East Asia including the Republic of Korea (ROK). Although gastrointestinal colonization of K. pneumoniae may cross the intestinal barrier to invade the liver, characteristics of gastrointestinal carriage K. pneumoniae of hvKP liver abscess patients in the ROK are not well known.METHODS: Characteristics of K. pneumoniae isolated from stool samples and liver aspirate samples of patients with hvKP liver abscess at a tertiary care hospital in the ROK between 2017 and 2018 were evaluated.RESULTS: Out of 37 patients with hvKP liver abscess, 11 patients were noted to have K. pneumoniae isolated from stool samples and were enrolled for analysis. The median age was 71 years. For hvKP isolates from the liver aspirate samples, the most common serotype was K1 (72.7%) followed by K2 (27.3%). For K. pneumoniae isolates from the stool sample, the majority was non-K1/K2 serotype (72.7%). Among non-K1/K2 serotype isolates, high variability of sequence type (ST; ST15, ST307, ST37, ST273, ST2622, and ST42) with high rate of presence of extended-spectrum beta-lactamase (100.0%) was noted. The concordance rate of the K. pneumoniae isolates between the liver aspirate samples and the stool samples from the primary hvKP liver abscess was low (27.3%).CONCLUSION: This study suggests that significant heterogeneity of K. pneumoniae colonizing intestinal tract of the hvKP liver abscess patients. Further studies involving a larger number of hvKP liver abscess patients with continuing surveillance are needed to define the changing epidemiology and the role of gastrointestinal K. pneumoniae in the hvKP liver abscess patients in the ROK.]]>
beta-Lactamases ; Colon ; Epidemiology ; Far East ; Humans ; Klebsiella pneumoniae ; Klebsiella ; Liver Abscess ; Liver ; Pneumonia ; Population Characteristics ; Republic of Korea ; Serogroup ; Tertiary Healthcare

Cognitive impairment is age-related and manageable only with early diagnosis and prevention. Moxibustion is widely accepted in East Asia as useful for preventing cognitive impairment. This systematic review of animal studies was conducted to verify the efficacy of moxibustion in preventing cognitive impairment and to elucidate the underlying mechanism. Randomized controlled animal trials that established the efficacy of moxibustion in preventing cognitive impairment were included in the analysis. Results of behavioral tests and the signaling pathways elucidated were extracted and a meta-analysis was conducted with the behavioral test results. The risk of bias was evaluated using 9 items, and reporting quality was evaluated using the ARRIVE (Animal Research: Reporting In Vivo Experiments) Guidelines Checklist. Ten trials involving 410 animals met the inclusion criteria. All studies reported the benefit of moxibustion in preventing cognitive deficits caused by Alzheimer's disease (AD). Among five studies using the Morris water maze test, a significant effect of moxibustion in decreasing the escape time was reported in three studies, increasing the crossing times in four studies, and prolonging the dwelling time in two studies. The effects of moxibustion were demonstrated to be mediated by an increase in the activity of neurotrophins and heat shock protein, modulation of the cell cycle, and suppression of apoptosis and inflammation. However, considering the small number of included studies, the lack of studies investigating entire signaling pathways, and a high risk of bias and low reporting quality, our results need to be confirmed through more detailed studies.
Alzheimer Disease ; Animal Experimentation ; Animals ; Apoptosis ; Behavior Rating Scale ; Bias (Epidemiology) ; Cell Cycle ; Checklist ; Cognition Disorders ; Early Diagnosis ; Far East ; Heat-Shock Proteins ; Inflammation ; Moxibustion ; Nerve Growth Factors ; United Nations ; Water

Over the past ten years there has been a marked increase in cases of severe fever and thrombocytopenia syndrome in East Asia. This tick-borne hemorrhagic fever presents along with clinical signs including high fever and leukopenia. In addition to humans, the virus has also been detected with shared genetic homology in farm animals including goats, cattle, horses, and pigs. Furthermore, several genotypes of severe fever and thrombocytopenia syndrome virus (SFTSV) are currently co-circulating between humans and animals. In China, where the virus was first detected in rural areas in 2009, the SFTSV mortality rate has been reported to be as 6% and higher than 30%, especially in immuno-compromised patients. Moreover, this virus has been isolated in neighbor countries including Japan and South Korea where the fatality rates in 2015 were more than 30% in both countries. In this review, we comprehensively summarize the virology, genotypes, pathogenesis, and epidemiology of SFTSV infection in humans and animals. Currently, a collaborative global approach against SFTSV infection is being undertaken; however, the need for continuous disease surveillance and production of an effective vaccine is imperative as this virus may lead to an epidemic of irreversible status in both humans and animals.
Animals ; Animals, Domestic ; Cattle ; China ; Epidemiology ; Far East ; Fever ; Genotype ; Goats ; Horses ; Humans ; Japan ; Korea ; Leukopenia ; Mortality ; Swine ; Thrombocytopenia ; Virology

Network scale-up is an indirect size estimation method, in which participants are questioned on sensitive behaviors of their social network members. Therefore, the visibility of the behavior affects the replies and estimates. Many attempts to estimate visibility have been made. The aims of this study were to review the main methods used to address visibility and to provide a summary of reported visibility factors (VFs) across populations. We systematically searched relevant databases and Google. In total, 15 studies and reports that calculated VFs were found. VF calculation studies have been applied in 9 countries, mostly in East Asia and Eastern Europe. The methods applied were expert opinion, comparison of NSU with another method, the game of contacts, social respect, and the coming-out rate. The VF has been calculated for heavy drug users, people who inject drugs (PWID), female sex workers (FSWs) and their clients, male who have sex with male (MSM), alcohol and methamphetamine users, and those who have experienced extra-/pre-marital sex and abortion. The VF varied from 1.4% in Japan to 52.0% in China for MSM; from 34.0% in Ukraine to 111.0% in China for FSWs; and from 12.0% among Iranian students to 57.0% in Ukraine for PWID. Our review revealed that VF estimates were heterogeneous, and were not available for most settings, in particular the Middle East and North Africa region, except Iran. More concrete methodologies to estimate the VF are required.
Africa, Northern ; Bias (Epidemiology)* ; China ; Drug Users ; Europe, Eastern ; Expert Testimony ; Far East ; Female ; Humans ; Iran ; Japan ; Male ; Methamphetamine ; Methods* ; Middle East ; Sex Workers ; Ukraine

Network scale-up is an indirect size estimation method, in which participants are questioned on sensitive behaviors of their social network members. Therefore, the visibility of the behavior affects the replies and estimates. Many attempts to estimate visibility have been made. The aims of this study were to review the main methods used to address visibility and to provide a summary of reported visibility factors (VFs) across populations. We systematically searched relevant databases and Google. In total, 15 studies and reports that calculated VFs were found. VF calculation studies have been applied in 9 countries, mostly in East Asia and Eastern Europe. The methods applied were expert opinion, comparison of NSU with another method, the game of contacts, social respect, and the coming-out rate. The VF has been calculated for heavy drug users, people who inject drugs (PWID), female sex workers (FSWs) and their clients, male who have sex with male (MSM), alcohol and methamphetamine users, and those who have experienced extra-/pre-marital sex and abortion. The VF varied from 1.4% in Japan to 52.0% in China for MSM; from 34.0% in Ukraine to 111.0% in China for FSWs; and from 12.0% among Iranian students to 57.0% in Ukraine for PWID. Our review revealed that VF estimates were heterogeneous, and were not available for most settings, in particular the Middle East and North Africa region, except Iran. More concrete methodologies to estimate the VF are required.
Africa, Northern ; Bias (Epidemiology) ; China ; Drug Users ; Europe, Eastern ; Expert Testimony ; Far East ; Female ; Humans ; Iran ; Japan ; Male ; Methamphetamine ; Methods ; Middle East ; Sex Workers ; Ukraine

Zika virus (ZIKV) was spread to both eastward and westward from Uganda where the virus was identified approximately in 1947 by a group of arbovirus researchers. In 2015, ZIKV reached Americas with major outbreaks in Brazil. Most countries with mosquito transmitted ZIKV infection are located in tropical and subtropical areas, where ZIKV is endemic with other flaviviruses, including JEV, dengue and yellow fever virus. Approximately 40 countries in Central and South Americas and territories in South Pacific Islands and South East Asia show autochthonous ZIKV endemics. American lineage of ZIKV is known significantly to be mutated in susceptibility to host and in pathogenicity from Asian and Asian lineages approximately since 2014. Early and specific identification of ZIKV infection is very important for the effective management of patients. First of all, optimal collection of specimens for the laboratory diagnosis is required for both nucleic acid testing (NAT) and serological tests. Specimens for NAT tests and serological tests should be determined by the available laboratory resources, work-flow in each laboratory and the geographic areas of specimen collected in addition to days after showing symptoms. Testing strategy for specific differentiation among flaviviruses will vary depending on the prevalence of viruses known to be circulating in the area where the patients were exposed. NAT will be employed for the patients presenting with onset of symptoms less than 7 days. Advanced diagnostic technologies should be continuously developed for the increase of specificity and sensitivity of ZIKV diagnosis.
Americas ; Arboviruses ; Asian Continental Ancestry Group ; Biology* ; Brazil ; Clinical Laboratory Techniques* ; Culicidae ; Dengue ; Diagnosis ; Disease Outbreaks ; Epidemiology* ; Far East ; Flavivirus ; Humans ; Pacific Islands ; Prevalence ; Sensitivity and Specificity ; Serologic Tests ; South America ; Uganda ; Virulence ; Yellow fever virus ; Zika Virus*

Inflammatory bowel disease (IBD) has become more common in Asia over the past few decades. The rate of increase in prevalence of the disease varies greatly in Asia, with several countries in East Asia experiencing a more than doubled increase in IBD prevalence over the past decade. Historically, ulcerative colitis (UC) is more common than Crohn's disease (CD) in Asia. However, a reverse trend is beginning to appear in more developed countries in Asia such as Japan, Korea, and Hong Kong. While Asian IBD patients share many similarities with their Western counterparts, there are important differences with significant clinical implications. In Asia, there are more men with CD, more ileo-colonic involvement in CD, less familial aggregation, fewer extra-intestinal manifestations and worse clinical outcomes for older-onset patients with UC. These differences are likely related to the different genetic makeup and environmental exposures in different regions. Evaluation of the differences and rates in epidemiologic trends may help researchers and clinicians estimate disease burden and understand the reasons behind these differences, which may hold the key to unravel the etiology of IBD.
Asia* ; Asian Continental Ancestry Group ; Colitis, Ulcerative ; Crohn Disease ; Developed Countries ; Environmental Exposure ; Epidemiology ; Far East ; Hong Kong ; Humans ; Inflammatory Bowel Diseases* ; Japan ; Korea ; Male ; Prevalence

The greatest burden of hip fractures around the world is expected to occur in East Asia, especially China. However, there is a relative paucity of information on the epidemiology and burden of fractures in East Asia. Osteoporosis is greatly under-diagnosed and under-treated, even among the highest-risk subjects who have already suffered fractures. The accessibility to bone densitometry, the awareness of the disease by professionals and the public, and the use and reimbursement of drugs are some of the areas which need improvement especially. Cost-effective analysis on screening strategy and intervention thresholds based on local epidemiology data and economic status are available only in Japan. In addition, clinical risk factor models for the assessment of fracture probability may be ethnic specific. Further research is needed to develop a cost-effective risk assessment strategy to identify high-risk individuals for screening and treatment based on local data. Moreover, inadequate calcium and vitamin D intake is still an issue faced by this region.
Asia ; Calcium ; China ; Densitometry ; Epidemiology ; Far East* ; Hip Fractures ; Japan ; Mass Screening ; Osteoporosis* ; Risk Assessment ; Risk Factors ; Vitamin D

Stroke is one of the leading causes of death and morbidity worldwide. The occurrence of stroke is strongly dependent on well-known vascular risk factors. After rapid modernization, urbanization, and mechanization, East Asian countries have experienced growth in their aged populations, as well as changes in lifestyle and diet. This phenomenon has increased the prevalence of vascular risk factors among Asian populations, which are susceptible to developing cardiovascular risk factors. However, differing patterns of stroke risk factor profiles have been noted in East Asian countries over the past decades. Even though the prevalence of vascular risk factors has changed, hypertension is still prevalent and the burden of diabetes and hypercholesterolemia will continue to increase. Asia remains a high tobacco-consuming area. Although indicators of awareness and management of vascular risk factors have increased in many East Asian countries, their rates still remain low. Here we review the burdens of traditional risk factors, such as hypertension, diabetes, hypercholesterolemia, and smoking in East Asia. We will also discuss the different associations between these vascular risk factors and stroke in Asian and non-Asian populations.
Asia ; Asian Continental Ancestry Group ; Cause of Death ; Diet ; Epidemiology ; Far East* ; Humans ; Hypercholesterolemia ; Hypertension ; Life Style ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Social Change ; Stroke* ; Urbanization

Chewing lice (Phthiraptera) that parasitize the globally threatened swan goose Anser cygnoides have been long recognized since the early 19th century, but those records were probably biased towards sampling of captive or domestic geese due to the small population size and limited distribution of its wild hosts. To better understand the lice species parasitizing swan geese that are endemic to East Asia, we collected chewing lice from 14 wild geese caught at 3 lakes in northeastern Mongolia. The lice were morphologically identified as 16 Trinoton anserinum (Fabricius, 1805), 11 Ornithobius domesticus Arnold, 2005, and 1 Anaticola anseris (Linnaeus, 1758). These species are known from other geese and swans, but all of them were new to the swan goose. This result also indicates no overlap in lice species between older records and our findings from wild birds. Thus, ectoparasites collected from domestic or captive animals may provide biased information on the occurrence, prevalence, host selection, and host-ectoparasite interactions from those on wild hosts.
Animals ; Bias (Epidemiology) ; Birds ; Far East ; Geese* ; Lakes ; Mastication* ; Mongolia ; Phthiraptera* ; Population Density ; Prevalence