Objective: On 2 September 2023, the Regional Epidemiology and Surveillance Unit of the Department of Health’s Center for Health Development in Calabarzon, Philippines, received a report of foodborne illness due to the ingestion of tuba-tuba (Jatropha curcas) seeds in Talao Talao Village, Lucena City. The objective of this study was to describe the public health event. Methods: A descriptive study was conducted. Cases were defined as previously well individuals who developed at least one of the following symptoms after eating tuba-tuba seeds: vomiting, abdominal pain, diarrhoea, headache or dizziness. Health records were reviewed, and key informant interviews and environmental surveys were conducted. Results: Ten cases were identified, ranging in age from 10 to 12 years. The onset of symptoms ranged from 1 to 4 hours after consumption. Six of the cases were taken to the hospital, although two went home before being admitted; all recovered after 3 days. The most common symptom was vomiting (100%); other symptoms included abdominal pain, diarrhoea, dizziness and headache. Discussion: This investigation confirmed that tuba-tuba seeds were the cause of symptoms among school-aged children in Lucena City. To prevent similar events in the future, we recommend intensifying educational campaigns at both the community and school levels, as tuba-tuba is common in the area.

[摘 要] 目的：探讨圣草次苷对食管癌KYSE30细胞增殖的影响，并基于铁死亡探讨其可能的作用机制。方法：将食管癌KYSE30细胞分为8组：对照组（常规培养）、RSL3组（用3 μmol/L铁死亡诱导剂RSL3处理）、圣草次苷组（用75 μmol/L圣草次苷处理）、圣草次苷 + Fer-1组（用5 μmol/L铁死亡抑制剂Fer-1 + 75 μmol/L圣草次苷处理）、Fer-1组（用5 μmol/L Fer-1处理）、oe-NC组（转染空白载体对照）、oe-STAT3组（转染STAT3过表达载体）、oe-STAT3 + 圣草次苷组（转染STAT3过表达载体后，用75 μmol/L圣草次苷处理）。采用CCK-8法、EdU掺入实验和克隆形成实验分别检测各组细胞的增殖能力，ELISA检测细胞内铁死亡相关指标的水平，WB法检测STAT3/GPX4通路相关蛋白的表达。构建KYSE30细胞裸鼠皮下移植瘤模型，观察圣草次苷及Fer-1对移植瘤生长的影响。结果：圣草次苷能够抑制KYSE30细胞增殖和克隆形成，增加活性氧（ROS）、丙二醛（MDA）、Fe2+水平，降低谷胱甘肽（GSH）水平（均P < 0.05），并抑制裸鼠移植瘤的生长，这些作用能够被Fer-1所逆转（P < 0.05）。STAT3过表达可消除圣草次苷对铁死亡的诱导效应及其对STAT3/GPX4通路的抑制作用（P < 0.05）。结论：圣草次苷能够通过抑制STAT3/GPX4信号通路来诱导食管癌KYSE30细胞铁死亡，从而在食管癌中发挥显著的抗肿瘤效应。

Background: A 2018 study on the global burden of disease, accidents, and risk factors reported that 1.6 million peo ple died in 2017 due to household air pollution. Poor indoor air quality has been highlighted as a contributing factor to respiratory diseases, cardiovascular conditions, and exacerbation of asthma and allergies. A 2019 study estimated that long-term exposure to fine particulate matter (PM2.5) with a diameter of 2.5 micrometers or less reduces average life expectancy by 1.8 years, with more severe effects in highly polluted regions. Additionally, a study by Miller et al. (2007) found that prolonged exposure to PM2.5 increases the risk of cardiovascular diseases, particularly among women. Direct measurement devices are highly effective in determining indoor PM2.5 concentrations, identifying sources of pollution, tracking pollutant dispersion, and monitoring temporal variations. Studies suggest that direct measurement is an accurate, cost-effective method that provides detailed data suitable for local conditions. Aim: To investigate the indoor air quality of houses and apartments in Darkhan city during the winter season using the Purple Air monitoring device. Materials and Methods: A cross-sectional study was conducted with a targeted sample of 128 households in Darkhan city. The study examined factors such as stove type, type of coal used, annual and daily coal consumption, frequency of heating, and chimney sealing conditions. To collect data, the Purple Air monitoring device was installed in each house hold for a month, after which it was retrieved. During retrieval, participants completed a questionnaire. The questionnaire consisted of 55 questions across 7 pages at the time of device installation and 25 questions across 3 pages at the time of device retrieval. The collected data was analyzed using SPSS 25.0. Results: A total of 128 households in Darkhan city participated in the study. The average duration of residence in the current home was 9.5 years, with no statistically significant variation. The distribution of housing types was as follows: traditional Mongolian gers (40.6%), houses (39.1%), and apartments (20.3%). The 24-hour average PM2.5 concentration was highest in gers (70.9 μg/m³), followed by houses (46.8 μg/m³) and apartments (22.8 μg/m³), with a statistically significant difference (p=0.0001). PM2.5 levels were most variable in gers, followed by houses and then apartments. House holds using central heating (apartments) had an average 24-hour PM2.5 concentration of 22.8 μg/m³, whereas households using stoves (gers and houses) had a significantly higher concentration of 59.4 μg/m³ (p=0.0001). However, there was no statistically significant difference between traditional and improved stoves. Among study participants, 21.4% reported that someone in their household smoked indoors. Additionally, 86.5% regularly burned incense, candles, or herbs, while 99.2% did not use an air purifier. Conclusion The indoor particulate matter concentration in houses and gers in Darkhan was 59.4μг/m3. Variations in stove types, poor chimney sealing limited space, and frequent gaps and cracks contribute to increased spread of indoor air pollutants.

Background: Social development due to fat, fast food, obesity and physical exercise depended on chronic cholecystitis and gallstones, still getting younger in recent years. Yaman Serdeg-3 is used in Mongolian Traditional Medicine for the liver and gallbladder and has been studied to support the excretion of bile. We have created a compound recipe, Yaman Serdeg-3 of Mongolia Traditional medicine, added Saussurea amara (L)DC herbal. Saussurea amara (L). DC is high in biologically active compounds, and pharmacology has investigated the bile-expelling action and the effects of the plant on cell growth. Chronic cholecystitis is a common chronic disease of the biliary tract in clinical patients. Symptoms can be seen in right upper abdominal cramps; some patients can be accompanied by abdominal muscle rigidity, the primary disease. It is caused by a large amount of bile blocking the patient’s gallbladder after the stone blocks the gallbladder duct. In the sac, induced acute cholecystitis was again caused by pathogenic factors to form the disease. Aim: Elucidating the effects of supplemental Yaman serdeg-3 in a gallbladder injury model. Materials and Methods: We received permission for animal experimentation from The Ethics Committee of Mongolia National University of Medical Sciences on the 10th of June 2022. The group created a model gallbladder disease with 0.5% a-naphthyl isothiocyanate [C11H7N5] dose (60 ml/kg), treatment with compound recipe Yaman Serdeg-3 (NYS-3) high dose (2.025 g/ml), medium dose (1.35g/ml), low dose (0.675g/ml), that used to compare URSO 250 (0.0042g/ml) for 21 days. The third group created a model liver disease with a 40% Carbon tetrachloride [CCl4] dose (4 ml/kg), treatment with compound recipe NYS-3 high dose (2.025 g/ml) and that was used to compare Hu gan pian (0.046g/ml) of China medicine for 21 days. Liver tissue pathological sections were collected quickly after blood collection in rats. The liver, stomach, and duodenum tissue on the right page were immersed in 10% neutral formalin and fixed for pathology. Histological examination: The fixed tissue was trimmed, dehydrated, embedded, and cut. After slides, HE staining, sealing, and other procedures, an optical microscope was used to observe. Results: In our study, the structure of the liver tissue cells in the high-dose group of Yaman serdeg-3 was preserved, the vessels had irregular blood vessels, and there was significant infiltration of chronic inflammation in the triple bypass. In this group, we divided the Yaman serged-3 into three groups: low-dose, medium-dose, and high-dose. In the model group with liver tissue analysis, the low-dose and medium-dose groups had fewer chronic inflammatory cells in triads and interstitial cells. In contrast, the fact that the high-dose group of Yaman serdeg-3 showed sparse trigeminal and interstitial and very few chronic inflammatory cells indicates that our study met its objectives, and the tissue analysis showed that the high-dose group was more effective. Conclusion During the acute and toxic liver disease model in rats, the inflammation process in the liver cells was high, and watery changes and fatty changes damaged the liver tissue. It has been confirmed that traditional herbal medicine, Yaman serdeg-3, reduced protein and fatty tissue changes in the hepatocyte membrane and accelerated liver and biliary tract regeneration. Furthermore, our study has shown that Yaman serdeg-3 may have stimulated bile secretion dose-dependently and accelerated hepatocyte regeneration. Also, liver tissue analysis of the control group showed significant inflammation in the triad and interstitial cells; blood vessels were filled with blood, and cell structure was preserved. In contrast, the comparison drug group had significant triad inflammation and fewer inflammatory cells in the interstitial cells.

Objective: This study aims to assess global trends in the use of open surgery versus minimally invasive surgery (MIS) for the treatment of single-level L4–5 degenerative lumbar spondylolisthesis (DLS). Methods: A cross-sectional online survey issued by the AO Spine Knowledge Forum Degenerative was conducted among AO Spine members between July and September 2023. Participants were presented with 3 clinical cases of L4–5 grade 1 DLS, each with varying degrees of stenosis and instability. The survey captured surgeon demographics and preferences for open versus MIS approaches. Statistical analysis, including chi-square tests and logistic regression, was performed to explore associations between surgical choices and surgeon demographics. Results: A total of 943 surgeons responded, with 479 completing the survey. Open surgery was the preferred approach in all 3 cases (58.8%, 57.3%, and 42.4%, respectively), particularly in cases involving central and bilateral foraminal stenosis. MIS was the second most common choice, particularly for unilateral foraminal stenosis with mild instability (38.8%). Surgeons’ preferences varied significantly by region, age, and fellowship training, with younger and fellowship-trained surgeons more likely to prefer MIS. Conclusion The study highlights the continued predominance of open surgery for DLS, especially in complex cases, despite the growing acceptance of MIS. Significant regional and demographic variations in surgical preferences suggest the need for tailored guidelines and standardized training protocols to optimize patient outcomes. Future research should focus on the long-term efficacy of these approaches and the impact of evolving technologies on surgical decision-making.

Objective: While minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) has shown superiority in key clinical metrics over the open approach, evidence regarding patient-reported outcomes remains limited. This study compared postoperative recovery trajectories and symptomatic improvement phases between MIS and open TLIF. Methods: This retrospective review included patients who underwent single-level MIS or open TLIF. Oswestry Disability Index (ODI) and Numerical Rating Scale (NRS) for back and leg pain were collected preoperatively and postoperatively. Segmented regression analysis with mixed-effects modeling, allowing for identification of distinct recovery phases, compared symptomatic trends between approaches. Results: Of 324 patients (268 MIS, 56 open), baseline demographics were similar except for greater preoperative leg pain in the MIS group (NRS: 6.0 vs. 5.0, p = 0.027). A segmented regression model identified 4 ODI recovery phases: postoperative disability phase (PDP, day 0 to 13), early improvement phase (day 13 to 28), late improvement phase (day 28 to 110), and plateau phase (later than day 110). The MIS group exhibited significantly lower disability exacerbation during PDP (β = 0.93 vs. 1.42 points per day, p = 0.008). Additionally, the plateau of NRS back occurred significantly earlier in the MIS group than in the open group (MIS, 26.7 ± 2.6 days vs. open, 51.7 ± 6.6 days, p < 0.001). Conclusion MIS-TLIF resulted in lower postoperative disability during the first 2 weeks compared to the open approach. Furthermore, low back pain achieved an earlier plateau in back pain by about 4 weeks in the MIS approach.

Background: Penile Cancer is a rare and aggressive disease. Related to complex metabolic processes. Objective: This study investigates the effectiveness ­of 18F-FDG PET/CT as a noninvasive method in evaluating penile cancer patients, focusing on the correlation between tissue expression of key tumor markers involved in glucose metabolism and proliferation, and the uptake of 18F-FDG. Methods: Fifty-one patients were selected and underwent 18F-FDG PET/CT-based staging. Semiquantitative analysis wasperformed using the maximum standardized uptake value ­(SUVmax ) and volumetric SUV ­(SUV2SD ). Tissue expressionanalysis of GLUT-1, hexokinase-II, Ki67, p16, and p53 was performed by tissue microarray. PCR evaluated HPV DNA. Results: Warty SCC showed the highest SUV value and significant differences in ­SUVmax (p=0.015). Higher ­SUVmax and SUV2SD values were observed in grade 3 tumors. In typical invasive SCC, grade 3, HPV+, p16-negative, p53-negative,GLUT-1 i-3, and HK-II i-3 tumors showed a higher mean SUV. The Ki-67 value significantly differed for grade 3 tumors (p=0.001) and HK-II i-1 tumors (p=0.036). Ki-67 positivity was also higher in HPV-, p16 i-2, p53 i-3, and GLUT-1 i-3 tumors; none of the differences were statistically significant. Conclusions The study highlights correlations between the uptake of 18F-FDG and the expression of markers associated with glycolytic metabolism in penile cancer. It suggests a potential trend where increased expression of glucose transport markers is linked to higher histological grades and Ki-67 expression. There were no significant differences regarding HPV positivity, demonstrating the complexity of penile cancer molecular biology and need more studies with a higher number of patients.

Objective: The variety and efficacy of biomarkers available that may be used objectively to diagnose major depressive disorder (MDD) in adults are unclear. This systematic review aims to identify and evaluate the variety of objective markers used to diagnose MDD in adults. Methods: The search strategy was applied via PubMed and PsycINFO over the past 10 years (2013–2023) to capture the latest available evidence supporting the use of biomarkers to diagnose MDD. Data was reported through narrative synthesis. Results: Forty-two studies were included in the review. Findings were synthesised based on the following measures: blood, neuroimagingeurophysiology, urine, dermatological, auditory, vocal, cerebrospinal fluid and combinatory—and evaluated based on its sensitivity/specificity and area under the curve values. The best predictors of blood (MYT1 gene), neuroimagingeurophysiological (5-HT1A auto-receptor binding in the dorsal and median raphe), urinary (combined albumin, AMBP, HSPB, APOA1), cerebrospinal fluid-based (neuron specific enolase, microRNA) biomarkers were found to be closely linked to the pathophysiology of MDD. Conclusion A large variety of biomarkers were available to diagnose MDD, with the best performing biomarkers intrinsically related to the pathophysiology of MDD. Potential for future research lies in investigating the joint sensitivity of the best performing biomarkers identified via machine learning methods and establishing the causal effect between these biomarkers and MDD.

Objective: Executive function correlates with the parasympathetic nervous system (PNS) based on static heart rate variability (HRV) measurements. Our study advances this understanding by employing dynamic assessments of the PNS to explore and quantify its relationship with inhibitory control (IC). Methods: We recruited 31 men aged 20–35 years. We monitored their electrocardiogram (ECG) signals during the administration of the Conners’ Continuous Performance Test-II (CCPT-II) on a weekly basis over 2 weeks. HRV analysis was performed on ECG-derived RR intervals using 5-minute windows, each overlapping for the next 4 minutes to establish 1-minute intervals. For each time window, the HRV metrics extracted were: mean RR intervals, standard deviation of NN intervals (SDNN), low-frequency power with logarithm (lnLF), and high-frequency power with logarithm (lnHF). Each value was correlated with detectability and compared to the corresponding baseline value at t0. Results: Compared with the baseline level, SDNN and lnLF showed marked decreases during CCPT-II. The mean values of HRV showed significant correlation with d’, including mean SDNN (R=0.474, p=0.012), mean lnLF (R=0.390, p=0.045), and mean lnHF (R=0.400, p=0.032). In the 14th time window, the significant correlations included SDNN (R=0.578, p=0.002), lnLF (R=0.493, p=0.012), and lnHF (R=0.432, p=0.031). Significant correlation between d’ and HRV parameters emerged only during the initial CCPT-II. Conclusion A significant correlation between PNS and IC was observed in the first session alone. The IC in the repeated CCPT-II needs to consider the broader neural network.

Objective: This study aimed to identify the factors contributing to post-traumatic growth (PTG) among nurses who experienced patient death during the coronavirus disease-2019 (COVID-19) pandemic and to evaluate the necessity of grief support is required. Methods: An online survey was conducted to assess the experiences of nurses at Ulsan University Hospital who lost patients during the past year of the pandemic. In total, 211 nurses were recruited. We obtained information on the participants’ demographic and clinical characteristics. For symptoms rating, we used the following scales: the Post-traumatic Growth Inventory (PTGI), Stress and Anxiety to Viral Epidemic-9 (SAVE-9), Patient Health Questionnaire (PHQ-9), Pandemic Grief Scale (PGS), and Utrecht Grief Rumination Scale (UGRS), and Grief Support in Healthcare Scale (GSHCS). Pearson’s correlation coefficients, linear regression, and mediation analysis were employed. Results: PTGI scores were significantly correlated with the SAVE-9 (r=0.31, p<0.01), PHQ-9 (r=0.31, p<0.01), PGS (r=0.28, p<0.01), UGRS (r=0.45, p<0.01), and GSHCS scores (r=0.46, p<0.01). The linear regression analysis revealed the factors significantly associated with PTGI scores: SAVE-9 (β=0.16, p=0.014), UGRS (β=0.29, p<0.001), and GSHCS (β=0.34, p<0.001). The mediation analysis revealed that nurses’ stress and anxiety about COVID-19 and grief rumination had a direct impact on PTG, with grief support serving as a significant mediator. Conclusion PTG was promoted by increases in the medical staff’s anxiety and stress related to COVID-19, grief rumination, and grief support. For the medical staff’s experience of bereavement to result in meaningful personal and professional growth, family members, colleagues, and other associates should provide thoughtful support.