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The hybrid confinement system combines various fiber types within a single matrix, allowing for the adjustment of volumetric ratios to optimize confinement performance. Synthetic FRPs are more expensive and have a higher carbon footprint due to significant CO 2 emissions during production. In response, this study presents an innovative hybrid confinement approach using two natural materials: cotton ropes and FSMS (CFS) to improve concrete strength and ductility. Specimens, standardized at 300 mm height and 150 mm diameter with longitudinal steel bars and stirrups, were divided into two groups based on CFS configurations. The stress-strain response of CFS-confined concrete displayed distinctive behavior: an initial parabolic phase leading to peak compressive stress (ultimate strength), followed by a linearly degrading phase. Across all subgroups, CFS confinement significantly enhanced ultimate strength and corresponding compressive strains, with Subgroup 2A achieving the highest improvements of 246 % in ultimate strength and 1477 % in strain. Moreover, the ductility gain was reported as high as 20 for CFS-confined concrete. A non-proportional enhancement in the compressive behavior was observed with the increase in confinement ratio. Predictive models were developed for the idealized two-branch response of CFS-confined concrete, encompassing expressions based on nonlinear regression for ultimate strength, corresponding strain, ultimate strain, and elastic modulus. Two existing models were modified to trach each branch of the response. Integrating these two adjusted models closely replicated the experimental compressive curves., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Reporting cumulative antimicrobial susceptibility testing data on a regular basis is crucial to inform antimicrobial resistance (AMR) action plans at local, national, and global levels. However, analyzing data and generating a report are time consuming and often require trained personnel., Objective: This study aimed to develop and test an application that can support a local hospital to analyze routinely collected electronic data independently and generate AMR surveillance reports rapidly., Methods: An offline application to generate standardized AMR surveillance reports from routinely available microbiology and hospital data files was written in the R programming language (R Project for Statistical Computing). The application can be run by double clicking on the application file without any further user input. The data analysis procedure and report content were developed based on the recommendations of the World Health Organization Global Antimicrobial Resistance Surveillance System (WHO GLASS). The application was tested on Microsoft Windows 10 and 7 using open access example data sets. We then independently tested the application in seven hospitals in Cambodia, Lao People's Democratic Republic, Myanmar, Nepal, Thailand, the United Kingdom, and Vietnam., Results: We developed the AutoMated tool for Antimicrobial resistance Surveillance System (AMASS), which can support clinical microbiology laboratories to analyze their microbiology and hospital data files (in CSV or Excel format) onsite and promptly generate AMR surveillance reports (in PDF and CSV formats). The data files could be those exported from WHONET or other laboratory information systems. The automatically generated reports contain only summary data without patient identifiers. The AMASS application is downloadable from https://www.amass.website/. The participating hospitals tested the application and deposited their AMR surveillance reports in an open access data repository., Conclusions: The AMASS is a useful tool to support the generation and sharing of AMR surveillance reports., (©Cherry Lim, Thyl Miliya, Vilada Chansamouth, Myint Thazin Aung, Abhilasha Karkey, Prapit Teparrukkul, Batra Rahul, Nguyen Phu Huong Lan, John Stelling, Paul Turner, Elizabeth Ashley, H Rogier van Doorn, Htet Naing Lin, Clare Ling, Soawapak Hinjoy, Sopon Iamsirithaworn, Susanna Dunachie, Tri Wangrangsimakul, Viriya Hantrakun, William Schilling, Lam Minh Yen, Le Van Tan, Htay Htay Hlaing, Mayfong Mayxay, Manivanh Vongsouvath, Buddha Basnyat, Jonathan Edgeworth, Sharon J Peacock, Guy Thwaites, Nicholas PJ Day, Ben S Cooper, Direk Limmathurotsakul. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.10.2020.)

Background: The world population is aging very rapidly and the impact is more severe in developing countries because of insufficient resources and low awareness of the challenges faced by older people. This study aimed to explore multimorbidity of older people in Myanmar and their health seeking behaviours., Methods: A community-based cross-sectional study was conducted in both urban and rural areas of Bago Region and Mon State during October 2016. A multistage sampling method was used to select 4,859 people aged 60 years and older. Participants were interviewed face-to-face using a questionnaire. Multinominal logistic regression was used to analyse data., Results: More than half of the study participants (57.9%) reported at least one chronic condition in the last year and 33.2% reported two or more conditions (multimorbidity). The common conditions were hypertension (67.3%), arthritis (24.7%), arrhythmia (14.7%), coronary heart disease (13.8%) and diabetes (13.7%). A majority (61.7%) of participants with a chronic condition took western medicine. Older people usually saw a doctor (60.2%) or health assistant (21.9%) at a nearby clinic or rural health center; 1.6% reported seeing uncredentialed medical persons. Factors associated with multimorbidity were being female (adjusted Prevalence Ratio (aPR) = 2.14, 95% confidence interval (CI) 1.63-2.82) and having fair (aPR = 2.20, 95% CI 1.59-3.04) or poor self-reported health (aPR = 3.93, 95% CI 2.79-5.52). Those with less than middle school education (aPR = 0.50, 95% CI 0.25-0.99) and those living in rural areas (aPR = 0.78, 95% CI 0.62-0.98) were less likely to have multimorbidity. Older people in rural areas had less access to health care than their urban counterparts., Conclusion: Chronic conditions are common among older people in Myanmar, with higher prevalence in women and in urban areas. The lower prevalence of chronic conditions in those who live in rural areas may be related to living a more traditional lifestyle., Competing Interests: The authors have declared that no competing interests exist.

Objectives: To explore the intake of fruits and vegetables in the Yangon region, Myanmar, and to describe associations between intake of fruits and vegetables (FV) and established risk factors for non-communicable diseases., Design: 2 cross-sectional studies, using the STEPs methodology., Setting: Urban and rural areas of the Yangon region of Myanmar., Participants: 1486, men and women, 25-74 years, were recruited through a multistage cluster sampling method. Institutionalised people, military personnel, Buddhist monks and nuns were not invited. Physically and mentally ill people were excluded., Results: Mean intake of fruit was 0.8 (SE 0.1) and 0.6 (0.0) servings/day and of vegetables 2.2 (0.1) and 1.2 (0.1) servings/day, in urban and rural areas, respectively. Adjusted for included confounders (age, sex, location, income, education, smoking and low physical activity), men and women eating ≥2 servings of fruits and vegetables/day had lower odds than others of hypertriglyceridaemia (OR 0.72 (95% CI 0.56 to 0.94)). On average, women eating at least 2 servings of fruits and vegetables per day had cholesterol levels 0.28 mmol/L lower than the levels of other women. When only adjusted for sex and age, men eating at least 2 servings of fruits and vegetables per day had cholesterol levels 0.27 mmol/L higher than other men., Conclusions: A high intake of FV was associated with lower odds of hypertriglyceridaemia among men and women. It was also associated with cholesterol levels, negatively among women and positively among men., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Background: Lifestyle changes, particularly dietary intake, had resulted in increasing trends of type-2 diabetes mellitus worldwide. However, dietary intake is diverse across country contexts. This study aimed to compare the dietary intake, food patterns, and blood glucose among middle-aged adults living in urban and suburban areas in Mandalay city, Myanmar, and explore their relationships., Methods: A cross-sectional community-based study was conducted during June-November 2014. Adults aged 35-64 were randomly selected and requested to record all food they ate in a 4-day diary. Fasting and 2-hour postprandial blood glucose values were measured over two consecutive days. Dietary intakes were calculated in terms of energy, macronutrients, glycemic index, and glycemic load, and food patterns were identified by factor analysis. The relationships between food pattern, dietary intake, and blood glucose were assessed., Results: Of 440 participants, dietary intake between urban and suburban residents was significantly different. Six food patterns were identified. There was no difference in fasting and 2-hour postprandial blood glucose between urban and suburban residents, but a strong correlation between fasting blood glucose and 2-hour postprandial blood glucose was found (correlation coefficient=0.8). Identification of abnormal blood glucose status using original fasting and converted 2-hour postprandial values showed substantial agreement (prevalence-adjusted bias-adjusted Kappa=0.8). Relationships between food patterns and blood glucose or abnormal blood glucose status were not found., Conclusion: Food patterns were associated with dietary intake, not with abnormal blood glucose status. Two-hour postprandial blood glucose was highly correlated with fasting blood glucose and may be used for identifying abnormal blood glucose status.