Search Results (3,180)

Rare earth elements (REEs) are increasingly recognized as modulators of male reproductive health. This review presents the first comprehensive and critical analysis of the detrimental and potentially beneficial effects of REEs on male vertebrate reproductive function. In vivo and in vitro studies show that elements, particularly Gadolinium, Lanthanum, and Yttrium, share a toxicological profile characterized by oxidative stress, inflammation, mitochondrial dysfunction, endocrine disruption, and impairment of the blood–testis barrier. These mechanisms converge on both somatic and germ cell populations, ultimately compromising spermatogenesis and hormonal balance. Limited epidemiological data in humans are consistent with experimental findings, indicating inverse associations between seminal REE levels and sperm quality. CeO₂ nanoparticles represent an exception, showing dose-dependent duality: although some murine studies describe toxic effects, a broader and more consistent body of evidence indicates their protective action by restoring testicular homeostasis in diabetic models, in rats exposed to pesticides, pharmacological agents or irradiation, and in in vitro-treated spermatozoa. Preliminary data on Yttrium (YO) and Gadolinium (GdVO₄) nanoparticles similarly point to protective effects under pathological conditions, whereas Neodymium and Samarium show reproductive toxicity, including hormonal disruption and impaired sperm quality. Overall, REEs cannot be considered a homogeneous class: some pose reproductive hazards, others show potential biomedical utility. A systematic, mechanistic research framework is needed to resolve these dualities. It should contextualise reproductive risks in relation to the growing environmental and occupational exposure to REEs, while simultaneously exploring the biomedical potential of those elements that exhibit protective profiles. Full article

Honey is a natural food product highly valued for its nutritional and biological properties. Its quality and safety are increasingly affected by environmental contamination and apicultural practices. Among the most relevant contaminants, pesticide residues, veterinary antibiotics, and heavy metals represent major concerns due to their potential impact on human health. This review provides a comprehensive overview of the occurrence, sources, and distribution of these contaminants in honey, with particular emphasis on their relationship with agricultural activities, environmental pollution, and beekeeping treatments. Advanced analytical techniques, including liquid chromatography–tandem mass spectrometry (LC-MS/MS), gas chromatography–mass spectrometry (GC-MS), and inductively coupled plasma–mass spectrometry (ICP-MS), are highlighted for their ability to enable sensitive multi-residue and trace-level detection. The application of chemometric tools for data analysis and sample classification is also addressed, supporting the identification of contamination patterns and origin-related differences. In addition, recent developments in rapid screening methods and environmentally sustainable analytical approaches are discussed. Overall, this review emphasizes the importance of continuous monitoring and the integration of advanced analytical strategies to ensure honey safety, support regulatory compliance, and protect consumers. Full article

Inflammation can either encourage or suppress tumor growth, thus having a two-sided effect on cancer development. This depends on the balance between pro-tumor and anti-tumor immune responses within the tumor microenvironment (TME). Pro-tumor inflammation, driven by specific immune cells, enhances blood flow and nutrient supply to tumors, promoting the activation of dormant cancer cells (DCCs). Conversely, antitumor inflammation hinders blood flow and can force active cancer cells into a state of dormancy. Tumors actively shift this balance towards pro-tumor inflammation to create a favorable environment for growth. Therefore, anti-inflammatory therapy may be an integral part of comprehensive cancer immunotherapy. This review explores how different anti-inflammatory medications, such as glucocorticoids, non-steroidal anti-inflammatory drugs (NSAIDs), antihistamines, anti-leukotrienes, statins, drugs that block pro-inflammatory cytokines, agents that inhibit oxidative phosphorylation, antioxidant vitamins, anti-angiogenic drugs, and low-dose chemotherapy, can be used to combat cancer. Granulocyte counts and erythrocyte sedimentation rate (ESR) can be used to assess inflammation levels and the effectiveness of anti-inflammatory treatments. We advocate for a paradigm shift in cancer treatment, moving away from aggressive tumor destruction, which triggers uncontrolled tumor regeneration, toward long-term immunological control of tumor growth while preserving the patient’s overall health. Full article

Objective: The long-term management of cardiovascular diseases (CVDs) requires comprehensive rehabilitation strategies aimed at optimizing functional recovery and promoting behavioral changes. These interventions may include digital technologies that emerged as promising approaches to facilitate lifestyle changes, such as dietary behavior and physical activity (PA). Aim: This review aimed to synthesize the current evidence for the potential impact of remotely delivered nutrition interventions with or without a combination of PA interventions on biochemical biomarkers, cardiovascular indexes, anthropometric parameters, levels of PA, exercise and functional capacity, adherence to the Mediterranean Diet (MD), diet quality and quality of life, rehospitalization, urgent visits, death and acute events in adults (≥18 years) with CVDs. Secondary outcomes were accessibility, safety, usability, and adherence. Methods: The PubMed, Web of Science, and Scopus databases were comprehensively searched up to 2026 for Randomized Controlled Trials (RCTs) published in English, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The methodological quality was assessed using the revised Cochrane Risk of bias tool for RCTs (RoB2). Results: 11 RCTs met the inclusion criteria. Sample sizes ranged from 66 to 879 participants. The duration of the interventions varied from 4 weeks to 12 months. The interventions were delivered remotely using a range of digital health technologies, including web-based programs, mobile phones, wearable devices, smartphone applications, and mini-apps. Favorable changes were observed in diet quality and in adherence to MD and PA levels, with no intervention-related adverse events reported. The RoB2 assessment indicated that the majority of included studies (6 out of 11) were classified as having some concerns regarding risk of bias. Conclusions: Remotely combined nutrition and PA interventions are a feasible and effective approach for improving mainly patient-reported outcomes in adults with CVDs. These findings support integrating remote multimodal rehabilitation into routine cardiovascular care and highlight the potential of telehealth-based models to enhance patients’ access to rehabilitation services. Full article

Metabolic diseases, including obesity and type 2 diabetes mellitus, represent a major global health burden and are closely linked to the composition and function of the gut microbiota. Advances in molecular methods have enabled detailed characterization of microbial communities and their interactions with diet, medications, and host physiology, positioning the microbiome as an active metabolic organ. However, the field faces persistent challenges in distinguishing causal relationships from associations, largely owing to substantial biological, exposure-related, and methodological heterogeneity. This review systematizes the principal lines of evidence connecting the gut microbiome to metabolic disorders and critically examines the sources of variability that limit reproducibility and cross-cohort transferability of these findings. We discuss the taxonomic, functional, and metabolite-based levels of microbiome analysis, evaluate the strengths and limitations of cross-sectional, case–control, cohort, and interventional study designs, and consider approaches for establishing causality, including fecal microbiota transplantation, Mendelian randomization, mediation analysis, causal diagrams, and triangulation of evidence. We conclude that only a comprehensive, standardized, and causally informed approach will allow reliable discrimination between true microbiota-driven effects and methodological artifacts, thereby advancing the integration of microbiome science into the management of metabolic diseases and diabetes. Full article

Background/Objectives: This study aimed to comprehensively evaluate the interaction between periodontal disease, sleep quality, and quality of life and to investigate the effects of the presence and severity of periodontal disease on individuals’ sleep patterns and oral health-related quality of life. Materials and Methods: A total of 195 individuals were included in the study. Participants’ sociodemographic data and dental habits were recorded. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while the impact of oral health on quality of life was evaluated using the Oral Health Impact Profile-14 (OHIP-14). Results: A significant difference was observed in OHIP-14 scores among the groups (p < 0.001), with median values of 6, 13, and 22 in the healthy, gingivitis, and periodontitis groups, respectively. OHIP-14 scores also increased significantly with the stage and grade of periodontitis (p < 0.001). PSQI scores differed significantly among the groups (p < 0.001), with median values of 4, 8, and 10 in the healthy, gingivitis, and periodontitis groups, respectively. However, no significant differences were observed in total PSQI scores across the stages or grades of periodontitis. In addition, a strong positive correlation was found between total PSQI and OHIP-14 scores (r = 0.63, p < 0.001). Multiple linear regression analysis confirmed that periodontal status remained independently associated with both PSQI and OHIP-14 scores after adjusting for age, sex, education level, and smoking status, with periodontitis showing the strongest association in both models (PSQI: B = 5.03; OHIP-14: B = 15.80, both p < 0.001). Conclusions: A significant relationship was identified between periodontal disease, sleep quality, and oral health-related quality of life. Furthermore, the strong positive correlation between sleep quality and oral health-related quality of life suggests that deterioration in sleep quality may be associated with poorer oral health-related quality of life. These findings indicate that periodontal health is not limited to oral tissues but is also closely associated with an individual’s overall well-being. Full article

Obesity is currently recognized as a global epidemic and contributes to numerous health complications. It is strongly associated with poor dietary habits, including the widespread availability and consumption of high-calorie foods. We conducted a narrative review of publications from major biomedical databases addressing obesity treatment and public-health interventions. One of the strategies for managing obesity is lifestyle modification—balanced diet and regular physical activity—supported by pharmacological and psychological treatment, and, in selected patients, metabolic and bariatric surgery. Beyond patient-level care, public-health-oriented measures should be considered, including taxation of sugar-sweetened beverages, restriction on advertising of unhealthy foods, regulation of the school food environment, front-of-pack nutrition labelling, mandatory food reformulation, subsidies and incentives for healthy foods, urban-planning policies that promote physical activity, and policies that expand access to bariatric surgery. A comprehensive approach integrating clinical care with public-health policy is likely to yield more effective outcomes than either alone. Full article

Based on microscopic survey data of 10,057 kiwifruit growers from the Shaanxi, Guizhou, and Sichuan provinces in China, this study takes the initial and sustained adoption of low-carbon agricultural technology by farmers as dependent variables. A comprehensive evaluation system is constructed based on the digital capability of farmers. The system covers four dimensions, namely, digital access, digital acquisition, digital processing, and digital sharing. Multiple empirical models, including Lasso regression, extreme gradient boosting, random forest, and back propagation neural network are adopted to compare the fitting and predictive performance of different approaches. The model comparison results demonstrate that the random forest model presents the optimal fitting performance among all alternative specifications. To identify the core influencing factors and explore the underlying mechanisms, this study employs the SHAP method to quantitatively evaluate the marginal contribution of each variable. The empirical findings reveal that the digital capability of farmers significantly and positively promote both initial and sustained adoption of low-carbon agricultural technology with distinct dimensional heterogeneity. Specifically, digital access and digital acquisition capability act as core driving factors for the initial adoption of technologies by farmers, while digital processing and digital sharing capability play a decisive role in facilitating sustained low-carbon technology application. In addition, farmers’ education level, health status, household income, cooperative participation, and household labour scale are crucial characteristic variables affecting the behaviours of farmers in the adoption of low-carbon technology across different stages. Accordingly, this study proposes targeted policy implications for low-carbon agricultural development. On the basis of promoting digital rural construction and improving the systems of digital skill training and digital agricultural technical services, it is essential to strengthen dynamic tracking surveys of farmers, accurately identify their technology adoption stages, and implement differentiated supporting policies. These targeted measures can effectively consolidate and assess the low-carbon production behaviours of farmers and promote the long-term and sustainable development of low-carbon agriculture. Full article

Compound hot–humid events are placing increasing pressure on urban health and land-use governance as climate warming and urban expansion continue. This study examined urban built-up areas in 21 prefecture-level cities and prefectures of Sichuan Province for 2000, 2005, 2010, 2015, 2020, and 2024. Using the IPCC hazard–exposure–vulnerability framework, ERA5-Land, MODIS land-cover, GHSL population, and socioeconomic data were combined to construct the Humid Heat Hazard Index (HI), Population-Density Exposure Index (EI), Socioeconomic Vulnerability Index (VI), and Comprehensive Urban Heat–Humidity Risk Index (HHRI). Contribution decomposition, LISA, and standard deviation ellipse analysis were then used to examine risk changes and spatial patterns. The mean HHRI decreased from 0.42 to 0.24, but rebounds appeared in 2010 and 2024. HI varied strongly among years and drove short-term risk changes, EI declined continuously, and VI dropped from 0.87 to 0.30, making it the main factor behind long-term risk reduction. Higher-risk areas were mainly located in southern Sichuan, southeastern Sichuan, and the central-eastern Sichuan Basin. LISA results showed high-risk clusters in basin cities and low-risk clusters on the western Sichuan Plateau. The standard deviation ellipse remained mostly within the basin and followed the basin urban belt. Future adaptation should combine public-service improvement with heat warnings, cooling services, and emergency preparedness. Full article

Background: Dementia is a global health priority affecting more than 55 million people worldwide, with projections indicating this figure will rise to 139 million by 2050. People living with dementia (PLWD) face profound difficulties accessing primary care services—the critical gateway to dementia diagnosis, ongoing management, and coordinated specialist referral. Despite growing evidence on individual barriers, a comprehensive synthesis integrating patient, caregiver, and system-level perspectives is lacking. Objectives: This systematic review and meta-synthesis aimed to identify, appraise, and synthesize evidence on the barriers and facilitators experienced by PLWD and their caregivers when accessing primary care services, and to propose evidence-based recommendations to address inequities. Methods: A systematic search was conducted to identify relevant articles in six electronic databases: PubMed, MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library, and Web of Science from January 2000 to December 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Qualitative, quantitative, and mixed-methods studies reporting barriers or facilitators to primary care access for PLWD were included. A convergent integrated synthesis and thematic meta-synthesis approach was applied. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: Forty-three studies from 18 countries met inclusion criteria. Barriers were categorized across five domains: (1) patient-level factors (stigma, denial, symptom normalization, and limited health literacy); (2) caregiver-level factors (burden, late symptom recognition, and cultural barriers); (3) provider-level factors (insufficient training, therapeutic nihilism, and time constraints); (4) system-level factors (fragmented care pathways, long waiting times, and poor care coordination); and (5) structural and societal factors (rurality, poverty, and ethnic minority status). Facilitators included caregiver advocacy, strong patient–GP relationships, dementia literacy campaigns, availability of memory clinics, and integrated care models. Disparities were consistently greater for ethnic minority groups, rural populations, and those with lower socioeconomic status. Conclusions: Barriers to primary care access in dementia are complex, overlapping, and mutually reinforcing. Effective strategies require multi-level interventions addressing individual, relational, provider, and system dimensions simultaneously. Full article

Clinical biochemical reports should reflect the clinical perspective, be well organized and biologically oriented, and present accurate reference values based on clinically relevant distributions. To illustrate possible quality issues, we selected Clinical Cases from The New England Journal of Medicine as it publishes comprehensive reports to teach internationally relevant high-level workups. We evaluated their organization with a system organ grouping and the consistency of reference values between comparable cases. We found that the ordering of tests varied across issues, and associated interpretative tests were not organized in a scholarly manner. In several cases, the reference values for hemoglobin did not align with WHO recommendations, the upper reference value for glycohemoglobin did not correspond to established guidelines, and the upper reference value for creatinine did not reflect internationally standardized methods. The ferritin reference values in young women were not adjusted for the postmenopausal age group. When searching for incident blood loss using a common reference in young women and those of postmenopausal age in a large primary health care cohort, the frequency of flagged low ferritin results was so low that the ratio of flagged results to the incidence rate of colorectal cancer was only 1.1 (0.95 confidence interval 1.0 to 1.3). In men, low ferritin flagging was far more prevalent, resulting in a ratio of 11.7 (0.95 confidence interval 11.2 to 12.1). Thus, men had an 11-fold higher theoretical relative sensitivity when detecting occult iron loss compared with women. System organ assessment is a basic clinical competence, and system organ classification for clinical biochemical tests could be used to organize clinical laboratory reports. The reference values provided should be biologically based, harmonized, and readily recognizable by the clinician to accurately guide decisions, in contrast to local procedural determinations. Examination of local laboratory data may reveal biased laboratory support. Full article

Anthropogenic air pollution represents a significant threat to both environmental and human health, with nitrogen oxides (NO_x) playing a substantial role in the formation of photochemical smog, acid rain, eutrophication, and respiratory diseases. In Bangladesh, NO_x emissions primarily originate from combustion sources such as road transportation, power generation, and industrial activities, while natural sources include lightning, wildfires, and soil emissions. Furthermore, ammonia emissions from fertilizers and livestock exacerbate air quality issues in both urban and rural settings. Despite the acknowledgment of vehicular and industrial contributions, comprehensive and systematic assessments of NO₂ trends across the nation remain scarce. This study presents a complementary, side-by-side assessment of ground-based NO₂ measurements from the Department of Environment (DoE) with atmospheric NO₂ retrieved from the Sentinel-5P TROPOMI Level-3 product via Google Earth Engine (GEE). Spatial distribution patterns of both ground-level and atmospheric NO₂ were analyzed using ArcGIS Pro, along with seasonal and interannual trend assessments from 2018 to 2024. Results indicated pronounced spatial and temporal variability in NO₂ concentrations. The highest levels were consistently recorded over Dhaka and surrounding industrial zones, with moderate accumulation in Chattogram. Winter months (December–February) exhibited hazardous concentrations, with a national maximum of 205.21 µg/m³, while monsoon periods recorded the lowest levels overall, as reflected in its seasonal mean (see below). Seasonal averages indicated the highest concentrations in winter (35.03 µg/m³), followed by pre-monsoon (29.16 µg/m³), with monsoon recording the lowest seasonal mean (19.94 µg/m³). Long-term analysis showed the highest national annual mean NO₂ con-centration in 2018 (44.32 µg/m³), decreasing to 14.81 µg/m³ by 2024, with non-monotonic year-to-year fluctuation in the intervening period (2020–2021 data were unavailable). These findings underscore the necessity for stricter emission regulations and targeted mitigation measures. As a policy recommendation, this may include the implementation of NO_x-selective catalytic reduction (SCR) using NH₃ over metal oxide and zeolite catalysts. This study provides evidence-based insights to support cleaner air initiatives and sustainable environmental management strategies in Bangladesh. Full article

Background/Objectives: Sleep disorders are common among older adults and have been increasingly linked to metabolic abnormalities and non-communicable diseases (NCDs). However, evidence on the relationship between sleep quality and health-related clinical outcomes and biomarkers in rural Northern Thailand remains limited. This study aimed to assess the association between sleep quality and health-related clinical outcomes and biomarkers among older adults in rural Northern Thailand. Methods: A cross-sectional study was conducted among 424 older adults in Phayao Province, rural Northern Thailand. Quota sampling was employed to ensure equal representation of participants with and without NCDs (n = 212 per group). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Physical health status was evaluated through measurements of blood pressure (BP), including systolic blood pressure (SBP) and diastolic blood pressure (DBP), and fasting blood sugar (FBS). Results: The participants’ mean PSQI score was 8.03 ± 4.86, and 29.7% had poor sleep quality (PSQI > 5). Hypertension (35.4%) and diabetes mellitus (17.5%) were the most common underlying diseases. The mean fasting blood sugar level was 116.33 ± 30.84 mg/dL, with 21.0% of participants presenting abnormal levels (≥126 mg/dL). Multivariable binary logistic regression demonstrated that each one-point increase in the overall PSQI score was significantly associated with higher odds of having an underlying disease (adjusted odds ratio [AOR] = 2.37; 95% confidence interval [CI]: 2.00–2.81), hypertension (AOR = 1.51; 95% CI: 1.37–1.66), diabetes mellitus (AOR = 1.42; 95% CI: 1.28–1.58), other non-communicable diseases (AOR = 1.94; 95% CI: 1.64–2.29), abnormal fasting blood sugar (AOR = 1.47; 95% CI: 1.33–1.63), elevated systolic blood pressure (AOR = 1.39; 95% CI: 1.28–1.51), and elevated diastolic blood pressure (AOR = 1.30; 95% CI: 1.19–1.43). Subjective sleep quality, sleep duration, and habitual sleep efficiency were also significantly associated with multiple health-related clinical outcomes and biomarkers. Although sparse data and quasi-complete separation may have influenced the precision of some regression estimates, the overall pattern of associations remained consistent and should be interpreted with appropriate caution. Conclusions: Higher overall PSQI scores were significantly associated with adverse health-related clinical outcomes and biomarkers among older adults in rural Northern Thailand. These findings highlight the clinical importance of routinely assessing sleep quality in older adults, particularly those with chronic conditions or increased cardiometabolic risk. Because of the cross-sectional design and the statistical uncertainty associated with sparse data in some regression models, the findings should be interpreted as evidence of associations rather than causal relationships. The observed associations are consistent with the likely bidirectional relationship between sleep disturbances and chronic diseases. Integrating sleep quality screening into routine health assessments, alongside comprehensive chronic disease management, may facilitate the early identification of older adults at increased cardiometabolic risk and support evidence-based health promotion strategies. Full article

Fever is one of the most common health conditions traditionally treated with medicinal plants in rural communities, yet comprehensive documentation of antipyretic ethnomedicinal knowledge in northeastern Thailand remains limited. This study presents a focused ethnobotanical analysis of medicinal plants used for fever treatment in Yasothon Province, northeastern Thailand, and assesses informant agreement regarding their antipyretic use using the fidelity level (FL). Ethnomedicinal data were collected through semi-structured interviews, participant observation, and guided field walks with 108 informants from nine districts between April 2024 and February 2026, and records related to fever treatment were extracted for detailed analysis. Voucher specimens were collected and taxonomically verified. A total of 129 medicinal plant species belonging to 108 genera and 46 families were recorded. Fabaceae was the most represented family, while native species predominated (83.72%). Trees constituted the largest growth form (45.74%), and wild plants accounted for 62.02% of all recorded species. Roots were the most frequently used plant part (39.53%), and decoction was the principal preparation method (93.02%). Twenty-five species exhibited an FL value of 100%. These findings highlight the richness of traditional antipyretic knowledge in Yasothon Province and provide a useful baseline for the preservation of biocultural heritage and for future ethnopharmacological research on medicinal plants used in fever treatment. Full article

Micro- and nanoplastics (MNPs) are emerging environmental pollutants, but evidence concerning their effects on endometrial injury and adverse pregnancy outcomes remains limited. Therefore, we employed the Targeted Risk Assessment of Environmental Chemicals (TRAEC) strategy to integrate evidence concerning endometrial injury and adverse pregnancy outcomes associated with exposure to MNPs. Following targeted screening, 21 unique studies yielded 24 literature-derived evidence entries. Together with one additional in vitro evidence item from the present study, 25 evidence items were included in the final CES calculation. The available evidence was quantitatively integrated across four predefined TRAEC dimensions: Reliability Scores, Weight of Concentrations, Risk Intensity, and Correlation Scores. Under the tested in vitro conditions, exposure to PS-NPs increased intracellular ROS accumulation, reduced mitochondrial membrane potential, promoted apoptosis, and decreased the expression of key endometrial receptivity proteins, namely HOXA10, FOXO1, and ITGB3, in primary human endometrial stromal cells. Based on this combined evidence pool, the final Comprehensive Evidence Score was 7.67, corresponding to a preliminary moderate-risk classification within the predefined TRAEC framework. In summary, the TRAEC strategy provides a structured approach for integrating multi-level evidence and deriving a framework-specific health-risk classification for exposure to MNPs. Full article