1.Indoor Particulate Matter Concentration in Households of Darkhan City
Nyamdorj J ; Bolor M ; Maralmaa E ; Yerkyebulan M ; Ser-Od Kh ; Myagmarchuluun S ; Shatar Sh ; Gantuya D ; Gregory C. Gray ; Junfeng Zhang ; Ulziimaa D ; Damdindorj B ; Khurelbaatar N ; Davaalkham D
Mongolian Journal of Health Sciences 2025;85(1):25-29
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.
2.The Clinical Utility of Biomarkers in Diagnosing Major Depressive Disorder in Adults: A Systematic Review of Literature From 2013 to 2023
Shi-han ANG ; Roger C. HO ; Roger S. MCINTYRE ; Zhisong ZHANG ; Soon-kiat CHANG ; Kayla M. TEOPIZ ; Cyrus SH HO
Psychiatry Investigation 2025;22(4):341-356
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.
3.The Clinical Utility of Biomarkers in Diagnosing Major Depressive Disorder in Adults: A Systematic Review of Literature From 2013 to 2023
Shi-han ANG ; Roger C. HO ; Roger S. MCINTYRE ; Zhisong ZHANG ; Soon-kiat CHANG ; Kayla M. TEOPIZ ; Cyrus SH HO
Psychiatry Investigation 2025;22(4):341-356
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.
4.The Clinical Utility of Biomarkers in Diagnosing Major Depressive Disorder in Adults: A Systematic Review of Literature From 2013 to 2023
Shi-han ANG ; Roger C. HO ; Roger S. MCINTYRE ; Zhisong ZHANG ; Soon-kiat CHANG ; Kayla M. TEOPIZ ; Cyrus SH HO
Psychiatry Investigation 2025;22(4):341-356
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.
5.The Clinical Utility of Biomarkers in Diagnosing Major Depressive Disorder in Adults: A Systematic Review of Literature From 2013 to 2023
Shi-han ANG ; Roger C. HO ; Roger S. MCINTYRE ; Zhisong ZHANG ; Soon-kiat CHANG ; Kayla M. TEOPIZ ; Cyrus SH HO
Psychiatry Investigation 2025;22(4):341-356
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.
6.The Clinical Utility of Biomarkers in Diagnosing Major Depressive Disorder in Adults: A Systematic Review of Literature From 2013 to 2023
Shi-han ANG ; Roger C. HO ; Roger S. MCINTYRE ; Zhisong ZHANG ; Soon-kiat CHANG ; Kayla M. TEOPIZ ; Cyrus SH HO
Psychiatry Investigation 2025;22(4):341-356
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.
7.Comparative analysis of household indoor PM2.5 concentrations and prevalence of hypertension between cities
Anujin M ; Myagmarchuluun S ; Erkebulan M ; Ser-Od Kh ; Shatar Sh ; Gantuyаa D ; Enkhjargal G ; Munkh-Erdene L ; Gregory C. Gray ; Jungfeng Zhang ; Damdindorj B ; Ulziimaa D ; Davaalkham D
Mongolian Journal of Health Sciences 2025;89(5):5-10
Background:
According to the World Health Organization (WHO), 6.7 million people die annually due to air pollution
caused by solid fuel use, with the majority of deaths resulting from respiratory diseases and cardiovascular conditions. In
Mongolia, air pollution ranks as the fourth leading risk factor contributing to mortality, following hypertension, diabetes,
and other major health risks. Although there have been numerous studies on outdoor air pollution in Mongolia, research
linking indoor air pollution at the household level with the health status of residents remains limited.
Aim:
To compare indoor PM2.5 concentrations in households of Ulaanbaatar and Darkhan and examine their association
with hypertension during the winter season.
Materials and Methods:
The study was conducted during November and December 2023, and January 2024, involving
240 households in Ulaanbaatar and Darkhan. Indoor PM2.5 concentrations were measured using Purple Air real-time
sensors continuously for 24 hours over approximately one month. After measuring indoor air pollution, individuals aged
18–60 years living in the selected households were recruited based on specific inclusion criteria. Blood pressure was
measured three times and the average value was recorded. Information on respiratory illnesses was collected through
structured questionnaires. Statistical analysis was performed using STATA version 19.0.
Results:
A total of 241 households participated in the study, with 116 from Ulaanbaatar and 125 from Darkhan. Of the
participants, 46.5% were male and 53.5% were female. In terms of housing type, 96 households (39.8%) lived in gers,
97 (40.2%) lived in stove-heated houses, and 48 (19.9%) lived in apartments. Among all participants, 66.0% (n=159) had
hypertension and 34.0% (n=79) had normal blood pressure. Among participants aged over 40, 69.9–88.5% had hypertension, which is statistically significantly higher compared to younger individuals (p=0.0001). By body mass index, 75.3%
(n=72) of overweight individuals and 78.4% (n=58) of obese participants had hypertension, showing a statistically significant difference compared to participants with normal weight (p=0.0001). The 24-hour average concentration of indoor
PM2.5 was measured using the Purple Air device, and the levels in gers and stove-heated houses exceeded the limit set
by the MNS 4585:2025 standard (37.5 µg/m³)
Conclusion
This study identified a relationship between environmental factors, such as air pollution and housing type,
and the prevalence of hypertension. The indoor PM2.5 concentration in gers and stove-heated houses was above the standard limit, indicating a negative impact on the health of those residents. Furthermore, the high prevalence of hypertension
among participants over the age of 40 and those who are overweight suggests a possible link to lifestyle and environmental conditions.
8.Comparative Analysis of Outdoor Particulate Matter Concentrations in Ulaanbaatar Using Direct Measurements and Fixed Monitoring Station Data
Maralmaa E ; ; Yerkyebulan M ; Ser-Od Kh ; Shatar Sh ; Gantuya D ; Munkh-Erdene L ; Enkhjargal G ; Myagmarchuluun S ; Gregory Gray ; Junfeng Zhang ; Ulziimaa D ; Damdindorj B ; Davaalkham D ; ; Darambazar G
Mongolian Journal of Health Sciences 2025;89(5):105-111
Background:
Particulate matter with an aerodynamic diameter of 2.5 micrometers or smaller (PM2.5) penetrates
deep into the alveoli through the respiratory tract and is characterized by its ability to induce oxidative stress, systemic
inflammation, and vascular inflammation. Mongolia ranks among the countries with the highest levels of air pollution. In
Ulaanbaatar, where more than half of the country’s population resides, wintertime PM2.5 concentrations often exceed 200
μg/m³, which is about eight times higher than the World Health Organization (WHO) guideline value. A study involving
1,200 adults in Ulaanbaatar showed that quality of life deteriorated sharply during periods of high air pollution, with
effects more pronounced among individuals who already had impaired respiratory function.
Aim:
To examine the relationship between indoor household PM2.5 concentrations and lung function indicators among
adults in Ulaanbaatar and Darkhan.
Materials and Methods:
This analytical cross-sectional study recruited adult participants from Ulaanbaatar and Darkhan
through targeted sampling. Household air quality was measured using PurpleAir sensors, which were installed in
participants’ homes for one month. After exposure measurement, lung function was assessed via spirometry. Statistical
analyses were conducted using SPSS version 25.0.
Results:
A total of 236 participants were included: 114 (48.3%) from Ulaanbaatar and 122 (51.7%) from Darkhan. The
sample consisted of 111 men (47.0%) and 125 women (53.0%). The mean indoor PM2.5 concentration was 66.24 μg/m³
(SD 44.87 μg/m³), ranging from a minimum of 7.79 μg/m³ to a maximum of 264.55 μg/m³. Stratification by housing type
showed the highest PM2.5 levels in gers (82.34 μg/m³), followed by detached houses (67.34 μg/m³), while apartments
had the lowest concentrations (32.24 μg/m³). Correlation analysis revealed statistically significant negative associations
between PM2.5 levels and measures of expiratory function, including the FEV1/FVC ratio, peak expiratory flow (PEF),
and mid-expiratory flow (FEF25–75). Reduced forced vital capacity (FVC) was observed in 9.4% of participants, reduced
forced expiratory volume in one second (FEV1) in 15.3%, and a decreased FEV1/FVC ratio in 3.8%.
Conclusion
Indoor household PM2.5 concentrations were highest in gers, and expiratory flow-related lung function
parameters showed significant negative associations with particulate exposure. This suggests that indoor PM2.5 primarily
affects airflow limitation rather than overall lung volumes in this population.
10.Effect of Shenfu injection on serum pepsinogenⅠ,Ⅱ and gastrin 17 in patients with sepsis: a single-center randomized controlled trial
Suming ZHANG ; Yaoyao ZHANG ; Bo WANG ; M. Salwa IMRAN ; Yancun LIU ; Yanfen CHAI
Chinese Journal of Emergency Medicine 2024;33(9):1281-1285
Objective:To investigate the effect of Shenfu injection on serum pepsinogen (PG) Ⅰ, PG Ⅱ and gastrin 17 (G17) in sepsis patients with acute gastrointestinal injury (AGI).Methods:From June 2021 to December 2022, a single-center randomized controlled clinical study was conducted to select patients with sepsis complicated with acute gastrointestinal injury (AGI) admitted to the ICU of the Affiliated Hospital of Xuzhou Medical University. Patients were randomly (random number) divided into Shenfu group and control group. All patients were given routine treatment of sepsis according to the guidelines, including treatment of primary disease, fluid resuscitation and supportive management. The Shenfu group was treated with Shenfu injection at the same time as routine treatment. The gastrointestinal injury indicators (PGⅠ, PGⅡ, G17 and AGI grades) before treatment and on the 3rd and 7th days of treatment, and duration of mechanical ventilation and length of ICU stay of the two groups were recorded and compared.Results:A total of 89 sepsis patients with AGI were enrolled, including 44 patients in the Shenfu group and 45 patients in the control group. Before treatment, there was no statistically significant difference in serum PGⅠ, PGⅡ, and G17 between the two groups of patients (all P>0.05). On the 3rd day of treatment, the serum PGⅠ levels in the Shenfu group were significantly lower than the control group [(156.46±62.90) μg/L vs. (183.03±45.44) μg/L, P<0.05]. There was no statistically significant difference in serum PGⅡ and G17 levels between the two groups (both P>0.05). On the 7th day of treatment, the serum levels of PG I, PG II, and G17 in the Shenfu group were significantly lower than those in the control group [(107.97±23.18) μg/L vs. (154.78±33.11) μg/L, (10.73±5.62) μg/L vs. (13.83±6.30) μg/L, (7.31±3.20) pmol/L vs. (9.29±3.92) pmol/L, all P<0.05]. The AGI grading, duration of mechanical ventilation, and length of ICU stay in Shenfu group were significantly reduced than those in the control group (all P<0.05). Conclusion:Shenfu injection can improve the serum gastric function, lower AGI grading, reduce mechanical ventilation time, and the length of ICU stay in sepsis patients with AGI.

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