Mongolian National University

The Diversity and Equity Committee (DEC) of the Asian Pacific Society of Nephrology (APSN) conducted a regional review to characterise disparities in kidney disease burden, healthcare access and nephrology service delivery across the Asia-Pacific (AP) region. A descriptive summary was compiled using national reports, registries, and expert inputs from DEC representatives. Data included kidney disease prevalence, dialysis and transplant modalities, healthcare system characteristics and disparity-related indicators. Comparative insights were drawn across countries using structured tables and narrative synthesis. The AP region exhibits a disproportionate burden of chronic kidney disease (CKD) and kidney failure with marked heterogeneity in disease aetiology, healthcare financing, and infrastructure. High-income countries such as Japan, Korea, Taiwan and Australia demonstrate mature universal insurance systems, comprehensive dialysis networks and national CKD prevention programs. Middle- and lower-income countries-including Indonesia, Myanmar, Mongolia and parts of South and Southeast Asia-face critical challenges such as workforce shortages, limited dialysis and transplant capacity and geographic inequities. Despite these challenges, several countries have introduced exemplary models to enhance equity and sustainability in kidney care: PD-first policies (Hong Kong, Thailand), pay-for-performance CKD programs (Taiwan), Kidney Health Plan 2033 (Korea), HALT-CKD (Singapore), and ACT-KID (Malaysia), indigenous kidney health efforts in Australia and the inclusion of additional insurance points for patient education in Japan. Persistent gaps remain in early detection, transplantation access, rural care and minority equity. Kidney disease care in the Asia-Pacific region reflects both diversity and disparity. Although universal health coverage and national kidney health initiatives have improved access in many countries, substantial inequities persist across geography, income and cultural groups. The collective experiences highlight both common challenges and innovative solutions. Strengthening regional collaboration, policy-driven efforts and sustainable workforce development are essential to achieving equitable kidney health for all.

Against the backdrop of rapid development in artificial intelligence and intelligent educational technology, English teaching urgently needs to shift from the traditional model focused on knowledge transmission and outcome evaluation to a new teaching paradigm emphasizing the learning process and ability development. Addressing current problems in English classrooms such as student inattention, insufficient interaction, delayed evaluation, and lack of learning support, this paper introduces the Attention-Interaction-Assessment-Support (AIAS) model. Guided by attention theory, social constructivism, and formative assessment and learning support theories, it systematically explores the construction and practical path of English teaching methodology based on the AIAS model. Starting with conceptual definition and theoretical foundations, the study comprehensively reconstructs English teaching objectives, content, process, and evaluation, forming a teaching methodology system centered on the learning process and characterized by interaction-driven and continuous support. It also proposes actionable practical paths from aspects such as teaching preparation, classroom implementation, after-class extension, and teacher professional development. The study concludes that the AIAS model helps improve student engagement and interaction quality, optimizes evaluation and support mechanisms, and promotes the coordinated development of language ability, thinking ability, and self-directed learning ability, thus having a positive significance for promoting innovation in English teaching models.

В статье проводится теоретический анализ роли математической грамотности как центральной детерминанты экономического роста. Исследуется эволюция концепции человеческого капитала от количественных показателей (годы обучения) к качественным когнитивным компетенциям. Предлагается теоретическая рамка, интегрирующая математическую грамотность в неоклассические и эндогенные модели роста (Солоу, Лукаса, Ромера) в качестве мультипликатора эффективности труда и инноваций. Анализируются эмпирические данные международных исследований (PISA, PIAAC, TIMSS), подтверждающие превосходство качества навыков над продолжительностью образования в объяснении вариаций ВВП. Обосновывается необходимость институциональных реформ и перехода к функциональной грамотности для обеспечения конкурентоспособности в условиях цифровизации и развития искусственного интеллекта. This article provides a theoretical analysis of the role of mathematical literacy as a central determinant of economic growth. The author explores the evolution of the human capital concept from quantitative indicators (years of schooling) to qualitative cognitive competencies. The paper proposes a theoretical framework integrating mathematical literacy into neoclassical and endogenous growth models (Solow, Lucas, Romer) as a multiplier of labor efficiency and innovation. Empirical data from international assessments (PISA, PIAAC, TIMSS) are analyzed, confirming the superiority of skill quality over educational duration in explaining GDP variations. The conclusion substantiates the need for institutional reforms and a shift toward functional literacy to ensure competitiveness amid digitalization and the development of artificial intelligence.

Weight gain associated with antiretroviral therapy, particularly second-generation integrase strand transfer inhibitors (INSTIs), is an increasingly recognized concern. However, literature remains mixed regarding whether these effects differ by sex/gender. This scoping review aims to map the pattern, timing, severity and risk factors for weight gain among cis and trans women initiating or switching to second-generation INSTIs, such as dolutegravir, bictegravir or cabotegravir. Four databases (EMBASE, MEDLINE, Web of Science and CINAHL) were searched for studies reporting on weight gain after initiating or switching to second-generation INSTIs in cis and trans women or mixed cohorts with data disaggregated by sex/gender between 2010 and 2024. Three reviewers independently conducted the screening, and two reviewers extracted data. Forty articles were included. Most studies reported trends of increased and excessive weight gain in cis women compared to cis men taking dolutegravir or bictegravir-based regimens, although findings were inconsistent and the extent of weight gain varied. Weight gain was particularly pronounced among treatment-naive cis women, those of Black ethnicity or in African settings, and participants receiving dolutegravir in combination with tenofovir alafenamide. Studies on weight gain in cis women taking cabotegravir-based regimens and trans women on any regimen were scarce. Second-generation INSTIs, especially dolutegravir, appear to be associated with greater average and excessive weight gain among cis women, although this effect varies by setting, regimen and clinical context. Further research, especially in diverse populations, is needed to explore underlying mechanisms, determine risk factors and evaluate these trends in newer antiretroviral medications.

Background: Early decline in kidney function is a major complication of type 2 diabetes mellitus (T2DM). The extent to which achievement of glycemic, blood pressure, lipid, and weight targets influences short-term renal trajectories remains insufficiently characterized. Methods: We conducted a retrospective analysis of 125 T2DM patients who had baseline and 1-year follow-up eGFR measurements at the Mongolia Japan Hospital of the MNUMS during 2023-2024. Clinical and metabolic control was categorized using standard thresholds. Renal outcomes were assessed using absolute 1-year eGFR change and the occurrence of ≥30% decline. Results: Mean eGFR declined from 91.2 ± 24.1 to 88.4 ± 25.5 mL/min/1.73 m2 over one year (mean change -3.77 ± 11.3 mL/min/1.73 m2); 7.2% experienced ≥30% decline. Individuals with pre-existing CKD showed significantly greater deterioration than those without (interaction p < 0.001). Poor glycemic control was consistently associated with greater decline: participants with HbA1c > 7.5% had a significant reduction and regression analyses showed an additional adjusted decline of -4.7 mL/min/1.73 m2 (p = 0.029) compared with those at target. Elevated blood pressure (>130/80 mmHg) was also associated with greater annual decline (adjusted β = -6.40, p = 0.024). Lower BMI (<25 kg/m2) predicted larger decreases in eGFR in both CKD and non-CKD groups. Lipid target achievement demonstrated small, inconsistent associations with renal outcomes. Conclusions: In this clinical cohort, poor glycemic control and elevated blood pressure were the strongest modifiable predictors of short-term kidney function decline, particularly among individuals without pre-existing CKD.

Objective: Mongolia is among the 30 high-burden countries for TB and DR-TB. Whole-genome sequencing (WGS) offers precise insights into TB transmission, strain diversity, and antimicrobial resistance (AMR), which are vital for TB control strategies. This study aimed to investigate the molecular epidemiology, lineage distribution, transmission clustering, and drug resistance patterns of M.tuberculosis collected from rural areas of Mongolia using NGS.Methods: A total of 50,194 individuals were screened in a national TB prevalence survey conducted according to WHO guidelines. From rural participants, 102 TB isolates were obtained; 100 with sufficient DNA quality were subjected to WGS. Bioinformatics analyses included lineage identification, AMR mutation profiling, and phylogenetic and clustering analyses. Results: Among the 100 isolates, lineage 2 (Beijing genotype) accounted for 72.0% and lineage 4 (Euro-American) for 28.0%. The Beijing type was dominant across all regions, especially the central region (84.6%) and showed high clustering (56.4%). A total of 13 clusters (≤12 SNVs) were identified; 86.6% were Beijing strains. MDR-TB comprised 10% of isolates, with 100% of MDR-TB strains belonging to the Beijing genotype. Resistance to isoniazid (23%) was common. Mutations associated with resistance were mainly found in katG, inhA, rpoB, pncA, rpsL, rrs, and embB genes. No resistance was observed to new drugs such as bedaquiline, linezolid, or clofazimine. Conclusions: In rural of Mongolia, M. tuberculosis Lineage 2 (modern Beijing genotype) is predominant, accounting for 72% of cases, with consistent distribution across geographic locations. Beijing strains demonstrated higher drug resistance compared to Euro-American types. Importantly, no resistance was detected to newly introduced TB drugs.