Search Results (16,409)

Aflatoxins are widespread hepatotoxic food contaminants, yet age-specific cumulative exposure to multiple aflatoxins and associated health risks remain poorly characterized. This study assessed cumulative dietary exposure to aflatoxin B₁ (AFB₁), B₂, G₁, and G₂, and hepatocellular carcinoma (HCC) risk across five age groups, evaluating the influence of packaging and retail sources on contamination. Contamination data of 1179 food samples and consumption data were integrated to calculate the margin of exposure (MoE) and annual HCC incidence. AFB₁ was most frequently detected and often co-occurred with other aflatoxins; bulk vegetable oils showed the highest total aflatoxin detection rate. Roasted peanuts contributed most to aflatoxin exposure, particularly among children aged 3–6 (MoE 900–1206). Rice, rice products, and coarse grains were primary contributors to aflatoxin-attributable HCC risk (0.008 cases per 100,000 person-years). Overall contamination was significantly higher in bulk products than in pre-packaged foods (p < 0.05) and in samples from farmers’ markets and grocery stores than in other sites (p < 0.05). These findings reveal non-negligible aflatoxin-related health risks for Guangzhou residents, especially young children and frequent consumers of staple grains and nuts. Targeted monitoring of high-risk foods and retail environments and age-specific dietary guidance are recommended to reduce population-level aflatoxin exposure and HCC risk. Full article

Background: Vitamin D deficiency is a common global health problem and remains highly prevalent in Türkiye, where limited food fortification and heterogeneous clinical practices contribute to variability in testing and supplementation strategies. Aims: To provide Türkiye-specific best practice recommendations for defining clinically relevant serum 25-hydroxyvitamin D [25(OH)D] thresholds, identifying adult risk groups for targeted testing, and recommending evidence-based prevention, treatment, and monitoring approaches while minimizing under-treatment and inappropriate high-dose use. Methods: This national expert consensus document was developed by endocrinologists from across Türkiye using a structured, modified Delphi methodology. Draft statements informed by systematic literature reviews were rated via online surveys using a 9-point Likert scale, followed by two Delphi rounds and a face-to-face consensus meeting in İstanbul in October 2025. Results: Recommendations addressed sun exposure, laboratory assessment, screening, supplementation, treatment, and follow-up. Serum 25(OH)D <20 ng/mL was defined as deficiency and <12 ng/mL as severe deficiency, with a target range of 20–50 ng/mL. Routine population-wide screening was not recommended; instead, targeted testing in high-risk adults and symptom-driven biochemical evaluation were endorsed. Empiric supplementation was recommended for selected high-risk groups, with cholecalciferol as the preferred agent. Higher individualized doses were suggested in obesity or malabsorption, while loading regimens were reserved for specific clinical indications, such as severe deficiency or certain medical conditions that impair vitamin D metabolism. Reassessment of 25(OH)D at 8–12 weeks was recommended. Conclusion: These consensus-based recommendations provide a practical, context-specific framework for assessing, preventing, treating, and monitoring vitamin D deficiency in adults in Türkiye. Full article

Thyroid hormones (THs) are essential regulators of human brain development, and disrupted TH availability during pregnancy or early life is linked to adverse neurodevelopmental outcomes. Concerns that environmental chemicals interfere with TH signalling have increased the need for human-relevant in vitro systems to identify thyroid hormone system-disrupting chemicals (THSDCs) for risk assessment. Here, we compared two human-induced pluripotent stem cell (hiPSC)-derived brain organoid models for THSDC assessment: (i) human cortical organoids (COs) generated by unguided differentiation, offering higher architectural complexity but lower throughput; and (ii) neural stem cell-derived organoids (NSCOs), designed for scalability with reduced cellular diversity. Both models expressed key TH handling components, including the transporter SLC16A2 (MCT8) and the inactivating enzyme DIO3. Using LC–MS/MS, we show that exogenous T3 is depleted from culture media and metabolized to 3,3′-T2 and 3′-T1 in both models, alongside upregulation of T3-responsive genes (HR, KLF9, DIO3, SEMA3C). Pulse and chronic co-exposures to reference disruptors iopanoic acid (IA, deiodinase inhibitor) and silychristin (SC, MCT8 inhibitor) altered T3 metabolism and modulated T3-responsive transcriptional endpoints. In NSCOs, high-content imaging revealed treatment-associated changes in cell composition, with chronic T3 reducing the SOX2-positive progenitor pool and THSDCs blocking this effect. Together, these findings provide a framework for organoid qualification—linking TH handling, transcriptomic responsiveness, and scalable phenotypic readouts—as a necessary step toward model validation and implementation of brain organoids in THSDC risk assessment pipelines. Full article

Endoscopic spine surgery (ESS)—including full-endoscopic transforaminal and interlaminar techniques, and unilateral biportal endoscopy (UBE)—offers patients smaller incisions, preserved paraspinal muscle, and faster recovery. Because the working corridor is narrow, intraoperative fluoroscopy plays a larger role than in open or microscopic approaches, making radiation exposure worthy of attention for both patients and surgeons. This narrative review aims to be a practical resource for the endoscopic spine surgeon. We synthesize the available literature on typical radiation doses across the main ESS techniques, compare them with minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open alternatives, review the factors that drive exposure, and walk through the full menu of dose-optimization options—from simple measures such as collimation, pulsed fluoroscopy, and leaded eyewear, through navigation platforms, to robotic guidance. A consistent practical observation is that the simplest, least expensive interventions often deliver the largest dose reductions. Capital-intensive technologies add real value, particularly for endoscopic interbody fusion, and work best alongside rather than in place of these basics. With routine dosimetry and straightforward as-low-as-reasonably-achievable (ALARA) practices, surgeons can continue to build on the already favourable profile of ESS while keeping radiation exposure low. Conclusions are tempered by the largely retrospective and heterogeneous nature of the underlying evidence. Full article

CRC remains a major cause of cancer-related morbidity and mortality worldwide. In recent years, the gut microbiota has gained increasing attention in CRC research. Intestinal microbes are not passive bystanders in tumor development. They may promote persistent inflammation, disrupt epithelial barrier integrity, alter microbial metabolites, and affect host immune and signaling pathways. Emerging evidence also suggests that microbiota-related metabolites and microbial functional alterations may influence host epigenetic regulation, including DNA methylation and chromatin-associated signaling, thereby further shaping colorectal carcinogenesis. Together, these changes can create a microenvironment that favors tumor initiation and progression. Several bacterial species, including Fusobacterium nucleatum, Parvimonas micra, and Peptostreptococcus anaerobius, have been repeatedly associated with CRC. In contrast, beneficial commensal microbes and their metabolites, especially short-chain fatty acids, may help maintain intestinal homeostasis and limit tumor-promoting processes. Because the gut microbiota is strongly shaped by diet, lifestyle, and environmental exposure, regional differences are also relevant. This is particularly important in Sichuan, China, where distinctive dietary habits and environmental features may influence microbial patterns associated with CRC risk and disease behavior. This review summarizes the main mechanisms linking the gut microbiota to CRC, examines the regional context of Sichuan, China, and discusses current and emerging clinical strategies. These include dietary intervention, probiotics, fecal microbiota transplantation, and microbiome-informed approaches to prevention, diagnosis, and treatment. Full article

Background/Objectives: Patients in long-term care hospitals (LTCHs) are at increased risk of harboring antimicrobial-resistant organisms due to frequent healthcare exposure and multiple comorbidities. This retrospective observational study aimed to compare the antimicrobial susceptibility of bacterial isolates from LTCH-onset infections (LTCHIs) with those from community-acquired infections (CAIs) in elderly patients. Methods: This study was conducted at a 700-bed urban tertiary university hospital and included patients aged ≥65 years with positive cultures for bacteremia, lower respiratory tract infections (LRTIs), or urinary tract infections (UTIs) within 48 h of admission. Medical records, including antimicrobial susceptibility test results, were reviewed for a total of 1780 patients and their isolates. Antimicrobial susceptibility patterns were compared between LTCHI and CAI patients. Results: Patients with LTCHI exhibited significantly higher antimicrobial non-susceptibility than those with CAIs across multiple pathogens and antimicrobial classes (p < 0.05). In bacteremia, Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae from LTCHI cases showed increased non-susceptibility to β-lactams and fluoroquinolones. In LRTIs, Pseudomonas aeruginosa and Acinetobacter baumannii demonstrated high non-susceptibility to carbapenems (52.9% and 90%, respectively) and aminoglycosides. In UTIs, LTCHI isolates exhibited broader resistance among Enterobacterales and P. aeruginosa. Notably, the proportion of multidrug-resistant organisms, including carbapenem-resistant Enterobacterales (15.4–50.0%) and carbapenem-resistant Acinetobacter baumannii (90.5%), was substantially higher in the LTCHI group across all infection sites. Conclusions: Elderly patients with LTCHI are more likely to harbor antimicrobial-resistant pathogens than those with CAIs. Careful consideration of LTCHI origin is therefore essential for empirical antibiotic selection and for strategies aimed at limiting further resistance. Full article

Hydrogenotrophic denitrification (H₂Den) is a promising strategy for NO₃⁻ removal from a supply water with low or negligible organic carbon content. However, its performance may be affected by emerging contaminants (ECs), which pose increasing risks to the environment and human health. This study investigates the acute effect of two widely detected ECs, acetaminophen (ACN) and chloramphenicol (CHP), at a 200 mg/L concentration, on H₂Den using anaerobic granular sludge (AnGS) as inoculum. Acute exposure to ACN enhanced NO₃⁻ removal, likely due to the formation of oxidizable metabolites serving as electron donors through the heterotrophic pathway. On day 3, the residual NO₃⁻ concentration had already dropped below the regulatory limit of 50 mg/L, reaching 4.3 mg NO₃⁻/L. In contrast, CHP initially inhibited the denitrification process, resulting in limited NO₃⁻ removal, i.e., a residual concentration of 145.4 mg NO₃⁻/L on day 3. Nevertheless, short-term microbial adaptation likely enabled performance recovery under CHP exposure. On day 6, both EC exposure tests allowed a NO₃⁻ removal above 97%, although CHP resulted in residual NO₂⁻, i.e., 37 mg NO₂⁻/L. In the presence of ACN, the accumulation of gaseous denitrification intermediates was observed, with NO concentration in the headspace peaking at 9.5% (i.e., 16.2 × 10⁻² µg NO/min/g VS) on day 6. Thus, in terms of either the production of gaseous intermediates or the presence of residual nitrogen in the liquid phase, ACN and CHP significantly influenced the denitrification performance, highlighting the importance of considering their presence in the operation of the denitrification process. Full article

Background: Shift-working healthcare workers (HCWs) are at elevated cardiovascular (CV) risk due to chronic circadian disruption; however, gender-stratified data on CV risk profiles and modifiable risk factor distribution by occupational exposure duration remain scarce in the Italian hospital setting. This cross-sectional study aimed to characterise the 10-year CV risk profile and the distribution of modifiable risk factors in a hospital-based sample of shift-working HCWs. Methods: A retrospective cross-sectional study was conducted using data from routine occupational health surveillance of shift-working HCWs at a large Italian hospital in Salento, Southern Italy (survey year: 2025). The 10-year CV risk was estimated using the CUORE Project algorithm, validated for the Italian population. Risk was stratified by gender, age group, and shift work duration. Multivariable logistic regression models, adjusted for age, marital status, and presence of children at home, evaluated associations between selected risk factors and CV risk category. The study was reported in accordance with STROBE guidelines. Results: Of 765 HCWs included (320 males, 445 females; mean age 49.3 ± 8.5 years), male workers showed a significantly higher mean 10-year CV risk score (4.98 ± 2.8 vs. 1.34 ± 0.9; p < 0.05). Among male workers, the odds of moderate/high CV risk increased progressively with shift work duration (aOR 6.4 for >30 years). Males also showed significantly higher prevalence of arterial hypertension, overweight, and obesity across all strata. Conclusions: Male shift-working HCWs represent a higher-risk subgroup, characterised by a greater burden of modifiable cardiovascular risk factors. Integration of validated risk assessment tools into occupational health surveillance may support targeted preventive strategies in hospital settings. Full article

Air quality in the San Joaquin Valley (SJV) ranks among the worst in the US. Exposures to traffic-related air pollutants have been associated with pediatric health complications, and few studies have investigated respiratory complications in relation to short-term exposures to PM less than 2.5 microns in diameter (PM_2.5) in the SJV. We used Bayesian Poisson spatiotemporal conditional autoregressive models to analyze the association between PM_2.5 and pediatric respiratory emergency department (ED) visits in Fresno County, California. Additional analyses stratified respiratory outcomes by sex and age group. Weekly ambient PM_2.5 levels were estimated for each zip code using community science and regulatory air monitors. Weekly residential zip code counts of respiratory ED visits were provided by Fresno County Department of Public Health and Valley Children’s Hospital from 2 April 2022 to 31 December 2024. A ten-fold increase in PM_2.5 was associated with increased asthma ED visits among females (Relative Risk (RR):1.15; 95% Credible Interval (CrI):1.01, 1.32) and children aged 0 to 4 (RR:1.18; 95% CrI:1.03, 1.34) and other chronic respiratory conditions among males (RR:1.93; 95% CrI:1.19, 3.16) and ages 10 to 14 (RR:2.90; 95% CrI:1.32, 6.30). Findings suggest that efforts to better assess and reduce pollution exposures will improve public health in the SJV. Full article

Background/Objectives: Propranolol (PROP) is a non-selective β-blocker widely prescribed for cardiovascular and neurological disorders. Its pharmacokinetics (PK) are highly variable, and co-administration with omeprazole (OME), a CYP2C19 substrate and inhibitor, may alter systemic exposure. Herein, this study aimed to investigate factors influencing PROP PK variability and evaluate the effect of OME coadministration using physiologically based pharmacokinetic (PBPK) modeling and population PK (popPK) analysis. Methods: PBPK models for PROP and OME were developed and validated against published data. DDI simulations were conducted across clinically relevant dosing regimens. A two-period fixed-sequence virtual trial of 125 subjects was simulated with PROP alone and PROP combined with OME. Population PK (popPK) analysis was performed on simulated plasma concentration data to identify covariates affecting PROP disposition and quantify DDI magnitude. Results: PBPK models were successfully developed and validated. PROP disposition was best described by a two-compartment model with linear elimination. Health status was found to influence clearance, and body surface area (BSA) affected the central volume of distribution. Co-administration with OME increased PROP exposure, with larger effects in patients with renal impairment. Simulated plasma concentrations remained below established toxicity thresholds. Conclusions: Virtual clinical trials integrating PBPK and popPK modeling provide a robust approach to identifying key determinants of PK variability and DDI risk. Although these findings were not directly translated to clinical observations, this helps identify sources of PK variability in PROP treatment settings and factors that may intensify its interaction with OME, thereby supporting model-informed precision dosing to enhance safety and efficacy. Full article

Objectives: The aim of this study was to analyze current trends in screen exposure and to provide a deeper understanding of the relationships between temperament, screen exposure, and psychological adjustment in preschoolers. Methods: The study was conducted in kindergartens and one health center in the city of Zagreb, using a convenience sample of 115 mothers who assessed their preschool children’s screen exposure, temperament, and psychological adjustment. Results: Descriptive data analysis indicated that children’s screen time generally fell within the American Academy of Child and Adolescent Psychiatry’s recommended guidelines. Correlation analysis indicated that externalizing problems were significantly positively correlated with impulsivity, activity, emotionality, and weekend screen time. Conversely, prosocial behavior was negatively correlated with impulsivity and weekend screen exposure. Moderation analyses revealed that weekend screen time significantly altered the associations between temperament and externalizing problems. Specifically, longer weekend screen exposure weakened the relationships between Impulsivity and externalizing problem and between Activity and externalizing problems, suggesting that screen time may buffer the impact of high-risk temperament profiles on behavioral difficulties. Weekend screen time did not moderate the relationship between Emotionality and externalizing problems. Similarly, longer screen exposure weakened the negative association between Impulsivity and prosocial behavior, indicating that screen time may reduce the extent to which impulsive temperament undermines prosocial functioning in preschool children. Conclusions: These findings provide deeper insight into the role of temperament and screen time exposure in predicting both maladaptive and prosocial behaviors among preschool-aged children. Full article

Background: ABO-incompatible living-donor liver transplantation (ABOi LDLT) can expand the donor pool for patients with hepatocellular carcinoma (HCC), but concerns remain regarding tumor recurrence and long-term survival. Methods: A systematic review and meta-analysis was performed according to PRISMA 2020. PubMed, Embase, and Web of Science were searched. Comparative studies evaluating oncologic outcomes after ABOi versus ABO-compatible (ABOc) LDLT for HCC were included in the quantitative synthesis; non-comparative studies were included in the qualitative synthesis. Hazard ratios (HRs) for recurrence-free survival (RFS) and overall survival (OS) were pooled using a random-effects model. When HRs were not directly reported, they were estimated from Kaplan–Meier curves using established methods. Results: Sixteen reports were screened, 12 full-text articles were assessed, and 8 studies were included in the systematic review. Three comparative single-center cohort studies were eligible for meta-analysis. Pooled analysis showed no significant difference between ABOi and ABOc LDLT for RFS (HR 1.07, 95% confidence interval [CI] 0.77–1.49; I² = 0%) or OS (HR 1.08, 95% CI 0.74–1.57; I² = 0%). Five additional studies were synthesized qualitatively, suggesting that recurrence risk may be influenced more by tumor biology and peri-transplant management, including desensitization intensity and immunosuppression exposure, than by ABO incompatibility itself. Conclusions: Current limited comparative evidence does not demonstrate inferior RFS or OS after ABOi LDLT in carefully selected patients with HCC. Larger multicenter comparative studies with standardized reporting of tumor biology, desensitization protocols, and immunosuppression exposure are warranted to confirm these findings and clarify protocol-related effects on post-transplant recurrence. Full article

Sports-related injuries remain a major challenge in team sports, with important consequences for athlete health, performance, and team success. Recent advances in artificial intelligence (AI) and sensor-based monitoring technologies have enabled the integration of large volumes of training, competition, and physiological data to support injury prediction and risk modelling. However, the literature is characterised by substantial methodological diversity, limiting the ability to draw consistent conclusions. Hence, this scoping review aimed to map the existing evidence on the use of AI and sensor-based monitoring technologies for injury prediction and risk modelling in team sports, and to identify key methodological trends and research gaps. The scoping review was conducted in accordance with the PRISMA-ScR guidelines. Systematic searches were performed in PubMed and Scopus. Eligible studies included team-sport athletes and applied AI or machine learning approaches to predict injury occurrence, injury risk, or related outcomes using data derived from wearable or monitoring systems. Data were charted on study characteristics, sports and competition level, data sources, modelling techniques, validation strategies, and performance metrics. The database search yielded 123 records (PubMed: n = 37; Scopus: n = 86). After screening and eligibility assessment, 11 studies met the inclusion criteria. Most studies focused on football and rugby and relied primarily on wearable-derived data, particularly GPS and inertial sensor outputs. Common predictors included external workload variables, training exposure, previous injury history, and, in some studies, wellness or physiological markers. A wide range of models was reported, including logistic regression, decision trees, random forests, support vector machines, and neural networks. Validation strategies and reported performance varied markedly, and external validation was rarely undertaken. Across the included studies, injury risk was most consistently associated with external workload metrics, previous injury history, and internal or physiological indicators of recovery and readiness. However, current models remain limited by heterogeneous methodologies, single-team datasets, and the lack of external validation. Future research should emphasise multimodal data integration and multi-centre validation to develop reliable, interpretable, and practically applicable AI-based injury prediction systems. Full article

This study aimed to establish a rapid analytical method for the determination of 69 pesticide residues in Platycodonis Radix using GC-MS/MS and UHPLC-MS/MS, as well as carry out a dietary risk assessment on 42 batches of Platycodonis Radix samples collected from different geographical origins. Samples were prepared using the QuEChERS method, followed by high-speed centrifugation and membrane filtration, and the target pesticides were analyzed in selected reaction monitoring (SRM) mode via GC-MS/MS and in multiple reaction monitoring (MRM) mode via UHPLC-MS/MS. Among the 42 tested batches of Platycodonis Radix samples, 3 out of 27 pesticide compounds were detected via GC-MS/MS screening, while only 1 pesticide compound was positive from the 42 compounds determined via UHPLC-MS/MS, and the risk assessment results demonstrated that both chronic and acute dietary exposure risks of all detected pesticides were considerably lower than 1. Full article

Background: Neuropathy and neuropathic pain (NP) are globally prevalent, remain difficult to manage, and are often exacerbated by underlying lifestyle factors. Alcohol use, particularly in the context of chronic consumption or dependence, is a recognized contributor to peripheral nerve damage, yet its association with neuropathy/NP has not been systematically evaluated. This systematic review synthesizes the current evidence on alcohol exposure, including quantity, frequency, and dependency, and its association with the incidence, prevalence, and severity of neuropathy/NP. Methods: This systematic review included observational studies assessing alcohol consumption patterns or dependence in relation to neuropathy/NP outcomes and was conducted in accordance with PRISMA guidelines. Exposure types were analyzed independently, and pooled odds ratios and relative risks were generated when sufficient data were available. The review was registered with PROSPERO number CRD42023484158. Results: Following de-duplication and exclusions, 76 studies were included, comprising cohort (n = 15), case–control (n = 12), and cross-sectional (n = 49) designs. While associations varied by study design and exposure category, alcohol dependence and consumption were more consistently linked with increased neuropathy incidence and severity, including electrophysiological evidence of compromised function. Notably, in studies examining alcohol cessation, abstinence was linked to clinical improvements in neuropathy/NP symptoms such as hypoesthesia and muscle weakness. While heterogeneity and risk of bias were present, largely due to the subjective classification of alcohol exposure and a lack of universally applied objective neuropathy measurement tools, multiple pooled estimates reached statistical significance. Conclusions: Evidence from observational studies supports an association between alcohol use, especially dependence, and the development and progression of neuropathy/NP, although causality remains unproven. Abstinence may offer therapeutic benefit, though further abstinence- and/or harm reduction-related interventional studies are required to clarify causality and guide low-cost, adjunctive strategies for alcohol-related neuropathy/NP. Full article