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PubMed2002

Incidence of leukemia in Asian migrants to the United States and their descendants.

OBJECTIVE: To generate clues regarding the causes of leukemia we compared leukemia incidence rates among Asian-American immigrants and their descendants to those of United States-born whites. METHODS: 535 Asian and 6629 white residents diagnosed with leukemia were identified through the Surveillance, Epidemiology and End Results Program during 1973 through 1986 in Hawaii, San Francisco/Oakland, and western Washington. A special tabulation of the 1980 US census was used to estimate the size and composition of the population at risk in these three areas. RESULTS: The incidence of leukemia, either considered as a whole or as individual types, did not appreciably vary between US-born and foreign-born Asian Americans. For all forms of leukemia combined the rates per 100,000 person-years among males were 6.5 for foreign-born Chinese, 7.4 for foreign-born Japanese, and 7.5 for foreign-born Filipino as compared to 7.5 for US-born Chinese, 7.1 for US-born Japanese, and 5.4 for US-born Filipino. The rates in foreign-born Asian females and US-born Asian females were also similar. Asian Americans had a lower incidence of leukemia than US whites (rate of 13.3/100,000 person-years), particularly for chronic lymphocytic leukemia. CONCLUSIONS: Irrespective of birthplace, Asian Americans possess one or more characteristics which make their risk for leukemia less than that of US whites.

Adult↗
PubMed2001

Design and development of the European American values scale for Asian Americans.

Existing instruments for measuring Asian American acculturation emphasize behavior acculturation to the exclusion of value acculturation. Most are based on the assumption that acquisition of European American behavior occurs simultaneously with the loss of Asian behavior. With the advent of the Asian Values Scale (AVS; B.S.K. Kim, D.R. Atkinson, & P.H. Yang, 1999), it is now possible to assess adherence to Asian cultural values. This article describes the development of a scale that can be used to measure Asian American adherence to European American values. The current scale, combined with the AVS, can be used to independently measure Asian American acculturation to European American values and enculturation in Asian values.

Acculturation↗
PubMed1994

Seroprevalence of human T-lymphotropic virus, hepatitis C virus, and human immunodeficiency virus in Asian American potential bone marrow donors.

BACKGROUND: Asian Americans are generally underrepresented both as volunteer blood and bone marrow donors. STUDY DESIGN AND METHODS: To investigate the risk of transfusion transmission of viruses that is associated with increasing participation by Asian American donors, antibodies to human T-lymphotropic virus (HTLV), hepatitis C, and human immunodeficiency virus in Asian American volunteers recruited as potential bone marrow donors were measured. A total of 1354 Asian Americans were enrolled in the study, of whom 54 percent were Chinese, 26 percent Japanese, 9 percent Filipino, 4 percent Korean, 3 percent Indian, and 5 percent of other Asian or mixed Asian and other ethnicity. The majority of the study population was aged 20 through 49 and of high socioeconomic status, as indicated by education and income. Viral antibodies were measured with both screening enzyme-linked immunosorbent assays and supplemental testing, and polymerase chain reaction was used to resolve discrepant HTLV results. RESULTS: Confirmed seroprevalence rates for HTLV were 0.15 percent with one manufacturer's Western blot and 0.3 percent with the other; however, no sample was positive for HTLV types I or II in polymerase chain reaction. Confirmed seroprevalence to hepatitis C virus was 0.5 percent. No subject was seropositive for human immunodeficiency virus. CONCLUSION: On the basis of the moderate size and high education level of this study population, it is concluded that Asian American volunteer bone marrow donors do not pose a greater risk for transmission of HTLV type I or II, human immunodeficiency virus, or hepatitis C virus than does the average American blood donor.

Adolescent↗
PubMed1998

Dieting behavior of Asian college women attending a US university.

Dieting behavior, body dissatisfaction, self-esteem, and food intake of 73 Asian women attending a US university were investigated and compared retrospectively with attitudes of 247 US-born female students at the same university. The Asian women reported restrained eating and body dissatisfaction only about half as often as the US women did. In both the Asian and US college women, body dissatisfaction scores were significantly correlated to body mass index and self-esteem scores. Fourteen percent of the Asian women in the restrained eating/body dissatisfied group, and 40% of the US students in that group reported intentional vomiting for weight control. Some of the Asian international students practiced undesirable dieting behaviors and reported body dissatisfaction levels similar to those of many US college women. College health professionals should recognize that disordered eating among Asian women must not be overlooked because of stereotypical perceptions about Asian women's body size and type.

Adolescent↗
PubMed2002

Increased fibrinogen levels among South Asians versus Whites in the United Kingdom are not explained by common polymorphisms.

Determinants of fibrinogen level among South Asians are not established. In 1997-1999, plasma fibrinogen levels and prevalences of the fibrinogen polymorphisms A alpha Thr312Ala, beta-445G/A, and B beta Arg448Lys and correlates were compared among 100 apparently healthy United Kingdom South Asians and 100 age- and sex-matched Whites. Mean fibrinogen levels were higher in South Asians (3.33 g/liter, 95% confidence interval (CI): 3.16, 3.51) than in Whites (2.84 g/liter, 95% CI: 2.72, 2.96) (p < 0.0001), but genotype distributions were similar. B beta Arg448Lys was related to fibrinogen in South Asians (RR (n = 67): 3.22 g/liter, 95% CI: 3.03, 3.43; RK (n = 26): 3.72 g/liter, 95% CI: 3.65, 4.11; KK (n = 7): 3.07 g/liter, 95% CI: 2.53, 3.72) (p = 0.04) and Whites (p = 0.06). beta-455G/A was related to fibrinogen in Whites (GG (n = 56): 2.68 g/liter, 95% CI: 2.56, 2.86; GA (n = 37): 2.97 g/liter, 95% CI: 2.79, 3.17; AA (n = 5): 3.22 g/liter, 95% CI: 2.85, 3.65) (p = 0.02) and South Asians (p = 0.07). After adjustment for age, gender, body mass index, hypertension, cholesterol, triglycerides, smoking, A alpha Thr312Ala, and beta-455G/A, fibrinogen levels remained significantly higher in South Asians (3.56 g/liter, 95% CI: 3.35, 3.77) than in Whites (3.03 g/liter, 95% CI: 2.85, 3.22) (p < 0.0001). These findings suggest that increased fibrinogen levels among South Asians versus Whites are not due to differences in the prevalence of genetic polymorphisms that encode for fibrinogen.

Adult↗
PubMed1993

Migration patterns and breast cancer risk in Asian-American women.

BACKGROUND: Breast cancer incidence rates have historically been 4-7 times higher in the United States than in China or Japan, although the reasons remain elusive. When Chinese, Japanese, or Filipino women migrate to the United States, breast cancer risk rises over several generations and approaches that among U.S. Whites. PURPOSE: Our objective was to quantify breast cancer risks associated with the various migration patterns of Asian-American women. METHODS: A population-based, case-control study of breast cancer among women of Chinese, Japanese, and Filipino ethnicities, aged 20-55 years, was conducted during 1983-1987 in San Francisco-Oakland, California, Los Angeles, California, and Oahu, Hawaii. We successfully interviewed 597 case subjects (70% of those eligible) and 966 control subjects (75%). RESULTS: A sixfold gradient in breast cancer risk by migration patterns was observed. Asian-American women born in the West had a breast cancer risk 60% higher than Asian-American women born in the East. Among those born in the West, risk was determined by whether their grandparents, especially grandmothers, were born in the East or the West. Asian-American women with three or four grandparents born in the West had a risk 50% higher than those with all grandparents born in the East. Among the Asian-American women born in the East, breast cancer risk was determined by whether their communities prior to migration were rural or urban and by the number of years subsequently lived in the West. Migrants from urban areas had a risk 30% higher than migrants from rural areas. Migrants who had lived in the West for a decade or longer had a risk 80% higher than more recent migrants. Risk was unrelated to age at migration for women migrating at ages less than 36 years. Ethnic-specific incidence rates of breast cancer in the migrating generation were clearly elevated above those in the countries of origin, while rates in Asian-Americans born in the West approximated the U.S. White rate. CONCLUSIONS: Exposure to Western lifestyles had a substantial impact on breast cancer risk in Asian migrants to the United States during their lifetime. There was no direct evidence of an especially susceptible period, during either menarche or early reproductive life. IMPLICATIONS: Because heterogeneity in breast cancer risk in these ethnic populations is similar to that in international comparisons and because analytic epidemiologic studies offer the opportunity to disentangle correlated exposures, this study should provide new insights into the etiology of breast cancer.

Adult↗
PubMed2005

Participation of Asian-American women in cancer treatment research: a pilot study.

Few Asian-American women participate in cancer treatment trials. In a pilot study to assess barriers to participation, we mailed surveys to 132 oncologists and interviewed 19 Asian-American women with cancer from Northern California. Forty-four oncologists responded. They reported as barriers language problems, lack of culturally relevant cancer information, and complex protocols. Most stated that they informed Asian-American women about treatment trials. Only four women interviewed knew about trials. Other patient-identified barriers were fear of side effects, language problems, competing needs, and fear of experimentation. Family decision making was a barrier for both oncologists and patients. Compared to non-Asian oncologists, more Asian oncologists have referred Asian-American women to industry trials and identified barriers similar to patients' reports. Our findings indicate that Asian-American women need to be informed about cancer treatment trials, linguistic barriers should be addressed, and future research should evaluate cultural barriers such as family decision making.

Adult↗
PubMed1997

The great success of Asian kidney transplant recipients.

BACKGROUND: Little has been written about allograft survival in non-African-American minority groups. We examine the success of kidney transplantation in 1900 Asian recipients. METHODS: Data from 42,252 cadaveric and 16,115 live donor kidney transplant recipients were monitored from the United Network for Organ Sharing Scientific Renal Transplant Registry from 1991 through 1996. RESULTS: Asian recipients exhibited the highest cadaveric allograft survival rates (89% 1-year and 83% 3-year survival) and the longest mean allograft half-life (18 years). Asian women had the highest mean graft half-life (23 years). Asians were less likely to be broadly sensitized and had a high incidence of IgA nephropathy causing end-stage renal disease. Although it has been suggested that their low body weights may help explain the excellent allograft outcome, Asians exhibited superior graft survival rates even when compared with low body weight recipients of other races. CONCLUSION: Asian renal allograft recipients, particularly Asian females, have the highest allograft survival rates of all racial groups.

Adult↗
PubMed2004

Coronary risk in South Asians: role of ethnicity and blood sugar.

BACKGROUND: Studies of South Asian immigrants in different countries have reported an increased predisposition to cardiovascular disease in comparison with the native populations. DESIGN: This study is a systematic review of longitudinal studies investigating differences in established risk factors for coronary heart disease (CHD) between Caucasians and South Asians. The aim was to develop a practical tool to estimate CHD risk in individuals. Secondarily data from the Health Survey for England 1999 (HSE 1999) were used to explore a possible role of differences in blood glucose in risk variation. METHODS: We used a systematic search to find relevant published papers. Data from the HSE 1999 were employed to study ethnic differences in blood glucose and glycosylated haemoglobin. RESULTS: Only two out of five longitudinal studies reported independent estimates of relative risks of CHD in South Asians compared to Caucasians. Risk in diabetic South Asians was predicted adequately by classical risk factors whilst risk in a non-diabetic study population was 79% greater than predicted. Non-diabetic South Asians have higher fasting blood glucose (FBG) and HbA1c than Caucasians after adjustment for CHD risk factors. CONCLUSIONS: The difference in risk of CHD between non-diabetic South Asian and Caucasians is not explained by differences in the impact of the traditional risk factors. Part may be due to higher blood sugar concentrations in non-diabetic South Asians.

Adult↗
PubMed2005

A comparison of urodynamic diagnoses and detrusor muscle function in white and South Indian Asian women.

PURPOSE: We compared urodynamic data and the final diagnosis after testing between white and Asian women investigated for urinary incontinence. MATERIALS AND METHODS: Urodynamic traces of consecutive women investigated between January 2002 and December 2003 were reviewed. Urodynamic diagnoses were classified as normal, urodynamic stress incontinence, detrusor overactivity (DOA) or mixed incontinence. In DOA cases the amplitude and number of detrusor contractions, and the volume at which the first involuntary contraction occurred were recorded. Data were compared by ethnic group. RESULTS: The distribution of diagnoses was significantly different between Asian and white women (p <0.0001). In Asian and white women we noted urodynamic stress incontinence in 22% and 53% (OR 0.24, 95% CI 0.13 to 0.48), DOA in 28% and 17% (OR 1.88, 95% CI 0.98 to 3.60) and mixed incontinence in 22% and 7% (OR 3.74, 95% CI 1.70 to 8.22), respectively. Post-void residual volume (p = 0.02), volume at strong desire to void (p = 0.03) and cystometric capacity (p = 0.0002) were lower in Asian women. In those with DOA the first contraction occurred at a lower volume in Asian woman (57 vs 179 ml, p = 0.002). Asian women had more contractions (5 vs 3, p = 0.009) with higher maximum (50 vs 32 cm H2O, p = 0.004) and average (34.4 vs 25.3 cm H2O, p = 0.03) detrusor pressure. CONCLUSIONS: In women who undergo urodynamics a greater proportion of Asian women have DOA and mixed incontinence compared with white women. Functional differences in detrusor contraction pressures exist, which may suggest a fundamental difference in bladder function or disease etiology. Exploration of this theory requires further study.

Asian People↗
PubMed2006

New insights into the epidemiology of chronic kidney disease in US Asians and Pacific Islanders.

PURPOSE OF REVIEW: In contrast to advances in our understanding of health disparities in other ethnic groups within the US, differential outcomes associated with chronic kidney disease among US Asians have gone largely unexamined. Until recently, risk estimates for chronic kidney disease outcomes among US Pacific Islanders were virtually unknown. This review highlights recent contributions to our understanding of chronic kidney disease outcomes in US Asians and Pacific Islanders. RECENT FINDINGS: Asians in the US appear to have a higher risk of end-stage renal disease relative to US whites after accounting for baseline kidney disease and many of the known risk factors for end-stage renal disease. The origins of the discrepancy in risk for end-stage renal disease between US Asians and whites do not appear to be explained by the socioeconomic and comorbidity disparities paradigm present in the US black vs. white model. Mounting evidence suggests that US Asians and Pacific Islanders receive substantially less predialysis care and proportionally fewer kidney transplants compared with US whites. Paradoxically, these populations have equivalent or better survival on dialysis. SUMMARY: These data highlight the need for studies to elucidate the mechanisms underlying the differential outcomes observed among US Asians and Pacific Islanders. Efforts to identify ethnicity-specific risk factors for kidney disease and interventions aimed at promoting predialysis care and kidney transplantation among US Asians and Pacific Islanders could substantially reduce morbidity, mortality, and costs.

Asian↗
PubMed2025

Stratifying Lung Adenocarcinoma Risk with Multi-ancestry Polygenic Risk Scores in East Asian Never-Smokers.

BACKGROUND: Lung adenocarcinoma (LUAD) in never-smokers is a major public health burden, especially among East Asian women. Polygenic risk scores (PRSs) are promising for risk stratification but are primarily developed in European-ancestry populations. We aimed to develop and validate single- and multi-ancestry PRSs for East Asian never-smokers to improve LUAD risk prediction. METHODS: PRSs were developed using genome-wide association study summary statistics from East Asian (8,002 cases; 20,782 controls) and European (2,058 cases; 5,575 controls) populations. Single-ancestry models included PRS-25, PRS-CT, and LDpred2; multi-ancestry models included LDpred2+PRS-EUR128, PRS-CSx, and CT-SLEB. Performance was evaluated in independent East Asian data from the Female Lung Cancer Consortium (FLCCA) and externally validated in the Nanjing Lung Cancer Cohort (NJLCC). We assessed predictive accuracy via AUC, with 10-year and (age 30-80) absolute risks estimates. RESULTS: The best multi-ancestry PRS, using East Asian and European data via CT-SLEB (clumping and thresholding, super learning, empirical Bayes), outperformed the best East Asian-only PRS (LDpred2; AUC=0.629, 95% CI:0.618,0.641), achieving an AUC of 0.640 (95% CI:0.629,0.653) and odds ratio of 1.71 (95% CI:1.61,1.82) per SD increase. NJLCC Validation confirmed robust performance (AUC =0.649, 95% CI: 0.623, 0.676). The top 20% PRS group had a 3.92-fold higher LUAD risk than the bottom 20%. Further, the top 5% PRS group reached a 6.69% lifetime absolute risk. Notably, this group reached the average population 10-year LUAD risk at age 50 (0.42%) by age 41, nine years earlier. CONCLUSIONS: Multi-ancestry PRS approaches enhance LUAD risk stratification in East Asian never-smokers, with consistent external validation, suggesting future clinical utility.

East Asian never smokers↗
PubMed2006

Ethnic characteristics of eyelashes: a comparative analysis in Asian and Caucasian females.

BACKGROUND: Despite similar biochemical composition of human hair between races, physico-morphological characteristics are not identical in different ethnic groups. Eyelashes have been investigated far less than scalp hair, and the information available is insufficient. OBJECTIVES: To obtain basic information about eyelashes and to clarify differences between female eyelashes in Asians and Caucasians. METHODS: Twenty Asian and 10 white Caucasian female volunteers aged between 20 and 29 years were admitted to the study. Lateral digital photographs of upper eyelashes were taken and curl-up and lift-up angles of upper eyelashes were measured from lateral views. Images of upper eyelashes were also taken using the phototrichogram technique and total numbers, lengths and thicknesses of upper eyelashes were obtained (a total of 4661 eyelashes; 2946 for Asian, 1715 for Caucasian). The central portion of the eyelashes or whole eyelashes were clipped and images were taken immediately and 7 days later to obtain the growth rate and anagen ratio of upper eyelashes. Numbers and thickness of eyelash cuticular layers were obtained by electron microscopy. RESULTS: Compared with Caucasians, Asian eyelashes revealed lower lift-up and curl-up angles, fewer numbers and a thicker transverse diameter. However, no statistical difference was observed in length or growth rate. Duration of anagen was estimated at about 2 months. The eyelash anagen ratio obtained from five Asians was 17.8 +/- 3.3%. By electron microscopy, the number of cuticular layers in transverse section was greater in Asian (8.0 +/- 1.2) than Caucasian females (6.5 +/- 1.1), but no statistical difference was found in single cuticle layer thickness between the two groups. Moreover, eyelash characteristics were not influenced by eye makeup in either race. CONCLUSIONS: Our results on eyelash morphology and growth characteristics demonstrated significant ethnic differences in Asian and Caucasian females that could provide basic information for future investigations.

Adult↗
PubMedDate not supplied

Prevalence and age of onset of type 1 diabetes in adult Asians in the Coventry Diabetes Study.

Although Asians are known to have an excess of Type 2 diabetes when compared with Europids, the relative prevalence of Type 1 diabetes in Asians remains controversial. The Coventry Diabetes Study enumerated all adult diabetic subjects in the electoral ward of Foleshill (population 10,304) by a house-to-house survey. Residents treated with insulin were classified as having either Type 1 or Type 2 diabetes on the basis of plasma C-peptide concentration and their diabetic history. Insulin treatment was received by 22% of Europids and 12% of Asians with previously diagnosed diabetes. Diabetic history was available for all and C-peptide for 69% of insulin-treated subjects. The age adjusted prevalence of Type 1 diabetes was 0.16 (95% CI 0.6-3.3)% in Europids and 0.12 (95% CI 0.4-2.7)% in Asians. Asians were found to have a significantly higher age at diagnosis (26 (range 19-34) vs 18 (6-29) years, p less than 0.05) than Europids, and all were born outside of the United Kingdom. No Type 1 diabetes was diagnosed under 19 years of age in Asians while 5 of the 8 Europid subjects with Type 1 diabetes were diagnosed under this age. Type 1 diabetes does occur in Asians born outside the UK but either commences later in life or, if of earlier onset, precludes migration to the UK.

Adult↗
PubMed2006

Is admission for epistaxis more common in Caucasian than in Asian people? A preliminary study.

OBJECTIVES: Epistaxis is a common ENT complaint. Although casual observation suggested that it is more common in Caucasian, compared with Asian people, a literature search failed to find any studies investigating ethnicity and epistaxis. The aim of this study was to identify any differences in emergency admission rates for epistaxis between Asian and Caucasian people. DESIGN: Retrospective observational study using hospital computerised data (HISS). SETTING: Large University Hospital accepting ENT emergencies. PARTICIPANTS: All Asian and Caucasian patients admitted under ENT care as an emergency (1 January 2000 to 30 November 2005), split into two groups: one composed of epistaxis patients, the other of all other ENT emergency admissions. MAIN OUTCOMES MEASURES: The proportions of Asian and Caucasian patients among the two patient groups, either epistaxis admissions or other ENT emergency admissions. RESULTS: The proportions of Asian and Caucasian patients in the group admitted with emergency epistaxis were 7.1% (100/1410) and 92.9% (1310/1410) respectively. However, the proportions of Asian and Caucasian patients in the group composed of any other ENT emergency were 13.2% (729/5515) and 86.8% (4786/5515), respectively (chi-squared P < 0.01). CONCLUSIONS: Caucasian people form an unexpectedly large, and Asians a smaller proportion of emergency epistaxis admissions. The possibility of an ethnic risk factor for epistaxis warrants further investigation.

Asian People↗
PubMed2005

The prevalence and clinical characteristics of cystic fibrosis in South Asian Canadian immigrants.

BACKGROUND: Cystic fibrosis (CF) is considered to be rare among individuals from the Indian subcontinent. Furthermore, affected individuals are reported to experience a more severe clinical course. AIMS: It was hypothesised that CF is under diagnosed in people of South Asian origin and therefore the prevalence may be higher than previously estimated. METHODS: The prevalence of CF in the South Asian and in the general population living in the same geographic region (Metropolitan Toronto) were compared between 1996 and 2001. Population data were obtained from the Canadian census survey. CF phenotype and genotype data were obtained from the Toronto CF database. RESULTS: Among 381 patients with CF, 15 were of South Asian descent. The age related prevalence of CF among the South Asian and general populations was: 0-14 years, 1:9200 versus 1:6600; 15-24 years, 1:13,200 versus 1:7600; older than 25 years, 1:56,600 versus 1:12,400. Age at diagnosis, duration and severity of symptoms at diagnosis, current nutritional status, and FEV(1) were similar in the two groups. While not significant, FEV1 tended to be lower (48% versus 57% predicted) among adult South Asians, compared to the general CF population. Also, the percentage with pancreatic sufficiency was higher (27% versus 16%) and the frequency of DeltaF508 allele was lower (50% versus 65.1%). CONCLUSIONS: These data suggest that the prevalence and natural history of CF in South Asians is similar to that among individuals of European origin. The relatively lower prevalence among older South Asians may reflect an improving recognition of CF in this ethnic subgroup.

Adolescent↗
PubMed2005

Use of mental health services by Asian Americans.

This study explored the use of mental health services by Asian Americans and other ethnic populations (N=104,773) in California. The authors used linear regression analyses to assess the role of ethnicity and diagnosis in predicting six-month use of services. East Asians used more services than Southeast Asians, Filipinos, other Asians, Caucasians, African Americans, Latinos, and Native Americans, even when severity of illness was taken into account. The findings suggest that aggregating Asian subpopulations into a single group in services research is no longer appropriate. Attention needs to be placed on the needs of Southeast Asians and other Asians, whose service use patterns approximate those of the traditionally most underserved groups, African Americans and Latinos.

Adult↗
PubMed2002

Ethnic variation in C-reactive protein: UK resident Indo-Asians compared with Caucasians.

BACKGROUND: The increased prevalence of coronary heart disease (CHD) in UK resident Indo-Asians is unexplained by the traditional cardiovascular risk factors of dyslipidaemia, hypertension, smoking and diabetes mellitus. C-reactive protein (CRP) has been implicated in the pathogenesis of CHD but the data on ethnic variation in CRP is conflicting. We therefore investigated whether CRP could help explain the increased prevalence of CHD in Indo-Asians. DESIGN AND METHODS: We measured CRP, using a highly sensitive assay, in 102 men (63 Caucasians and 39 Indo-Asians) and 89 women (58 Caucasians and 31 Indo-Asians). All subjects, aged between 40 and 70 years, were nondiabetic and nonsmokers. RESULTS: Serum CRP correlated (P < 0.05) positively with coronary risk. Serum HDL cholesterol concentrations were lower (P<0.05) in Indo-Asian women when compared with Caucasian women, but otherwise the ethnic groups were matched for calculated coronary risk and cardiovascular risk factors. Serum CRP concentrations were similar in Indo-Asians (women 2.29 (1.52) mg/l [mean (SD)]; men 1.77 (1.46) mg/l) and Caucasians (women 2.23 (1.54) mg/l; men 1.94 (1.45) mg/l). CONCLUSIONS: Altered CRP concentrations does not appear to be implicated in the increased prevalence of CHD in UK resident Indo-Asians.

Asia↗