (EGJC) is increasing in both Western and Eastern countries. Despite this trend, a globally accepted treatment strategy remains elusive due to the tumor’s anatomical complexity and variability in clinical practice. Aim: This review aims to provide a comprehensive overview of current evidence regarding EGJC treatment, focusing on the surgical approach, extent of lymph node dissection, and perioperative therapy. Special attention is given to regional differences and the implications of recent clinical trials. Findings: Transhiatal and minimally invasive surgical approaches have demonstrated favorable safety profiles, particularly for Siewert type II tumors. Lymph node dissection strategies are increasingly tailored based on the extent of esophageal invasion. Pre- and postoperative chemotherapy and chemoradiotherapy are standard in the West, while East Asian countries are gradually adopting these approaches through trials such as RESOLVE (China) and PRODIGY (Korea). Immunotherapy has also emerged as a promising option following the CheckMate 577 trial. Conclusions: EGJC requires individualized treatment planning based on tumor characteristics and regional practices. While ongoing trials continue to inform optimal management, international collaboration and a stepwise, biomarker-informed approach will be essential to harmonize treatment strategies for this anatomically and therapeutically complex disease. Full article

Background: East Asia accounts for the highest number of anxiety disorders cases globally, with China, Japan, and Republic of Korea representing 17.5% of global incidence according to GBD 2021. These nations offer a unique context for examining how different modernization paths impact anxiety disorders patterns. This study examined anxiety disorders incidence trends across these countries from 1992 to 2021 to compare disease burdens and inform public health strategies. Methods: Using GBD 2021 data, we employed age–period–cohort analysis to evaluate factors affecting anxiety disorders incidence, examining age-specific rates, period effects, and birth cohort influences. Results: All three countries experienced sharp increases in anxiety disorders following COVID-19. Age-standardized incidence rates decreased by 4.89% in China and 10.52% in Japan from 1992 to 2019, while remaining stable in Republic of Korea. Net drift was −0.40% for China, −0.50% for Japan, and approximately 0 for Republic of Korea. Local drifts were positive among older adults in China and Japan, and middle-aged adults in Republic of Korea. Longitudinal age curves showed inverted V-shaped patterns, peaking in the 10–14 age group across all three countries. China and Republic of Korea exhibit a second peak during middle age, while Japan shows continuous decline after the 10–14 age group. Period and cohort effects indicating overall decreases in China and Japan, with minimal changes in Republic of Korea. Conclusions: Different modernization trajectories have produced distinct anxiety disorders patterns across these East Asian nations. The elevated risk among adolescents across all countries warrants targeted interventions, while high risks among middle-aged adults in China and Republic of Korea requires age-specific approaches. Countries should utilize their healthcare systems’ strengths to create targeted strategies for reducing anxiety disorders while addressing pandemic-related mental health impacts. Full article

Middle East (ME) countries have arid and semi-arid climates with low annual precipitation and considerable geographical and temporal variability, which contribute to their extremely erratic rainfall. The generation of timely and accurate climatic information for the ME is anticipated to be aided by global reanalysis products and satellite-based precipitation estimations. Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks (PERSIANN) and Climate Hazards Group Infra-Red Precipitation (CHIRPS) on Google Earth Engine (GEE) were used to study rainfall in eleven chosen ME counties from 2000 to 2023. This study shows that Saudi Arabia (509.64 mm/December–January–February; DJF), Iraq (211.50 mm/September–October–November; SON), Iran (306.35 mm/SON), Jordan (161.28 mm/DJF), Kuwait (44.66 mm), Syria (246.51 mm/DJF), UAE–Qatar–Bahrain (28.62 mm/SON), Oman (64.90 mm/June–July–August; JJA), and Yemen (240.27 mm/SON) were the countries with the highest rainfall. Due to improved ground station integration, CHIRPS also reports larger rainfall anomalies, with a peak of 59.15 mm in DJF, mainly in northern Iran, Iraq, and Syria. PERSIANN understates heavy rainfall, probably because it relies on infrared satellite data, with a maximum anomaly of 4.15 mm. Saudi Arabia saw heavy rain during the JJA months, while others received less. More accurate rainfall forecasts in the ME can lessen the effects of floods and droughts, promoting environmental resilience and regional economic stability. Therefore, a more comprehensive understanding of all the relevant components is necessary to address these difficulties. Both environmental and human impacts must be taken into account for sustainable solutions. Full article

Familial adenomatous polyposis (FAP) is the most common hereditary colorectal adenomatous polyposis and cancer syndrome which has historically been associated with a near absolute risk of colorectal cancer. However, the morbidity and mortality from colorectal cancer has been greatly diminished by pre-symptomatic genetic testing which identifies affected individuals and by appropriately timed, risk-reducing surgery of the colorectum. Following colorectal surgery, cancer risk beyond the retained rectum or ileal pouch includes other gastrointestinal organs, especially those of the upper gastrointestinal tract. While genotype–phenotype correlations exist for the severity of colonic polyposis, they have not been demonstrated for upper gastrointestinal tract manifestations. We reviewed the impact of ethnicity on the upper gastrointestinal manifestations of FAP by a comparison of published data in patients with FAP from Asian and Western countries. Our main findings demonstrate that following risk-reducing surgery to mitigate colorectal cancer risk, patients with FAP remain at increased risk for upper gastrointestinal polyposis and cancer. The duodenal and gastric phenotype differs between patients with FAP from the West and the East, and all should be followed in a multidisciplinary surveillance program. Following risk-reducing surgery to mitigate colorectal cancer risk, patients with familial adenomatous polyposis remain at increased risk for upper gastrointestinal polyposis and cancer. The duodenal and gastric phenotype differs between patients with FAP from the West and the East, and all should be followed in a multidisciplinary surveillance program. Full article

Background: Employing the most recent dataset from the Global Burden of Disease (GBD) Study 2021, this report sought to delineate the current epidemiologic landscape of breast cancer in Asian women. Methods: We examined the evolving trends in disease prevalence and explored the correlations between breast cancer and factors such as age, temporal periods, and generational cohorts. We utilized an autoregressive integrated moving average (ARIMA) model to predict the incidence and deaths of breast cancer in Asia. Results: From 1990 to 2021, the age-standardized incidence rate (ASIR), age-standardized DALYs rate (ASDR), and age-standardized mortality rate showed an overall upward trend for Asian women with breast cancer. In 2021, the high-income Asia Pacific region had the highest ASIR value, while South Asia had the lowest ASIR value. The highest age-standardized mortality rate and ASDR values in 2021 occurred in Southeast Asia, while the lowest values for these metrics were in East Asia. In 2021, breast cancer incidence and DALYs were highest in the 50–54 age group, with deaths peaking in the 55–59 age group. The leading risk factor attributed to breast cancer deaths in Asia in 1990 and 2021 was a “diet high in red meat”. Breast cancer incidence and mortality rates are expected to continue to rise in Asia over the next 10 years. Conclusions: The burden of breast cancer in Asian women is increasing, especially in low SDI countries. This study highlighted the differences between populations and regions and predicted the incidence and mortality rates of breast cancer in Asia over the next decade using an ARIMA model. An increased awareness of breast cancer risk factors and prevention strategies is necessary to reduce breast cancer burden in the future. Full article

This article compares the precept revival movements in Korean and Japanese Buddhism in the early modern period. It examines how monks in both countries, in particular, in the Korean Hyujŏng lineage and the Japanese Shingon sect, restored and utilized the precept tradition to re-establish Buddhist identity in the midst of rapid political and social change. Although in different ways, Buddhism in the early modern period in both countries experienced state control and an anti-Buddhist milieu, making it difficult to maintain its religious identity. Various efforts were made to overcome this hardship, the most prominent of which was the precept revival movement. In the early 19th century, in Chosŏn Korea, Taeŭn and Paekp’a sought to restore the bhikṣu lineage by overhauling the bhikṣu ordination rituals through the “reception of the precepts through an auspicious sign” and “the reception of the ten wholesome precepts”, respectively, while in mid-to-late 18th-century Japan, the Shingon master Jiun advocated a return to the teachings of Śākyamuni through the Shōbō-ritsu movement. While both countries focused on precept revival as a way to solidify Buddhist religious identity, Korea emphasized the restoration of the bhikṣu lineage, while Japan, especially in the Shingon-shū, emphasized a return to the fundamental teachings of the Buddha. These differences stem from the unique historical backgrounds of the two countries and the distinctive developments of their Buddhist traditions. By comparing the precept revival movements in both countries, this study examines how different precept traditions influenced the identity of East Asian Buddhism in the early modern period and how these efforts have been fundamental in maintaining Buddhist orthodoxy into the modern era. Full article

The East Asian world has shared both universal characteristics and regional particularities, forming a Buddhist cultural area for more than 1500 years. One of the main features of East Asian Buddhism is a “state–Buddhist link”. This article will focus on the early modern period, and on the periphery, Korea and Japan, rather than the center, China. If we can identify the attributes of the institutional connection between the state and Buddhism in this peripheral area of the East Asian world, and in a period when Buddhism was less prominent than before, we can understand it as a long-term universal characteristic of East Asian Buddhist cultures. In this article, I have tried to locate the common ground between Japanese and Korean Buddhism in the early modern period at two points: the change in the perception of Buddhism in the early modern period and the mechanism of the relationship between the state and Buddhism. The common ground here is that there is a movement in the two countries to break away from the negative perception of Buddhism in the early modern period and approach its historical reality. In terms of the mechanism of the relationship between the state and Buddhism, the Edo period saw the implementation of the temple parish system, which linked temples and people in each region, allowing the shogunate to indirectly control the people, while each sect was able to establish financial stability and thus its sectarian identity. In late Chosŏn, the institutionalization of the monk state service allowed the state to utilize the monk labor force and the surplus goods of the temples, and in return, the Buddhist community was allowed to rather peacefully exist in Confucian society. This shows that there was a close relationship between the two. There are many differences between Japanese and Korean Buddhism in the early modern period, but they share the characteristics of state Buddhism, where the state and Buddhism were institutionally related. The mechanism of the win–win relationship between the state and Buddhism can be understood as a universal characteristic of East Asian Buddhist history beyond Japan and Korea in the early modern period. Full article

The Manchurian fruit moth, Grapholita inopinata (Heinrich) (Lepidoptera: Tortricidae), is an important pest of fruit crops, particularly apples (Malus spp., Rosaceae), and is classified as a quarantine pest in many European countries and other world regions. Until recently, this species was known only in Northeastern China, Japan, and Russia (from Eastern Siberia and the Far East). To determine the westernmost distribution of G. inopinata and assess its abundance, we conducted nine-year pheromone monitoring across 13 administrative regions of Russia from 2014 to 2018 and 2021 to 2024. A total of 1866 traps were deployed, capturing 31,962 G. inopinata specimens in 1811 traps. The species was newly detected in eight regions—seven in Asian Russia and one in European Russia (Perm Krai). These findings doubled the moth’s known range on the Asian continent and extended its western boundary to 56° E in European Russia. Between 2021 and 2024, G. inopinata was generally found at low densities across the surveyed regions (≤10 males per trap per week), with the exception of Perm Krai, Omsk, and Novosibirsk Oblasts, where moderate abundance (up to 38 males per trap per week) was recorded. In contrast, from 2014 to 2018, moderate to high population densities (up to 94 males per trap per week), including mass occurrences (over 100 males per trap per week), were observed in Krasnoyarsk Krai, with an absolute peak capture of 303 males in one trap in June 2017. Notably, in 2015–2017, male flight activity in southern Krasnoyarsk Krai exhibited two distinct peaks: one in mid-to-late June and another from late July to mid-August, indicating the development of two generations. This is the first-ever record of a bivoltine seasonal cycle for G. inopinata in Siberia. These findings are critical for improving pest risk assessments and developing early detection strategies, supporting more effective monitoring and management approaches of this orchard pest. Full article

Human outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) are more common in Middle Eastern and Asian human populations, associated with clades A and B. In Africa, where clade C is dominant in camels, human cases are minimal. We reviewed 16 studies (n = 6198) published across seven African countries between 2012 and 2024 to assess human MERS-CoV cases. We also analyzed data from four cohort studies conducted in camel-keeping communities between 2018 and 2024 involving camel keepers, camel slaughterhouse workers, and hospital patients with acute respiratory illness (ARI). The analysis showed a pooled MERS-CoV prevalence of 2.4% (IQR: 0.6, 11.4) from 16 publications and 1.14% from 4 cohort studies (n = 2353). Symptomatic cases were rarely reported, with most individuals reporting camel contact, and only 12% had travel history to the Middle East. There was one travel-associated reported death, resulting in a mortality rate of 0.013%. The findings suggest a low camel-to-human transmission of clade C MERS-CoV in Africa. Ongoing research focuses on genomic comparisons between clade C and the more virulent clades A and B, alongside the surveillance of viral evolution. This study highlights the need for continuous monitoring but indicates that MERS-CoV clade C currently poses a minimal public health threat in Africa. Full article