Genetic characterization of cucumber genetic resources in the NARO Genebank indicates their multiple dispersal trajectories to the East.

KEY MESSAGE: Genotyping-by-sequencing of 723 worldwide cucumber genetic resources revealed that cucumbers were dispersed eastward via at least three distinct routes, one to Southeast Asia and two from different directions to East Asia. The cucumber (Cucumis sativus) is an economically important vegetable crop cultivated and consumed worldwide. Despite its popularity, the manner in which cucumbers were dispersed from their origin in South Asia to the rest of the world, particularly to the east, remains a mystery due to the lack of written records. In this study, we performed genotyping-by-sequencing (GBS) on 723 worldwide cucumber accessions, mainly deposited in the Japanese National Agriculture and Food Research Organization (NARO) Genebank, to characterize their genetic diversity, relationships, and population structure. Analyses based on over 60,000 genome-wide single-nucleotide polymorphisms identified by GBS revealed clear genetic differentiation between Southeast and East Asian populations, suggesting that they reached their respective region independently, not progressively. A deeper investigation of the East Asian population identified two subpopulations with different fruit characteristics, supporting the traditional classification of East Asian cucumbers into two types thought to have been introduced by independent routes. Finally, we developed a core collection of 100 accessions representing at least 93.2% of the genetic diversity present in the entire collection. The genetic relationships and population structure, their associations with geographic distribution and phenotypic traits, and the core collection presented in this study are valuable resources for elucidating the dispersal history and promoting the efficient use and management of genetic resources for research and breeding in cucumber.

Racial/Ethnic Disparities in Psychiatric Traits and Diagnoses within a Community-based Sample of Children and Youth: Disparités raciales/ethniques dans les traits et diagnostics psychiatriques au sein d'un échantillon communautaire d'enfants et de jeunes.

OBJECTIVE: Racial/ethnic disparities in the prevalence of psychiatric disorders have been reported, but have not accounted for the prevalence of the traits that underlie these disorders. Examining rates of diagnoses in relation to traits may yield a clearer understanding of the degree to which racial/ethnic minority youth in Canada differ in their access to care. We sought to examine differences in self/parent-reported rates of diagnoses for obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders after adjusting for differences in trait levels between youth from three racial/ethnic groups: White, South Asian and East Asian. METHOD: We collected parent or self-reported ratings of OCD, ADHD and anxiety traits and diagnoses for 6- to 17-year-olds from a Canadian general population sample (Spit for Science). We examined racial/ethnic differences in trait levels and the odds of reporting a diagnosis using mixed-effects linear models and logistic regression models. RESULTS: East Asian (N = 1301) and South Asian (N = 730) youth reported significantly higher levels of OCD and anxiety traits than White youth (N = 6896). East Asian and South Asian youth had significantly lower odds of reporting a diagnosis for OCD (odds ratio [OR]East Asian = 0.08 [0.02, 0.41]; ORSouth Asian = 0.05 [0.00, 0.81]), ADHD (OREast Asian = 0.27 [0.16, 0.45]; ORSouth Asian = 0.09 [0.03, 0.30]) and anxiety (OREast Asian = 0.21 [0.11, 0.39]; ORSouth Asian = 0.12 [0.05, 0.32]) than White youth after accounting for psychiatric trait levels. CONCLUSIONS: These results suggest a discrepancy between trait levels of OCD, ADHD and anxiety and rates of diagnoses for East Asian and South Asian youth. This discrepancy may be due to increased barriers for ethnically diverse youth to access mental health care. Efforts to understand and mitigate these barriers in Canada are needed.

We know that there is there are differences in the prevalence of childhood mental illnesses by race/ethnic group, which may be related to disproportionate access to mental health care. What is unknown is whether there this difference in prevalence is related to differences in the presence of symptoms for mental illness or whether children and youth from marginalized racial/ethnic groups have symptoms but are not getting diagnosed. This information is needed to understand the degree to which children and youth from marginalized race/ethnicity groups are accessing mental health care in Canada. We tested the differences in reported symptoms and diagnosis of three common and impairing childhood-onset disorders (obsessive-compulsive disorder­OCD), attention-deficit/hyperactivity disorder­ADHD and anxiety disorders) in children and youth (6­17 years of age) living in Canada that were from three racial/ethnic groups: White, South Asian and East Asian. East Asian and South Asian youth reported significantly higher levels of OCD and anxiety traits than White youth. However, East Asian and South Asian youth were significantly less likely than White youth to have a reported diagnosis of OCD, ADHD or anxiety even after accounting for symptom levels for each disorder. Our findings suggest that East and South Asian children are less likely than White children to get a diagnosis for common mental illness even if they have symptoms of that mental illness. This gap in receiving a diagnosis might be because of more barriers to mental health care for children and youth from marginalized racial/ethnic groups but we need more research to pinpoint the cause.

Global and regional estimates of tuberculosis burden attributed to high fasting plasma glucose from 1990 to 2019: emphasis on earlier glycemic control.

BACKGROUND: Previous studies have shown subjects suffering from diabetes or persistent hyperglycemia were more likely to develop tuberculosis (TB). However, the global burden of TB attributed to high fasting plasma glucose (HFPG) remains unclear. This study aimed to characterize the global, regional, and national TB burden attributed to HFPG from 1990 to 2019. METHODS: With Global Burden of Disease study 2019, the numbers and age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years (DALY) rates (ASDR) of TB attributed to HFPG at global, regional, and national levels from 1990 to 2019 were extracted. The locally weighted regression model was applied to estimate the TB burden for different socio-demographic index (SDI) regions. RESULTS: Globally, the ASMR and ASDR attributed to HFPG were 2.70 (95% UI, 1.64-3.94) and 79.70 (95% UI, 50.26-112.51) per 100,000 population in 1990, respectively. These rates decreased to 1.46 (95% UI, 0.91-2.08) and 45.53 (95% UI, 29.06-62.29) in 2019. The TB burden attributed to HFPG remained high in low SDI and Central Sub-Saharan Africa regions, while it declined with most significantly in high SDI and East Asia regions. Additionally, the ASMR and ASDR of TB attributed to HFPG were significantly higher in the male and the elderly population. CONCLUSIONS: The global TB burden attributable to HFPG decreased from 1990 to 2019, but remained high in low SDI regions among high-risk populations. Thus, urgent efforts are required to enhance the awareness of early glycemic control and TB treatment to alleviate the severe situation.

Colorectal cancer and its attributable risk factors in East Asia, 1990-2030.

BACKGROUND: The disease burden of colorectal cancer in East Asia has been at a high level. However, the epidemiological characteristics of the disease burden in this region have not been systematically studied. METHOD: Data were obtained from the Global Burden of Disease 2019 program. Joinpoint analysis was used to identify long-term trends in mortality of colorectal cancer. Independent effects of age, period, and cohort were detected by the age-period-cohort model. The Bayesian age-period-cohort model was performed to predict the burden of colorectal cancer across East Asia by 2030. RESULTS: From 1990 to 2019, the average annual percentage change (AAPC) showed upward trends in mainland China (1.05 [95% confidence interval (CI)], 0.82, 1.28) as well as Taiwan Province of China (1.81 [95% CI], 1.51, 2.10) but downward in Japan (-0.60 [95% CI], -0.70, -0.49) (P < 0.05). Attributable risk factors for colorectal cancer in East Asia remained stable over 30 years, while the risk of metabolic factors is noteworthy in the future. In the next decade, the age-standardized death rate (ASDR) of colorectal cancer in China was predicted to surpass that of Japan and South Korea in expectation. CONCLUSION: The mortality of colorectal cancer is escalating in developing countries, while it is gradually declining in high-income countries across East Asia. Nonetheless, the disease burden of colorectal cancer in high-income countries remains substantial level.

Trends in gastric cancer incidence and mortality in Asia and association analysis with human development index, 1990-2019.

OBJECTIVES: To describe the epidemiological time trends and gender, age and regional differences of gastric cancer in Asia during 1990-2019, and to analyze the association between the human development index (HDI) and the statistical indicators of the burden of disease. METHODS: Describing trends in age-standardized incidence rates (ASIR) and age-standardized mortality rate (ASMR) in Asia from 1990 to 2019 based on GBD-reported population-based surveillance of gastric cancer in Asia. Obtained ASIR, ASMR, and mortality to incidence ratios (MIR) for gastric cancer in different countries in 2019, with association analysis by Kruskal-Wallis nonparametric test. RESULTS: The annual percentage change in ASIR and ASMR in Asia from 1990 to 2019 was - 1.20% and - 1.91%. Male gastric cancer patients have higher ASIR and ASMR than female gastric cancer patients. Decreasing trends in ASIR and ASMR for the total population in five Asian regions. From 1990 to 2019, the average annual change in ASMR was - 2.45%, - 1.43%, - 0.53%, - 0.62%, and - 0.27% for Central Asia, East Asia, high-income Asia-Pacific, South Asia, and Southeast Asia, respectively (p < 0.05). Both incidence and mortality were concentrated in the age groups of 85-89 and 89-94 years. Classifying Asian countries into different levels of HDI, only MIR was associated with HDI levels. CONCLUSION: ASIR and ASMR of gastric cancer in the total population, different regions, and countries in Asia from 1990 to 2019 showed an overall decreasing trend. The MIR index is suggestive of survival rates and the role of cancer care in individual countries. Asian countries should develop different strategies for gastric cancer screening and prevention according to high-risk age, high-risk gender and HDI.

Developing Climate Change and Health Impact Monitoring with eHealth at the South East Asia Community Observatory and Health and Demographic Surveillance Site, Malaysia (CHIMES).

Background: Malaysia is projected to experience an increase in heat, rainfall, rainfall variability, dry spells, thunderstorms, and high winds due to climate change. This may lead to a rise in heat-related mortality, reduced nutritional security, and potential migration due to uninhabitable land. Currently, there is limited data regarding the health implications of climate change on the Malaysian populace, which hinders informed decision-making and interventions. Objective: This study aims to assess the feasibility and reliability of using sensor-based devices to enhance climate change and health research within the SEACO health and demographic surveillance site (HDSS) in Malaysia. We will particularly focus on the effects of climate-sensitive diseases, emphasizing lung conditions like chronic obstructive pulmonary disease (COPD) and asthma. Methods: In our mixed-methods approach, 120 participants (>18 years) from the SEACO HDSS in Segamat, Malaysia, will be engaged over three cycles, each lasting 3 weeks. Participants will use wearables to monitor heart rate, activity, and sleep. Indoor sensors will measure temperature in indoor living spaces, while 3D-printed weather stations will track indoor temperature and humidity. In each cycle, a minimum of 10 participants at high risk for COPD or asthma will be identified. Through interviews and questionnaires, we will evaluate the devices' reliability, the prevalence of climate-sensitive lung diseases, and their correlation with environmental factors, like heat and humidity. Results: We anticipate that the sensor-based measurements will offer a comprehensive understanding of the interplay between climate-sensitive diseases and weather variables. The data is expected to reveal correlations between health impacts and weather exposures like heat. Participant feedback will offer perspectives on the usability and feasibility of these digital tools. Conclusion: Our study within the SEACO HDSS in Malaysia will evaluate the potential of sensor-based digital technologies in monitoring the interplay between climate change and health, particularly for climate-sensitive diseases like COPD and asthma. The data generated will likely provide details on health profiles in relation to weather exposures. Feedback will indicate the acceptability of these tools for broader health surveillance. As climate change continues to impact global health, evaluating the potential of such digital technologies is crucial to understand its potential to inform policy and intervention strategies in vulnerable regions.

Analyzing the impact of industrial growth and agricultural development on environmental degradation in South and East Asia.

This study aims to examine the impact of industrial growth, agricultural value added, economic growth, and renewable energy consumption on environmental pollution in South and East Asian countries using panel ARDL approach over the period 1970-2020. Furthermore, the impact of institutional quality in this relationship is uniquely explored. Baseline model suggests that environmental damage is exacerbated by agricultural value added and industrial growth in the long run, but not in the short run. The relationship between economic growth and carbon emissions is an obvious inverted U-shaped link in the long run, but it is a U-shaped association in the short run. Renewable energy consumption has significant adverse effects on environmental pollution both in the short and long term. In the long run, institutional quality plays a stronger moderating role in the association between baseline regressors and environmental pollution. Also, institutional quality helps to expand the ability of industry and agriculture to improve environmental quality. Lastly, the threshold results reflect that the impact of regressors on environmental degradation is penetrating into the level of institutional quality. The strong progressive effects of agricultural and industrial growth on environmental degradation are more similar to the existing literature in the long term, but not in the short term. In addition, the long-term condensation effect of renewable energy on CO2 emissions and the enhancing effect of economic growth on CO2 emissions are relatively similar to existing literature. In contrast to weak institutional quality, strong institutions can improve the ability of agriculture and industry to reduce environmental damage.

Financial fragility, human resource management, and transition to renewable energy in Asian economies: a comparative analysis.

The main hurdle in deploying renewable energy projects is the high initial cost, making it difficult for businesses and individuals to afford it. The fragility of the financial sector and human resource management further slows the pace of renewable energy demand. Therefore, we aim to investigate the impact of financial fragility and human resource management on renewable energy consumption over time horizon 1997-2020. To that end, the analysis employed the ARDL-PMG model. For Asia as a whole and all other sub-regions, including South East Asia, East Asia, South Asia, and Western Asia, the estimates for bank non-performing loans are notably negative. In general, these findings imply that a rise in financial fragility significantly reduces renewable energy consumption in the long run. In the short run, the estimates attached to both bank non-performing loans and bank costs are negatively significant in Asia and sub-regions of Western Asia only. The results for the human resources show that it exerts a significant and positive influence on renewable energy demand in Asia as a whole, South Asia, East Asia, and Western Asia. The estimates attached to human resources are statistically insignificant in all models in the short run. In the end, some important public strategies and their implementations have been discussed.

Treatment strategy changes for inflammatory bowel diseases in biologic era: results from a multicenter cohort in Japan, Far East 1000.

Many molecular targeted agents, including biologics, have emerged for inflammatory bowel diseases (IBD), but their high prices have prevented their widespread use. This study aimed to reveal the changes in patient characteristics and the therapeutic strategies of IBD before and after the implementation of biologics in Japan, where the unique health insurance system allows patients with IBD and physicians to select drugs with minimum patient expenses. The analysis was performed using a prospective cohort, including IBD expert and nonexpert hospitals in Japan. In this study, patients were classified into two groups according to the year of diagnosis based on infliximab implementation as the prebiologic and biologic era groups. The characteristics of therapeutic strategies in both groups were evaluated using association analysis. This study analyzed 542 ulcerative colitis (UC) and 186 Crohn's disease (CD). The biologic era included 53.3% of patients with UC and 76.2% with CD, respectively. The age of UC (33.9 years vs. 38.8 years, P < 0.001) or CD diagnosis (24.3 years vs. 31.9 years, P < 0.001) was significantly higher in the biologic era group. The association analysis of patients with multiple drug usage histories revealed that patients in the prebiologic era group selected anti-tumor necrosis factor (TNF)-α agents, whereas those in the biologic era group preferred biologic agents with different mechanisms other than anti-TNF-α. In conclusion, this study demonstrated that both patient characteristics and treatment preferences in IBD have changed before and after biologic implementation.

Exploring the nonlinear relationship among financial development, human capital and CO2 emissions: a comparative study of South and East Asian emerging economies.

Despite worldwide commitments to reduce fossil fuel consumption in favour of alternative energies, several countries still rely on carbon-intensive sources to meet their energy demands. The previous studies show inconsistent results on the association between financial development and CO2 emissions. As a result, the impact of financial development, human capital, economic growth and energy efficiency on CO2 emission is evaluated here. Empirical research on a panel of 13 South and East Asian (SEA) nations between 1995 and 2021 using the CS-ARDL. Estimates from the empirical analysis considering energy efficiency, human capital, economic growth and overall energy use yield different findings. Financial development has a negative effect on CO2 emission, while economic growth positively impacts CO2 emission. The data also show that improving human capital and energy efficiency has a positive, though statistically insignificant, impact on CO2 emission. According to the causes and effects analysis, CO2 emission will be influenced by policies that aim to improve financial development, human capital, and energy efficiency, but not vice versa. Policy considerations that can be implemented in light of these findings and sustainable development goals can be accomplished by promoting financial resources and human capital.

Burden of non-communicable diseases among adolescents and young adults aged 10-24 years in the South-East Asia and Western Pacific regions, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.

BACKGROUND: Although non-communicable diseases (NCDs) remain the leading causes of mortality and disability worldwide, little comprehensive or recent evidence of the burden of NCDs among adolescents and young adults in the South-East Asia and Western Pacific regions is available. We aimed to report population shifts in people aged 10-24 years and their NCD burden from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS: We retrieved data from GBD 2019 for people aged 10-24 years in the South-East Asia and Western Pacific regions from 1990 to 2019. We presented population shifts and analysed deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for NCDs. We also quantified the associations of deaths and DALYs with the Socio-demographic Index (SDI) and Universal Health Coverage (UHC) effective coverage index using Spearman correlation and linear regression analyses. Percentages are reported to 1 decimal place and rates are reported to 2 decimal places. FINDINGS: In 2019, there were 559·2 million young people aged 10-24 years in the South-East Asia region and 335·0 million in the Western Pacific region; India and China remained the countries with greatest number of this age group. In 1990-2019, India had an absolute increase of 139·4 million adolescents, while China had a decrease of 134·3 million. In 2019, NCDs accounted for 27·3% (95% uncertainty interval 25·1 to 29·2) and 34·6% (33·5 to 36·1) of total deaths, and 49·8% (45·3 to 54·4) and 65·1% (60·6 to 69·3) of total DALYs in the South-East Asia and the Western Pacific regions, respectively. Neoplasms, cardiovascular diseases, and mental disorders were the leading causes of NCD burden in 42 countries. Kiribati had the highest rates of deaths (62·82 [50·77 to 76·11] per 100 000 population), YLLs (4364·73 [3545·04 to 5275·63] per 100 000 population), and DALYs (9368·73 [7713·65 to 11340·99] per 100 000 population) for NCDs, whereas Australia (6976·51 [5044·46 to 9190·01] per 100 000 population) and New Zealand (6716·81 [4827·25 to 8827·69] per 100 000 population) had the largest rates of YLDs due to NCDs. From 1990 to 2019 across both regions, the rate of death due to NCDs declined by over a third (-32·8% [-41·1 to -22·9] in the South-East Asia region and -40·0% [-48·6 to -30·4] in the Western Pacific region), and DALYs decreased by about 12% (-12·0% [-16·8 to -7·7] in the South-East Asia region and -12·8% [-17·7 to -8·7] in the Western Pacific region), whereas the proportion of NCD burden relative to all-cause burden increased (45·7% [32·9 to 61·7] for deaths and 41·2% [35·2 to 48·8] for DALYs in the South-East Asia region; 11·8% [7·1 to 21·5] for deaths and 18·2% [14·6 to 22·0] for DALYs in the Western Pacific region). The rate of deaths and DALYs due to NCDs decreased monotonically alongside increases in SDI (rs=-0·57 [95% CI -0·81 to -0·32] for deaths and rs=-0·30 [-0·61 to 0·03] for DALYs). The rate of deaths (rs=-0·89 [95% CI -0·97 to -0·80]) and DALYs (rs=-0·67 [-0·93 to -0·41]) due to NCDs also decreased alongside increases in the UHC effective coverage index. INTERPRETATION: Specific preventive and health service measures are needed for adolescents and young adults in countries with different levels of socioeconomic development to reduce the burden from NCDs. FUNDING: National Natural Science Foundation of China. TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.

A Bibliometric Analysis of Myopia Research in East Asia in the 21st Century: The Socio-Economic Status and Quantitative Analysis.

The purpose of this study is to assess the quantity and quality of myopia related articles from 2001 to 2021 using bibliometric methods. The number of published articles and citations, the correlation analysis between gross domestic product (GDP) and annual publication number and citations was investigated. The proportion of myopia articles from East Asia accounted for 55.28% in 2021. The researchers from China published the most articles on myopia during 2001 to 2021, followed by Japan and South Korea. The annual number of articles and citations from China and South Korea showed an exponential increase with strong positive correlation with GDP. All 3 countries in East Asia are mainly researching refractive surgery, prevalence, and glaucoma, and research on children's myopia is particularly active in China, and in Japan. The researchers from East Asia published more than half of articles on myopia since 2019, in order of China, Japan, and South Korea. The annual number of articles and citations from China and South Korea showed an exponential increase with strong positive correlation with GDP whereas those from Japan did not. All 3 countries are mainly researching refractive surgery, and glaucoma, and research on children's myopia is particularly active in China, and in Japan.

The role of renewable, non-renewable energy consumption, trade, economic growth, and urbanization in achieving carbon neutrality: A comparative study for South and East Asian countries.

This study uses a comparative approach for comparing the nexus of economic growth, renewable and nonrenewable energy consumption, urbanization, trade, and CO2 emissions for South and East Asian countries from 2000 to 2018. The short- and long-run connections between the variables are explored using the dynamic common correlated effects (DCCE) CS-ARDL approach, and the causal linkages are assessed using the Dumitrescu-Hurlin (DH) panel causality test. The data show that the factors have long-term relationships. The findings show that nonrenewable energy consumption and economic growth increase long-term CO2 emissions in South Asia, but trade and use of renewable energy consumption reduce CO2 emissions in the short term. Long-term causal relationships between CO2 emissions, renewable energy use, economic growth, and trade are also revealed by the South Asian causality test. In East Asia, economic growth, NREC, trade, and urbanization increased CO2 emissions in the short and long run, while REC appears to reduce CO2 emissions. According to the causality analysis, long-run bidirectional causation exists between CO2 emissions, renewable energy use, economic growth, and trade. Furthermore, policy suggestions may be made, such as using renewable energy sources to lessen CO2 emissions and improving education and corruption to forecast economic growth in the examined areas.

Assessment of Characteristics of Imaging Biomarkers for Quantifying Anterior Cingulate Cortex Changes: A Twin Study of Middle- to Advanced-Aged Populations in East Asia.

Background and Objectives: Our aim was to assess genetic and environmental effects on surface morphological parameters for quantifying anterior cingulate cortex (ACC) changes in middle- to advanced-age East Asians using twin analysis. Materials and Methods: Normal twins over 39 years old comprising 37 monozygotic pairs and 17 dizygotic pairs underwent 3-dimensional (3D) T1-weighted imaging of the brain at 3T. Freesurfer-derived ACC parameters including thickness, standard deviation of thickness (STDthickness), volume, surface area, and sulcal morphological parameters (folding, mean, and Gaussian curvatures) were calculated from 3D T1-weighted volume images. Twin analysis with a model involving phenotype variance components of additive genetic effects (A), common environmental effects (C), and unique environmental effects (E) was performed to assess the magnitude of each genetic and environmental influence on parameters. Results: Most parameters fit best with an AE model. Both thickness (A: left 0.73/right 0.71) and surface area (A: left 0.63/right 0.71) were highly heritable. STDthickness was low to moderately heritable (A: left 0.48/right 0.29). Volume was moderately heritable (A: left 0.37). Folding was low to moderately heritable (A: left 0.44/right 0.28). Mean curvature (A: left 0.37/right 0.65) and Gaussian curvature (A: right 0.79) were moderately to highly heritable. Right volume and left Gaussian curvature fit best with a CE model, indicating a relatively weak contribution of genetic factors to these parameters. Conclusions: When assessing ACC changes in middle- to advanced-age East Asians, one must keep in mind that thickness and surface area appear to be strongly affected by genetic factors, whereas sulcal morphological parameters tend to involve environmental factors.

A hybrid of long short-term memory neural network and autoregressive integrated moving average model in forecasting HIV incidence and morality of post-neonatal population in East Asia: global burden of diseases 2000-2019.

BACKGROUND: To forecast the human immunodeficiency virus (HIV) incidence and mortality of post-neonatal population in East Asia including North Korea, South Korea, Mongolia, Japan and China Mainland and Taiwan province. METHODS: The data on the incidence and mortality of HIV in post-neonatal population from East Asia were obtained from the Global Burden of Diseases (GBD). The morbidity and mortality of post-neonatal HIV population from GBD 2000 to GBD 2013 were applied as the training set and the morbidity and mortality from GBD 2014 to GBD 2019 were used as the testing set. The hybrid of ARIMA and LSTM model was used to construct the model for assessing the morbidity and mortality in the countries and territories of East Asia, and predicting the morbidity and mortality in the next 5 years. RESULTS: In North Korea, the incidence and mortality of HIV showed a rapid increase during 2000-2010 and a gradual decrease during 2010-2019. The incidence of HIV was predicted to be increased and the mortality was decreased. In South Korea, the incidence was increased during 2000-2010 and decreased during 2010-2019, while the mortality showed fluctuant trend. As predicted, the incidence of HIV in South Korea might be increased and the mortality might be decreased during 2020-2025. In Mongolia, the incidence and mortality were slowly decreased during 2000-2005, increased during 2005-2015, and rapidly decreased till 2019. The predicted incidence and mortality of HIV showed a decreased trend. As for Japan, the incidence of HIV was rapidly increased till 2010 and then decreased till 2015. The predicted incidence of HIV in Japan was gradually increased. The mortality of HIV in Japan was fluctuant during 2000-2019 and was slowly decreased as predicted. The incidence and mortality of HIV in Taiwan during 2000-2019 was increased on the whole. The predicted incidence of HIV during was stationary and the mortality was decreased. In terms of China Mainland, the incidence and mortality of HIV was fluctuant during 2000-2019. The predicted incidence of HIV in China Mainland was stationary while the mortality was rapidly decreased. CONCLUSION: On the whole, the incidence of HIV combined with other diseases in post-neonatal population was increased before 2010 and then decreased during 2010-2019 while the mortality of those patients was decreased in East Asia.

Health awareness and skilled birth attendance: An assessment of sustainable development goal 3.1 in south and south-east Asia.

BACKGROUND: The United Nation's Sustainable Development Goal 3.1 aims to reduce maternal mortality worldwide to 70 per 100,000 live births by 2030, which requires greater skilled birth attendant (SBA) coverage and increased health awareness. By evaluating relevant sociodemographic factors, this study aimed to identify different groups of women who lack health awareness and access to SBA services in eight selected low-and-middle-income countries (LMICs) of South and South-East Asia (SSEA), namely, Afghanistan, India, Indonesia, Myanmar, Nepal, Pakistan, Philippines, and Timor-Leste. METHODS: Nationally representative Demographic and Health Surveys (DHS) on women aged 15-49 years were analysed with a pooled sample of 95,521. Complex survey-adjusted logistic regression models were fitted to assess sociodemographic factors, SBA coverage, and health awareness. RESULTS: Women with higher health awareness were 44.4% (95% CI:1.32-1.58, p<0.001) more likely to access SBAs compared to the rest. Women and/or their partners with no or primary-level education, who were poorer, became young mothers (≤20 years), not involved in decision-making, or hardly exposed to media were less likely to seek SBAs and have higher health awareness. Women in rural areas with more children were also less likely to use SBAs. Timor-Leste, Afghanistan, Myanmar, and Nepal underperformed on SBA coverage amongst the selected LMICs of the SSEA region. CONCLUSION: Health education and mass-media-driven awareness could be an interventional avenue for LMICs to increase SBA coverage. Future studies comparing health policies within the SSEA region are required to identify reasons behind some nations' underperformance, while others are on track to achieve SDG 3.1.

Health financing policy responses to the COVID-19 pandemic: a review of the first stages in the WHO South-East Asia Region.

COVID-19 imposed unprecedented financing requirements on countries to rapidly implement effective prevention and control measures while dealing with severe economic contraction. The challenges were particularly acute for the 11 countries in the WHO South-East Asia Region (SEAR), home to the lowest average level of public expenditure on health of all WHO regions. We conducted a narrative review of peer-reviewed, grey literature and publicly available sources to analyse the immediate health financing policies adopted by countries in the WHO SEAR in response to COVID-19 in the first 12 months of the pandemic, i.e. from 1 March 2020 to 1 March 2021. Our review focused on the readiness of health systems to address the financial challenges of COVID-19 in terms of revenue generation, financial protection and strategic purchasing including public financial management issues. Twenty peer-reviewed articles were included, and web searches identified media articles (n = 21), policy reports (n = 18) and blog entries (n = 5) from reputable sources. We found that countries in the SEAR demonstrated great flexibility in responding to the COVID-19 pandemic, including exploring various options for revenue raising, removing financial barriers to care and rapidly adapting purchasing arrangements. At the same time, the pandemic exposed pre-existing health financing policy weaknesses such as underinvestment, inadequate regulatory capacity of the private health sector and passive purchasing, which should give countries an impetus for reform towards more resilient health systems. Further monitoring and evaluation are needed to assess the long-term implications of policy responses on issues such as government capacity for debt servicing and fiscal space for health and how they protect progress towards the objectives of universal health coverage.

Efficient and cost-effective non-invasive population monitoring as a method to assess the genetic diversity of the last remaining population of Amur leopard (Panthera pardus orientalis) in the Russia Far East.

Small populations of the endangered species are more vulnerable to extinction and hence require periodic genetic monitoring to establish and revisit the conservation strategies. The Amur leopard is critically endangered with about 100 individuals in the wild. In this study, we developed a simple and cost-effective noninvasive genetic monitoring protocol for Amur leopards. Also, we investigated the impact of fecal sample's age, storage, and collection season on microsatellite genotyping success and data quality. We identified 89 leopard scats out of the 342 fecal samples collected from Land of the Leopard between 2014-2019. Microsatellite genotyping using 12 markers optimized in 3 multiplex PCR reactions reveals presence of at least 24 leopard individuals (18 males and 6 females). There was a significant difference in the success rate of genotyping depending on the time from feces deposition to collection (p = 0.014, Fisher's exact test), with better genotyping success for samples having <2 weeks of environmental exposure. Amur leopard genetic diversity was found low (Ho- 0.33, HE- 0.35, and NA- 2.57) with no visible population substructure and recent bottleneck signature. Although a historical bottleneck footprint was observed. Mitochondrial DNA diversity was also found low with two haplotypes differing by a point mutation reported in 1,769 bp of investigated sequence covering parts of cytochrome b gene (846 bp), NADH-5 gene (611 bp) and control region (312 bp). We recommend periodic genetic monitoring of wild Amur leopards following the proposed methodology to achieve cost effectiveness and efficiency.