The field of onco-microbiome is rapidly expanding. Multiple studies have shown the crucial role of gut microbiota in the regulation of nutrient metabolism, immunomodulation and protection against pathogens. Tools for manipulating the gut microbiota include dietary modification and faecal microbiota transfer. Accumulating evidence has also documented the application of specific intestinal microbiome in cancer immunotherapy, notably in enhancing the efficacy of immune checkpoint inhibitors. The aim of this review is to focus on the East Asian microbiome and to provide a current overview of microbiome science and its clinical application in cancer biology and immunotherapy.
Humans ; Gastrointestinal Microbiome ; Neoplasms/microbiology* ; Immunotherapy/methods* ; Asia, Eastern ; Medical Oncology ; Fecal Microbiota Transplantation ; Immune Checkpoint Inhibitors/therapeutic use* ; East Asian People

INTRODUCTION: Randomised controlled trials (RCTs) have informed guideline recommendations for the management of stable coronary artery disease (CAD). However, the real-world impact of contemporary guidelines and trials on practising physicians in the Asia-Pacific region remains uncertain. We aimed to evaluate the knowledge, attitudes and practices among cardiovascular physicians in the region regarding stable CAD management. METHOD: An anonymised cross-sectional electronic survey was administered to cardiovascular practitioners from the Asia Pacific, assessing 3 domains: 1) baseline knowledge on recent trials and society guideline, 2) attitudes towards stable CAD, and 3) case scenarios reflecting management preferences. Correlations among knowledge, attitudes and practice scores were assessed between physicians from developed and developing countries using Pearson correlation. RESULTS: Overall, 713 respondents from 21 countries completed the survey. The mean knowledge score was 2.90±1.18 (out of 4), with 37.3% of respondents answering all questions correctly, while 74.6% noted that guidelines have significant impact on their practice. Despite guidelines recommending optimal medical therapy, majority chose revascularisation (range 53.4- 90.6%) as the preferred strategy for the case scenarios. Practitioners from developed regions had higher knowledge scores and lower attitude scores compared to developing regions, while practice scores were similar in both groups. Weakly positive correlations were noted between knowledge, attitude and practice scores. CONCLUSION Variations exist in knowledge and attitudes towards guideline recommendations and correspondingly actual clinical practice in the Asia Pacific, with most practitioners choosing an upfront invasive strategy for the treatment of stable CAD. These differences reflect real-world disparities in guideline interpretation and clinical adoption.
Humans ; Coronary Artery Disease/therapy* ; Cross-Sectional Studies ; Practice Patterns, Physicians'/statistics & numerical data* ; Asia ; Health Knowledge, Attitudes, Practice ; Surveys and Questionnaires ; Male ; Practice Guidelines as Topic ; Female ; Attitude of Health Personnel ; Middle Aged ; Developing Countries

BACKGROUND: Pulmonary arterial hypertension (PAH) presents a significant health burden in Asia and remains a critical challenge. This study aims to delineate the PAH burden in Asia from 1990 to 2021. METHODS: Using the latest data from the Global Burden of Disease 2021, we evaluated and analyzed the distributions and patterns of PAH disease burden among various age groups, sexes, regions, and countries in Asia. Additionally, we examined the associations between PAH disease burden and key health system indicators, including the socio-demographic index (SDI) and the universal health coverage (UHC) index. RESULTS: In 2021, there were 25,989 new PAH cases, 103,382 existing cases, 13,909 PAH-associated deaths, and 385,755 DALYs attributed to PAH in Asia, which accounted for approximately 60% of global PAH cases. The age-standardized rates (ASRs) for prevalence and deaths were 2.05 (95% uncertainty interval [UI]: 1.66-2.52) per 100,000 population and 0.31 (95% UI: 0.23-0.38) per 100,000 population, respectively. From 1990 to 2021, Asia reported the lowest ASRs for PAH prevalence but the highest ASRs for deaths compared to other continents. While the ASRs for prevalence increased slightly, ASRs for mortality and DALYs decreased over time. This increasing burden of PAH was primarily driven by population growth and aging. The burden was especially pronounced among individuals aged ≥60 years and <9 years, who collectively accounted for the majority of deaths and DALYs. Moreover, higher SDI and UHC levels were linked to reduced incidence, but higher prevalence rates. CONCLUSIONS Although progress has been made in reducing PAH-related mortality and DALYs, the disease continues to impose a substantial burden in Asia, particularly among older adults and young children. Region-specific health policies should focus on improving early diagnosis, expanding access to treatment, and effectively addressing the growing PAH burden in the region.
Humans ; Global Burden of Disease ; Male ; Female ; Middle Aged ; Adult ; Asia/epidemiology* ; Prevalence ; Aged ; Pulmonary Arterial Hypertension/mortality* ; Adolescent ; Young Adult ; Child ; Child, Preschool ; Infant ; Hypertension, Pulmonary/epidemiology*

OBJECTIVE: Traditional medicine (TM) has played a key role in the health care system of East Asian countries, including China, Japan and South Korea. This bibliometric study analyzes the recent research status of these three TMs, including traditional Chinese medicine (TCM), traditional Korean medicine (TKM), and Kampo medicine (KM). METHODS: Research topics of studies published for recent 10 years (2014 to 2023), through a search on MEDLINE via PubMed, was analyzed. Medical Subject Headings were used to distinguish between the three TMs researches. Bibliographic information was analyzed through VOSViewer version. Total 10,151 documents were included: TCM studies (n=9,630); TKM studies (n=256); and KM studies (n=295). RESULTS: Comparing the three co-occurrence analysis maps, TCM studies generally overwhelm the quantitative scale of TKM and KM studies. In the trend of the latest research of TCM, not only corona virus disease 2019 (COVID-19), but also clinical research topics such as gastrointestinal microbiome and diabetes mellitus have emerged, with in silico research approaches being actively applied. In the case of TKM, obesity and cooperative treatment with Western medicine are gaining attention. In KM, COVID-19 and Scutellaria baicalensis were recent research focuses. Unique features that distinguished from the other two TM research trends included 'gut microbiota', 'diabetes mellitus', 'clinical trials', 'disease models', and 'quality control' in the TCM map; 'prospective studies', 'cell line, tumor', and 'panax' in the TKM map; and 'aged, 80 and over', 'retrospective studies', 'glycyrrhiza', 'panax', and 'paeonia' in the KM map. Also, some quantitative and qualitative differences were found in author co-operation maps in each TM. CONCLUSIONS This analysis revealed that there were clear quantitative and qualitative differences among TCM, TKM, and KM. Although these medicines have a common root, they may have become distinct due to factors such as the size of research funds, cultural differences, and the medical licensing system.
Bibliometrics ; Humans ; Medicine, Chinese Traditional ; Medicine, Kampo ; Medicine, East Asian Traditional ; Medicine, Korean Traditional ; Asia, Eastern ; COVID-19 ; SARS-CoV-2

OBJECTIVES: To analyze the trends of disease burden of lip and oral cancers in East Asia from 1990 to 2021 and its future projections. METHODS: We used the Global Burden of Disease 2021 database to conduct a comprehensive analysis of disease burden data from China (including Taiwan Province of China), Japan, Republic of Korea, Democratic People's Republic of Korea and Mongolia. The data were stratified by age, gender and major risk factors, and a Bayesian age-period-cohort model was employed to predict the future trends. RESULTS: From 1990 to 2021, the burden of lip and oral cancers in East Asian countries exhibited a steady increase. Taiwan Province of China experienced the most significant increases in incidence, prevalence, mortality, and disability-adjusted life years (DALYs), while Mongolia saw a decline in both mortality and DALYs. In 2021, Taiwan Province of China reported the highest rates of lip and oral cancer incidence (27.50 per 100 000), prevalence (137.92 per 100 000), mortality (9.59 per 100 000), and DALYs (292.07 person-years per 100 000), particularly among male and elderly populations. Tobacco use and alcohol consumption significantly exacerbated the disease burden in Taiwan Province of China and Japan. Future projections indicate that the incidence and prevalence of lip and oral cancer in China (excluding Taiwan Province of China) will continue to rise, while their mortality rates are expected to decline in most regions, except for Taiwan Province of China and Democratic People's Republic of Korea. CONCLUSIONS By the year 2035, the disease burden of lip and oral cancers in East Asia is expected to continue to increase, especially in Taiwan Province of China. To address this challenge, it is essential to implement effective measures to control major risk factors, promote early screening, and ensure equitable distribution of healthcare resources.
Humans ; Mouth Neoplasms/epidemiology* ; Incidence ; Lip Neoplasms/epidemiology* ; Asia, Eastern/epidemiology* ; Male ; Disability-Adjusted Life Years ; Prevalence ; Female ; Forecasting ; Risk Factors ; Cost of Illness ; Middle Aged ; Global Burden of Disease ; Aged ; Bayes Theorem

OBJECTIVE: The Asia-Pacific region has a high chronic obstructive pulmonary disease (COPD) burden, but studies on its trends are limited. Using the Global Burden of Disease (GBD) 2019 data, we analyzed COPD trends in 36 countries and territories from 1990 to 2019 and predicted future incidence trends through 2034. METHODS: COPD data by age and sex from the GBD 2019 database were analyzed for incidence, prevalence, mortality, and disability-adjusted life years (DALY) rates from 1990 to 2019. Joinpoint regression identified significant annual trends, and age-standardized incidence rates were predicted through 2034 using age-period-cohort models. RESULTS: The incidence, prevalence, mortality, and disease burden of COPD have been decreasing, and the incidence rates will continue to decrease or remain stable until 2034 in most selected countries and territories, except for a few Southeastern Asian countries. The Lao People's Democratic Republic and Vietnam are projected to experience an increase in COPD incidence from 165.3 per 100,000 in 2019 to 177 per 100,000 in 2034 and from 179.9 per 100,000 in 2019 to 192.5 per 100,000 in 2034, respectively. Older males had a higher incidence than any other sex or age group. The sex gap in incidence rates continues to widen, though it is smaller and less significant in the younger age group than in those in the older one. CONCLUSION COPD rates are expected to decline until 2034 but remain a health risk, especially in countries with rising rates. Urgent action on tobacco control, air pollution, and public education is needed.
Humans ; Pulmonary Disease, Chronic Obstructive/mortality* ; Male ; Female ; Middle Aged ; Aged ; Incidence ; Asia/epidemiology* ; Adult ; Prevalence ; Cost of Illness ; Aged, 80 and over ; Disability-Adjusted Life Years ; Young Adult ; Global Burden of Disease ; Adolescent

Objective: The aim of this study was to assess research productivity on preterm birth (PTB) in Southeast Asian (SEA) countries and its correlation with socioeconomic characteristics and burden of disease. Methods: A systematic review of preterm birth publications by SEA authors indexed in Scopus, PubMed, ClinicalTrials. gov, and Cochrane was done. Case reports, cohorts, control trials, reviews and cost analysis studies done by SEA researches involving pathophysiology, diagnosis, management, and complications of preterm birth was included in the study while published letters to editors were excluded. The correlation of bibliometric indices, namely Scopus citations, and PlumX metrics indices (citations, usage, captures, mentions, and social media), with socioeconomic status and burden of preterm birth in SEA countries were analyzed by computing for the correlation coefficient (r) and p-value at an alpha of 0.05. Results: Thailand had the highest number of publications and the highest count across all bibliometric indices among all countries in SEA. The percent gross domestic product (GDP) per capita allotted for research and development (R & D) had direct correlation with publications and captures while crude birth rates had indirect correlation with publications, citations, and captures. Neonatal mortality had indirect correlation with publications and captures. Conclusion Support for research and development is essential to increase research productivity in SEA, which in turn may help in finding solutions to decrease the rate of preterm birth in the region.
Bibliometric Analysis ; Bibliometrics ; Preterm Birth ; Premature Birth ; Gross Domestic Product ; Asia, Southeastern

COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China in late 2019. Rapidly spreading worldwide, it was declared a pandemic by the World Health Organization (WHO) in early 2020 [1]. Various mitigation strategies, such as physical distancing, travel restrictions, and other public health protocols, were enforced globally to curb virus transmission [2,3]. However, these measures also disrupted daily life, work environments, and public health systems, posing significant challenges in balancing virus prevention and continuation of economic activity [4]. This paper aimed to highlight key lessons from the Third Environmental and Occupational Health (EOH) Forum on public health emergency response as demonstrated by selected Asian countries. Proceedings from the forum were reviewed and analyzed, arriving at the following lessons and themes: proactive and strategic public health interventions, leadership and governance, community participation, policy adjustments, technological integration and innovation, and balancing health and economic activities. The forum, themed “Environmental and Occupational Health Initiatives During the COVID-19 Pandemic,” was held virtually in November 2020 [5]. Understanding environmental and occupational health interventions as well as the themes of strategies by Asian countries, provides valuable insights into early pandemic management and contributes to a repository of knowledge that can be adapted and applied globally, enhancing the overall effectiveness of pandemic responses.
Occupational Health ; Environmental Health ; Publich Health ; COVID-19 ; Pandemics ; Asia

Objective: To analyze the trends of incidence and age change for global female breast cancer in different regions of the world according to the database from Cancer Incidence in Five Continents Time Trends (CI5plus) published by the International Association of Cancer Registries (IACR). Methods: The recorded annual female breast cancer (ICD-10: C50) incidence data and corresponding population at-risk data (1998-2012) were extracted from CI5plus published by IACR. The annual change percentage and average annual change percentage (AAPC) were calculated to examine the trends of incidence. The age-standardized mean age at diagnosis and proportion of incidence cases by age were calculated to analyze the relationship between incidence and age. Results: For crude incidence, except in Northern America, all other regions showed an upward trend, with Asia showing the most obvious upward trend (AAPC: 4.1%, 95% CI: 3.9%, 4.3%). For age-standardized incidence, in Asia, Latin America and Europe, the rising trends had slowed down, in Oceania and Africa, the trends began to be stable, and in Northern America, the trend showed a downward trend (APPC: -0.6%; 95% CI: -1.0%, -0.1%). The mean age at diagnosis were increased from 1998 to 2012 in Asia, Latin America, Oceania and Europe, with an annual increase of 0.12 years, 0.09 years, 0.04 years and 0.03 years, respectively. But after age-standardized, only Europe still kept increasing year by year, with an annual increase of 0.02 years, while Northern America showed a decreasing trend, with an annual decrease of about 0.03 years. Conclusions: From 1998 to 2012, the trends of incidence and age change for global female breast cancer vary in different regions of the world, and the global population aging is widespread, which affects the trend of the actual age change. Prevention and control strategies should be targeted at different age groups in different regions.
Humans ; Female ; Breast Neoplasms/epidemiology* ; Incidence ; Asia/epidemiology* ; Europe/epidemiology* ; Risk Factors

Background: Stroke is currently the second leading cause of death worldwide and is one of the leading causes of long-term disability . Mood disorders are prevalent after a stroke and may hinder physical, functional, and cognitive recovery; hence, it is undeniably necessary to recognize them early. Stroke mortality is generally higher in Asia as most of the countries therein are in economic transition . Socioeconomic status is a major contributor to stroke burden as greater odds of disability are found in patients with lower educational status and income. Objectives: The primary objective of this study is to identify the psychiatric morbidities commonly seen after a stroke in Asia. Search Methods: The following databases were utilized for extensive literature search: PubMed (January 2002 to June 2022), Cochrane Library (January 2002 to June 2022), and EBSCO (January 2002 to June 2022). The search made use of keyword combinations, Boolean operators "AND" and "OR," truncations, and field tags last October 2022. Selection Criteria: Articles on the prevalence and cross-sectional studies were included if they involved stroke survivors who developed post-stroke psychiatric morbidities in Asia. Additional inclusion criteria consisted of studies that have to be written in the English language and having free full texts available. Data Collection and Analysis: This systematic review made use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and guidelines. The JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data was used in the assessment for the quality of articles to be included in this systematic review. Results and Conclusion Affective disorders and generalized anxiety disorder were the common psychiatric morbidities identified post-stroke. The Hospital Anxiety and Depression Scale (HADS) may be used to diagnose post-stroke depression and anxiety. Males in their middle to late adulthood with higher National Institutes of Health Stroke Scale (NIHSS) scores and poor stroke outcomes (higher scores in the Modified Rankin Scale) were associated with a higher likelihood of developing the aforementioned psychiatric morbidities.
Depression ; Anxiety ; Mania ; Psychotic Disorders ; Asia