Mainland South Research Articles

Management of Moderate-to-Severe Atopic Dermatitis in Adults: A Cross-Sectional Survey of Dermatologists Within the Asia-Pacific Region.

Limited evidence is available on real-world management of atopic dermatitis (AD) among Asian adults. This cross-sectional study aimed to assess current approaches in AD diagnosis and management in Asia. Practising dermatologists regularly treating patients with moderate-to-severe AD were recruited from eight Asia-Pacific territories, namely Mainland China, Hong Kong, India, Japan, Singapore, South Korea, Taiwan, and Thailand. A survey was administered to eligible dermatologists after screening and taking informed consent. Data from fully completed submissions were analysed using descriptive statistics. The study was reviewed by the institutional review board in each territory. Data from 271 dermatologists were included for analysis. About one-third (31.7%) reported that they referred to the Hanifin and Rajka criteria during diagnosis. The majority of dermatologists used clinical impression when assessing AD severity and treatment response. Reduction of eczema and pruritus was the primary treatment objective when managing both acute (98.1%) and chronic (69.1%) AD. More than half of dermatologists preferred adding systemic anti-inflammatory medication for patients who did not respond to maximized topical treatment, while 43.6% would switch to another systemic medication for those failing to respond to maximized systemic treatment. Topical corticosteroids were frequently selected by dermatologists. For systemic therapies, oral corticosteroids were most frequently used, followed by cyclosporin and dupilumab. Narrow-band ultravioletB was the most common phototherapy reported (84.9%). There was considerable variation in estimated average and maximum durations of therapies used to treat AD. This study has provided insights on the real-world management of moderate-to-severe AD in the Asia-Pacific region. The diverse approaches in diagnosis and treatment highlight the multifactorial nature of AD, reliance on clinical judgement, and importance of personalized care. To improve outcomes in patients with AD, it will be crucial to develop biomarkers for diagnosis, reduce subjectivity in assessment, as well as promote access to newer and effective therapies.

Coastal connectivity of marine predators over the Patagonian Shelf during the highly pathogenic avian influenza outbreak

Animal movement and population connectivity are key areas of uncertainty in efforts to understand and predict the spread of infectious disease. The emergence of highly pathogenic avian influenza (HPAI) in South America poses a significant threat to globally significant populations of colonial breeding marine predators in the South Atlantic. Yet, there is a poor understanding of which species or migratory pathways may facilitate disease spread. Compiling one of the largest available animal tracking datasets in the South Atlantic, we examine connectivity and inter‐population mixing for colonial breeding marine predators tagged at the Falkland Islands. We reveal extensive connectivity for three regionally dominant and gregarious species over the Patagonian Shelf. Black‐browed albatrosses (BBA), South American fur seals (SAFS) and Magellanic penguins (MAG) used coastal waters along the Atlantic coast of South America (Argentina and Uruguay). These behaviours were recorded at or in close proximity to breeding colonies and haul‐out areas with dense aggregations of marine predators. Transit times to and from the Falkland Islands to the continental coast ranged from 0.2–70 days, with 84% of animals making this transit within 4 days ‐ a conservative estimate for HPAI infectious period. Our findings demonstrate BBA, SAFS and MAG connectivity between the Falkland Islands and mainland South America over an expansive spatial network and numerous pathways, which has implications for infectious disease persistence, transmission and spread. This information is vital in supporting HPAI disease surveillance, risk assessment and marine management efforts across the region.

Bridging the Gap: Comparing Patient-Clinician Views on Treatment Goals and Communication in the Management of Atopic Dermatitis Within the Asia-Pacific Region.

It remains unclear how patients with atopic dermatitis (AD) and clinicians perceive the level of patient-clinician communication and if there could be potential lapses. This cross-sectional study aims to compare perspectives between patients with AD and dermatologists regarding communication and treatment expectations in Asia. Moderate-to-severe patients with AD and practicing dermatologists were recruited from eight Asia-Pacific territories, including Mainland China, Hong Kong, India, Japan, Singapore, South Korea, Taiwan, and Thailand. Patients and dermatologists completed separate surveys designed to elicit their expectations regarding AD management, and their perceived level of patient-clinician communication. Patients were also asked about their treatment satisfaction and whether they prefer additional treatment beyond what was prescribed. Demographic information and responses were analyzed using descriptive statistics. The study was reviewed by the institutional review board in each territory, and all participants provided informed consent. A total of 1103 patients and 271 dermatologists completed the surveys. Both patients and dermatologists were largely aligned in their top treatment goals in AD management. However, greater proportions of patients prioritized the prevention of exacerbation (78.0% versus 47.2%), minimization of treatment adverse effects (46.4% versus 9.1%), and improvement in mental health (16.0% versus 4.9%), compared with dermatologists. Although patient-clinician communication was observed to be generally good, 10.9% of patients reported dissatisfaction with communication in AD management. The majority of patients were either "very satisfied" or "satisfied" with their latest acute AD treatment, but 65.5% of patients still desired additional treatment. This multinational study has provided insights on the perspectives of Asian patients and dermatologists in treatment goals, AD management, and communication. In general, both patients and dermatologists were aligned in treatment goals and there was satisfactory patient-clinician communication in most aspects. However, potential areas of improvement have been identified to further enhance patient-centered care.

Social safety net features in East Asia: A comparative analysis using the model family approach

AbstractEast Asian (EA) social welfare has been described as productivist, where social policies are subordinate to economic development. However, EA comparative studies often focus on a few select social policies and seldom examine welfare programs as a bundle. We contribute to the depiction of divergent features of EA safety nets by exploring welfare content (generosity, coverage, protective vs. productive, and work incentives) and welfare outcomes (poverty reduction and income redistribution) for lower‐income populations in the largest city in mainland China, Hong Kong, Japan, Singapore, South Korea, and Taiwan. We collected model family (MF) data and analyzed the data through descriptive statistics and regression models. We found that Taiwan and Hong Kong, followed by Japan, have more generous programs for reducing poverty, while Korea focuses on productive programs; Singapore offers wide coverage and strong work incentives for low‐income families yet lags behind in generosity; and China appears to be a laggard in welfare provision in the region. Our findings reveal heterogeneity within EA welfare systems, and our synthesis of welfare features using MF data offers a promising, innovative strategy for conducting comparative research in regions with limited comparable data.

The Spatial Awareness Behind the Naming of Social Groups and Geographical Areas in Mainland South Sulawesi

In the sociological paradigm of space, as a place whatever its form and name as long as it is inhabited or used as a base for human activity, it is not a passive natural entity but rather dynamic. This is made possible by the spatial dialectics and social reproduction that take place accompanying the development of a space along with the meaning of it which is always changing and dynamic. This paper examines spatial identity in naming social groups and geographical areas in Sulawesi using place identity theory, social identity theory, and identity process theory. This type of research is a literature review with a sociology of space approach that uses data and analysis descriptively from a number of relevant literature. The results showed that some social group names in Sulawesi are a representation of the geographical structure of a space, so that when mentioning the name of the group or its residential center, it will reflect its spatial identity. This fact is sociologically a spatial awareness that has been created in the long history of Sulawesi as well as can be categorized as local community intelligence

An assessment of renewable energy development in Belt and Road Initiative countries: An entropy and TOPSIS approach

The development of renewable energy is a significant global factor in the achievement of a green economic recovery after the epidemic, and to enhance sustainable social development in the future. However, the Belt and Road Initiative (BRI) countries are experiencing regional differences in renewable energy development owing to the different economic and social levels. It is of theoretical and practical significance to assess the situation of renewable energy development in BRI countries, in order to identify the advantages and disadvantages of renewable energy development and to enhance energy cooperation between countries. In this paper, a multidimensional assessment for BRI countries (47 countries/regions across Asia, Europe, Africa, the Americas, and Oceania) was carried out based on empirical data, (including institutional, economic, technological, energy and environmental facets). The Entropy Weight Method and the Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) were selected to assess the level of renewable energy development in BRI countries during the period 2009–2017. The results demonstrated that BRI countries/regions had a low overall level of renewable energy development during the study period, but a stable and rising development trend was identifiable. For example, certain countries/regions (e.g. Mainland China, Indonesia, Pakistan, Russia, South Africa and New Zealand) experienced significant growth during the period. When analyzed by continents, the Americas and Oceania had the highest level of renewable energy development, followed by Europe, with Asia and Africa ranking lowest. Europe and Oceania’s notable advantages in “institutional and economic facets” were primarily as a result of the enhanced governance capability and superior economic development. The superior maturity of renewable energy technology in the Americas and Oceania contributes to the superior performance in the “technological facet”. The countries with superior development in the “energy and environmental facets” are located in Asia, Oceania and Europe.

Sejarah Berdirinya Masjid Cheng Ho di Kawasan Sriwijaya

The variety of cultures and religions of the population in Indonesia is because Indonesia has various ethnicities and races too. In Palembang, there are not only ethnic Malays, there are also people of Javanese, Indian, Acehnese and Chinese/Chinese descent. The ethnic Chinese in Palembang are thought to have come from Kuang Tung and Chyang Chou in mainland South China. This place is mostly Muslim, like the Yunnan region where Admiral Cheng Ho came from. In Palembang, there is also cultural acculturation where Palembang people marry ethnic Chinese. Ethnic Chinese are included in PITI. The founders of the Islamic Tauhid Faith Builders (PITI) are Halim (Yu), Ting and Sadiqin. The aim of PITI is to unite with Muslims, to become a gathering place for learning about the Islamic religion. This is why a mosque was founded. This mosque was built with ethnic Chinese patterns and was named the Al-Islam Muhammad Cheng Ho Mosque. The Muhammad Cheng Ho Mosque in the city of Palembang was founded by PITI or the Indonesian Chinese Islamic Association. This PITI institution regulates and maintains the Al Islam Muhammad Cheng Ho Mosque. This mosque has routine Islamic activities in the mosque, for example recitation, etc. The Cheng Ho Mosque is an interesting study because it takes the concept of cultural acculturation in the Palembang area. So what is the history and factors related to the Al-Islam Muhammad Cheng Ho Mosque in Palembang.

East Asians' T-scores for the diagnosis of osteoporosis should be calculated using ethnicity- and gender-specific BMD reference ranges: justifications.

The 2013 ISCD consensus recommended a Caucasian female reference database for T-score calculation in men, which says "A uniform Caucasian (non-race adjusted) female reference database should be used to calculate T-scores for men of all ethnic groups." However, this statement was recommended for the US population, and no position was taken with respect to BMD reference data or ethnicity matching outside of the USA. In East Asia, currently, a Japanese BMD reference database is universally adopted in Japan for clinical DXA diagnosis, while both local BMD and Caucasian BMD reference databases are in use in Mainland China, South Korea, Taiwan, and Singapore. In this article, we argue that an ethnicity- and gender-specific BMD database should be used for T-score calculations for East Asians, and we list the justifications why we advocate so. Use of a Caucasian BMD reference database leads to systematically lower T-scores for East Asians and an overestimation of the prevalence of osteoporosis. Using a female BMD reference database to calculate T-scores for male patients leads to higher T-score values and an underestimation of the prevalence of osteoporosis. Epidemiological evidence does not support using a female BMD reference database to calculate T-scores for men. We also note that BMD reference databases collected in Asia should be critically evaluated for their quality.

Diverging Destinies in East Asia

Research on diverging destinies provides a compelling and influential framework for understanding relationships between socioeconomic bifurcation in family behavior and inequality within and across generations. Articulations of the diverging destinies framework stress its broad relevance for low-fertility societies, but empirical evaluations in East Asia are limited. We address this gap by summarizing and synthesizing scholarship on socioeconomic differentials in family behavior and relationships between family circumstances and children's well-being in mainland China, Japan, South Korea, and Taiwan. We seek an understanding of how and why the diverging destinies framework is or is not helpful for understanding family change and inequality in societies characterized by a highly asymmetric gender division of labor, strong emphasis on family investment in children, and limited public support for families. This article provides a contextual and empirical basis upon which to build subsequent research on family change and inequality in East Asia.

A matter of when, not whether: A meta-analysis of modesty bias in East Asian self-ratings of job performance.

Much attention has been paid to the question of whether there is a modesty bias in East Asian employees' self-ratings of job performance (i.e., a tendency to self-rate their performance lower than supervisors rate it). However, empirical results are conflicting, with some studies supporting the modesty bias and others not supporting it. We suggest that moderators representing boundary conditions for the modesty bias effect may shed light on these conflicting results. In essence, the question should not be "whether there is a modesty bias," but rather "when is there a modesty bias?" We propose three moderators: purpose of the ratings (administrative, developmental, or research), job performance dimension (task performance, organizational citizenship behavior, or leadership), and country-level in-group collectivism. Based on 40 studies (63 independent samples) with samples from East Asia (mainland China, Japan, South Korea, and Taiwan), we found no evidence of a modesty bias. That is, East Asian employees' self-ratings were, on average, higher than supervisor-ratings of job performance (i.e., a leniency bias). The one exception was when ratings were collected for research purposes; in this case, there was, on average, no mean difference between self- and supervisor-ratings. Thus, East Asian employees' research-purpose self-ratings are more modest, but this does not cross into a "modesty bias." In all, our results do not support a modesty bias as a widespread cultural norm among East Asian employees. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Different pathways of the second demographic transition in four East Asian societies: evidence from the 2006 and 2016 East Asian Social Surveys

This study uses the 2006 and 2016 East Asian Social Surveys to map value changes related to the second demographic transition in mainland China, Japan, South Korea, and Taiwan. The study examines trends in attitudes towards cohabitation, childrearing, and divorce over a 10-year period in the four East Asian societies. The findings suggest that the second demographic transition, if any in East Asia, is an uneven process between societies, and mainland China stands out as the only society in which attitudes had become more conservative, even after controlling for compositional differences in population. In the other three societies, attitudes had shifted to be more liberal. Moreover, the study finds little evidence on the diffusion within societies, given their similar trends across different sociodemographic groups. From an ideational perspective, mainland China and the other three East Asian societies illustrated different patterns of attitude changes regarding marriage and family. From a behavioral perspective, trends in attitudes do not always align with demographic patterns at the macro level, especially in mainland China. More studies are needed to understand the nuanced differences in ideational shifts between societies and the relationship between ideational and behavioral changes in East Asia.

Efficacy and Safety of Belimumab in Patients With Lupus Nephritis: Subgroup Analyses of a Phase 3 Randomized Trial in the East Asian Population

Belimumab improved kidney outcomes in patients with active lupus nephritis (LN) in BLISS-LN, leading to its approval in the United States and the European Union. As data on treatment of East Asian patients with LN are limited, we evaluated the efficacy and safety of belimumab in the BLISS-LN East Asian subgroup. Prespecified subgroup analysis of BLISS-LN, a phase 3, placebo-controlled, randomized 104-week trial. Adults with biopsy-proven, active LN were randomized (1:1) to belimumab or placebo, plus standard therapy. Patients were administered intravenous belimumab 10mg/kg, or placebo, plus standard therapy (oral glucocorticoids and either cyclophosphamide for induction followed by azathioprine for maintenance, or mycophenolate mofetil for both induction and maintenance). At the investigator's discretion, 1-3 intravenous pulses of methylprednisolone, 500-1,000mg each, could be administered during induction. The primary end point was primary efficacy renal response (PERR; ie, urinary protein-creatinine ratio≤0.7g/g, estimated glomerular filtration rate no more than 20% below preflare value or≥60mL/min/1.73m2, and no treatment failure) at week 104. Key secondary end points included complete renal response (CRR; urinary protein-creatinine ratio<0.5g/g, estimated glomerular filtration rate no more than 10% below preflare value or≥90mL/min/1.73m2, and no treatment failure) at week 104; PERR at week 52; time to kidney-related event or death; and safety. PERR and CRR were analyzed using a logistic regression model, and time to a kidney-related event or death was analyzed using a Cox proportional hazards regression model. 142 patients from mainland China, Hong Kong, South Korea, and Taiwan were included (belimumab, n=74; placebo, n=68). At week 104, more belimumab than placebo patients achieved PERR (53% vs 37%; OR, 1.76 [95% CI, 0.88-3.51]) and CRR (35% vs 25%; OR, 1.73 [95% CI, 0.80-3.74]). At week 52, more belimumab than placebo patients achieved PERR (62% vs 37%; OR, 2.74 [95% CI, 1.33-5.64]). Belimumab reduced the risk of a kidney-related event or death compared with placebo at any time (HR, 0.37 [95% CI, 0.15-0.91]). Safety was similar across treatment groups. Small sample size and lack of formal significance testing. Safety and efficacy profiles were consistent with BLISS-LN overall population, supporting benefits of belimumab treatment in the East Asian subgroup with LN. This study was funded by GSK (GSK study no. BEL114054). Registered at ClinicalTrials.gov with study number NCT01639339.

Direct and indirect effects and feedbacks of biomass burning aerosols over Mainland Southeast Asia and South China in springtime

Southeast Asia is one of the largest biomass burning (BB) source regions in the world. In order to promote our understanding of BB aerosol characteristics and environmental impacts, this study investigated the emission, composition, evolution, radiative effects, and feedbacks of BB aerosols from Mainland Southeast Asia during 15 March to 15 April 2019 by using an online-coupled regional chemistry/aerosol-climate model RIEMS-Chem. Model results are compared against a variety of ground and vertical observations, indicating a generally good model performance for meteorology, aerosol chemical compositions, and aerosol optical properties. It is found that BB aerosols contributed significantly to regional particulate matter (PM), accounting for up to 90 % of the near-surface PM2.5, BC, and OC concentrations over the BB source regions of north Mainland Southeast Asia and for approximately 30–70 % over wide downwind areas including most areas of southwest China and portions of south China. At the top of atmosphere (TOA), BB aerosols exerted a positive all-sky radiative effect (DREBB) up to 25 W/m2 over north Vietnam and south China, a negative DREBB up to −10 W/m2 over Myanmar, western Thailand, and southwest China. Meanwhile, the indirect radiative effect (IREBB) was consistently negative, with the maximum of −10 W/m2 over downwind areas with cloud coverage, e.g., from north Vietnam to most of south China. The subregional (95–125°E and 10–30°N) and period mean DREBB and IREBB at TOA were estimated to be 0.69 W/m2 and − 0.63 W/m2, respectively, leading a total radiative effect (TREBB) of 0.06 W/m2 at TOA. The radiative effects of BB aerosols led to decreases in sensible and latent heat fluxes, near-surface temperature, PBL height, and wind speed of 6.0 Wm−2, 9.0 Wm−2, 0.26 °C, 38.7 m, and 0.1 m/s, respectively, accompanied with an increase in RH of 1.9 %, averaged over the subregion and the study period. The accumulated precipitation during the study period was apparently reduced by BB aerosols from east Thailand to south China, with the maximum reduction up to 14 cm (exceeding 40 %) over north Vietnam and south China. TREBB tended to increase mean near-surface PM2.5 and its component concentrations, with the maximum percentage increase up to 24 % over the BB source regions of north Mainland Southeast Asia, resulting from the combined effects of dynamic and chemical feedbacks. DREBB generally dominated over IREBB in the feedback-induced PM2.5 concentration changes.

Asia subpopulation analysis from the phase III POLARIX trial.

7558 Background: In the pivotal Phase III POLARIX trial, Pola-R-CHP demonstrated significantly improved progression-free survival (PFS) compared with R-CHOP, with a similar safety profile in patients with previously untreated DLBCL (Tilly et al. 2022). An Asia subpopulation analysis was included as part of the trial design; patients enrolled in Asia were analyzed for the purpose of registration in China of POLARIX (NCT03274492). Methods: Patients from mainland China, Hong Kong, Japan, South Korea, and Taiwan (enrolled during the global phase), and from the China extension cohort were included in the Asia subpopulation. POLARIX methods were previously described (Tilly et al. 2022). Briefly, patients with untreated DLBCL were randomized 1:1 using the same stratification factors to receive six cycles of Pola-R-CHP or R-CHOP, plus two cycles of rituximab alone. The purpose of this analysis was to evaluate consistency of PFS (defined as ≥50% risk reduction in PFS) in the Asia subpopulation with the global population. Results: Overall, 281 patients (intent-to-treat population; 150, 85, 31 and 15 patients in mainland China, Japan, South Korea and Taiwan, respectively) were analyzed (141 received Pola-R-CHP and 140 received R-CHOP); 160 patients from the global population and 121 from the China extension cohort. Median age was 63 (range 19–79) years, and most patients had an International Prognostic Index of 3–5 (61.9%). At the data cut-off of June 28, 2021, (median follow-up of 24.2 months) PFS was superior with Pola-R-CHP vs R-CHOP (hazard ratio [HR] 0.64; 95% confidence interval [CI]: 0.40–1.03) and met the consistency definition with the global population. The 2-year PFS rate was 74.2% (95% CI: 65.7–82.7) with Pola-R-CHP vs 66.5% (95% CI: 57.3–75.6) with R-CHOP. Other key efficacy results were similar to the global study results (Table). The safety profile was generally comparable for Pola-R-CHP vs R-CHOP, including rates of grade 3–4 adverse events (AEs; 72.9% vs 66.2%), serious AEs (32.9% vs 32.4%), grade 5 AEs (1.4% vs 0.7%), AEs leading to discontinuation of any study treatment (5.0% vs 7.2%), and incidence of peripheral neuropathy (all grades, 44.3% vs 50.4%), respectively. Key efficacy results. CR, complete response. Conclusions: The results from the Asia subpopulation of POLARIX were consistent with the global study, with a clinically meaningful improvement in PFS (risk of disease progression, relapse or death reduced by 36%) following treatment with Pola-R-CHP vs R-CHOP, and a comparable safety profile in Asian patients with previously untreated DLBCL. Clinical trial information: NCT03274492. [Table: see text]

Genetic Differentiation of Brown Planthopper Nilaparvata lugens (Stål) Populations in Asia

Brown Planthopper is one of the economically important rice pests that cause several crop failures in Asian countries. Unfortunately, Brown Planthopper could migrate to neighboring countries to generate interpopulation breeding, thus further increasing the gene flow and spreading insecticide resistance. This research aimed to understand the genetic differentiation of Brown Planthopper among all Asian populations. This study used two COI sequences from Malang, Indonesia, and 25 sequences from GenBank to analyze the genetic structure with phylogenetic tree and haplotype network. The uncorrected pairwise distance result showed that the Brown Planthopper population in Asia has a relatively low genetic distance. We also found that the Brown Planthopper population was clustered based on the geographical region of South Asia, East Asia-Mainland South East Asia, and Indonesia. Thus, we concluded that the migration of Brown Planthopper was limited to East Asia and Mainland South East Asia only. Further studies are needed to confirm the migration route of Brown Planthopper in South Asia and Southeast AsiaKeywords: BPH, Genetic differentiation, Haplotype network, Phylogenetic

The contagion effect of jump risk across Asian stock markets during the Covid-19 pandemic

This paper tests the market jump contagion hypothesis in the context of the Covid-19 pandemic. We first use a nonparametric approach to identify jumps by decomposing the realized volatility into continuous and jump components, and we use the threshold autoregressive model to describe the jump interdependency structure between different markets. We empirically investigate the contagion effect across several major Asian equity markets (Mainland China, Hong Kong, Japan, South Korea, Singapore, Thailand, and Taiwan) using the 5-minute high frequency data. Some key findings emerge: jump behaviors occur frequently and make an important contribution to the total realized volatility; jump dynamics exhibit significant nonlinearity, asymmetry, and the feature of structural breaks, which can be effectively captured by the threshold autoregressive model; jump contagion effects are obviously detected and this effect varies depending on the regime.

POS-304 A TARGETED LITERATURE REVIEW OF PREVALENCE AND TREATMENT PATTERNS OF IgA NEPHROPATHY IN MAINLAND CHINA, TAIWAN, AND SOUTH KOREA

IgA nephropathy (IgAN) is the most common primary glomerulonephritis (GN) worldwide with higher rates in East and Pacific Asia compared to North America and Europe. Despite high reported prevalence of IgAN in these countries, the overall disease prevalence across Asia is not available. Treatment patterns of IgAN patients across Asian countries have also not been summarized. This literature review synthesized IgAN prevalence and treatment patterns among patients in Asian countries/regions, specifically Mainland China, Taiwan, and South Korea. A targeted literature review (TLR) was conducted in PubMed, Chinese (China National Knowledge Infrastructure, WANFANG) and Korean (Korean Medical Database, Korean Information Service System) databases for studies on IgAN prevalence and treatment patterns (e.g., percentage of patients using a given therapy, treatment adherence) from January 2010-May 2021. Grey literature searches using Google Scholar and Baidu (for China) were also conducted. This targeted review included 27 publications. IgAN prevalence is highly variable across Mainland China, Taiwan, and South Korea, with prevalence rates ranging from 6%-62%. In Mainland China, mean prevalence of IgAN is estimated at 25% among patients with renal biopsies (range: 6%-41%) and 38% (range: 30%-50%) among primary GN patients. In Taiwan, mean prevalence of IgAN is estimated at 12% (range: 11%-13%) among patients with renal biopsies and 26% among primary GN patients. In South Korea, mean prevalence of IgAN is estimated at 38% (range: 26%-62%) among patients with renal biopsies and 51.6% (range: 51.3%-51.9%) among primary GN patients. Country-specific treatment guidelines were identified for Mainland China only. Studies on real-world treatment patterns of IgAN were scarce in the study countries/regions. In Mainland China, only two pediatric and four adult IgAN patient studies were identified. No study reporting IgAN treatment patterns in Taiwan was identified. Three studies among adult IgAN patients in South Korea were identified. Among adult IgAN patients, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARBs) were the most common treatment ranging from 27.7%-90% in Mainland China and South Korea, followed by immunosuppressants (1.6%-85.5%) and steroids (10%-36.1%). ACEI/ARB and steroid use was also high among Chinese pediatric IgAN patients, ranging from 1.6%-45% across included studies. Approximately 6% of Chinese pediatric IgAN patients reported mycophenolate mofetil (MMF) use and 50% of patients underwent a tonsillectomy in one study sample. One study reported less optimal adherence with steroid treatment among Chinese IgAN patients, particularly among younger and female patients, due to concerns over side effects of steroid use. This TLR suggests variable IgAN prevalence in Mainland China, Taiwan, and South Korea. IgAN treatment primarily consisted of ACEI/ARBs, and high steroid use was found despite mixed evidence on its benefits and safety. There are also limited data on IgAN treatment patterns from Taiwan. Further research into IgAN epidemiology and treatment patterns at national levels across multiple Asian countries/regions is warranted to address gaps in evidence.

Dynamic evolution of Mhc haplotypes in cynomolgus macaques of different geographic origins.

The major histocompatibility complex (MHC) plays a key role in immune defense, and the Mhc genes of cynomolgus macaque display a high degree of polymorphism. Based on their geographic distribution, different populations of cynomolgus macaques are recognized. Here we present the characterization of the Mhc class I and II repertoire of a large pedigreed group of cynomolgus macaques originating from the mainland north of the isthmus of Kra (N = 42). Segregation analyses resulted in the definition of 81 unreported Mafa-A/B/DRB/DQ/DP haplotypes, which include 32 previously unknown DRB regions. In addition, we report 13 newly defined Mafa-A/B/DRB/DQ/DP haplotypes in a group of cynomolgus macaques originating from the mainland south of the isthmus of Kra/Maritime Southeast Asia (N = 16). A relatively high level of sharing of Mafa-A (51%) and Mafa-B (40%) lineage groups is observed between the populations native to the north and the south of isthmus of Kra. At the allelic level, however, the Mafa-A/B haplotypes seem to be characteristic of a population. An overall comparison of all currently known data revealed that each geographic population has its own specific combinations of Mhc class I and II haplotypes. This illustrates the dynamic evolution of the cynomolgus macaque Mhc region, which was most likely generated by recombination and maintained by selection due to the differential pathogenic pressures encountered in different geographic areas.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00251-021-01249-y.

Effective COVID-19 Control: A Comparative Analysis of the Stringency and Timeliness of Government Responses in Asia.

Aim: Many governments in East and Southeast Asia responded promptly and effectively at the onset of the COVID-19 pandemic. Synthesizing and analyzing these responses is vital for disease control evidence-based policymaking. Methods: An extensive review of COVID-19 control measures was conducted in selected Asian countries and subregions, including Mainland China, Hong Kong, Taiwan, South Korea, Singapore, Japan, and Vietnam from 1 January to 30 May 2020. Control measures were categorized into administrative, public health, and health system measures. To evaluate the stringency and timeliness of responses, we developed two indices: the Initial Response Index (IRI) and the Modified Stringency Index (MSI), which builds on the Oxford COVID-19 Government Response Tracker (OxCGRT). Results: Comprehensive administrative, public health, and health system control measures were implemented at the onset of the outbreak. Despite variations in package components, the stringency of control measures across the study sites increased with the acceleration of the outbreak, with public health control measures implemented the most stringently. Variations in daily average MSI scores are observed, with Mainland China scoring the highest (74.2), followed by Singapore (67.4), Vietnam (66.8), Hong Kong (66.2), South Korea (62.3), Taiwan (52.1), and Japan (50.3). Variations in IRI scores depicting timeliness were higher: Hong Kong, Taiwan, Vietnam, and Singapore acted faster (IRI > 50.0), while Japan (42.4) and Mainland China (4.2) followed. Conclusions: Timely setting of stringency of the control measures, especially public health measures, at dynamically high levels is key to optimally controlling outbreaks.

El Niño–Southern Oscillation (ENSO) effect on interannual variability in spring aerosols over East Asia

Abstract. Effects of the El Niño–Southern Oscillation (ENSO) on the interannual variability in spring aerosols over East Asia are investigated using the Modern Era Retrospective analysis for Research and Applications Version 2 (MERRA-2) reanalysis aerosol data. Results show that the ENSO has a crucial effect on the spring aerosols over mainland South East Asia, southern China, and the ocean south of Japan. The above-normal (below-normal) aerosols are found over these regions during the ensuing spring of El Niño (La Niña). In contrast to the local aerosol diffusion in winter, the ENSO affects East Asian aerosols in the following spring mainly via the modulation of upstream aerosol generation and transport processes. The underlying physical mechanism is that during the ensuing spring of El Niño (La Niña), the dry (wet) air and reduced (enhanced) precipitation are beneficial for the increase (reduction) in biomass burning activities over northern mainland South East Asia, resulting in more (fewer) carbonaceous aerosol emissions. On the other hand, the anomalous anticyclone (cyclone) over the north-western Pacific (WNP) associated with El Niño (La Niña) enhances (weakens) the low-level south-westerly wind from northern mainland South East Asia to southern Japan, which transports more (less) carbonaceous aerosol downstream. Anomalous precipitation plays a role in reducing aerosols over the source region, but its washout effect over the downstream region is limited. The ENSO's impact on the ensuing spring aerosols is mainly attributed to the eastern Pacific ENSO rather than the central Pacific ENSO.