Search Results (22,313)

Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit to the host. Research has traditionally focused on bacterial species, particularly Lacticaseibacillus and Bifidobacterium, whose mechanisms are well-characterised. However, probiotic yeasts represent a functionally distinct category, with Saccharomyces boulardii as the most studied representative and Kluyveromyces marxianus as an emerging candidate. Bacterial and yeast probiotics differ in cell biology, antibiotic susceptibility, immune receptor engagement, and metabolic output. Bacterial strains provide mucosal adhesion and direct short-chain fatty acid (SCFA) generation but are susceptible to antibacterial therapy. Yeast strains are intrinsically antibiotic-resistant, offer enzymatic activities such as β-galactosidase and glycosidases, and exert indirect bifidogenic effects that amplify luminal SCFA concentrations beyond what either category achieves alone. These non-overlapping profiles support a complementary rather than competitive conceptualisation of their use. When combined with prebiotic substrates such as fructooligosaccharides or galactooligosaccharides, this integrated approach addresses the principal axes of intestinal homeostasis more comprehensively than any single-organism intervention. Prospective randomised trials are needed to determine whether this mechanistic complementarity translates into additive or synergistic clinical benefit. This review synthesises the available evidence and proposes a framework for their complementary use. The proposed framework is hypothesis-generating: it rests largely on mechanistic and preclinical data, and its clinical validity requires confirmation in adequately powered controlled trials. Full article

For decades, industrial trans fatty acids (iTFAs) have remained a critical focus of the scientific community, the food industry, and regulatory authorities because of their well-established role in the development of cardiovascular diseases, metabolic disorders, and chronic systemic inflammation. Rather than providing a descriptive overview, this review critically synthesizes current evidence on the elimination of industrial TFAs by integrating health, technological, regulatory, and sustainability perspectives into a comprehensive interdisciplinary analysis. The review outlines the biochemical characteristics and dietary sources of trans fatty acid isomers, highlighting the continuing scientific debate regarding the differential health effects of industrially produced and naturally occurring ruminant-derived TFAs. It also examines the evolution of scientific evidence that led to major regulatory actions by international organizations, including the World Health Organization (WHO) and the European Commission, resulting in legally binding restrictions that have substantially reduced industrial TFA intake and improved public health. Particular emphasis is placed on the critical assessment of current fat reformulation strategies, considering not only their technological functionality but also their nutritional quality, long-term metabolic implications, and contribution to sustainable food systems. Full hydrogenation, fractionation, chemical and enzymatic interesterification, and oleogelation are comparatively evaluated with respect to their advantages, limitations, and potential technological, nutritional, and environmental trade-offs. In addition, lipid microencapsulation is discussed as an emerging strategy for protecting oxidation-sensitive polyunsaturated fatty acids (PUFAs), thereby facilitating their incorporation into functional foods while maintaining nutritional quality. Unlike previous reviews that primarily focus on health outcomes or individual processing technologies, this review systematically integrates the sustainability dimensions of alternative fat modification approaches, including resource efficiency, energy consumption, clean label product development, and circular economy principles. Furthermore, it identifies current knowledge gaps related to the long-term metabolic safety, industrial scalability, and environmental performance of emerging lipid technologies. By combining these complementary perspectives, the review provides a comprehensive interdisciplinary synthesis that supports evidence-based fat reformulation and offers practical guidance for researchers, food manufacturers, and policy makers seeking to develop safer, nutritionally improved, technologically functional, and environmentally sustainable lipid systems. Full article

The estrobolome, defined as the collection of gut microbial genes encoding enzymes that metabolize estrogens and, by extension, the taxa that harbor them, has emerged as a central node of the new concept of “microbial endocrinology” within the gut–vagina axis. By regulating enterohepatic recirculation of conjugated estrogens, the estrobolome may modulate systemic estrogen availability and thereby may influence the estrogen-dependent biology of gynecological organs and tissues, including ovaries, endometrium, and the vaginal mucosa with its Lactobacillus-dominated ecosystem. In this narrative review, we synthesize current evidence on how gut microbial β-glucuronidases, sulfatases, and related enzymes shape circulating estrogen pools and, in turn, gynecological health. We outline the enzymatic and taxonomic architecture of the estrobolome, describe its major ecological determinants, and integrate these with mechanisms of the gut–vagina axis. We then examine how estrobolome function varies across a woman’s lifespan and how these dynamics intersect with vaginal health, dysbiosis, and conditions such as recurrent vaginitis, endometriosis, and polycystic ovary syndrome. We also review emerging strategies that may modulate the estrobolome as a microbial endocrine organ and discuss their potential downstream effects on gynecological health. Finally, we highlight major research gaps, particularly the need for causal, longitudinal, multi-omics studies explicitly linking estrobolome activity, systemic estrogens, and gynecological outcomes. Overall, available data support a mechanistically plausible but incompletely defined role for the estrobolome as a key microbial endocrine player in the gut–vagina axis and point toward microbiome-informed strategies to preserve and restore gynecological health across a woman’s lifespan. Full article

Background/Objectives: Ultra-processed foods (UPFs) are linked to cardiometabolic disease, but cross-sectional surveys often underestimate or invert these associations due to age structure, diagnosis-related dietary changes, and reporting bias. This study explores the potential influence of these biases and examines cross-sectional associations between dietary proxies and prevalent cardiometabolic conditions using the most recent national data from Spain. Methods: We analyzed the 2023 Spanish Health Survey (n = 21,032). Body Mass Index (BMI) was derived from self-reported weight and height. Hypertension and diabetes were defined as self-reported medical diagnoses. Dietary items were mapped as UPF-rich proxies, processed-meat exposure, protective dietary markers, and beverage comparators. Weighted logistic models were adjusted for sociodemographic and lifestyle factors. Bias-probing analyses included stratification by self-rated health, exclusion of severe chronic comorbidities (n = 4107), and model-based beverage contrasts. Results: Prevalence reached 53.6% for excess weight, 23.9% for prevalent hypertension, and 7.4% for prevalent diabetes. Weekly fast-food consumption was consistently associated with excess weight (OR 1.20, 95% CI 1.07–1.35), obesity (OR 1.28, 95% CI 1.09–1.50), prevalent hypertension (OR 1.18, 95% CI 1.02–1.37), and prevalent diabetes (OR 1.33, 95% CI 1.10–1.61). Excluding participants with severe chronic comorbidities strengthened the fast-food association with prevalent diabetes (OR 1.46, 95% CI 1.17–1.81). Conclusions: Fast food emerged as the most consistent adverse dietary marker co-occurring across all prevalent outcomes, whereas processed meat was specifically associated with prevalent excess weight and obesity rather than prevalent cardiometabolic diagnoses. Stratified and sensitivity analyses provided empirical patterns consistent with age confounding and possible post-diagnosis dietary changes influencing cross-sectional associations, highlighting the need for cautious interpretation in public health surveillance. Full article

Chronic kidney disease (CKD), one of the major global public health burdens, continues to exhibit a rising prevalence worldwide. The growing population of patients with end-stage renal disease (ESRD) has led to an increasing demand for renal replacement therapy (RRT). Although dialysis effectively prolongs survival, it fails to fully replicate kidney function. In addition, the persistent shortage of donor kidneys results in prolonged waiting periods for kidney transplantation. Emerging renal replacement strategies, such as kidney organoids, have demonstrated considerable potential. However, multiple technical limitations continue to hinder their near-term clinical translation. Bioartificial kidneys (BAKs), which integrate engineering and biological technologies, generally consist of artificial filtration membranes and living-cell bioreactors designed to mimic native kidney function. Advances in nanotechnology, biomaterials, and tissue engineering have accelerated the development of implantable bioartificial kidneys (iBAKs), making them an important research direction in renal replacement therapy. These innovations have improved membrane performance, biocompatibility, and cellular integration; however, substantial challenges remain regarding long-term stability, immune compatibility, and clinical validation before translation into human applications. Specifically, limited cell sources and uncertain long-term biocompatibility remain major barriers to iBAK development. In the future, biosensors and artificial intelligence (AI) technologies may be incorporated into bioartificial kidneys to enable personalized precision therapy. This review focuses on the developmental and major challenges of bioartificial kidneys, with detailed discussion of recent progress in implantable artificial kidneys. Full article

Digital ecosystems, misinformation exposure, mental-health vulnerability and unequal access to care create distinctive challenges for young people. Although youth participation in health governance is increasingly advocated internationally, structured evidence from youth deliberative processes remains limited in Portugal. This study synthesises priorities expressed in two national deliberative initiatives coordinated by the Sociedade Portuguesa de Literacia em Saúde: the Mini-Assemblies of Health 2022–2023, with particular attention to the 3rd Mini-Assembly on Fighting Health Misinformation, and the Youth Health Choices Forum 2024. Both processes used a structured nominal-group logic to support idea generation, clarification, recording and prioritisation. The analysis used low-inference cross-session thematic aggregation to preserve propositional integrity and remain close to participants’ formulations. Five priority domains were identified: digital health communication and misinformation control; curriculum-integrated and peer-mediated health literacy; low-threshold and non-stigmatising mental-health access; equity and functional accessibility of services; and institutional youth participation in health governance. Participant quotations are retained, in translated form, to preserve youth voice and to show how recommendations emerged from concrete deliberative formulations. The findings suggest that nominal group technique (NGT)-based youth deliberation can generate operational recommendations for policy and practice, including credibility mechanisms for digital health information, school-based health-literacy integration, autonomy-preserving access routes for mental-health support, and permanent youth participation structures. The findings support recognising young people not only as vulnerable recipients of health information but also as interpreters of digital health ecosystems and contributors to the design of more responsive health governance. Full article

Substituted p-phenylenediamine-derived quinones (PPD-Qs) have become ubiquitous contaminants in various environmental matrices. However, the understanding of the potential health risks posed by human exposure to these emerging compounds remains limited. In this case–control study, we investigated the association between urinary concentrations of six PPD-Q congeners and colorectal cancer (CRC) risk. Detection frequencies of all target PPD-Qs in human urine ranged from 73.7% to 88.2% in the control group and from 70.2% to 89.6% in the case group. 6PPD-Q (2-((4-methylpentan-2-yl)amino)-5-(phenylamino)cyclohexa-2,5-diene-1,4-dione; mean 1.37 μg/g creatinine), 77PD-Q (2,5-bis((5-methylhexan-2-yl)amino)cyclohexa-2,5-diene-1,4-dione; 0.68 μg/g creatinine), and IPPD-Q (2-(isopropylamino)-5-(phenylamino)cyclohexa-2,5-diene-1,4-dione; 0.70 μg/g creatinine) were the predominant PPD-Qs in urine from healthy controls. In CRC cases, 6PPD-Q had the highest mean urinary level (mean 1.75 μg/g creatinine), followed by DPPD-Q (2,5-bis(phenylamino)cyclohexa-2,5-diene-1,4-dione; 0.83 μg/g creatinine) and IPPD-Q (0.73 μg/g creatinine). After multivariable adjustment, higher urinary levels of 6PPD-Q (OR for Q4 vs. Q1 = 1.79, 95% CI: 1.26–2.32), CPPD-Q (2-(cyclohexylamino)-5-(phenylamino)cyclohexa-2,5-diene-1,4-dione; OR = 1.60, 95% CI: 1.26–1.94), and DPPD-Q (OR = 1.47, 95% CI: 1.25–1.68) were significantly associated with increased CRC odds, with nonlinear exposure–response patterns observed. Mixture analysis suggested a positive joint association between urinary PPD-Q concentrations and the odds of CRC, with 6PPD-Q and DPPD-Q contributing most strongly to the estimated statistical association. These findings highlight the need for further prospective studies and potential regulatory considerations to mitigate public health impacts from these contaminants. Full article

In recent years, plastic litter in marine ecosystems has emerged as a global concern. Consequently, efforts to control, mitigate, and remove micro- and macroplastics from marine systems have intensified. In order to thoroughly analyze this topic, the present work provides a comprehensive overview of various strategies aimed at reducing plastic waste pollution spread in marine areas. Based on this, worldwide regulations limiting single-use plastic (SUP) products and microplastics in health care products were discussed. Further attention was also paid to bioplastic production as a potential alternative to non-degradable ones, with particular attention to their different degradability rates in various environmental compartments. Finally, strategies for the reduction in plastic pollution were specifically analyzed through a review of plastic litter collection/removal systems from beaches and the marine environment as well as different waterways. According to the above-mentioned aspects, this work highlights the significance of marine plastic litter pollution and provides support for the identification and selection of effective strategies for the mitigation of the impact of such litter on the environment. Full article

Klebsiella pneumoniae (K. pneumoniae) is a leading cause of hospital- and community-acquired lower respiratory infections (LRI). The emergence of antimicrobial resistance (AMR), especially carbapenem-resistant strains (CRKP), poses a serious global health threat. Using Global Burden of Disease (GBD) 2021 data, we estimated AMR-related mortality for K. pneumoniae-associated LRI across regions from 1990 to 2021. Joinpoint regression analysis identified temporal trends. Global mortality declined overall, with a 70% reduction in under-5 deaths but a doubling among adults over 70 years. Deaths associated with and attributable to AMR decreased by 18.9% and 4.5%, respectively. The age-standardized mortality rate (ASMR) fell by nearly 50%. In contrast, the mortality burden associated with carbapenem resistance increased markedly, with AMR-associated deaths rising by 157% and disproportionately affecting high-burden regions such as Sub-Saharan Africa and South Asia. Despite overall progress, the increasing mortality burden associated with carbapenem resistance in K. pneumoniae-associated LRI poses a critical and persistent global health threat. Full article

Background and objectives: Artificial intelligence (AI) is increasingly embedded in public health workflows, yet adoption among practitioners remains uneven and is shaped by knowledge, legal awareness, and operational barriers. This cross-sectional study characterised determinants of AI adoption among healthcare professionals and examined how legal concern moderates the translation of technical knowledge into practical use, at a single Romanian tertiary academic centre. Methods: We surveyed 93 healthcare professionals (physicians, nurses, public health specialists, residents) at the “Pius Brînzeu” Clinical Emergency County Hospital and “Victor Babeș” University of Medicine and Pharmacy Timișoara. Participants were classified as AI adopters or non-adopters. Likert-derived composite scores (0–100; Cronbach’s α 0.79–0.88) quantified knowledge, trust, legal concern, privacy concern, and workflow confidence. Group comparisons used independent-samples t-tests and χ² tests; associations used Pearson correlation; predictors of adoption and usage intensity were modelled with logistic and multiple linear regression; a two-way ANOVA tested profession-by-training effects. Significance was set at p < 0.05. Benjamini–Hochberg false-discovery-rate correction was applied across the 18 bivariate tests reported in this study, and adjusted q-values are reported alongside unadjusted p-values. Results: Adopters (n = 51) were younger (34.7 ± 7.5 vs. 43.2 ± 8.5 years; p < 0.001) and reported higher knowledge (67.3 vs. 48.6; p < 0.001) and workflow confidence (64.2 vs. 41.9; p < 0.001) but lower legal concern (58.4 vs. 71.2; p < 0.001). Knowledge correlated positively with usage intensity (r = 0.536; p < 0.001), whereas legal concern correlated negatively (r = −0.426; p < 0.001). In multivariable models, younger age (OR = 0.91; p = 0.004), knowledge (OR = 1.06; p = 0.005), and trust (OR = 1.07; p = 0.005) independently predicted adoption. The linear model explained 46.1% of usage variance. Stratified analysis suggested legal concern attenuated the knowledge–usage slope (β: 0.51→0.18); however, the formal knowledge-by-concern interaction term was not statistically significant (p = 0.191), and this pattern is therefore exploratory. Conclusions: In this modest, single-centre sample, AI adoption was independently associated with knowledge and trust, and legal concern was independently and negatively associated with usage intensity; the apparent dampening of the knowledge–usage relationship by legal concern was suggestive but not statistically confirmed. Targeted legal-regulatory literacy and structured training may support practical AI uptake in public health settings, pending confirmation in larger, multicentre studies. Full article

The adultification of Black adolescent girls, viewing them as less innocent and more adult-like, has implications for their sexual and psychological well-being. Adultification creates bias, which hyper-sexualizes Black girls, increasing vulnerability to early sexual activity, sexual abuse, and lack of support, while hindering their ability to seek protection. However, protection from parents, peers, and communities may play a critical role in mitigating this risk for Black girls. The current study examined the role of maternal, paternal, peer friendships, and communal protective factors in mediating the association between adultification and sexual risk among Black girls. Girls’ responses (N = 575), 9–18 years old, were analyzed. Multiple linear regression analyses were conducted to estimate the mediating effects of protective factors (mother, father, friendship, and communal) on adultification and sexual risk. In separate mediation models, paternal relationships and friendship partially mediated the association between adultification and sexual risk. However, in a parallel mediation model that simultaneously examined maternal and paternal relationships, friendship, and community protection, friendship emerged as the only significant indirect pathway. Greater adultification was associated with stronger peer friendship, which in turn was associated with greater sexual risk. Programs, policies, and interventions addressing the sexual health of Black girls should consider how peer relationships shape responses to adultification and promote peer environments that support healthy sexual development. Full article

Wine labels influence consumer purchasing choices. With no- and lower-alcohol wines increasingly available, and marketing often centering on healthier choices, it is important to consider the information provided on the labels of these products. Therefore, this cross-sectional audit of no- and lower-alcohol wines presents a snapshot representation of earlier emerging data found in three major retail outlets on the Central Coast, NSW, Australia, that were audited for front and back label information (including alcohol content, nutrition, and health messaging). One hundred and eleven unique labels were identified (46 no-alcohol and 65 lower-alcohol wines). Most lower-alcohol wines (72.3%) typically included information on alcohol by volume ABV% on front labels. Narrative wording of alcohol content on front labels was more frequent (81.5%); however, wording with “Lighter in alcohol” was 50%, followed by “Lower alcohol” at 12.3%. No-alcohol wines reported ABV% on less than half of front labels (43.5%), but all front labels included a narrative descriptor of alcohol content. The most common descriptor was “Zero alcohol” (41.3%), followed by “Alcohol free” (23.9%). All no-alcohol wines and 44.6% of the lower-alcohol wines contained nutrition information panels. Almost half the back labels included a diversity of marketing messaging, with overall themes of suggested drinking occasion and/or health-related properties (43.1% lower-alcohol labels: 45.7% no-alcohol labels). These data show a variance in alcohol content labeling, associated descriptors, and presentation of nutritional and other information. This study is important for directing future research on the utility and understanding of these labels. Full article

The geropsychosis hypothesis proposes that anxiety, mood, psychotic, and neurocognitive disorders may share a common biophysical origin with aging itself, rather than arising from wholly disparate pathological routes in many instances. Specifically, we postulate that these conditions may emerge from the bioaccumulation of metals, advanced glycation end products (AGEs), advanced lipoxidation end products (ALEs), and their hybrid complexes in post-pubescent individuals. Such inputs may drive self-reinforcing molecular feedback loops underlying clinically meaningful insults against the nervous system, extending emerging conceptualizations of aging to mental health. Through comprehensive analysis of upstream molecular damage and neural function, this framework offers a mechanistic foundation for conceptualizing several mental disorders as emerging from a unified source. In doing so, the geropsychosis hypothesis may help identify new therapeutic targets and intervention strategies to address underlying contributors to psychiatric pathology. Full article

Background/Objectives: Childhood-onset systemic lupus erythematosus (cSLE) is a chronic, multisystem autoimmune disease that is associated with more severe organ involvement, more intensive drug therapy, and increased long-term organ damage compared with adult-onset disease. The objectives of this study were to evaluate the performance of widely used small area-level multidimensional indicators of neighborhood disadvantage in a mixed urban–rural cSLE cohort against disease outcomes. Methods: This retrospective cohort study utilized electronic health records to identify and evaluate pediatric patients with cSLE across a single center in South Carolina between 1 January 2020 and 31 December 2024. Primary outcomes included disease activity at diagnosis, measured by Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K); the achievement of a low lupus disease activity state (LLDAS) by the last visit; the development of major organ involvement; and the rates of unplanned hospitalizations and emergency department visits. The associations of the census tract-level Area Deprivation Index (ADI), Social Vulnerability Index (SVI), and Childhood Opportunity Index (COI) with clinical presentation and outcomes were estimated using generalized linear models and logistic regression. Results: A total of 85 patients with cSLE were included, of which 76% reported being of Black race, and 28% lived in rural areas. Lupus disease severity was inconsistent across the metrics of area-level social vulnerability, neighborhood deprivation, child opportunity, and rurality. Patients who lived in more socially vulnerable communities were more likely to attain LLDAS during follow-up, while those who lived in lower-opportunity areas were more likely to develop CNS lupus. Baseline disease activity, renal involvement, and healthcare use were not significantly associated with area-level social disadvantages or rurality. Conclusions: In this single-center, mixed urban–rural cohort of children with cSLE, indicators of neighborhood-level disadvantage and rurality alone explained little variation in disease severity and disease control overall. The utility of available small area-level metrics is likely context-dependent and influenced by regional features, population characteristics, and the outcomes being studied. Future work should integrate individual- and area-level factors across diverse settings to better understand the drivers of health disparities. Full article

MP contamination in drinking water is an emerging public health concern, yet standardized analytical workflows and exposure assessments remain limited and fragmented. This study provides an exploratory assessment of MP exposure through drinking water, combining particle-resolved analysis with consumption-based estimates. Laser Direct Infrared (LDIR) spectroscopy was applied within the analytical workflow to characterize MPs across different drinking water supply types. Ten drinking-water samples (five bottled, two tap, two public dispensers, and one office dispenser) were analyzed within a 10–500 µm size window, and particle-resolved results were combined with a consumption survey to support preliminary exposure estimates. MPs in the 10–150 µm range were detected in six of ten samples, while tap waters and all blanks were particle-free, supporting analytical robustness. Bottled waters showed the highest MP abundances (6–148 particles L⁻¹) and mass concentrations (0.03–22.4 µg L⁻¹). Particle-size distributions were right-skewed and dominated by particles ≤ 30 µm. PET, PU, PA, and ABS predominated, consistent with packaging and dispensing origins. EDI estimates for bottled-water consumers ranged from 0.1008 to 0.3023 µg kg-bw⁻¹ day⁻¹ across three consumption scenarios (1–3 L day⁻¹). Despite the limited sample size, the results support LDIR for source discrimination and exposure screening, providing a basis for future research. Full article