University Of Medicine 1 Yangon

Despite the growing prominence of the triple bottom line (TBL) framework in university sustainability discourse, empirical research examining how environmental, social, and economic outcomes are realized across diverse national contexts within higher education institutions remains limited. This qualitative study explored how 12 STARS-rated universities from both Anglo-American and Emerging regions have achieved TBL outcomes and the institutional and contextual factors that influence them. In-depth interviews with sustainability coordinators revealed that environmental outcomes, such as zero-waste goals and carbon neutrality, were well developed; social outcomes, such as student engagement, SDG-aligned curricula, and gender equity, showed emerging integration; and economic outcomes, such as sustainable procurement and green budgeting, remained less defined. The findings also showed that internal drivers, such as governance arrangements, capacity, culture, and external drivers, such as rankings, funding availability, and national policies, shaped the scope and success of initiatives. These findings highlight that TBL implementation in universities is an uneven, contextually mediated process and provide insights for higher education leaders seeking to strengthen institutional strategies for sustainability transformation.

Direct agricultural use of digestate from food waste is hindered by its high phytotoxicity, and the addition of common auxiliary materials during composting increases the project cost. In this study, mature compost (MC) was used to replace part of mushroom residue as auxiliary materials for controlled experiments at a pilot-scale horizontal double-layer mechanical composting device. The results showed that the MC addition heated up more rapidly than the control group (NC), peaking at 72 °C on day 5. The moisture content was reduced from 47.17% to 25.36%, which was lower than the final value of 28.48% in the NC. The final humic acid (HA) content in the MC group (60.88 g/kg) was higher than that in the NC (44.82 g/kg). The seed germination index (GI) for both groups exceeded 70%, meeting the national standard. The MC group achieved a final GI of 119.37%, which was significantly higher than that of the NC (81.29%). The phylum Firmicutes became the dominant group in the MC group during the thermophilic phase, demonstrating strong thermotolerance and a high capacity for degrading recalcitrant organic compounds such as cellulose. At the genus level, Bacillus demonstrated a relatively high abundance during the thermophilic phase. These findings imply that the MC addition improves the composting property, enhances the degree of humification, and shortens the composting time, providing technical support for the improvement of aerobic composting of food waste digestate, thus contributing to more sustainable waste management by promoting a circular economy and reducing reliance on external inputs.

Thyroid hormone is essential in human metabolism. Hypothyroidism causes bradycardia, sinus pause, sinus arrest, and the most severe form, myxedema coma, and cardiopulmonary arrest. Most cardiovascular manifestations secondary to hypothyroidism are reversible with timely thyroid hormone replacement. Herein, we report a case of a 53-year-old woman with hypothyroidism who experienced episodes of prolonged sinus arrest, which resolved following temporary pacing and initiation of levothyroxine therapy. Factors such as seasonal variation, medication noncompliance, recent viral illness, and concurrent escitalopram use likely contributed to her presentation. This case highlights the importance of prompt recognition and management of hypothyroid-related cardiac arrhythmias.

The first case of AIDS was described in 1981 when the U.S. Centres for Disease Control and Prevention reported unusual clusters of Pneumocystis pneumonia (PCP) among homosexual men in Los Angeles. During the early years there was no effective treatment. In 1983, scientists at the Pasteur Institute in Paris discovered a retrovirus, later named Human Immunodeficiency Virus (HIV), as the causative agent of AIDS. This discovery led to the introduction of diagnostic tests and paved the way for drug discoveries. The first antiretroviral drug, zidovudine (Azidothymidine or AZT) was approved in 1987. The introduction of combination antiretroviral therapy (cART) in the mid 1990s, using three antiretroviral drugs in combination effectively suppressed the virus, improving the quality of life and extending survival for many individuals. HIV-related mortality rates climbed steadily through the 1980s and peaked in 1995, but have dropped gradually due to the introduction of ART. Today, individuals living with HIV who adhere to ART can achieve an undetectable viral load, meaning the level of HIV in the blood being so low it cannot be detected by standard tests. This not only improves health outcomes and long term survival but also means the virus cannot be sexually transmitted – a concept known as “undetectable equals untransmissible or U = U.” Despite many advances HIV pandemic is not over. In 2023, the global number of people living with HIV was 39.9 million compared to 27.2 million in 2000. There is still a need to increase public awareness, healthcare inequalities exist, stigma and social barriers are still present in many places, and there are also economic and political factors in some parts of the world. To end the HIV pandemic, a multi-pronged approach is required.

BackgroundTo date, there has not been an evaluation of antipsychotic prescription practices specific to the Association of Southeast Asian Nations (ASEAN) region. This study examined antipsychotic prescription for schizophrenia patients in ASEAN countries based on Research on Asian Psychotropic Prescription (REAP) survey.MethodsThis study used data from the fourth REAP antipsychotic survey (REAP-AP4), conducted between March and May 2016 using standardized procedures. In total, 1817 adult schizophrenia patients from six ASEAN countries were analysed.ResultsPrescription formulation was significantly associated with illness duration (G (24) = 150.595, p < .001) and prescribing country (G (20) = 571.423, p < .001). Oral antipsychotic monotherapy was the most common prescription across all illness durations, with a decreasing trend from 3-6 months to 10-20 years. Oral antipsychotic monotherapy was also the most commonly used prescription in almost all countries. The frequency of long-acting injection (LAI)-oral combination antipsychotic prescription increased with the patient's illness duration and is more commonly prescribed in Malaysia, Singapore, and Thailand.ConclusionLAI-oral combination antipsychotics were prescribed more frequently within patients with longer duration of illness in more developed countries. Antipsychotic monotherapy and oral antipsychotic prescriptions were prevalent across all illness durations and in most ASEAN countries.