BackgroundHead and neck cancer (HNC) poses a significant public health challenge worldwide, yet the long-term trends and heterogeneity of its burden within East Asia remain inadequately characterized. This study aims to provide a comprehensive assessment of the HNC burden in five East Asian countries from 1990 to 2023 and project future trends.MethodsUtilizing data from the Global Burden of Disease (GBD) 2023, we analyzed the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of HNC in China, Japan, the Republic of Korea, the Democratic People’s Republic (DPR) of Korea, and Mongolia. We employed a comprehensive analytical approach encompassing age-standardized rates, temporal trends, Joinpoint regression, risk factor attribution, age-period-cohort analysis, as well as decomposition and forecasting analyses.ResultsFrom 1990 to 2023, substantial heterogeneity was observed. China demonstrated significant declines in age-standardized incidence rate (ASIR) and mortality rate (ASMR). Conversely, Japan experienced concerning increases in ASIR and ASMR. The Republic of Korea maintained a stable ASIR while achieving a marked ASMR reduction. The Democratic People’s Republic of Korea showed increases in both ASIR and ASMR, while Mongolia reported declines in ASIR and ASMR. Age distribution shifted markedly towards older populations in China, Japan, and the Republic of Korea. Smoking remained the predominant risk factor across HNC subtypes. Forecasts to 2038 project a continued rise in ASIR for Japan and the DPR of Korea, and a high ASMR for the DPR of Korea.ConclusionThe HNC burden in East Asia exhibits divergent national trajectories, with smoking remaining the predominant attributable risk factor. Further research is needed to elucidate underlying causes of these cross-country disparities.

Canine distemper virus (CDV) is a highly contagious, multi-host pathogen that spreads readily among susceptible animals and often causes mass mortality. Yanbian Prefecture, located at the border area of China, Russia, and North Korea, represents a critical region for pathogen surveillance due to its unique geographical characteristics and animal trade activities; however, little is known about the prevalent CDV strains in this area or their pathogenic mechanisms. In this study, a CDV strain, designated CDV-Yanbian (CDV-YB), was successfully isolated from an anal swab sample collected from a suspected infected dog in Yanbian Prefecture and identified as the Asia-1 genotype through genetic analysis. To further elucidate the molecular mechanisms underlying CDV-host interactions, we examined the expression changes of inflammation-related signaling pathway genes and the occurrence of pyroptosis in canine adipose-derived mesenchymal stem cells (ADMSCs) following CDV infection using RT-qPCR and Western blot. Our results revealed that CDV infection activated the Janus kinase 2 - Signal transducer and activator of transcription 3 (JAK2-STAT3), mitogen-activated protein kinase (MAPK), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and phosphatidylinositol 3-kinase-Akt (PI3K-Akt) pathways and upregulated NLR family pyrin domain containing 3 (NLRP3) inflammasome activation. Furthermore, inhibition of the JAK2-STAT3 pathway using AG490 reduced NLRP3 inflammasome activation. Taken together, our findings demonstrate that CDV activates multiple inflammatory signaling pathways and, via the JAK2-STAT3 pathway, upregulates NLRP3 inflammasome activation in host cells, and pyroptosis was also observed. These findings provide a foundation for understanding CDV pathogenesis and informing future research on this important virus.

ABSTRACT This article challenges the prevailing emphasis on technological superiority within contemporary deterrence frameworks, contending instead that adaptive force employment remains decisive in modern conflict. It develops a hybrid analytical model that systematically extends Stephen Biddle’s “modern system” of force employment to grey-zone conflict and synthesises it with Sun Tzu’s principles of deception and psychological targeting. Drawing on original case studies of North Korea’s UAV incursions, coordinated cyberattacks, and the 2024 “filth balloon” campaign, the study demonstrates how low-cost, low-tech operations can achieve strategic effect by exploiting doctrinal blind spots and societal vulnerabilities in high-capability adversaries. These cases reveal how hybrid tactics bypass conventional defence systems, undermine public morale, and disrupt political cohesion – often without kinetic escalation. The findings question the adequacy of traditional deterrence-by-punishment approaches in grey-zone conflict and advocate a shift towards deterrence-by-resilience, emphasising doctrinal adaptability and societal robustness. The analysis contributes to a growing body of scholarship on asymmetric coercion and the evolving character of warfare in the twenty-first century.

Remotely sensed evapotranspiration-based ensemble streamflow modeling in an ungauged watershed under climate and land use/cover change, North Korea.

This article analyses the misperceptions, confirmation bias and groupthink exhibited by South Korea’s progressive presidents regarding North Korea’s nuclear armament and the prospects for denuclearisation. Historically, progressive administrations have characterised North Korea’s nuclear programme as fundamentally defensive—intended for regime survival—and as a negotiable issue that could be resolved through voluntary disarmament. These perceptions have persisted to the present, reinforced by entrenched confirmation bias and groupthink. An in-depth examination of the Moon Jae-in administration demonstrates that the misperceptions, confirmation bias and groupthink held by the president and his advisors regarding Pyongyang’s willingness to denuclearise led to an overemphasis on negotiations. This approach ultimately provided North Korea with the time necessary to consolidate its nuclear arsenal and undermine the credibility of the US nuclear umbrella. Consequently, South Korea’s progressive political leaders must transcend these cognitive biases and prioritise the development of robust deterrence and defence measures to protect the South Korean public from the North Korean nuclear threat.

Introduction Objectives Sectoral sanctions are a policy instrument situated at the intersection of economic governance and national security strategy, intended to weaken rival states by targeting key areas of their economies. They explore the prerequisites for their effectiveness, namely coordination, flexibility, proportionality, and adherence to international norms, and evaluate their practical consequences in the case of the Russian Federation. The study contends that, despite generating measurable economic pressure, the overall impact of these sanctions has been limited, as Russia has demonstrated economic adaptability, mitigated the effects of restrictions, strengthened its military capacity, and intensified strategic ties with China, Iran, and North Korea. The findings suggest that sanctions can achieve their intended strategic outcomes only if they are implemented rigorously and sustained over time. However, their effectiveness is shaped by the evolving international system, which is no longer centered exclusively on the Western cultural sphere. Sectoral sanctions can serve as an important instrument of deterrence in international politics when cooperating state partners are united. Material and Methods Qualitative content analysis of academic literature, policy documents, and strategic reports. Comparative analysis of Western and Russian approaches to national security and sanctions policy Results Sanctions must be implemented in a comprehensive and coordinated manner, otherwise, they are unlikely to produce the intended outcomes or meaningfully impact the national security apparatus of the targeted state. Conclusions Sectoral sanctions serve as a vital instrument, forming a central component of a national security doctrine focused on self-driven development, the continuity of strategic planning, and the formulation of a comprehensive state's grand strategy.

Early-onset colorectal cancer (EO-CRC) is increasing globally with substantial regional variation. We assessed epidemiological changes in EO-CRC in five East Asian populations. Using GBD 2023 data, we calculated age-standardized incidence, prevalence, mortality, and DALY rates (ASIR, ASPR, ASMR, ASDR), counts, and average annual percent changes (AAPC). Decomposition, age-period-cohort (APC), and forecast analyses assessed trends and risk factor contributions to mortality. In 2023, these populations accounted for 25%-31% of global EO-CRC cases. China had the highest absolute burden, and Taiwan (Province of China) had the highest ASR. From 1990 to 2023, North Korea had the highest ASIR increase (AAPC = 1.34%), while South Korea's ASMR declined most (AAPC = -2.58%). Males had a higher burden than females. Decomposition analysis showed epidemiological changes increased incidence outside China but generally reduced mortality except in North Korea, with effects stronger for deaths than incidence. APC analysis revealed accelerated risk with age; period effects varied: North Korea showed the largest relative risk increase (RR 0.93 → 1.32), and China showed a post-2014 rebound. Projections to 2038 suggest continued rises in incidence and DALYs. Risk analysis identified low calcium intake as the main mortality driver in North Korea, and low milk, low whole grains, and high red meat intake in the other populations; high BMI and processed meat-related deaths also increased markedly. EO-CRC incidence is rising in East Asia, with China highest in absolute numbers and Taiwan in ASR; men are disproportionately affected. Burden and risk analyses reveal population-specific effects. Interventions should target diet, screening, and sex- and population-specific risk factors.

• The study identifies six innovative methods to analyze economies with scarce data. • Forensic economic approaches uncover credible insights from authoritarian regimes. • Satellite, trade, price, and refugee data together reveal hidden patterns of activity. • Text mining of official documents exposes unintended signals about economic change. • Emerging data technologies promise to transform research on closed and fragile states. Some economies are “black holes” where reliable data is scarce due to government control, low capacity, or conflict. Despite these challenges, researchers have found ways to gather useful information. This paper draws on the literature on North Korea to review six key methods: satellite imagery, reports from aid agencies, trade data, prices, refugee surveys, and official documents. These sources are imperfect, and require close attention to research design and measurement error. Nonetheless, they demonstrate that it is possible to extract information from economic black holes and to draw meaningful insights about them.

Against the backdrop of population aging (over 29% of Japan's population aged 65 and above) and urbanization (regional urbanization rate rising from 38.5 to 67.3%) in East Asia, the socioeconomic driving mechanism of the disease burden of hip and knee osteoarthritis (OA) remains unclear. A systematic analysis was conducted to examine the evolving trends in the disease burden of hip and knee OA in East Asia (including China, Japan, South Korea, Mongolia, and North Korea) from 1990 to 2023, as well as its associations with socioeconomic factors, to provide a basis for public health policies. Based on the 2023 edition of the Global Burden of Disease (GBD) database, relevant data of hip and knee OA in five East Asian countries from 1990 to 2023 (170 country-year observations in total) were extracted. Descriptive analysis, correlation analysis, and ARIMA prediction model were used to analyze the association between Socio-Demographic Index (SDI) and disease burden indicators (DALYs rate, prevalence rate, incidence rate). The disease burden in high-SDI countries was significantly higher than that in low-SDI countries (Japan's DALYs rate, 59.32 per 100,000 population; Mongolia's DALYs rate, 22.45 per 100,000 population, P < 0.001). There was a strong positive correlation between SDI and DALYs rate (r = 0.726; 95% CI, 0.631-0.805). Females (DALYs rate, 45.23 per 100,000 population in 2023) and the 40-49 age group were high-risk populations. The disease burden of hip and knee OA in East Asia is significantly correlated with the level of socioeconomic development. It is essential to formulate differentiated prevention and control strategies for countries with different SDI levels to reduce the population's disease burden. Key Points • First systematic analysis of hip and knee osteoarthritis disease burden in five East Asian countries from 1990 to 2023, revealing a strong positive correlation with the Socio-Demographic Index (SDI) • Identified females and the 40-49 age group as high-risk, with disease burden growth significantly faster in low-SDI countries than high-SDI ones • Proposed differentiated prevention strategies: elderly rehabilitation in high-SDI, addressing urban-rural disparities in mid-SDI, and enhancing diagnostic capacity in low-SDI countries • Provided data support for public health policy and medical resource allocation for osteoarthritis in East Asia.

ABSTRACT For populations living under persistent nuclear threat, such as South Korea, denuclearization represents a direct pathway to peace. Yet the conditions under which South Koreans support denuclearization negotiations with North Korea remain underexplored. This study examines South Korean public attitudes toward denuclearization agreements using a pre-registered survey experiment with 2,400 nationally matched respondents. Participants evaluated a hypothetical agreement in which North Korea commits to dismantling its nuclear program in exchange for one of five concessions: regime security guarantees, sanctions relief, financial assistance, withdrawal of US troops and extended deterrence, or South Korea’s permanent commitment to nonproliferation. Support is highest for low-cost concessions and significantly lower when agreements impose substantial economic burdens or security trade-offs. Across all scenarios, trust in North Korea’s compliance remains uniformly low. These findings reveal the fragility of domestic support for denuclearization and highlight the importance of cost sensitivity, while pointing to persistent distrust as a key constraint on public support.

This article analyzes how North Korea is rebalancing its asymmetric dependence on China through an autonomy-seeking strategy in the context of a fragmented Northeast Asian order. It argues that North Korea’s post-2022 strategy can be interpreted as a form of proactive asymmetric management. This strategy appears to leverage great-power competition to restructure patronage relations while preserving ties with China. Such adjustments may be contributing to shifts in strategic dynamics in Northeast Asia, thereby heightening the risk of miscalculation. These dynamics underscore the limits of control-oriented patronage and point instead to the primacy of crisis and escalation risk management as dependence becomes harder to convert into compliance.

ABSTRACT This research examines South Korea’s involvement in North Korea’s archaeological site management as a form of heritage practice. It focuses on how inter-Korean collaborative projects at the Manwoldae site have influenced existing site management practices in North Korea, particularly in terms of decision-making and heritage interpretation. The study applies Authorised Heritage Discourse (AHD) and Authorised Dictatorial Discourse (ADD) to analyse heritage practices in North Korea and South Korea. Drawing on archival sources, it investigates the joint excavation project and its outcomes regarding stakeholder groups, operational strategies, interpretative frameworks, and broader impact. This paper argues that, while it is difficult to directly assess the impact of South Korean governmental involvement on an archaeological site located in North Korea, the collaborative process has nevertheless reshaped heritage interpretations of the Manwoldae and beyond. These changes include shifts in stakeholder dynamics, site management approaches, and heritage interpretations, and increased engagement with international heritage bodies.

ABSTRACT This article examines the dynamics of hydro-hegemony along the Imjin River and the impact of North Korea’s actions on South Korea’s water security. Originating in North Korea and flowing into South Korea, the Imjin River has become a source of environmental and geopolitical tension due to North Korea’s unilateral policies and the absence of transboundary water cooperation. Despite North Korea’s weaknesses across the three core components of hydro-hegemonic power – material power, ideational power, and bargaining power – its upstream position enables it to function as a ‘weak hegemon’ capable of exerting significant control over the river’s flow and water quality. These conditions have resulted in consequences such as water pollution, flood-related threats, and heightened vulnerability of South Korea’s water infrastructure. The findings indicate that the future management of the Imjin River may follow two divergent pathways: the continuation of the current situation, which would lead to increased uncertainty, intensified hydro-political threats, and greater fragility in the South; or the pursuit of a cooperative framework, in which joint mechanisms, data sharing, and active water diplomacy could enhance water security and environmental sustainability.

ABSTRACT This study traces the trajectory of a borderland regime and the roles of key actors in bordering and infrastructuring within the diaspora of female defectors – turned entrepreneurs – from North Korea. While previous research has explored the coexistence of bordering and infrastructuring in borderlands, the roles of actors, particularly in the Global East, have been less studied. This research conceptualises actors such as informal markets, multiple nation-states, brokers, churches and families – identified through interviews, observations and document analysis – as part of a borderland regime in the North Korean diaspora to South Korea. Women developed networks among these actors during defection from North Korea and settlement – networks that were constantly renegotiated in a shifting geopolitical environment. In the repurposing of infrastructure, the line between formal and informal networks often becomes blurred, with some actors fulfilling both roles and the defectors themselves becoming integral links in the circularity of these networks. This research highlights these networks’ interconnectedness and offers a relational approach to debordering in the Global East, contributing to the understanding of survival and empowerment strategies.

Hemorrhagic fever with renal syndrome (HFRS) is highly prevalent in northeastern China, especially along the borders with Russia and North Korea. However, the prevalence of HFRS-causing orthohantaviruses in rodents in these regions remains unclear. Rodents were captured across the tri-border region. Lung tissues were collected to detect human-pathogenic Hantaan virus (HTNV), Seoul virus (SEOV), and Amur virus (AMRV). Complete viral genome sequences from positive samples were amplified for phylogenetic and homology analyses. A total of 430 rodents from four species were captured from five villages in the tri-border region, with Apodemus agrarius as the dominant species, accounting for 41.4%. HTNV was detected in 8.4% of A. agrarius and 3.6% of R. norvegicus individuals, with viral loads ranging from 2.2-6.9 log₁₀ copies/μL and 4.1-6.9 log₁₀ copies/μL, respectively. AMRV was identified in 6.3% of A. peninsulae individuals, with viral loads between 3.6-6.7 log₁₀ copies/μL. SEOV was not detected in any samples. No significant differences in viral prevalence were observed across years, seasons, or collection habitats, nor in viral load between virus species or rodent species. One AMRV and ten HTNV complete genome sequences were successfully obtained. Phylogenetic analysis revealed that the identified HTNV strains formed a distinct clade with previously reported strains from northeastern China and Russia, showing nucleotide and amino acid similarities of 87.5-97.6% and 97.1-100.0%, respectively. AMRV exhibited a close evolutionary relationship with strains isolated from patients and from A. peninsulae in China, displaying nucleotide and amino acid similarities of 80.6-84.7% and 92.3-97.7%, respectively, compared to HTNV. Our study confirms natural infections of HTNV in A. agrarius and R. norvegicus, and of AMRV in A. peninsulae, in the tri-border region of China, Russia, and North Korea. Further epidemiological studies on orthohantavirus infections in humans and rodents are warranted in this border region.

This article examines the dilemmas of North Korea’s nuclear strategy through an integrated framework linking realist security imperatives, strategic culture and leadership identity, and the inward-looking political economy. Existing studies typically capture only part of North Korea’s behavior; what remains underexplored is how these logics operate simultaneously and generate internal contradictions. The article conceptualizes North Korea’s nuclear posture as a triadic dilemma shaped by the interaction of deterrence needs, oppositional nationalism, identity-based legitimation, and a ruling-coalition logic for elite cohesion and controlled governance. This interaction produces a paradox in which nuclear weapons strengthen regime authority and deterrence while worsening sanctions-driven economic decline, diplomatic isolation, and security instability. By framing these tensions as a dilemma among deterrence, economic sustainability, and crisis stability, the article explains why North Korea remains locked into an internally contradictory yet resilient nuclear posture. It concludes with policy implications, highlighting the need to calibrate pressure and engagement.

The rapidly changing world is challenging established logistics routes. Coronavirus, the escalating situation in the Red Sea, a special military operation, and much more are changing cargo delivery routes from China to Europe. Northeast China borders Russia, Mongolia, and North Korea. Several international railway lines pass through the region, but they are unable to cope with the rapidly growing freight volume. Local Chinese authorities are trying to stimulate the development of new multimodal international transport routes. In this article, the author attempted to analyze the development features of the New Northeast Land-Sea Corridor, which connects the coast of the Bohai Gulf, the interior regions of northeast China, Mongolia and Russia. Despite the efforts of the governments of the regions in northeast China, the construction of the New Corridor is facing problems. The stumbling block is the presence of several unfinished sections of railway lines in Inner Mongolia, China, a long new section of railway in Mongolia. At the same time, the author emphasizes the obvious advantages of the new transport corridor: Connecting the coast of Liaoning Province with the interior regions of Northern China, Mongolia, and Russia will reduce transportation costs, mitigate potential transport risks, and increase regional trade exchanges, optimize the structure of commodity flows, create new jobs and new opportunities for economic development in areas along the new transport artery. China’s New Northeast Transport Corridor is an "engine" for sustainable development, security and stability of supply chains. The construction of the corridor is based on a new development concept and complies with the principles of environmental friendliness, openness, convenience, efficiency and sharing.

Warm-sector thunderstorms (WSTs), characterized by weak synoptic forcing and extreme precipitation rates, pose a major global forecasting challenge. This study investigates the mesoscale processes initiating WSTs over the complex terrain of the Democratic People's Republic of Korea (DPRK), a region where triggering mechanisms remain poorly understood. We analyze three extreme rainfall events (Hoichang 2016, Unpa 2017, Pyongyang 2018), each producing rainfall rates exceeding 60 mm h⁻1 under the weak forcing typical of the northwestern periphery of the West Pacific Subtropical High. While operational global models failed to predict these events, the convection-permitting WRF model skillfully replicated the initiating mechanisms and subsequent convection. Model performance was quantitatively assessed using multiple verification metrics, including Probability of Detection (POD), False Alarm Ratio (FAR), Bias, and Critical Success Index (CSI). Integrated analysis of observations and high-resolution (3 km) Weather Research and Forecasting (WRF) model simulations reveals a consistent trigger: mesoscale boundary-layer convergence lines. These zones formed through the interaction of synoptic southwesterlies with localized, terrain-modulated flows and were collocated with horizontal moisture gradients. Crucially, the three-dimensional structure of Convective Available Potential Energy (CAPE) manifested as narrow, vertical towers of high instability, delineating regions of deep convection initiation 2–4 h in advance. A pre-convective, deep moist layer (relative humidity &gt;80% in the 850–700 hPa layer) was identified as a necessary precondition. This study establishes terrain-forced boundary-layer convergence as a primary trigger for WSTs over the DPRK, providing a valuable framework for improving prediction in other monsoonal regions with complex topography.

This article examines the role of United Nations sanctions as instruments for preventing military conflicts, providing a comprehensive analysis of their legal foundations, effectiveness, and ethical implications within the framework of international law and international relations. Since the establishment of the United Nations in 1945, economic sanctions have emerged as a prominent tool for maintaining international peace and security, with the Security Council possessing unique authority under Chapter VII of the UN Charter to impose binding sanctions measures against states whose actions threaten global stability. This study investigates three fundamental dimensions of UN sanctions that are essential for understanding their contemporary role in conflict prevention. First, the article analyzes the legal architecture underlying UN sanctions, examining the constitutional foundations in the UN Charter, the evolution of Security Council practice, the development of various sanctions regimes, and the obligations imposed upon member states in implementing these measures. Second, the effectiveness of sanctions in preventing military conflicts is assessed through empirical analysis of case studies including Iraq, Iran, and North Korea, drawing upon theoretical frameworks from the scholarly literature to identify the determinants of sanctions success or failure. Third, the ethical implications of sanctions are interrogated, with particular attention to humanitarian concerns regarding the impact on civilian populations, the principle of proportionality in calibrating sanctions severity, and human rights considerations including procedural justice in sanctions implementation. The findings reveal that while sanctions represent a significant non-military alternative to the use of force in addressing threats to international peace, their effectiveness depends on complex interactions among legal, political, and contextual factors that resist simple generalization. The analysis concludes that the ethical tensions inherent in sanctions practice require ongoing attention to balancing security imperatives against humanitarian considerations, and that future development of sanctions policy should incorporate more robust procedural protections, systematic humanitarian impact assessments, and continued innovation in targeting techniques that maximize pressure on decision-makers while minimizing civilian harm. This study contributes to a more nuanced understanding of the role of UN sanctions in conflict prevention and offers recommendations for enhancing their legitimacy and effectiveness within the international legal order.

Since 2015, there has not been a comprehensive database of cities across the world. While debates about what defines a "city" remain open in urban science, we center our efforts toward developing a replicable and transparent methodology to construct a globally valid dataset of cities, agglomerations, capitals, municipalities, and urban centers. Such an endeavor is both timely and necessary given that comparative research, governmental collaborations, and cross-national comparisons among urban areas yield valuable knowledge about human settlements to inform climate resilience and sustainability planning. Our approach is bottom-up and anchored in accessibility. We begin with Wikipedia, a dynamic, crowd-sourced platform, and cross-check its entries with an expert database based on census data. When discrepancies arise, we turn to official governmental websites to confirm information. We integrate these three sources into a harmonized database that includes every urban settlement worldwide with at least 50,000 residents (7,468 in total). For China, Brazil, France, Japan, India, Pakistan, Somalia and North Korea we apply a higher inclusion threshold of 100,000. Each entry lists country and city names and is complemented by a terminology lexicon explaining how different nations define and classify cities. This approach enables us to not only catalogue urban settlements but also to make visible how cities are constructed and recognized within diverse global national governance frameworks.