Assessment of anthropogenic particles content in commercial beverages

Microplastic (MPs) pollution is a current global concern that is affecting all environmental compartments and food sources. In this work, anthropogenic particles occurrence (MPs and natural and synthetic cellulosic particles), have been determined in 73 beverages packed in different containers. Overall, 1521 anthropogenic particles were found, being the lowest occurrence in water samples (7.2 ± 10.1 items·L-1) while beer had the highest (95.5 ± 91.8 items·L-1). Colourless/white particles were the most detected followed by blue and red colours. The highest mean size was 783 ± 715 μm in soft drinks. Cellulosic, both natural and semisynthetic particles, were the composition mostly found but regarding plastic polymers, it was polyester. Phenoxy resin particles from the can coatings were also identified in all metal containers which indicates that leaching from the packaging may be happening. The total estimated daily intake were 0.077 and 0.159 items·kg-1 body weight (b.w.)·day-1 for children and adult population, respectively.

Effectiveness of exposure-based treatment for childhood anxiety disorders: An open clinical trial to test its relation with indices of emotional processing and inhibitory learning

BACKGROUND AND OBJECTIVES

The current study examined how effectiveness of exposure-based CBT was related to indices of emotional processing and inhibitory learning during exposure exercises.

METHODS

Adolescents with anxiety disorder(s) (N = 72; age 11-19; 85% girls) received a group-based, intensive two-week treatment of which effectiveness was indexed by the SCARED and by ratings of anxiety and approach towards individualized goal situations. To index emotional processing, subjective units of distress (SUDs) were used to indicate both initial and final fear level, and absolute, relative, and total dose of fear reduction. To index inhibitory learning, subjective threat expectancies (STEs) were used to indicate initial and final threat expectancy, and absolute, relative, and total dose of expectancy change.

RESULTS

From pre-treatment to follow-up, there was a large-sized reduction of anxiety symptoms, small-sized decrease of subjective anxiety and a large-sized increase in subjective approach towards individual treatment goals. Higher fear levels prior to exposure were related to a larger decrease of symptoms. Higher threat expectancies after exposure exercises were independently associated with less decrease of anxiety and increase of approach towards treatment goals. Total dose of experienced fear reduction and total dose of experienced expectancy change were (partly) independently related to more increase in approach towards individualized goal situations.

LIMITATIONS

As patients also received other treatment elements, the results cannot be interpreted unequivocally.

CONCLUSIONS

The pattern of findings seems to indicate that emotional processing (as indexed by fear reduction) and inhibitory learning (as indexed by expectancy change) are both relevant in exposure-based CBT.

Assessing the combined effect of multiple metal exposures on pregnancy and birth outcomes: Methodological insights in systematic review research

This systematic review focused on pregnant women and aimed to evaluate how exposure to multiple metals impacts their pregnancy and birth outcomes. Previous research has predominantly focused on the effects of individual metal exposures on adverse birth outcomes. However, it is crucial to recognize that real-world scenarios often involve simultaneous exposure to multiple pollutants. Recent studies have emphasized the significance of considering exposure to mixtures of metals to gain a more comprehensive understanding of their collective health impacts. This article outlines the essential steps taken during the systematic review process, which involved synthesizing existing evidence and evaluating the strength and consistency of the relationship between metal mixtures and pregnancy and birth outcomes.

Examining carcinogenic and noncarcinogenic health risks related to arsenic exposure in Ethiopia: A longitudinal study

Background

The carcinogenic properties of arsenic make it one of the most hazardous chemicals globally. Nevertheless, the exact level of human exposure to arsenic and the associated risks of cancer and non-cancer effects through different pathways in Ethiopia are still uncertain.

Objective

The primary aim of this study was to evaluate the risk of both cancer and non-cancer outcomes among children and adults who have been exposed to arsenic through drinking water in the Adami Tulu Jido Kombolcha district of Ethiopia.

Methods

For this study, a longitudinal study design was employed. A total of 45 groundwater sources were sampled using the census sampling method. The concentrations of total arsenic were measured using Agilent 7900 series inductively coupled plasma mass spectrometry. Carcinogenic and noncarcinogenic risk assessments were conducted by calculating lifetime cancer risk and hazard quotients. Microsoft Office Excel was utilized to calculate human health risk indices, and descriptive statistical analysis were performed using SPSS software.

Results

Our findings revealed that during the dry season, the mean arsenic concentration in the groundwater samples was 11.15 ± 9.38 µg/L, while during the rainy season, it was 10.67 ± 8.16 µg/L. The total cancer risk for children, resulting from oral ingestion and skin contact, was 1.15 × 10-2 and 1.07 × 10-2 during the dry and rainy seasons, respectively. For adults, the total cancer risk from oral ingestion and skin contact during the dry and rainy seasons was 4.95 × 10-3 and 4.59 × 10-3, respectively. Furthermore, the total hazard quotients for children via oral ingestion and skin absorption were 25.9 and 24.0 during the dry and rainy seasons, respectively. For adults, the total hazard quotients from ingestion and dermal contact during the dry and rainy seasons were 11 and 10, respectively.

Conclusions

The findings indicate that the risks of cancer and non-cancer effects resulting from arsenic exposure through ingestion and dermal exposure were found to exceed the acceptable thresholds in both seasons. These results emphasize the urgent need for focused attention on the study population in the study area due to the high likelihood of experiencing adverse health outcomes.

Biomonitoring and health risk assessment of exposure to phthalate esters in waste management workers

Humans are at risk of exposure to phthalates due to the widespread use of plasticized plastics, and one of the major concerns is occupational exposure. The present study investigated occupational exposure to phthalates at one of the greatest solid waste management sites in the second-largest country in the Middle East. Carcinogenic and non-carcinogenic health risks were assessed by human biomonitoring (HBM). The concentration of phthalate esters was determined using gas chromatography-mass spectrometry (GC-MS), and the daily intake (DI) of phthalate was calculated based on the adjusted urinary creatinine concentrations. Moreover, carcinogenic and non-carcinogenic risks were assessed. Monte Carlo simulations were performed for uncertainty and sensitivity analysis. The highest concentration recorded was 130.80 µg/g creatinine for mono-ethyl phthalate (MEP) among the composting group, while the lowest concentration was 0.49 µg/g creatinine for Monobenzyl phthalate (MBzP) among the office group. All estimates of daily intake were below the reference concentration, and differences between the DI at site sections were statistically significant (p < 0.05). The non-carcinogenic risk level was negligible. The excess lifetime cancer risk (ELCR) values corresponding to di-(2-ethylhexyl) phthalate (DEHP) exposure were 2.07E-04 among the composting group and 2.07E-04 among the processing group, posing a definite risk. The carcinogenic risk value among the office group was in a possible risk category with ELCR values of 9.75 E-05. The on-site workers of waste management sites can be highly exposed to phthalates, and their health risk is considerable. Appropriate measures and interventions should be considered to reduce occupational exposure to phthalates.

Veterinarians and zoonotic pathogens, infections and diseases - questionnaire study and case series, Finland

BACKGROUND

Veterinarians are at risk for numerous zoonotic infections. In this paper, we summarise descriptions of zoonotic infections from a questionnaire study and a series of work-related zoonotic cases, aiming to add to the knowledge on occupational zoonotic risks of veterinarians.

METHODS

We collected data on zoonotic infections contracted by veterinarians in Finland in two studies:1) using a questionnaire in 2009, and 2) inviting veterinarians who had encountered an occupational zoonosis to report it in structured interviews in 2019.

RESULTS AND CONCLUSIONS

In the questionnaire study in 2009, of 306 veterinarians several reported zoonotic bacterial skin infections (12%), dermatophytosis (ringworm; 4.2%), virus infections (3.9%), bacterial gastroenteritis (3.3%), other bacterial zoonoses (2.3%), and parasitic infections/infestations (2.3%). In the 2019 interviews, 16 occupational zoonosis cases were reported. Of them, seven were selected to the case series. The selected cases included Capnocytophaga canimorsus sepsis following a dog bite, cryptosporidiosis after a contact with calves, cutaneous listeriosis following calving assistance, Salmonella gastroenteritis contracted at laboratory, Trichophyton dermatophytosis after equine contact, Bacillus anthracis exposure at necropsy, and exposure to rabies through a horse bite. In four of the seven cases, the veterinarian disagreed or strongly disagreed with having had good knowledge of the zoonosis before the incident. The results from the questionnaire study and the case series illustrate the variety of zoonotic pathogens that veterinarians may encounter. There is a need to improve the occupational health of veterinarians and to increase awareness in the occupational health sector. We encourage addressing this need using a One Health approach.

Headache Attributed to a Substance or Its Withdrawal

Identification of substances that may cause or trigger headache is important to start effective treatment early to prevent unnecessary suffering, deterioration in quality of life, and the development of chronic pain. Treatment in case of medication overuse and other chronic headache should be decisive and effective. Drug withdrawal and introduction of effective prophylactic medication for the underlying headache disorder should be the primary treatment strategy. Typical headache-inducing substances are nitric oxide, phosphodiesterase, cocaine, alcohol, histamine, carbon oxide, and calcitonin gene-related peptide. The withdrawal of caffeine, estrogen, and opioids is most often associated with the development of headache.

Human biomonitoring of dioxins, furans, and non-ortho dioxin-like polychlorinated biphenyls (PCBs) in blood plasma from Old Crow, Yukon, Canada (2019)

Dioxins, furans, and dioxin-like polychlorinated biphenyls (PCBs) are a group of persistent and toxic chemicals that are known to have human health effects at low levels. These chemicals have been produced for commercial use (PCBs) or unintentionally as by-products of industry or natural processes (PCBs, dioxins, and furans). Additionally, dioxin-like PCBs were formerly used in electrical applications before being banned internationally (2004). These chemicals are widely dispersed in the environment as they can contaminate air and travel hundreds to thousands of kilometers before depositing on land or water, thereafter, potentially entering food chains. Community concerns surrounding the safety of traditional foods prompted a human biomonitoring project in Old Crow, Yukon Territory (YT), Canada (2019). Through collaborative community engagement, dioxins and like compounds were identified as a priority for exposure assessment from biobanked samples. In 2022, biobanked plasma samples (n = 54) collected in Old Crow were used to measure exposures to seven dioxins, ten furans, and four dioxin-like PCBs. 1,2,3,6,7,8-HxCDD, 1,2,3,7,8,9-HxCDD, 1,2,3,4,6,7,8-HpCDD, OCDD, 2,3,4,7,8-PeCDF, 1,2,3,6,7,8-HxCDF, PCB 126, and PCB 169 were detected in at least 50 % of samples. Among these analytes, the only congener at elevated levels was PCB 169, which was approximately ∼2-fold higher than the general population of Canada. No significant sex-based or body mass index (BMI) differences in biomarker concentrations were observed. Generally, the concentrations of the detected congeners increased with age, except for 1,2,3,4,6,7,8-HpCDD. For the first time, this research measures dioxin and like-compound exposures in Old Crow, advancing the information available on chemical exposures in the Arctic. Further research could be directed towards the investigation of PCB 169 exposure sources and temporal monitoring of exposures and determinants.

Release kinetics and risk assessment of additives in plastic advertising banners

Plastic advertising banners (PABs) have been widely used for advertising and publicizing with large usage amount. The PABs are usually added with plenty of chemical additives for improving material performance, and the additives can be released during the lifetime of the PABs. However, limited knowledge is available on the composition and release of the additives in the PABs. In this study, benzenoids were found as the dominant additive categories in PABs. Release kinetics of benzenoid additives with high detection frequency and high abundance from the PABs under indoor and outdoor environments were investigated. During the 150-day release experiment, average release rates of the additives from the PABs under outdoor and indoor environments were 8.3 × 10-10 kg/m2·s and 6.3 × 10-10 kg/m2·s, respectively. The release rates of the additives were negatively related to the thickness of the PAB samples. Health risk assessment indicated that chemicals associated with PABs have potential carcinogenic risks to salesmen in the shopping malls. The risks of chemical exposure associated with PABs to consumers in the shopping malls were acceptable. This study unveils a considerable source of chemical exposure to humans.

Response of salivary microbiome to temporal, environmental, and surface characteristics under in vitro exposure

The microbiome of saliva stains deposited at crime scenes and in everyday settings is valuable for forensic investigations and environmental ecology. However, the dynamics and applications of microbial communities in these saliva stains have not been fully explored. In this study, we analyzed saliva samples that were exposed to indoor conditions for up to 1 year and to different carriers (cotton, sterile absorbent cotton swab, woolen, dacron) in both indoor and outdoor environments for 1 month using high-throughput sequencing. The analysis of microbial composition and Mfuzz clustering showed that the salivary flora, specifically Streptococcus (cluster7), which was associated with microbial contamination, remained stable over short periods of time. However, prolonged exposure led to significant differences due to the invasion of environmental bacteria such as Pseudomonas and Achromobacter. The growth and colonization of environmental flora were promoted by humidity. The neutral model predictions indicated that the assembly of salivary microbial communities in outdoor environments was significantly influenced by stochastic processes, with environmental characteristics having a greater impact on community change compared to surface characteristics. By incorporating data from previous studies on fecal and vaginal secretion microbiology, we developed RF and XGBoost classification models that achieved high accuracy (>98 %) and AUC (>0.8). Additionally, a RF regression model was created to determine the time since deposition (TsD) of the stains. Time inference models yielded a mean absolute error (MAE) of 7.1 days for stains exposed for 1 year and 14.2 h for stains exposed for 14 days. These findings enhance our understanding of the changes in the microbiome of saliva stains over time, in different environments, and on different surfaces. They also have potential applications in assessing potential microbial contamination, identifying body fluids, and inferring the time of deposition.

Short-term effects of air pollution and weather on physical activity in patients with chronic obstructive pulmonary disease (COPD)

INTRODUCTION

Patients with chronic obstructive pulmonary disease (COPD) accumulate low levels of physical activity. How environmental factors affect their physical activity in the short-term is uncertain.

AIM

to assess the short-term effects of air pollution and weather on physical activity levels in COPD patients.

METHODS

This multi-center panel study assessed 408 COPD patients from Catalonia (Spain). Daily physical activity (i.e., steps, time in moderate-to-vigorous physical activity (MVPA), locomotion intensity, and sedentary time) was recorded in two 7-day periods, one year apart, using the Dynaport MoveMonitor. Air pollution (nitrogen dioxide (NO2), particulate matter below 10 μm (PM10) and a marker of black carbon (absorbance of PM2.5: PM2.5ABS), and weather (average and maximum temperature, and rainfall) were estimated the same day (lag zero) and up to 5 days prior to each assessment (lags 1-5). Mixed-effect distributed lag linear regression models were adjusted for age, sex, weekday, public holidays, greenness, season, and social class, with patient and city as random effects.

RESULTS

Patients (85% male) were on average (mean ± SD) 68 ± 9 years old with a post-bronchodilator forced expiratory volume in 1 s (FEV1) of 57 ± 18% predicted. Higher NO2, PM10 and PM2.5ABS levels at lag four were associated with fewer steps, less time in MVPA, reduced locomotion intensity, and longer sedentary time (e.g., coefficient (95% CI) of -60 (-105, -15) steps per 10 μg/m3 increase in NO2). Higher average and maximum temperatures at lag zero were related to more steps and time in MVPA, and less sedentary time (e.g., +85 (15, 154) steps per degree Celsius). Higher rainfall at lag zero was related to fewer steps and more sedentary time.

CONCLUSION

Air pollution affects the amount and intensity of physical activity performed on the following days in COPD patients, whereas weather affects the amount of physical activity performed on the same day.

State mechanisms of change in eating disorder symptoms and fears during an online imaginal exposure treatment for eating disorders

Anxiety and fear are key characteristics of eating disorders (EDs). Exposure therapy is a specific type of intervention aimed at reducing fear and anxiety and is efficacious in treating a variety of anxiety and related disorders. A growing body of research suggests that exposure therapy is also efficacious for the treatment of EDs. However, there is currently little research investigating mechanisms of change during exposure therapy for EDs. The current study (N = 143) expanded on an open series trial of imaginal exposure for EDs that found significant reductions in ED symptoms and core ED fears. In the current study we investigated change in state drive for thinness, body dissatisfaction, and anxiety as mechanisms underpinning change in ED symptoms and core ED fears during four sessions of online imaginal exposure treatment for EDs. We found that state body dissatisfaction, but not state drive for thinness or anxiety, was a mechanism of change for ED symptoms and some core ED fears. Our findings suggest that body dissatisfaction may be a mechanism driving change during exposure therapy for EDs. Optimizing exposure treatments to focus on body dissatisfaction may improve treatment outcomes for EDs.

Smallholder farmers' vulnerability to climate change and variability: Evidence from three agroecologies in the Upper Blue Nile, Ethiopia

This study delves into the profound impact of climate change on agriculture in Ethiopia, particularly the vulnerabilities faced by smallholder farmers and the resulting implications for poverty. Focusing on three distinct agroecologies, namely: highland, midland, and lowland zones. The study employed a robust methodology, combining a cross-sectional survey, spatial-temporal trend analysis using GIS, and the development of an overall vulnerability index through the balanced weighted average method. The study, encompassing 646 households, combines data from a variety of sources and analytical tools like the vulnerability index, ArcGIS 10.8, and ERDA's IMAGINE 2015. Utilizing the LVI-IPCC scale, the study shows that climate change is an immediate vulnerability in all agroecological zones. It identifies highland areas as the most sensitive and exposed regions, while lowland households are found to be the most vulnerable in terms of overall vulnerabilities. The research reveals specific challenges faced by communities, such as inadequate health facilities and insufficient food and water supplies in both highland and lowland agroecosystems. Additionally, our investigation has observed a significant alteration in land use practices, specifically the shift from communal grazing land to private cultivation and plantations, emphasizing eucalyptus. This alteration enhances the ecosystem's vulnerability to climate disturbances. The study suggests targeted interventions, such as advocating for sustainable land-use practices, afforestation, and adopting climate-smart agriculture practices. It is important to implement policy measures that prioritize conserving and restoring shrubland, grazing land, and natural forests to ensure both long-term socio-economic and ecosystem resilience. The study's nuanced insights are instrumental in understanding the diverse challenges posed by climate change in Ethiopian agriculture, supporting informed policymaking and sustainable interventions.

The impact of indoor air pollution on children's health and well-being: the experts' consensus

BACKGROUND

Pollution of the indoor environment represents a concern for human health, mainly in case of prolonged exposure such as in the case of women, children, the elderly, and the chronically ill, who spend most of their time in closed environments.

MAIN BODY

The aim of the study is to organize a group of experts in order to evaluate the evidence and discuss the main risk factors concerning indoor air and the impact on human health as well as challenging factors regarding preventive strategies to reduce pollution. The experts highlighted the main risk factors concerning indoor air, including poor ventilation, climatic conditions, chemical substances, and socio-economic status. They discussed the impact on human health in terms of mortality and morbidity, as well as challenging factors regarding preventive strategies to reduce pollution.

CONCLUSION

The experts identified strategies that can be reinforced to reduce indoor pollution and prevent negative consequences on human health at national and local levels.

The Importance of Practicing at Home During and Following Cognitive Behavioral Therapy for Childhood Anxiety Disorders: A Conceptual Review and New Directions to Enhance Homework Using Mhealth Technology

Practicing newly acquired skills in different contexts is considered a crucial aspect of Cognitive Behavioral Therapy (CBT) for anxiety disorders (Peris et al. J Am Acad Child Adolesc Psychiatry 56:1043-1052, 2017; Stewart et al. Prof Psychol Res Pract 47:303-311, 2016). Learning to cope with feared stimuli in different situations allows for generalization of learned skills, and experiencing non-occurrence of the feared outcome helps in developing non-catastrophic associations that may enhance treatment outcomes (Bandarian-Balooch et al. J Behav Ther Exp Psychiatry 47:138-144, 2015; Cammin-Nowak et al. J Clin Psychol 69:616-629, 2013; Kendall et al. Cogn Behav Pract 12:136-148, 2005; Tiwari et al. J Clin Child Adolesc Psychol 42:34-43, 2013). To optimize treatment outcome, homework is often integrated into CBT protocols for childhood anxiety disorders during and following treatment. Nevertheless, practicing at home can be challenging, with low motivation, lack of time, and insufficient self-guidance often listed as reasons for low adherence (Tang and Kreindler, JMIR Mental Health 4:e20, 2017). This conceptual review provides an overview of (1) how existing CBT childhood programs incorporate homework, and empirical evidence for the importance of homework practice, (2) evidence-based key elements of practice, and (3) how mHealth apps could potentially enhance practice at home, including an example of the development and application of such an app. This review therefore sets the stage for new directions in developing more effective and engaging CBT-based homework programs for childhood anxiety disorders.

Ticks - public health risks in urban green spaces

BACKGROUND

Urban green spaces are important for human health, but they may expose visitors to tick-borne diseases. This not only presents a potential public health challenge but also undermines the expected public health gains from urban green spaces. The aim of this study is to assess the public health risk of tick-borne diseases in an urban green space used for recreation in Stockholm, Sweden.

METHODS

We used a mixed method approach identifying both the magnitude of the tick hazard and the extent of the human exposure to tick-borne diseases. At six entry points to an urban green space, we sampled ticks and documented microhabitat conditions from five randomly assigned 2 m × 2 m plots. Surrounding habitat data was analyzed using geographical information system (GIS). Nymphs and adult ticks were tested for Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum using TaqMan qPCR. Positive B. burgdorferi (s.l.) ticks were further analyzed by nested PCR amplification and sequence analysis. Population census data and visitor count data were used to estimate the degree of human exposure to tick-borne diseases. To further understand the degree to which visitors get in contact with infected ticks we also conducted interviews with visitors to green spaces.

RESULTS

High tick densities were commonly found in humid broadleaved forest with low field vegetation. High pathogen prevalence was significantly correlated with increasing proportions of artificial areas. Integrating the tick hazard with human exposure we found that the public health risk of tick-borne diseases was moderate to high at most of the studied entry points. Many of the visitors frequently used urban green spaces. Walking was the most common activity, but visitors also engaged in activities with higher risk for tick encounters. Individual protective measures were connected to specific recreational activities such as picking berries or mushrooms.

CONCLUSIONS

The number of visitors can be combined with tick inventory data and molecular analyses of pathogen prevalence to make crude estimations of the public health risk of tick-borne diseases in urban green spaces. The risk of encountering infected ticks is omnipresent during recreational activities in urban green spaces, highlighting the need for public health campaigns to reduce the risk of tick-borne diseases.

Biological and functional responses of the benthic surf zone community to different beach types

In this study, we analyzed the biological descriptors and functional traits of the benthic community inhabiting the water/bottom layer in the surf zones of three sandy beaches: a tide-dominated flat, and two intermediate beaches, from tide-modified to wave-dominated. Samples were collected seasonally in the inner surf zone by hand-towing a benthic sledge equipped with two nets, one above the other, across transects parallel to the shore, capturing the benthic community in two levels, close to the seafloor. A total of 116 species were collected, with a total of 327,678 specimens. Arthropods were 99.63% of all individuals caught across the three beaches, mainly represented by peracarid crustaceans. An important species turnover was detected along the shore, with a significant change in community composition. The biological descriptors and some functional traits vary among beaches: the total density, the density of individuals of small (5-10 mm length) and very small sizes (<5 mm length), the density of larval forms, and the presence of colonial species were higher in the tide-dominated flat (sometimes also in the tide-modified beach). More arthropods and more mobile individuals were found in those beaches, while mollusks and sedentary individuals were found in high number in the wave-dominated beach. Stratification was present across the three studied beaches, with higher densities in the near-bottom layer. In the tide-dominated beach, there was also a higher richness in this layer, with a nested community between levels. In the wave-dominated beach, similar richness was registered between levels, with a different community composition (and some differences in functional traits), indicating that some species can maintain their position close to the bottom despite the turbulent conditions experienced on this beach. Differences in wave conditions among beach types could be an important factor driving the biological descriptors and functional traits of the benthic community in surf zone ecosystems. Therefore, acknowledging their role is crucial in deciphering global patterns in surf zone biodiversity.

Prevalence rates of neurodegenerative diseases versus human exposures to heavy metals across the United States

Novel means are needed to identify individuals and subpopulations susceptible to and afflicted by neurodegenerative diseases (NDDs). This study aimed to utilize geographic distribution of heavy metal sources and sinks to investigate a potential human health risk of developing NDDs. Known or hypothesized environmental factors driving disease prevalence of Alzheimer's Disease (AD), Parkinson's Disease (PD), and amyotrophic lateral sclerosis (ALS) are heavy metals, including arsenic (As), cadmium (Cd), manganese (Mn) and mercury (Hg). Lead (Pb) has been associated with AD and ALS. Analyzable mediums of human exposure to heavy metals (i.e., toxic metals and metalloids), or proxies thereof, include infant blood, topsoil, sewage sludge, and well water. U.S. concentrations of heavy metals in topsoil, sewage sludge, well water, and infant blood were mapped and compared to prevalence rates of major NDDs. Data from federal and state agencies (i.e., CDC, EPA, and the US Geological Survey) on heavy metal concentrations, age distribution, and NDD prevalence rates were geographically represented and statistically analyzed to quantify possible correlations. Aside from an expected significant association between NDD prevalence and age (p < 0.0001), we found significant associations between the prevalence of the sum of three major NDDs with: Pb in topsoil (p = 0.0433); Cd (p < 0.0001) and Pb (p < 0.0001) in sewage sludge; Pb in infant blood (p < 0.0001). Concentrations in sewage sludge of Cd and Pb were significantly correlated with NDD prevalence rates with an odds ratio of 2.91 (2.04, 4.225 95%CI) and 4.084 (3.14, 5.312 95%CI), respectively. The presence of toxic metals in the U.S. environment in multiple matrices, including sewage sludge, was found to be significantly associated with NDD prevalence. This is the first use of sewage sludge as an environmental proxy matrix to infer risk of developing NDDs.

A review of emerging health threats from zoonotic New World mammarenaviruses

Despite repeated spillover transmission and their potential to cause significant morbidity and mortality in human hosts, the New World mammarenaviruses remain largely understudied. These viruses are endemic to South America, with animal reservoir hosts covering large geographic areas and whose transmission ecology and spillover potential are driven in part by land use change and agriculture that put humans in regular contact with zoonotic hosts.We compiled published studies about Guanarito virus, Junin virus, Machupo virus, Chapare virus, Sabia virus, and Lymphocytic Choriomeningitis virus to review the state of knowledge about the viral hemorrhagic fevers caused by New World mammarenaviruses. We summarize what is known about rodent reservoirs, the conditions of spillover transmission for each of these pathogens, and the characteristics of human populations at greatest risk for hemorrhagic fever diseases. We also review the implications of repeated outbreaks and biosecurity concerns where these diseases are endemic, and steps that countries can take to strengthen surveillance and increase capacity of local healthcare systems. While there are unique risks posed by each of these six viruses, their ecological and epidemiological similarities suggest common steps to mitigate spillover transmission and better contain future outbreaks.

Theoretical Health Risk Assessment Based on Potentially Toxic Element Profiling of Cosmetic Products in Istanbul Street Bazaars

Toxic elements that pose a potential threat to human health are found as impurities in various cosmetic products. In this study, the inorganic profile of 19 elements (Li, B, Mg, Al, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Sr, Mo, Cd, Sb, Ba, Hg, and Pb) in 90 cosmetic products (lipsticks, lip glosses, lip pencils and eye shadows) were detected by inductively coupled plasma-mass spectrometry after microwave acid digestion method and hazard indices (HI) of 9 toxic elements (Pb, Cd, Cr, Ni, Co, As, Hg, Sb, and Al) were calculated for the assessment of theoretical health risk. Satisfactory method performance parameters were found for each analyte. The results were compared with the maximum permissible limits set by regulatory agencies; 38 of 41 lip products (92.68%) and all eye shadows (n = 49) exceeded the established limits. The HI was found to be ≥ 1 in 82.76% of lip products for oral exposure, whereas HI was ≤ 1 for dermal exposure in all lip products (n = 41) and only one eye shadow sample was ≥ 1 (2.04%). Remarkable results were also detected for 19 elements in this study, which conducted a comprehensive inorganic profiling for the first time. Wide-range concentrations of Mg, Al, Ba, Mn, Cu, Zn, and Sr elements were remarkable. HI values were firstly brought out in this study, although Al, as a well-known toxic element, has not been listed in regulations yet. In conclusion, it is obviously seen that continuous monitoring of cosmetics is crucial not only for toxic elements but also for other essential or non-toxic elements to prevent consumers from long-term exposure.

Blood lead, cadmium and hair mercury concentrations and association with soil, dust and occupational factors in e-waste recycling workers in Bangladesh

BACKGROUND

Electronic waste (e-waste) recycling activities release toxic metals, which pose substantial hazard to the environment and human health. We evaluated metal concentrations in biological and environmental samples, and examined the associations between biological lead (Pb), cadmium (Cd), and mercury (Hg) with soil and dust metals, and other possible determinants, among populations exposed and non-exposed to e-waste in Bangladesh.

METHODS

A total of 199 e-waste workers and 104 non-exposed individuals were recruited. We measured blood Pb (BPb) and Cd (BCd) concentrations and total Hg (THg) from hair samples. Data were collected on occupational, and behavioral factors. We fitted an elastic net regression (ENET) to model the relationship between a set of influencing factors and metals as outcome variables while controlling for potential covariates.

RESULTS

The median concentrations of BPb (11.89 μg/dL) and BCd (1.04 μg/L) among exposed workers were higher than those of non-exposed workers (BPb: 3.63 μg/dL and BCd: 0.83 μg/L respectively). A 100 ppm increment in soil Pb level was associated with an increase in ln-Pb (transformed) in blood (β = 0.002; 95% CI = 0.00, 0.02). Similarly, ln-BCd level increased (β = 0.02; 95% CI = 0.001, 0.07) with every ppm increase in dust Cd level. The number of years worked in e-waste activities was associated with elevated ln-BPb (β = 0.01; 95% CI = 0.01, 0.02) and ln-BCd levels (β = 0.003; 95% CI = 0.00, 0.05). Smoking significantly contributed to elevated levels of ln-BCd (β = 0.46; 95% CI = 0.43, 0.73). An increment of 100 kg of e-waste handling per week led to an increase in ln-BPb levels (β = 0.002; 95% CI = 0.00, 0.01), while respondents knowledge about adverse impact on e-waste reduced the ln-BPb level (β = -0.14; 95% CI = -0.31, -0.03). Fish consumption frequency had a positive association with THg in hair.

CONCLUSIONS

Our data show the need for workplace controls to reduce exposure to Pb and Cd with a broader view of exposure source taken.

In-situ analysis and quantitative dataset of the impact assessment of perceived level of exposure to pollution and health condition

One of the challenges of rapid climate change evolution and the leading risk factor is increasing air pollution. This work aims to investigate the perceived level of exposure to pollution associated with health outcomes. The study involves two groups of people within the concentrated population of Ewekoro and Ota residents. Considerations were also given to staff of general hospital in the two towns. The resident in perception on pollution generated from the factories and the rate of exposure of the two were noted. The questionnaire totalling 652 was administered putting into the consideration the population and analysis using SPSS. From all indication, the perceived level of exposure and the health condition of the inhabitants in Ota and Ewekero. The measure taken by the government was seen to be high at 81 % compare to 45 % in Ota industrial estate.

Beyond stereotypes: The role of exposure in reshaping Children's biases towards women as coaches in sports

The underrepresentation of women in sports coaching, linked to discrimination and bias may, according to contact theory, be mitigated by increasing the visibility of women coaches, especially among children. Our study examined whether young athletes exposed to women coaches affected their explicit and implicit biases compared to unexposed peers. Seventy-five children aged between 4 and 17 years were evaluated using two explicit attitude measures and an Implicit Association Task. Results indicated that participants with women coach experience were more explicitly satisfied with woman coaches, preferred them more as potential coaches, and associated men with sports less than those without such exposure. Whilst exposure and implicit bias significantly predicted explicit satisfaction, exposure did not moderate the bias relationship. This suggests that exposure to women coaches reduces negative attitudes in young athletes but does not significantly affect the underlying influence of implicit biases, indicating a need for more comprehensive strategies to address gender inequalities in sports coaching.

A tool to assess risk of bias in non-randomized follow-up studies of exposure effects (ROBINS-E)

BACKGROUND

Observational epidemiologic studies provide critical data for the evaluation of the potential effects of environmental, occupational and behavioural exposures on human health. Systematic reviews of these studies play a key role in informing policy and practice. Systematic reviews should incorporate assessments of the risk of bias in results of the included studies.

OBJECTIVE

To develop a new tool, Risk Of Bias In Non-randomized Studies - of Exposures (ROBINS-E) to assess risk of bias in estimates from cohort studies of the causal effect of an exposure on an outcome.

METHODS AND RESULTS

ROBINS-E was developed by a large group of researchers from diverse research and public health disciplines through a series of working groups, in-person meetings and pilot testing phases. The tool aims to assess the risk of bias in a specific result (exposure effect estimate) from an individual observational study that examines the effect of an exposure on an outcome. A series of preliminary considerations informs the core ROBINS-E assessment, including details of the result being assessed and the causal effect being estimated. The assessment addresses bias within seven domains, through a series of 'signalling questions'. Domain-level judgements about risk of bias are derived from the answers to these questions, then combined to produce an overall risk of bias judgement for the result, together with judgements about the direction of bias.

CONCLUSION

ROBINS-E provides a standardized framework for examining potential biases in results from cohort studies. Future work will produce variants of the tool for other epidemiologic study designs (e.g. case-control studies). We believe that ROBINS-E represents an important development in the integration of exposure assessment, evidence synthesis and causal inference.

Gastrointestinal tract exposure to particles and DNA damage in animals: A review of studies before, during and after the peak of nanotoxicology

Humans ingest particles and fibers on daily basis. Non-digestible carbohydrates are beneficial to health and food additives are considered safe. However, titanium dioxide (E171) has been banned in the European Union because the European Food Safety Authority no longer considers it non-genotoxic. Ingestion of microplastics and nanoplastics are novel exposures; their potential hazardous effects to humans have been under the radar for many years. In this review, we have assessed the association between oral exposure to man-made particles/fibers and genotoxicity in gastrointestinal tract cells and secondary tissues. We identified a total of 137 studies on oral exposure to particles and fibers. This was reduced to 49 papers with sufficient quality and relevance, including exposures to asbestos, diesel exhaust particles, titanium dioxide, silver nanoparticles, zinc oxide, synthetic amorphous silica and certain other nanomaterials. Nineteen studies show positive results, 25 studies show null results, and 5 papers show equivocal results on genotoxicity. Recent studies seem to show null effects, whereas there is a higher proportion of positive genotoxicity results in early studies. Genotoxic effects seem to cluster in studies on diesel exhaust particles and titanium dioxide, whereas studies on silver nanoparticles, zinc oxide and synthetic amorphous silica seem to show mainly null effects. The most widely used genotoxic tests are the alkaline comet assay and micronucleus assay. There are relatively few results on genotoxicity using reliable measurements of oxidatively damaged DNA, DNA double strand breaks (γH2AX assay) and mutations. In general, evidence suggest that oral exposure to particles and fibers is associated with genotoxicity in animals.

Influence of the geographic location and house characteristics on the concentration of microplastics in indoor dust

Microplastics (MPs) are known for their ubiquity, having been detected in virtually any environmental compartment. However, indoor MPs concentrations are poorly studied despite being closely related to human exposure. The present study aims to evaluate the presence of MPs in settled atmospheric dust in 60 houses distributed in 12 districts of the metropolitan city of Lima, Peru, and investigate the influence of their geographical location and house characteristics. MPs concentration ranged from 0.01 to 33.9 MPs per mg of dust. Fibers and blue were the most frequent shape and color (98 % and 69 %, respectively). Also, 82 % of the particles were between 500 μm - 5 mm in size. A higher concentration of MPs was identified in the center-south of the city. The houses located on the highest floors (levels 4 to 13 to ground) displayed higher concentrations. MPs were primarily composed of polyester (PET), polypropylene (PP), and ethylene-vinyl acetate (EVA), among others. The polymers identified suggest that MPs derived from the fragmentation of components frequently found in houses, such as synthetic clothing, food storage containers, toys, carpets, floors, and curtains. The incorporation of MPs from the outside into dwellings is not ruled out. Future studies should evaluate the influence of consumption habits and housing characteristics on the abundance of MPs.

Systemic inflammation indices as hematological biomarkers of inflammatory response in non-silicotic workers exposed to respirable silica dust

This cross-sectional study was performed to assess whether systemic inflammatory indices, including systemic inflammation response index (SIRI), systemic immune‑inflammation index (SII), and aggregate index of systemic inflammation (AISI), can be considered as possible inflammatory markers in silica-exposed workers with no diagnosis of silicosis. We studied 371 non-silicotic workers exposed to respirable silica dust (RSD) and 1422 reference workers. The workers' exposure to RSD were assessed and the inflammatory indices were compared between subgroups of the exposed workers based on the severity and duration of exposure. Correlations between inflammatory indices and the pulmonary function parameters were investigated. Also, the receiver operating characteristic (ROC) curve and Youden index were used to determine the cut-off values of the SII, SIRI, and AISI. Significant dose-response relationships were observed between duration of exposure and all indices except monocytes and LMR. No significant interaction was observed between duration of exposure to RSD and smoking. Borderline significant correlations were observed between AISI and SIRI with forced expiratory volume (FEV1) and FEV1 to forced vital capacity (FVC) ratio. Higher AUCs were obtained for SII and AISI, respectively. The cut-off values for these biomarkers to be considered abnormal were > 348.48 for SII, > 183.78 for AISI, and > 0.768 for SIRI. Overall, the present study showed for the first time, that SII, AISI, and SIRI might be considered as available, easy-to-obtain, and non-expensive markers of inflammation in non-silicotic workers with a long duration of exposure to RSD who are at risk of developing silicosis in subsequent years.

Environmental health hazards of untreated livestock wastewater: potential risks and future perspectives

Due to technological and economic limitations, waste products such as sewage and manure generated in livestock farming lack comprehensive scientific and centralized treatment. This leads to the exposure of various contaminants in livestock wastewater, posing potential risks to both the ecological environment and human health. This review evaluates the environmental and physical health risks posed by common pollutants in livestock wastewater and outlines future treatment methods to mitigate these risks. Residual wastes in livestock wastewater, including pathogenic bacteria and parasites surviving after epidemics or diseases on various farms, along with antibiotics, organic wastes, and heavy metals from farming activities, contribute to environmental damage and pose risks to human health. As the livestock industry's development increasingly impacts society's future negatively, addressing the issue of residual wastes in livestock wastewater discharge becomes imperative. Ongoing advancements in wastewater treatment systems are consistently updating and refining practices to effectively minimize waste exposure at the discharge source, mitigating risks to environmental ecology and human health. This review not only summarizes the "potential risks of livestock wastewater" but also explores "the prospects for the development of wastewater treatment technologies" based on current reports. It offers valuable insights to support the long-term and healthy development of the livestock industry and contribute to the sustainable development of the ecological environment.

Paclitaxel therapeutic drug monitoring - International association of therapeutic drug monitoring and clinical toxicology recommendations

Paclitaxel, one of the most frequently used anticancer drugs, is dosed by body surface area, which leads to substantial inter-individual variability in systemic drug exposure. We evaluated clinical evidence regarding the scientific rationale and clinical benefit of individualized paclitaxel dosing based on measured systemic concentrations, known as therapeutic drug monitoring (TDM). In retrospective studies, higher systemic exposure is associated with greater toxicity and efficacy of paclitaxel treatment across several disease types and dosing regimens. In prospective trials, TDM reduces variability in systemic exposure, and has been demonstrated to reduce toxicity while retaining treatment efficacy for 3-weekly dosing in patients with advanced non-small cell lung cancer. Despite the demonstrated benefits of paclitaxel TDM, clinical adoption has been limited due to the challenges with sample collection and analysis. Based on our review, we strongly recommend TDM for patients receiving every 3-week paclitaxel in combination with a platinum agent for advanced NSCLC, due to the prospectively demonstrated clinical benefits, and find moderate evidence to recommend TDM for paclitaxel 3-hour infusions for other tumor types and preliminary evidence suggesting potential usefulness for paclitaxel administered by 1-hour infusions.

Toenail zinc and risk of prostate cancer in the MCC-Spain case-control study

BACKGROUND

Some researchers have suggested that zinc (Zn) could reduce the risk of prostate cancer (PC). However, research from observational studies on the relationship between PC risk and biomarkers of Zn exposure shows conflicting results.

OBJECTIVES

To evaluate the association between toenail Zn and PC, considering tumour extension and aggressiveness, along with a gene-environment approach, exploring the interaction of individual genetic susceptibility to PC in the relationship between toenail Zn and PC.

METHODS

In MCC-Spain study we invited all incident PC cases diagnosed in the study period (2008-2013) and recruited randomly selected general population controls. In this report we included 913 cases and 1198 controls with toenail Zn determined by inductively coupled plasma mass spectrometry. To measure individual genetic susceptibility, we constructed a polygenic risk score based on known PC-related single nucleotide polymorphisms. The association between toenail Zn and PC was explored with mixed logistic and multinomial regression models.

RESULTS

Men with higher toenail Zn had higher risk of PC (OR quartile 4 vs.1: 1.41; 95% CI: 1.07-1.85). This association was slightly higher in high-grade PC [(ISUP≤2 Relative risk ratio (RRR) quartile 4 vs.1: 1.36; 1.01-1.83) vs. (ISUP3-5 RRR quartile 4 vs.1: 1.64; 1.06-2.54)] and in advanced tumours [(cT1-cT2a RRR quartile 4 vs.1: 1.40; 95% CI: 1.05-1.89) vs. (cT2b-cT4 RRR quartile 4 vs.1: 1.59; 1.00-2.53)]. Men with lower genetic susceptibility to PC were those at higher risk of PC associated with high toenail Zn (OR quartile 4 vs.1: 2.18; 95% CI: 1.08-4.40).

DISCUSSION

High toenail Zn levels were related to a higher risk for PC, especially for more aggressive or advanced tumours. This effect was stronger among men with a lower genetic susceptibility to PC.

Human health risk assessment of metal-contaminated soils in Sydney estuary catchment (Australia)

Sydney estuary catchment supports the largest city in Australia and provides essential eco-social and environmental services; however, the region has been influenced by extensive anthropogenic modification. Soil metal concentrations in the catchment had been studied previously; however, the current investigation was designed to determine the risk posed by these contaminants to human health. Soil metal concentrations were higher than observed in most global capitals and increased substantially in the south and south-east of the catchment and close to the central business district. Road-side soils and road dust contained the highest concentration of metals in the catchment. Lead in catchment soils was closely related to traffic density and sourced from the historic use of Pb in petrol. A human health assessment indicated that soil Cd, Ni and Zn posed no non-carcinogenic risk (NCR), or carcinogenic risk (CR) for children, or adults in Sydney estuary catchment and that Cu and Cr may pose minor NCR for children. Vehicle-related Pb raised the greatest human health risk in catchment soils and may pose NCR at 32% and 4.3% of sites for children and adults, respectively. Inconsistent analytical techniques used in CR and NCR evaluations produce incomparable assessments and a consistent` methodology is suggested to improve interpretation. Human health risk may well be higher than commonly calculated due to pollutants present in urban soil not being included in assessments.

Association of urinary chlorpyrifos, paraquat, and cyproconazole levels with the severity of fatty liver based on MRI

BACKGROUND

The objective of this study was to detect the urinary levels of chlorpyrifos, paraquat, and cyproconazole in residents living in Fuyang City and to analyze the correlation between these urinary pesticides levels and the severity of fatty liver disease (FLD).

METHODS

All participants' fat fraction (FF) values were recorded by MRI (Magnetic resonance imaging). First-morning urine samples were collected from 53 participants from Fuyang Peoples'Hospital. The levels of three urinary pesticides were measured using β-glucuronidase hydrolysis followed by a. The results were analyzed by using Pearson correlation analysis and binary logistic regression analysis to reveal the correlation between three urinary pesticides and the severity of fatty liver.

RESULTS

53 individuals were divided into 3 groups based on the results from MRI, with 20 cases in the normal control group, 16 cases in the mild fatty liver group, and 17 cases in the moderate and severe fatty liver group. Urinary chlorpyrifos level was increased along with the increase of the severity of fatty liver. Urinary paraquat level was significantly higher both in the low-grade fatty liver group and moderate & serve grade fatty liver group compared with the control group. No significant differences in urinary cyproconazole levels were observed among the three groups. Furthermore, urinary chlorpyrifos and paraquat levels were positively correlated with FF value. And chlorpyrifos was the risk factor that may be involved in the development of FLD and Receiver Operating Characteristic curve (ROC curve) analysis showed that chlorpyrifos and paraquat may serve as potential predictors of FLD.

CONCLUSION

The present findings indicate urinary chlorpyrifos and paraquat were positively correlated with the severity of fatty liver. Moreover, urinary chlorpyrifos and paraquat have the potential to be considered as the predictors for development of FLD. Thus, this study may provide a new perspective from the environmental factors for the diagnosis, prevention, and treatment of FLD.

Opportunities and Challenges Associated with the Uptake of Residential Clean Fuel Usage

PURPOSE OF REVIEW

Almost 3 billion people worldwide use solid fuel for cooking and heating. This review examines (i) household energy practices and infrastructures and their influence on fuel usage in different contexts; (ii) barriers in adoption of household clean energy technologies and uses in diverse settings and population groups and (iii) potential air pollution exposure reduction in homes through using processed fuel.

RECENT FINDINGS

Population health burden from solid fuel combustion-derived particulate air pollution has been estimated in several low- and middle-income countries. However, such studies have not been carried out in high income countries (e.g., UK). Irrespective of the region, fuel prices are the most dominant factor influencing the choice of fuel. Laboratory studies suggest processed fuel - pellets and briquettes - reduce particulate matter emissions by 70-80% and can be a promising alternative. Adoption of clean fuels for domestic energy needs facilitates progress towards five of the UN Sustainable Development Goals (SDGs). There is evidence that a variety of factors, including cost savings, encourage and hinder such uptake. These factors include price fluctuations, expenses, and the usage of clean fuels. Due to their distinct development scenarios, more expansive policy frameworks, and political economies of energy, these determinants are localized in character and differ significantly amongst economies. Therefore, in order to create innovative plans for the adoption of clean fuel use, strategies centred on local settings must be developed while keeping broad socio-technical and socio-economic issues in mind. Solid fuel processing - pelletization and briquetting - have the potential to reach Liquefied Petroleum Gas (LPG)-like emissions, and could be a potential strategy to mitigate exposure to household air pollution.

Enhancing co-seismic landslide susceptibility, building exposure, and risk analysis through machine learning

Landslides are devastating natural disasters that generally occur on fragile slopes. Landslides are influenced by many factors, such as geology, topography, natural drainage, land cover, rainfall and earthquakes, although the underlying mechanism is too complex and very difficult to explain in detail. In this study, the susceptibility mapping of co-seismic landslides is carried out using a machine learning approach, considering six districts covering an area of 12,887 km2 in Nepal. Landslide inventory map is prepared by taking 23,164 post seismic landslide data points that occurred after the 7.8 MW 2015 Gorkha earthquake. Twelve causative factors, including distance from the rupture plane, peak ground acceleration and distance from the fault, are considered input parameters. The overall accuracy of the model is 87.2%, the area under the ROC curve is 0.94, the Kappa coefficient is 0.744 and the RMSE value is 0.358, which indicates that the performance of the model is excellent with the causative factors considered. The susceptibility thus developed shows that Sindhupalchowk district has the largest percentage of area under high and very high susceptibility classes, and the most susceptible local unit in Sindhupalchowk is the Barhabise municipality, with 19.98% and 20.34% of its area under high and very high susceptibility classes, respectively. For the analysis of building exposure to co-seismic landslide susceptibility, a building footprint map is developed and overlaid on the co-seismic landslide susceptibility map. The results show that the Sindhupalchowk and Dhading districts have the largest and smallest number of houses exposed to co-seismic landslide susceptibility. Additionally, when conducting a risk analysis based on susceptibility mapping, as well as considering socio-economic and structural vulnerability in Barhabise municipality, revealed that only 106 (1.1%) of the total 9591 households, were found to be at high risk. As this is the first study of co-seismic landslide risk study carried out in Nepal and covers a regional to the municipal level, this can be a reference for future studies in Nepal and other parts of the world and can be helpful in planning development activities for government bodies.

Microplastics in commercial marine fish species in the UK - A case study in the River Thames and the River Stour (East Anglia) estuaries

The aim of this study was to assess the abundance of microplastics in the gastro-intestinal tracts of three commercially important fish species in the UK, to determine whether catch location, feeding habits and fish size influence the amount of microplastics within fish. Fish were collected from two rivers in the UK: the River Thames and the River Stour (East Anglia). Fish were collected from two sites in the River Thames and one site in the River Stour. Species selected were European flounder (Platichthys flesus), whiting (Merlangius merlangus), and Atlantic herring (Clupea harengus), and were chosen to represent benthic and pelagic feeding habits. Across all locations, 41.5 % of fish had ingested at least one microplastic particle (37.5 % of European flounder, 52.2 % of whiting, and 28.6 % of Atlantic herring). The average number by species was 1.98 (±3.50) microplastics/fish in European flounder, 2.46 (±3.10) microplastics/fish in whiting and 1.47 (±3.17) microplastics/fish in herring. There were no significant differences in the number or mass of microplastics in fish based on river, site, species or habitat. However, the number and mass of microplastics within benthic fish (European flounder) in the River Stour were significantly higher than in benthic fish from the River Thames. By number of microplastics, larger and heavier fish were more highly contaminated. This study enhances our understanding of microplastics in commercially important fish but highlights that fish contamination is not easily predicted by feeding habits or catch location alone. Exposure and uptake is likely to vary with changing environmental conditions. Fish size tends to be a good predictor of contamination, with larger fish generally containing more microplastics. This is the first study to directly compare concentrations of microplastics in fish from different UK rivers and the first evidence of microplastics in the River Stour.

Dose-response relationship between lung function and chest imaging response to silica exposures in artificial stone manufacturing workers

BACKGROUND

Occupational exposure to artificial stone, a popular material used for countertops, can cause accelerated silicosis, but the precise relationship between silica dose and disease development is unclear.

OBJECTIVES

This study evaluated the impact of silica exposure on lung function and chest imaging in artificial stone manufacturing workers.

METHODS

Questionnaire and spirometry assessments were administered to workers in two plants. A high-exposure subset underwent further evaluation, including chest CT and DLco. Weighting factors, assigned as proxies for silica exposure, were based on work tasks. Individual cumulative exposures were estimated using area concentration measurements and time spent in specific areas. Exposure-response associations were analyzed using linear and logistic regression models.

RESULTS

Among 65 participants, the mean cumulative silica exposure was 3.61 mg/m3-year (range 0.0001 to 44.4). Each 1 mg/m3-year increase was associated with a 0.46% reduction in FVC, a 0.45% reduction in FEV1, and increased lung function abnormality risk (aOR = 1.27, 95% CI = 1.03-1.56). Weighting factors correlated with cumulative exposures (Spearman correlation = 0.59, p < 0.0001), and weighted tenure was associated with lung function abnormalities (aOR = 1.04, 95% CI = 1.01-1.09). Of 37 high-exposure workers, 19 underwent chest CT, with 12 (63%) showing abnormal opacities. Combining respiratory symptoms, lung function, and chest X-ray achieved 91.7% sensitivity and 75% specificity for predicting chest CT abnormalities.

CONCLUSION

Lung function and chest CT abnormalities occur commonly in artificial stone workers. For high-exposure individuals, abnormalities on health screening could prompt further chest CT examination to facilitate early silicosis detection.

Hexachlorobenzene and omega-3 fatty acid intake from traditional foods in the northern Yukon: A risk and benefit analysis

A human biomonitoring study was conducted in the community of Old Crow, Yukon, in 2019, finding that levels of hexachlorobenzene (HCB) in plasma were elevated in the community relative to the general Canadian population. The aim of this study was to estimate dietary intake of both hexachlorobenzene, and the nutrient omega-3 fatty acids from locally harvested traditional foods in Old Crow, with the aim of identifying possible regional sources of exposure. A stochastic model was constructed to estimate intake of both hexachlorobenzene and the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Average predicted hexachlorobenzene exposure levels from traditional food consumption in Old Crow were below the tolerable daily intake of 1600-1700 ng/kg body weight/day in both average (18 ng/kg body weight/day) and short-term maximum (27 ng/kg body weight/day) exposure models. The primary contributors to average hexachlorobenzene intake were caribou fat, bone marrow, ribs, and kidneys, and Chinook salmon muscle. Average estimated dietary EPA + DHA intake levels from traditional foods were below the recommendation of 2.1 to 3.2 g of EPA + DHA per week in the average (1.6 g/week) exposure model, but above this recommendation in the short-term maximum model (3.3 g/week). The primary contributors to average EPA + DHA intake were the meat of Chinook, coho, and, chum salmon muscle, and whitefish muscle and eggs. The results of this study support the message that traditional foods continue to be an important source of nutrients and other health benefits and that the health benefits of traditional foods generally outweigh contaminant risks.

Diagnosis and management of complications following pelvic organ prolapse surgery using a synthetic mesh: French national guidelines for clinical practice

Complications associated with pelvic organ prolapse (POP) surgery using a synthetic non-absorbable mesh are uncommon (<5%) but may be severe and may hugely diminish the quality of life of some women. In drawing up these multidisciplinary clinical practice recommendations, the French National Authority for Health (Haute Autorité de santé, HAS) conducted an exhaustive review of the literature concerning the diagnosis, prevention, and management of complications associated with POP surgery using a synthetic mesh. Each recommendation for practice was allocated a grade (A,B or C; or expert opinion (EO)), which depends on the level of evidence (clinical practice guidelines).

PREOPERATIVE PATIENTS' INFORMATION

Each patient must be informed concerning the risks associated with POP surgery (EO).

HEMORRHAGE, HEMATOMA

Vaginal infiltration using a vasoconstrictive solution is not recommended during POP surgery by the vaginal route (grade C). The placement of vaginal packing is not recommended following POP surgery by the vaginal route (grade C). During laparoscopic sacral colpopexy, when the promontory seems highly dangerous or when severe adhesions prevent access to the anterior vertebral ligament, alternative surgical techniques should be discussed per operatively, including colpopexy by lateral mesh laparoscopic suspension, uterosacral ligament suspension, open abdominal mesh surgery, or surgery by the vaginal route (EO).

BLADDER INJURY

When a bladder injury is diagnosed, bladder repair by suturing is recommended, using a slow resorption suture thread, plus monitoring of the permeability of the ureters (before and after bladder repair) when the injury is located at the level of the trigone (EO). When a bladder injury is diagnosed, after bladder repair, a prosthetic mesh (polypropylene or polyester material) can be placed between the repaired bladder and the vagina, if the quality of the suturing is good. The recommended duration of bladder catheterization following bladder repair in this context of POP mesh surgery is from 5 to 10 days (EO).

URETER INJURY

After ureteral repair, it is possible to continue sacral colpopexy and place the mesh if it is located away from the ureteral repair (EO).

RECTAL INJURY

Regardless of the approach, when a rectal injury occurs, a posterior mesh should not be placed between the rectum and the vagina wall (EO). Concerning the anterior mesh, it is recommended to use a macroporous monofilament polypropylene mesh (EO). A polyester mesh is not recommended in this situation (EO).

VAGINAL WALL INJURY

After vaginal wall repair, an anterior or a posterior microporous polypropylene mesh can be placed, if the quality of the repair is found to be satisfactory (EO). A polyester mesh should not be used after vaginal wall repair (EO).

MESH INFECTION (ABSCESS, CELLULITIS, SPONDYLODISCITIS)

Regardless of the surgical approach, intravenous antibiotic prophylaxis is recommended (aminopenicillin + beta-lactamase inhibitor: 30 min before skin incision +/- repeated after 2 h if surgery lasts longer) (EO). When spondylodiscitis is diagnosed following sacral colpopexy, treatment should be discussed by a multidisciplinary group, including especially spine specialists (rheumatologists, orthopedists, neurosurgeons) and infectious disease specialists (EO). When a pelvic abscess occurs following synthetic mesh sacral colpopexy, it is recommended to carry out complete mesh removal as soon as possible, combined with collection of intraoperative bacteriological samples, drainage of the collection and targeted antibiotic therapy (EO). Non-surgical conservative management with antibiotic therapy may be an option (EO) in certain conditions (absence of signs of sepsis, macroporous monofilament polypropylene type 1 mesh, prior microbiological documentation and multidisciplinary consultation for the choice of type and duration of antibiotic therapy), associated with close monitoring of the patient.

BOWEL OCCLUSION RELATED TO NON-CLOSURE OF THE PERITONEUM

Peritoneal closure is recommended after placement of a synthetic mesh by the abdominal approach (EO).

URINARY RETENTION

Preoperative urodynamics is recommended in women presenting with urinary symptoms (bladder outlet obstruction symptoms, overactive bladder syndrome or incontinence) (EO). It is recommended to remove the bladder catheter at the end of the procedure or within 48 h after POP surgery (grade B). Bladder emptying and post-void residual should be checked following POP surgery, before discharge (EO). When postoperative urine retention occurs after POP surgery, it is recommended to carry out indwelling catheterization and to prefer intermittent self-catheterization (EO).

POSTOPERATIVE PAIN

Before POP surgery, the patient should be asked about risk factors for prolonged and chronic postoperative pain (pain sensitization, allodynia, chronic pelvic or non-pelvic pain) (EO). Concerning the prevention of postoperative pain, it is recommended to carry out a pre-, per- and postoperative multimodal pain treatment (grade B). The use of ketamine intraoperatively is recommended for the prevention of chronic postoperative pelvic pain, especially for patients with risk factors (preoperative painful sensitization, allodynia, chronic pelvic or non-pelvic pain) (EO). Postoperative prescription of opioids should be limited in quantity and duration (grade C). When acute neuropathic pain (sciatalgia or pudendal neuralgia) resistant to level I and II analgesics occurs following sacrospinous fixation, a reintervention is recommended for suspension suture removal (EO). When chronic postoperative pain occurs after POP surgery, it is recommended to systematically seek arguments in favor of neuropathic pain with the DN4 questionnaire (EO). When chronic postoperative pelvic pain occurs after POP surgery, central sensitization should be identified since it requires a consultation in a chronic pain department (EO). Concerning myofascial pain syndrome (clinical pain condition associated with increased muscle tension caused by myofascial trigger points), when chronic postoperative pain occurs after POP surgery, it is recommended to examine the levator ani, piriformis and obturator internus muscles, so as to identify trigger points on the pathway of the synthetic mesh (EO). Pelvic floor muscle training with muscle relaxation is recommended when myofascial pain syndrome is associated with chronic postoperative pain following POP surgery (EO). After failure of pelvic floor muscle training (3 months), it is recommended to discuss surgical removal of the synthetic mesh, during a multidisciplinary discussion group meeting (EO). Partial removal of synthetic mesh is indicated when a trigger point is located on the pathway of the mesh (EO). Total removal of synthetic mesh should be discussed during a multidisciplinary discussion group meeting when diffuse (no trigger point) chronic postoperative pain occurs following POP surgery, with or without central sensitization or neuropathic pain syndromes (EO).

POSTOPERATIVE DYSPAREUNIA

When de novo postoperative dyspareunia occurs after POP surgery, surgical removal of the mesh should be discussed (EO).

VAGINAL MESH EXPOSURE

To reduce the risk of vaginal mesh exposure, when hysterectomy is required during sacral colpopexy, subtotal hysterectomy is recommended (grade C). When asymptomatic vaginal macroporous monofilament polypropylene mesh exposure occurs, systematic imaging is not recommended. When vaginal polyester mesh exposure occurs, pelvic +/- lumbar MRI (EO) should be used to look for an abscess or spondylodiscitis, given the greater risk of infection associated with this type of material. When asymptomatic vaginal mesh exposure of less than 1 cm2 occurs in a woman with no sexual intercourse, the patient should be offered observation (no treatment) or local estrogen therapy (EO). However, if the patient wishes, partial excision of the mesh can be offered. When asymptomatic vaginal mesh exposure of more than 1 cm2 occurs or if the woman has sexual intercourse, or if it is a polyester prosthesis, partial mesh excision, either immediately or after local estrogen therapy, should be offered (EO). When symptomatic vaginal mesh exposure occurs, but without infectious complications, surgical removal of the exposed part of the mesh by the vaginal route is recommended (EO), and not systematic complete excision of the mesh. Following sacral colpopexy, complete removal of the mesh (by laparoscopy or laparotomy) is only required in the presence of an abscess or spondylodiscitis (EO). When vaginal mesh exposure recurs after a first reoperation, the patient should be treated by an experienced team specialized in this type of complication (EO).

SUTURE THREAD VAGINAL EXPOSURE

For women presenting with vaginal exposure to non-absorbable suture thread following POP surgery with mesh reinforcement, the suture thread should be removed by the vaginal route (EO). Removal of the surrounding mesh is only recommended when vaginal mesh exposure or associated abscess is diagnosed.

BLADDER AND URETERAL MESH EXPOSURE

When bladder mesh exposure occurs, removal of the exposed part of the mesh is recommended (grade B). Both alternatives (total or partial mesh removal) should be discussed with the patient and should be debated during a multidisciplinary discussion group meeting (EO).

Detailed aggregate exposure analysis shows that exposure to fragrance ingredients in consumer products is low: Many orders of magnitude below thresholds of concern

The Research Institute for Fragrance Materials (RIFM) and Creme Global Cremeglobal.com partnered to develop an aggregate exposure model for fragrance ingredients. The model provides a realistic estimate of the total exposure of fragrance ingredients to individuals across a population. The Threshold of Toxicological Concern (TTC) and Dermal Sensitization Threshold (DST) were used to demonstrate the magnitude of low exposure to fragrance materials. The total chronic systemic, inhalation, and dermal 95th percentile exposures on approximately 3000 fragrance ingredients in RIFM's inventory were compared to their respective TTC or DST. Additionally, representative fragrance ingredients were randomly selected and analyzed for exposure distribution by product type (i.e., cosmetic/personal care, household care, oral care, and air care) and route of exposure. It was found that 76 % of fragrance ingredients fall below their respective TTC limits when compared to 95th percentile systemic exposure, while 99 % are below inhalation TTC limits. The lowest 95th percentile aggregate exposure by product type was from household care products, then air care, and oral care products. The highest exposure was from personal care/cosmetic products. The volume of use for most fragrance ingredients (63 %) was <1 metric ton, estimating that environmental exposure to fragrance ingredients is likely low.

Organophosphate esters in the urban atmosphere of Thessaloniki city, Greece

The occurrence of organophosphate esters (OPEs) in the atmosphere of the urban area of Thessaloniki city, Greece was studied. OPEs were determined in particulate matter (PM2.5) and precipitation during the period 2020-2021. ∑OPEs in rainwater ranged from 520 to 4719 ng L-11 (mean: 1662 ng L-1) with tris (2-butoxyethyl) phosphate (TBOEP) and tris (1-chloro-2-propyl) phosphate (TClPP) being the most abundant compounds. TBOEP and TClPP as well as triphenylphosphine oxide (TPPO) and tris (chloroethyl) phosphate (TCEP) were the dominant OPEs in PM2.5. Concentrations of ∑OPEs in PM2.5ranged from 2.82 to 13.3 ng m-3 (mean: 5.93 ng m-3). Wet deposition fluxes of OPEs were estimated and air mass back trajectories were used to elucidate possible source profiles. An overall low health risk for local population via inhalation of OPEs was revealed.

Positive mood induction does not reduce return of fear: A virtual reality exposure study for public speaking anxiety

Previous laboratory work has shown that induction of positive mood prior to fear extinction decreases the negative valence of the conditional stimulus (CS) and reduces reinstatement of fear. Before translating these insights to clinical practice, it is important to test this strategy in anxious individuals. Students with a high fear of public speaking (N = 62) were randomized to either a positive mood induction, a negative mood induction, or no induction control group. All participants performed two weekly sessions of virtual reality exposure and a 1-week follow-up test including a spontaneous recovery test and reinstatement test after a social rejection (unconditional stimulus). We used self-reported fear measures and skin conductance responses. We expected that the positive group, compared to the other groups, would evaluate the CS (i.e., speaking in front of an audience) as less negative following exposure and would show less spontaneous recovery and reinstatement of fear following a social rejection. Although mood was successfully manipulated, there were no group differences in CS valence following exposure. In all conditions, VR exposure successfully reduced public speaking fear, and these effects were stable at follow-up. In contrast with expectations, the positive group showed more spontaneous recovery of CS negative valence than the negative group. To conclude, we found no evidence that positive mood induction prior to exposure optimizes exposure effects for anxious individuals.

Blood Pb levels are associated with prostate cancer prevalence among general adult males: Linking National Cancer Registry (2002-2017) and KNHANES (2008-2017) databases of Korea

BACKGROUND

Exposure to heavy metals may increase the risk of developing prostate cancer. However, these observations are often inconsistent and not based on clinically diagnosed cases.

OBJECTIVE

To investigate the association of lead (Pb), cadmium (Cd), and mercury (Hg) exposure with clinically determined prostate cancer cases among adult males in South Korea.

METHODS

Metal biomonitoring data and cancer information from the general Korean population were extracted by linking National Cancer Center (NCC) cancer registration data (2002-2017) with Korea National Health and Nutrition Examination Survey (KNHANES) data (2008-2017). Among them, 46 prostate cancer cases (designated as 'all-prostate'), including 25 diagnosed after heavy metal measurement (designated as 'post-prostate'), and 93 matching controls were chosen. Logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) between the heavy metal levels and prostate cancer.

RESULTS

Post-prostate patients exhibited higher blood Pb levels than controls (median 3.1 μg/dL vs. 2.38 μg/dL, p = 0.01). For all-prostate cancer, the OR of prostate cancer increased by 2.04-fold for every doubling of Pb levels (95% CI = 1.08-3.87, p = 0.03). The OR was also significantly elevated when comparing the third quartile (Q3) to the lowest quartile (Q1), with ORs ranging from 3.38 to 7.95, depending on model (p < 0.05). Blood Pb levels maintained a positive association with inconsistent significance for post-prostate cancer patients. For Cd and Hg, no statistically significant association was established.

SIGNIFICANCE

By linking two national health databases for the first time, we constructed an unbiased database of prostate cancer cases and matching controls. We found that blood Pb concentrations were associated with the risk of prostate cancer in Korean men at the current level of exposure.

Investigating strontium isotope linkage between biominerals (uroliths), drinking water and environmental matrices

This study presents the mineralogy and strontium isotope ratio (87Sr/86Sr) of 21 pathological biominerals (bladder and kidney stones) collected from patients admitted between 2018 and 2020 at the Department of Urology of the San Pio Hospital (Benevento, southern Italy). Urinary stones belong to the calcium oxalate, purine or calcium phosphate mineralogy types. Their corresponding 87Sr/86Sr range from 0.707607 for an uricite sample to 0.709970 for a weddellite one, and seem to be partly discriminated based on the mineralogy. The comparison with the isotope characteristics of 38 representative Italian bottled and tap drinking waters show a general overlap in 87Sr/86Sr with the biominerals. However, on a smaller geographic area (Campania Region), we observe small 87Sr/86Sr differences between the biominerals and local waters. This may be explained by external Sr inputs for example from agriculture practices, inhaled aerosols (i.e., particulate matter), animal manure and sewage, non-regional foods. Nevertheless, biominerals of patients that stated to drink and eat local water/wines and foods every day exhibited a narrower 87Sr/86Sr range roughly matching the typical isotope ratios of local geological materials and waters, as well as those of archaeological biominerals from the same area. Finally, we conclude that the strontium isotope signature of urinary stones may reflect that of the environmental matrices surrounding patients, but future investigations are recommended to ultimately establish the potential for pathological biominerals as reliable biomonitoring proxies, taking into the account the contribution of the external sources of Sr.

Virtual reality exposure with vibrotactile stimulation for the treatment of fear of flying: A pilot study

BACKGROUND AND OBJECTIVES

Virtual reality (VR) interventions are becoming more prevalent in treating fear of flying (FoF). Since multisensory stimulation can enhance the sense of presence in a virtual environment, the present study compared virtual reality exposure with and without vibrotactile cues to determine its contribution to the realism of the virtual experience.

METHODS

A repeated measures design was used. Thirty-one participants were exposed to two experimental conditions with a minimum of a one-week interval between them: one in which participants were exposed to the virtual environment with vibrotactile cues (smart chair, SC), and another in which participants were exposed to the virtual environment without vibrotactile cues (ordinary chair, OC). The administration order of both conditions was counterbalanced to avoid possible order effects.

RESULTS

Participants felt higher levels of sense of presence when using the SC than the OC. However, the addition of vibrotactile stimulation partially influenced experienced anxiety. Some personality traits were also associated with participants' sense of presence and anxiety responses during the exposure.

LIMITATIONS

The sample size was smaller than required. Moreover, only self-reported measures were used. Finally, a roller coaster instead of an airplane scenario was used for the exposure, which might not have been suitable enough for provoking anxiety in participants with FoF.

CONCLUSIONS

Vibrotactile cues enhanced the sense of presence. However, the addition of vibrotactile stimulation did not have a consistent effect on anxiety experienced during exposure. Therefore, the benefits of incorporating vibrotactile cues in virtual reality environments for exposure therapy are not clear.

Exposure assessment of children to dietary mycotoxins: A pilot study conducted in Ribeirão Preto, São Paulo, Brazil

Exposure to mycotoxins through food is a major health concern, especially for youngsters. This study performed a preliminary investigation on children's exposure to dietary mycotoxins in Ribeirão Preto, Brazil. Sampling procedures were conducted between August and December 2022, to collect foods (N = 213) available for consumption in the households of children (N = 67), including preschoolers (aged 3-6 years, n = 21), schoolers (aged 7-10 years, n = 15), and adolescents (aged 11-17 years, n = 31) cared in the Vila Lobato Community Social Medical Center of Ribeirão Preto. Ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS) was used to determine concentrations of the mycotoxins in foods. Mycotoxins measured in all foods comprised aflatoxins (AFs), fumonisins (FBs), zearalenone (ZEN), T-2 toxin, deoxynivalenol (DON) and ochratoxin A (OTA). Higher incidence and levels were found for FBs, ZEN, and DON in several commonly consumed foods. Furthermore, 32.86 % foods had two to four quantifiable mycotoxins in various combinations. The mean estimated daily intake (EDI) values were lower than the tolerable daily intake (TDI) for AFs, FBs, and ZEN, but higher than the TDI (1.0 µg/kg bw/day) for DON, hence indicating a health risk for all children age groups. Preschoolers and adolescents were exposed to DON through wheat products (EDIs: 2.696 ± 7.372 and 1.484 ± 2.395 µg/kg body weight (bw)/day, respectively), while schoolers were exposed through wheat products (EDI: 1.595 ± 1.748 µg/kg bw/day) and rice (EDI: 1.391 ± 1.876 µg/kg bw/day). The results indicate that wheat-based foods and rice may be risky to children, implying the need for stringent measures to avoid DON contamination in these products.

Pre-vaccination seroprevalence of SARS-CoV-2 antibodies in the Volta Region, Ghana

Objectives

Before administration of the first dose of the AstraZeneca 2019 SARS-CoV-2 vaccine to selected prioritized groups in the Volta regional capital of Ghana, we determined the pre-vaccination status of prospective recipients and established the baseline exposure status 1 year after the first case was reported.

Methods

After informed consent, blood samples were collected for the detection of SARS-CoV-2 immunoglobulin (Ig) M/IgG antibodies using rapid diagnostic test kits. A total of 409 individuals (mean age 27 years) consented and participated in the study, comprising 70% students and others were health staff and educators who presented themselves for vaccination.

Results

The overall exposure rate of SARS-CoV-2 was 12.7% (95% confidence interval [CI] 9.6-16.3). The prevalence of SARS-CoV-2 IgM and IgG were 4.2% (95% CI 2.4-6.6) and 5.6% (95% CI 3.6-8.3), respectively. IgM and IgG were detected in 2.9% (95% CI 1.5-5.1) of the respondents. The exposure rates were higher in participants over 40 years old (15.5%). Participants without a history of COVID-19-like symptoms had an exposure rate of 13.0% and those without any chronic diseases was 13.2%.

Conclusion

Pre-vaccination exposure was relatively low and underscored the need for vaccination i to increase protection in communities and disease outcomes.

Prediction of poor exposure in endoscopic mitral valve surgery using computed tomography

OBJECTIVES

In endoscopic mitral valve surgery, optimal exposure is crucial. This study aims to develop a predictive model for poor mitral valve exposure in endoscopic surgery, utilizing preoperative body profiles and computed tomography images.

METHODS

We enrolled patients undergoing endoscopic mitral valve surgery with available operative video and preoperative computed tomography. The degree of valve exposure was graded into 0 (excellent), 1 (fair), 2 (poor) and 3 (very poor). Intrathoracic dimensions-anteroposterior width (chest anteroposterior) and left-to-right width (chest width) of the thorax, height of right hemi-thorax (chest height), angle between the left ventricular axis and the horizontal plane (left ventricle apex angle), heart width, level of diaphragm in midline, and vertical distance between the midline diaphragm level and the highest top of the right diaphragm (Δdiaphragm) were measured.

RESULTS

Among 263 patients, mitral valve exposure was graded as 0 in 131 (49.8%), 1 in 72 (27.4%), 2 in 46 (17.5%) and 3 in 14 (5.3%). Body mass index, chest width, left ventricle apex angle, heart width and Δdiaphragm were identified as independent predictors of grades 2 and 3 exposure by stepwise logistic regression analysis, with an area under the receiver operating characteristic curve of 0.822 (P < 0.001). Univariate logistic regression for grade 3 exposure prediction revealed that Δdiaphragm had the largest area under the curve (0.826, P < 0.001).

CONCLUSIONS

Poor mitral valve exposure occurred in approximately one-fourth of the endoscopic surgery series and might be predicted preoperatively using body mass index and computed tomography measurements to help determine the surgical approach.

Exposure to MEHP during Pregnancy and Lactation Impairs Offspring Growth and Development by Disrupting Thyroid Hormone Homeostasis

Mono(2-ethylhexyl) phthalate (MEHP), as a highly toxic and biologically active phthalate metabolite, poses considerable risks to the environment and humans. Despite the existence of in vitro studies, there is a lack of in vivo experiments assessing its toxicity, particularly thyroid toxicity. Herein, we investigated the thyroid-disrupting effects of MEHP and the effects on growth and development of maternal exposure to MEHP during pregnancy and lactation on the offspring modeled by SD rats. We found that thyroid hormone (TH) homeostasis was disrupted in the offspring, showing a decrease in total TH levels, combined with an increase in free TH levels. Nonhomeostasis ultimately leads to weight loss in female offspring, longer anogenital distance in male offspring, prolonged eye-opening times, and fewer offspring. Our findings indicate that maternal exposure to MEHP during pregnancy and lactation indirectly influences the synthesis, transport, transformation, and metabolism of THs in the offspring. Meanwhile, MEHP disrupted the morphology and ultrastructure of the thyroid gland, leading to TH disruption. This hormonal disruption might ultimately affect the growth and development of the offspring. This study provides a novel perspective on the thyroid toxicity mechanisms of phthalate metabolites, emphasizing the health risks to newborns indirectly exposed to phthalates and their metabolites.

Risk of exposure to aflatoxin M1 through consumption of cow's milk among children in Magadu, Morogoro

Aflatoxin M1 (AFM1) contamination of milk affects the general population with particular attention to children who frequently consume milk as part of complementary food. This study determined AFM1 contamination of cow's milk and estimated the health risk of dietary AFM1 through consumption of cow's milk among children (6 to 36 months) in the Magadu ward of Morogoro region in Tanzania. A total of 165 mother-baby pairs were recruited and interviewed on child feeding practices with a focus on feeding of cow's milk in the past 24 h. Alongside the interview, 100 raw cows' milk samples were collected from subsampled respondent households and were analyzed for AFM1 using enzyme-linked immunosorbent assay (ELISA). The results showed that about 35% of the surveyed children consumed cow's milk in the form of plain milk, incorporated in porridge and/or tea. The amount consumed varied from 62.5 to 500 mls with a median of 125 (125, 250) mls at a frequency of 1 to 2 times a day. All raw cows' milk (100%) samples (n = 100) were found contaminated with AFM1 at concentrations ranging from 0.052 to 9.310 µg/L and median of 2.076 µg/L (1.27, 2.48). All samples were contaminated by AFM1 at levels above the limits of 0.05 µg/L of raw milk set by the Tanzania Bureau of Standard and the European Union, while 97% exceeded 0.5 µg/L set by the US Food and Drug Administration. Exposure to AFM1 due to consumption of cow's milk ranged from 0.0024 to 0.077 µg/kg bw per day with a median of 0.019 (0.0016, 0.026) µg/kg bw per day, while the margin of exposure (MOE) ranged from 5.19 to 166.76 and median 20.68 (15.33, 25.40) implying high risk of public health concern. This study recommends that advocacy on consumption of cows' milk to combat undernutrition in children should consider a holistic approach that considers the milk's safety aspect.

In vitro susceptibility of Neisseria gonorrhoeae to netilmicin and etimicin in comparison to gentamicin and other aminoglycosides

PURPOSE

Single doses of gentamicin have demonstrated clinical efficacy in the treatment of urogenital gonorrhea, but lower cure rates for oropharyngeal and anorectal gonorrhea. Formulations selectively enriched in specific gentamicin C congeners have been proposed as a less toxic alternative to gentamicin, potentially permitting higher dosing to result in increased plasma exposures at the extragenital sites of infection. The purpose of the present study was to compare the antibacterial activity of individual gentamicin C congeners against Neisseria gonorrhoeae to that of other aminoglycoside antibiotics.

METHODS

Antimicrobial susceptibility of three N. gonorrhoeae reference strains and 152 clinical isolates was assessed using standard disk diffusion, agar dilution, and epsilometer tests.

RESULTS

Gentamicin C1, C2, C1a, and C2a demonstrated similar activity against N. gonorrhoeae. Interestingly, susceptibility to the 1-N-ethylated aminoglycosides etimicin and netilmicin was significantly higher than the susceptibility to their parent compounds gentamicin C1a and sisomicin, and to any other of the 25 aminoglycosides assessed in this study. Propylamycin, a 4'-propylated paromomycin analogue, was significantly more active against N. gonorrhoeae than its parent compound, too.

CONCLUSION

Selectively enriched gentamicin formulations hold promise for a less toxic but equally efficacious alternative to gentamicin. Our study warrants additional consideration of the clinically established netilmicin and etimicin for treatment of genital and perhaps extragenital gonorrhea. Additional studies are required to elucidate the mechanism behind the advantage of alkylated aminoglycosides.