Banzrai, Chimeglkham
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Товч нэр
Banzrai, Chimeglkham
Бүтэн нэр
Banzrai Chimeglkham
Латин нэр
Banzrai Chimeglkham
Албан тушаал
Судлаач
ORCID
12 results
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Item type:Publication, Comparison of outcome after thrombolytic therapy between young and old Mongolian patients with acute ischemic stroke(Elsevier BV, 2023-12-01); ; ; Tsagaankhuu Guntev - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Disability of stroke by its sybtypes in the population of Ulaanbaatar, Mongolia(Elsevier BV, 2023-12-01); ; ; ; Tuguldur Erdenedalai - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SARS-CoV-2 вирусын түгээмэл илэрч буй мутациуд(2021-09-01) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Portable HEPA filter air cleaner use during pregnancy and children's behavior problem scores: a secondary analysis of the UGAAR randomized controlled trialBACKGROUND: Developmental exposure to particulate matter (PM) air pollution may impair children's behaviors. Our objectives were to quantify the impact of reducing indoor PM using portable HEPA filter air cleaners during pregnancy on behavioral problems in children and to assess associations between indoor fine PM (PM2.5) concentrations during pregnancy and children's behavior. METHODS: This is a secondary analysis of a single-blind parallel-group randomized controlled trial in which we randomly assigned 540 non-smoking pregnant women to receive 1 or 2 HEPA filter air cleaners or no air cleaners. We administered the Behavior Assessment System for Children (BASC-3) to caregivers when children were a mean age of 23 months, and again at a mean age of 48 months. Primary outcomes were the four BASC-3 composite scales: externalizing problems, internalizing problems, adaptive skills, and the behavioral symptoms index. We imputed missing data using multiple imputation with chained equations. The primary analysis was by intention-to-treat. In a secondary analysis, we evaluated associations between BASC-3 composite indices and modeled trimester-specific PM2.5 concentrations inside residences. RESULTS: We enrolled participants at a median of 11 weeks gestation. After excluding miscarriages, still births and neonatal deaths, our analysis included 478 children (233 control and 245 intervention). We observed no differences in the mean BASC-3 scores between treatment groups. An interquartile increase (20.1 µg/m3) in first trimester PM2.5 concentration was associated with higher externalizing problem scores (2.4 units, 95% CI: 0.7, 4.1), higher internalizing problem scores (2.4 units, 95% CI: 0.7, 4.0), lower adaptive skills scores (-1.5 units, 95% CI: -3.0, 0.0), and higher behavior symptoms index scores (2.3 units, 95% CI: 0.7, 3.9). Third trimester PM2.5 concentrations were also associated with some behavioral indices at age 4, but effect estimates were smaller. No significant associations were observed with PM2.5 concentrations during the second trimester or for any of the BASC indices when children were 2 years old. CONCLUSION: We found no benefit of reducing indoor particulate air pollution during pregnancy on parent-reported behaviors in children. Associations between indoor PM2.5 concentrations in the first trimester and behavioral scores among 4-year old children suggest that it may be necessary to intervene early in pregnancy to protect children, but these exploratory findings should be interpreted cautiously. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01741051.Scopus© Citations 11 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Who benefits most from a prenatal HEPA filter air cleaner intervention on childhood cognitive development? The UGAAR randomized controlled trial(2023-08); ; ; BACKGROUND: Air pollution exposure during pregnancy affects children's brain function. Maternal stress and nutrition, socioeconomic status, and the child's sex may modify this relationship. OBJECTIVE: To identify characteristics of children with the largest increases in full-scale IQ (FSIQ) after their mothers used HEPA filter air cleaners during pregnancy. METHODS: In this randomized controlled trial we randomly assigned women to receive 1-2 air cleaners or no air cleaners during pregnancy. We analyzed maternal hair samples for cortisol and dehydroepiandrosterone (DHEA). When the children were 48 months old, we measured FSIQ with the Wechsler Preschool and Primary Scale of Intelligence. We evaluated ten potential modifiers of the intervention-FSIQ relationship using interaction terms in separate regression models. To account for correlations between modifiers, we also used a single regression model containing main effects and intervention x modifier terms for all potential modifiers. RESULTS: Among 242 mother-child dyads with complete data, the intervention was associated with a 2.3-point increase (95% CI: -1.5, 6.0 points) in mean FSIQ. The intervention improved mean FSIQ among children of mothers in the bottom (5.4 points; 95% CI: -0.8, 11.5) and top (6.1 points; 95% CI: 0.5, 11.8) cortisol tertiles, but not among those whose mothers were in the middle tertile. The largest between-group difference in the intervention's effect was a 7.5-point (95% CI: -0.7, 15.7) larger increase in mean FSIQ among children whose mothers did not take vitamins than among children whose mothers did take vitamins (interaction p-value = 0.07). We also observed larger benefits among children whose mothers did not complete university, and those with lower hair DHEA concentrations, hair cortisol concentrations outside the middle tertile, or more perceived stress. CONCLUSION: The benefits of reducing air pollution during pregnancy on brain development may be greatest for children whose mothers who do not take vitamins, experience more stress, or have less education.Scopus© Citations 4 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Portable HEPA filter air cleaner use during pregnancy and children's autistic behaviors at four years of age: The UGAAR randomized controlled trialBACKGROUND: Developmental exposure to airborne particulate matter (PM) may increase children's risk of developing autism spectrum disorder. We quantified the impact of reducing PM exposure during pregnancy on the development of autistic traits in children. We also assessed associations between indoor fine PM (PM2.5) concentrations during pregnancy and autistic traits. METHODS: In this parallel-group randomized controlled trial, we randomized 540 non-smoking pregnant women to receive HEPA filter air cleaners or to a control group, which did not receive air cleaners. We administered the Social Responsiveness Scale (SRS-2) to caregivers when children were a median of 48 months (range: 48 to 51 months). Our primary outcome was the SRS-2 total T-score. We imputed missing data using multiple imputation with chained equations and our primary analysis was by intention to treat. In secondary analyses, we estimated associations between full pregnancy and trimester-specific indoor PM2.5 concentrations and T-scores. RESULTS: We enrolled participants at a median of 11 weeks' gestation. Our analysis included 478 children (233 control, 245 intervention). The intervention reduced average indoor PM2.5 concentrations by 29 % (95 % CI: 21, 37 %). The mean SRS-2 total T-score was 0.5 units lower (95 % CI: -2.5, 1.5) among intervention participants, with evidence of larger benefits for children at the high end of the T-score distribution. An interquartile range (9.6 µg/m3) increase in indoor PM2.5 during pregnancy was associated with 1.8-unit (95 % CI: 0.3, 3.2) increase in mean SRS-2 total T-score. Effect estimates for PM2.5 concentrations by trimester were smaller and confidence intervals spanned no effect. CONCLUSION: Reducing indoor PM during pregnancy had little impact on mean autism-related behavior scores in children. However, indoor PM2.5 concentrations during pregnancy were associated with higher scores. Exposure to particulate matter during pregnancy may influence the development of autistic traits in childhood. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01741051.Scopus© Citations 10 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Portable HEPA filter air cleaner use during pregnancy and children's body mass index at two years of age: The UGAAR randomized controlled trial(2021-11); ; IMPORTANCE: Gestational exposure to particulate matter (PM) air pollution may increase the risk of childhood obesity, but the impact of reducing air pollution during pregnancy on obesity-related outcomes in childhood has not been examined. OBJECTIVE: To assess the impact of reducing gestational PM exposure on body mass index (BMI) at two years of age. METHODS: In this single-blind, parallel group randomized controlled trial in Ulaanbaatar Mongolia, we randomly assigned 540 pregnant women to receive 1-2 portable high efficiency particulate air (HEPA) filter air cleaners or no air cleaners. We measured height and weight when children were a mean age of 23.8 months. Our primary outcome was age- and sex-specific BMI z-score based on the World Health Organization 2007 Growth Charts. Secondary outcomes included age- and sex-specific weight z score, overweight/obesity (defined as BMI z-score > 2.00), and catch-up growth (defined using various cut-offs to identify children with relatively low birth weight for sex and gestational age and relatively high age- and sex-specific weight in childhood). We imputed missing outcome data using multiple imputation with chained equations and our primary analysis was by intention to treat (ITT). We estimated intervention effects on continuous and binary outcomes using linear and logistic regression, respectively. RESULTS: After excluding known miscarriages, still births, and neonatal deaths our analysis included 480 children (235 control and 245 intervention). The mean (SD) child BMI z score was 0.79 (1.0); 9.8% of children were overweight or obese. The mean BMI z score of children who were randomly assigned to the intervention group was 0.16-units lower (95% CI: -0.35, 0.04) than children in the control group. The intervention was also associated with reductions in overweight/obesity (odds ratio = 0.59; 95% CI: 0.31, 1.12). Catch-up growth occurred less frequently in the intervention group, but effect estimates varied depending on the specific definition of catch-up growth and confidence intervals consistently spanned no effect. CONCLUSIONS: We found that the use of portable air cleaners during pregnancy was associated with improvements in obesity-related outcomes, although some effect estimates lacked precision. Reducing PM exposure during pregnancy may lead to improvements in cardiometabolic health in childhood.Scopus© Citations 17 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Монгол хүмүүст тохиолдох цустасалдах харвалтын үед бүлэн уусгах эмчилгээний үр дүнг судалсан нь(2023-05-18); Г.ЦагаанхүүҮндэслэл: Цустасалдах харвалтын (ЦТХ) цочмог үед эмнэлзүйн Тархины шигдээс шинж тэмдэг эхэлснээс хойш 4.5 цагийн дотор хэрэглэхийг зөвлөж Тромболиз буй эмчилгээний арга бол тархины цусан гүйдлийг хурдан сэргээх, Тавилан хагас ишемийн хүрээ өргөсөхөөс хамгаалахад рекомбинант эдийн Рекомбинант эдийн плазминоген идэвхжүүлэгчийг (РЭПИ) вен судсаар тарьж хэрэглэх – плазминоген бүлэн уусгах эмчилгээ (БУЭ) бөгөөд үүний үр дүнгийн талаарх судалгаа идэвхжүүлэгч Монголд нарийвлан хийгдээгүй байна. Зорилго: ЦТХ-ын шинж тэмдэг эхэлснээс 4.5 цагийн дотор Монгол хүмүүст бүлэн уусгах бэлдмэлийг (алтеплазе) вен судсаар тарьж, уг эмчилгээний аюулгүй байдал, үр дүнг судлах. Арга, аргачлал: Эмнэлэгт суурилсан ретроспектив ажиглалтын судалгааны аргаар ШУГТЭ-ийн харвалтын тасагт ЦТХ-ын улмаас 20132023 онуудад БУЭ хийлгэсэн нийт 105 өвчтөний үндсэн үзүүлэлт, Америкийн Эрүүл мэнд, Харвалтын үндэсний хүрээлэнгийн шалгуур (NIHSS), лабораторийн хийгээд дүрст шинжилгээний үзүүлэлтийг ашиглан дүн шинжилгээ хийв. БУЭ-ний эмнэлзүйн үр дүнг 3 сарын хугацаанд мэдрэлийн алдагдсан үйл-ажиллагааны сэргэлт “Сайн”, “Муу” гэсэн шалгуураар (Рэнкин оноо 0-2 vs 3-6) болон эмнэлэгт хэвтсэн хугацааны нас баралтын үзүүлэлтээр тогтоосон. ЦТХ-ын хүндрэлийг БУЭ-ний аюулгүйн хэрэгжилтийн протоколоор тодорхойлов. Ложистик регрессийн загварыг ашиглан, БУЭ болон алдагдсан үйл-ажиллагааны сэргэлт хоорондын хамаарлыг үнэлэв. Үр дүн: ЦТХ-ын шинж тэмдэг илэрснээс хойш БУЭ эхэлсэн дундаж хугацаа 203.78±44.15 мин байв (хэлбэлзэл 77-286 мин). ЦТХ-ын 3 сарын хяналтын хугацаанд 58 өвчтөнд (55.2%) “Сайн” үр дүн, 47 өвчтөнд (44.8%) “Муу” үр дүн гарсан бол нас баралт 19 тохиолдолд (18.1%) бүртгэгдэв. БУЭний “Сайн” үр дүнг таамаглах хүчин зүйлcэд нас <65 (p=0.038), NIHSS оноо <15 (p<0.001), жижиг судасны бөглөрөл (р<0.001), зүрхний гаралтай тромбоэмболи (p=0.019) тогтоогдсон бол эмнэлэгт хэвтэх үеийн NIHSS оноо >15 (OR 7.573, 95% CI 2.526-22.710, p<0.001), том артерийн тромбоз (OR 15.365, 95% CI 3.548-66.517, p< 0.001); ДРАГОН оноо >5 (дунд артерийн тодрол, ахимаг нас, эмнэлэгт хэвтэх үеийн глюкозийн түвшин, NIHSS оноо, харвалтын шинж илэрснээс БУЭ хүртэлх хугацааны нийлбэр оноо) (OR 5.228, 95% CI, 5.447-16.845, p<0.001) байх зэрэг нь “Муу” үр дүнг таамаглах бие даасан хүчин зүйлс болох нь тогтоогдов. Дүгнэлт: ЦТХ-ын хөнгөнөөс дунд зэрэгтэй, жижиг судасны бөглөрөл, зүрхний гаралтай тромбоэмболийн дэдхэв бүхий харьцангуй залуу (<65 нас) Монгол хүмүүст рекомбинант эдийн плазминоген идэвхжүүлэгч үр дүнтэй байна. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Portable HEPA Filter Air Cleaner Use during Pregnancy and Children's Cognitive Performance at Four Years of Age: The UGAAR Randomized Controlled Trial(American Chemical Society (ACS), 2022-06); ; ; BACKGROUND: Developmental exposure to air pollution is associated with diminished cognitive abilities in observational studies, but no randomized controlled trial has examined the effect of reducing air pollution on cognition in children. OBJECTIVES: We sought to quantify the impact of reducing exposure to particulate matter (PM) during pregnancy on children's cognitive performance at 4 y of age. METHODS: In this single-blind, parallel-group, randomized controlled trial in Ulaanbaatar, Mongolia, we randomly assigned 540 nonsmoking pregnant women (268 intervention and 272 control) to receive 1-2 portable high-efficiency particulate air (HEPA) filter air cleaners or no air cleaners. The air cleaners were used from a median of 11 wk gestation until the end of pregnancy. The primary outcome was full-scale intelligence quotient (FSIQ) assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) when children were a median of 48 months old. We imputed missing outcome data using multiple imputation with chained equations, and our primary analysis was by intention to treat. RESULTS: After excluding known miscarriages, stillbirths, neonatal deaths, and medical conditions that impeded cognitive testing and imputation, 475 (233 control and 242 intervention) children were included in our analyses. In an unadjusted analysis, the mean FSIQ of children who were randomly assigned to the intervention group was 2.5 points [95% confidence interval (CI): -0.4, 5.4 points] higher than that of children in the control group. After adjustment to account for an imbalance in preterm birth between groups, the effect estimate increased to 2.8 points (95% CI: -0.1, 5.7). CONCLUSIONS: Reducing PM air pollution during pregnancy may improve cognitive performance in childhood. https://doi.org/10.1289/EHP10302.Scopus© Citations 21 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prenatal exposure to indoor PM2.5 and children's cognitive performance at 4 years of age: an observational analysis from the UGAAR randomized controlled trial(2026-10); ; ; Outdoor fine particulate matter (PM2.5) concentrations during pregnancy are linked to reduced cognitive performance in children. We previously reported that portable HEPA filter air cleaners use during pregnancy improved children's mean full-scale IQ (FSIQ), but no previous studies have evaluated the relationship between indoor PM2.5 during pregnancy and FSIQ in childhood. We conducted an observational analysis using data from the Ulaanbaatar Gestation and Air Pollution Research (UGAAR) randomized controlled trial. Using a previously developed model of weekly indoor PM2.5 concentrations, we estimated the average concentrations in participants' homes over the full pregnancy and in each trimester. When the children were four years old, we measured FSIQ using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV). We used multiple linear regression to assess the adjusted relationships between interquartile range (IQR) contrasts in indoor PM2.5 during pregnancy and FSIQ among 475 mother-child dyads. An 8.8 μg/m3 increase in indoor PM2.5 concentration over the full pregnancy was associated with a reduction of 1.4 points (95% CI: -3.4, 0.6) in mean FSIQ. The strongest association between PM2.5 concentrations and FSIQ was in the first trimester, when a 19.1 μg/m3 contrast was associated with a 2.8-point reduction (95% CI: -5.7, 0.2) in mean FSIQ. Indoor PM2.5, particularly during early pregnancy, may impair brain development, leading to lower mean FSIQ scores in four-year old children. These results, combined with our previous analysis of HEPA filter air cleaners, indicate that reducing PM2.5 exposure during pregnancy has beneficial effects on children's cognitive performance.