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Objective: The advent of video-assisted thoracoscopic surgery in Mongolia has faced funding and accessibility challenges, leading to languid adoption. A Mongolian-Canadian collaboration was inaugurated to support the development of a self-sustainable, self-governed minimally invasive thoracic surgery (MITS) program in Mongolia. Methods: A multidisciplinary Canadian thoracic surgery team collaborated with the National Cancer Center of Mongolia Thoracic Surgery service from 2016 to 2023. The team engaged in patient rounds, MITS procedures, and service education. Program and patient outcomes were reviewed. Results: Thirty-four patients underwent MITS procedures as part of the Mongolian-Canadian collaboration. Median age was 51 years (range, 16-76 years), and 41% (14 out of 34) were men. Lung, esophageal, and mediastinal procedures composed 50% (17 out of 34), 21% (7 out of 34), and 21% (7 out of 34) of procedures, respectively. Conversion rate, median operative time, and hospital length of stay were 0%, 172.5 minutes, and 8 days, respectively. The complication rate was 9% (3 out of 34) with 3% (1 out of 34) being Clavien-Dindo >3 requiring re-operation. Thirty-day mortality was 0%. Mongolia's thoracic surgery team progressed from surgical assists to primary operators and a self-governed program. In 2023, the National Cancer Center of Mongolia's thoracic surgery service independently conducted 72% (50 out of 69) of esophagectomies and 91% (48 out of 53) of pulmonary resections via minimally invasive technique compared with 0% in 2015. Conclusions: The Mongolian-Canadian collaboration demonstrated successful transfer of MITS proficiency through global noncolonialist surgical partnership, consequentially shifting the national thoracic surgical paradigm. Continued collaboration will focus on sustainability and supporting local surgeons in regional dissemination of MITS proficiency with the aim of globalizing thoracic surgical excellence.

The article looks into Anti-Money Laundering and Combating the Financing of Terrorism (AML/CFT) policy issues through all stages of a policymaking process, across two Central Asian nations, Kazakhstan and Kyrgyz Republic . It does so through the prism of the role of key actors at each stage of policymaking. Among the key findings of this paper is that the implementation of anti-laundering policy in Kyrgyzstan has constantly been confronted with opposition from a range of key actors, specifically fractions within the parliament, as well as business communities and NGOs, while Kazakhstan faced policy implementation hurdles in a much less degree since both chambers of the national parliament did not express open resistance to the adoption of new amendments to the basic Law. Despite the higher resistance to AML/CFT policy implementation in the Kyrgyz parliament vis-à-vis its Kazakh counterpart, Kyrgyz Republic succeeded in passing the new Law due to a change in political power in 2017. Although both Kazakhstan and Kyrgyz Republic appear to move in the same policy direction overall while taking adequate measures to improve their AML/CFT policy systems in accordance with international standards, the specific stages of policymaking reveal interesting discrepancies, especially at the policy formulation and decision-making stages. This research appears to be the first and somewhat unique scholarly attempt to analyze a policy issue through a comprehensive policymaking cycle, i.e. all the way from agenda-setting to policy evaluation. More importantly, it looks into Central Asian context, the region that remains largely understudied.

The paper reviews existing literature on the role of the internet in addressing corruption by breaking it down into instrumental, important, and critical roles, across two types of political regimes – (semi-)authoritarian and democracies. It analyzes the key resources and strategies utilized by governments and activists across these regimes, and looks into the common themes that emerge as a result of analyzing literature sources, i.e. the notion of crisis, lack of a single accepted definition of corruption across nations, factors found to positively correlate with reduced corruption, and the evolving nature of the internet. The paper finds that neither regime can be perfectly immune against mass-scale protests caused by dissatisfaction with worsening corruption. However, the regimes differ in the nature of protests, with semi-authoritarian regimes witnessing more violent and aggressive uprisings fueled by long-accumulated social disappointment with previous repressive regimes than across much of democracies.

Background: Lean metabolic dysfunction-associated steatotic liver disease (MASLD), characterized by a BMI < 25 kg/m² (or < 23 kg/m² in Asians), presents a challenging prognosis compared to non-lean MASLD. This study examines cardiovascular outcomes in both lean and non-lean MASLD cohorts., Methods: In this meta-analysis, pooled odds ratios (ORs) within 95 % confidence intervals (CIs) were calculated for primary outcomes (cardiovascular mortality and major adverse cardiovascular events [MACE]) and secondary outcomes (cardiovascular disease [CVD], all-cause mortality, hypertension, and dyslipidemia). Studies comparing lean and non-lean MASLD within the same cohorts were analyzed, prioritizing those with larger sample sizes or recent publication dates., Results: Twenty-one studies were identified, encompassing lean MASLD patients (n = 7153; mean age 52.9 ± 7.4; 56 % male) and non-lean MASLD patients (n = 23,514; mean age 53.2 ± 6.8; 63 % male). Lean MASLD exhibited a 50 % increase in cardiovascular mortality odds compared to non-lean MASLD (OR: 1.5, 95 % CI 1.2-1.8; p < 0.0001). MACE odds were 10 % lower in lean MASLD (OR: 0.9, 95 % CI 0.7-1.2; p = 0.7), while CVD odds were 40 % lower (p = 0.01). All-cause mortality showed a 40 % higher odds in lean MASLD versus non-lean MASLD (p = 0.06). Lean MASLD had 30 % lower odds for both hypertension (p = 0.01) and dyslipidemia (p = 0.02) compared to non-lean MASLD., Conclusion: Despite a favorable cardiometabolic profile and comparable MACE rates, lean individuals with MASLD face elevated cardiovascular mortality risk., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests Basile Njei reports a relationship with NIH CTSA Grant Number TL1 TR001864 that includes: funding grants. Basile Njei reports a relationship with Yale Liver Center award NIH P30 DK034989 that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

There are multiple mechanisms by which The Coronavirus-19 (COVID-19) infection can cause electrolyte abnormalities, which may not be the case for bacterial causes of pneumonia. This study aimed to assess the differences in electrolyte levels between patients suffering from COVID-19 and bacterial pneumonia. This is an original, retrospective study. Two cohorts of hospitalized patients were included, 1 suffering from COVID-19 and the other from bacterial pneumonia. Their day 1 and day 3 levels of sodium, potassium, magnesium, and phosphorus, as well as their outcomes, were extracted from the charts. Statistical analysis was subsequently performed. Mean admission levels of sodium, potassium, phosphorus, and magnesium were 135.64 ± 6.13, 4.38 ± 0.69, 3.53 ± 0.69, and 2.03 ± 0.51, respectively. The mean day 3 levels of these electrolytes were 138.3 ± 5.06, 4.18 ± 0.59, 3.578 ± 0.59, and 2.11 ± 0.64, respectively. Patients suffering from bacterial pneumonia were significantly older (N = 219, mean = 64.88 ± 15.99) than patients with COVID-19 pneumonia (N = 240, mean = 57.63 ± 17.87). Bacterial pneumonia group had significantly higher serum potassium (N = 211, mean = 4.51 ± 0.76), and magnesium (N = 115, mean = 2.12 ± 0.60) levels compared to COVID-19 group (N = 227, mean = 4.254 ± 0.60 for potassium and N = 118, mean = 1.933 ± 0.38 for magnesium). Only magnesium was significantly higher among day 3 electrolytes in the bacterial pneumonia group. No significant association between electrolyte levels and outcomes was seen. We found that COVID-19 patients had lower potassium and magnesium levels on admission, possibly due to the effect of COVID-19 on the renin-angiotensin-aldosterone system as well as patient characteristics and management. We did not find enough evidence to recommend using electrolyte levels as a determinator of prognosis, but more research is needed., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)