Search Results (49,770)

Background/Objectives: Food insecurity has been associated with adverse eating patterns, which increase the risk for overweight and obesity. However, most studies measure food insecurity and eating behaviors cross-sectionally, not assessing whether experiencing food insecurity over time influences eating behaviors. Therefore, this study assessed the relationship between cumulative food insecurity and food approach and food avoidance eating behaviors and evaluated the effect of breastfeeding intensity and duration on this relationship. Methods: The Study of Women, Infant Feeding and Type 2 Diabetes after Gestational Diabetes Pregnancy (SWIFT) is a prospective longitudinal cohort of 1033 mothers diagnosed with gestational diabetes and their youth. Breastfeeding intensity and duration were assessed at research visits and through mailed monthly surveys from birth to one year postpartum. The SWIFT study in Youth (SWIFT-Y) was a cohort of 701 SWIFT offspring that consented to participate in a research visit 11–16 years postpartum. Youth’s BMI was measured at 11–16 years old through a research visit or their electronic health record. At each of the four research visits (6–9 weeks, one year, two years, and 11–16 years postpartum), participants were categorized as being food secure (0) or food insecure (1). Scores across the four visits were summed (range 0–4), reflecting the number of assessments one was classified as food insecure. The Child Eating Behavior Questionnaire was used to measure the prevalence of eight eating behaviors in the youth, with higher scores indicating that the behaviors were more apparent. According to the measure, the behaviors were categorized into two groups: food approach and food avoidance. Food approach consists of youth’s food responsiveness, emotional overeating, enjoyment of food, and desire to drink, and has been positively associated with a child’s BMI. Food avoidance includes the youth’s satiety responsiveness, slowness in eating, emotional undereating, and food fussiness, and is negatively associated with BMI. Linear regressions assessed whether cumulative food insecurity was associated with eating patterns, and exploratory analysis analyzed whether this relationship differed by breastfeeding duration (<six months, ≥six months) and intensity (exclusive, not exclusive), controlling for the child’s BMI and sociodemographic characteristics. Results: In this complete-case secondary analysis (n = 321), each additional experience of food insecurity was associated with a higher food approach score (B = 0.30, 95% CI [0.04, 0.57], p = 0.03), but not food avoidance (B = −0.03, 95% CI [−0.21, 0.15], p = 0.74). These results varied by breastfeeding duration (B = −0.74, p = 0.001), as the relationship remained significant among those who were breastfed for <six months (B = 0.73, p < 0.001) but was attenuated among those who were breastfed for ≥six months (B = −0.26, p = 0.18). Conclusions: Experiencing food insecurity more during childhood is associated with adverse eating patterns at 11–16 years old. However, breastfeeding for ≥six months influenced this relationship, suggesting that early-life feeding may impact the effect of food insecurity on one’s eating behaviors later in life. Full article

Pancreatic cancer is a highly lethal malignancy with an increasing global incidence. Although metabolic dysfunction has been implicated in pancreatic cancer risk, the strength and consistency of evidence across different metabolic traits remain uncertain. Evidence for dietary exposures related to metabolic regulation is also less clearly established. This umbrella review synthesised evidence from systematic reviews, meta-analyses, and umbrella reviews evaluating metabolic dysfunction and related dietary exposures in relation to pancreatic cancer risk. A systematic search of PubMed, Web of Science, and PROSPERO identified reviews published between 1 January 2021 and 1 February 2026. Seventeen reviews met the inclusion criteria. The primary search focused on metabolic dysfunction. Dietary exposures identified during the screening process were retained as a secondary evidence domain when they were considered relevant to glycaemic regulation, insulin response, adiposity, or wider metabolic health. Primary-study overlap was slight, with an overall corrected covered area (CCA) of 1.59% and weighted corrected covered area (wCCA) of 1.40%; within the principal evidence domains of adiposity-related exposures and metabolic dysfunction, the CCA and wCCA were 1.15% and 1.81%, respectively. Metabolic dysfunction demonstrated the strongest and most consistent associations with pancreatic cancer risk. Metabolic syndrome, diabetes mellitus, hyperglycaemia, and abdominal obesity were graded as probable evidence. Hyperglycaemia showed the strongest component-level association (RR = 1.55, 95% CI: 1.42–1.70), while diabetes mellitus was consistently associated with increased risk across both cohort and case–control studies. Abdominal obesity, assessed using waist circumference and waist-to-hip ratio, was also positively associated with risk. General obesity, prediabetes, and reduced HDL cholesterol were graded as limited/suggestive evidence, whereas hypertriglyceridaemia was graded as limited/no conclusion. Related dietary exposures generally showed weaker and less consistent associations, with no exposure supported by convincing evidence. Overall, pancreatic cancer risk was more consistently associated with systemic metabolic dysfunction, particularly impaired glucose regulation, diabetes, metabolic syndrome, and abdominal adiposity, than with the related dietary exposures examined. However, the evidence remains predominantly observational and does not establish causality. Full article

Background/Objectives: High-risk human papillomavirus (HR-HPV) causes cervical cancer, but other sexually transmitted infections (STIs) act as possible cofactors. We herein evaluated the feasibility, logistics, and epidemiology of a community-based screening program in Romania using an innovative veil-based self-sampling device and a digital platform. Methods: Adult women self-collected genital secretions using the Vaginal Veil Collector V-Veil UP2™ device (V-Veil-Up Production SRL, Pitesti, Romania). A digital platform managed registration and results. Dry impregnated veils were transported at ambient temperature via standard courier to an accredited French laboratory for molecular testing using in parallel the Allplex™ HPV HR Detection assay (Seegene, Seoul, Republic of Korea), detecting 14 HR-HPVs, and the Allplex™ STI Essential Assay (Seegene), detecting 7 major pathogens causing STIs [Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum]. Results: Among 960 included women (mean age 41.3 years), technical success was high: 97.7% of samples yielded valid results for HR-HPV and 97.4% for STIs. Sample stability at ambient temperature eliminated cold-chain requirements. Overall, 17.2% of women were positive for HR-HPV and 26.7% for an STI. The most frequent genotypes were HPV-68 (3.0%), HPV-16 (2.9%), and HPV-31 (2.3%); Ureaplasma parvum (24.0%) was the most prevalent bacterial pathogen. The 18–29 age group exhibited the highest risk for HR-HPV (22.2%) and STIs (36.8%). Multivariate analysis revealed strong biological associations: Chlamydia trachomatis was independently associated with overall HR-HPV (aOR: 4.52; 95% CI: 1.26–16.11) and multiple HR-HPV infections (aOR: 13.96; 95% CI: 3.70–52.64). Mycoplasma hominis and Ureaplasma species were also independently associated with HR-HPV (aOR: 1.83 and 1.67, respectively) or nonvaccine types (aOR: 2.75 and 5.03, respectively). Conclusions: Veil-based self-sampling combined with digital logistics is highly feasible, scalable, and overcomes geographical barriers. The marked association between Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma species, and HR-HPV strongly advocates for integrated molecular co-testing models in public health screening programs. Full article

Background: Short-video platforms (e.g., Douyin, TikTok) have gained immense popularity among young adults, yet their addictive potential and health consequences remain understudied. Unlike gaming addiction, which has been linked to myopia and mental distress, short-video viewing may pose distinct risks due to its fragmented, high-frequency, and pre-sleep usage patterns. This study aimed to investigate the relationships between short-video viewing and multifaceted health outcomes in Chinese young adults, with a focus on dose–response relationships. Methods: A cross-sectional survey was conducted among 328 young adults aged 20–33 years. Participants were categorized into a non-addicted group (daily short-video viewing < 0.5 h, n = 164) and a short-video viewing group (daily viewing ≥ 1 h, n = 164), further divided by duration: 1–2 h (n = 96), 3–4 h (n = 29), 5–6 h (n = 22), and >6 h (n = 17). Outcome measures included the Hospital Anxiety and Depression Scale (HADS), Van Dream Anxiety Scale (VDAS), 36-Item Short-Form Health Survey (SF-36), Ocular Surface Disease Index (OSDI), Internet Addiction Test (IAT), Chinese Internet Addiction Scale—Revised (CIAS-R), and Mobile Phone Addiction Index (MAPI). Linear regression, one-way ANOVA with Tukey post hoc comparisons (or Kruskal–Wallis tests with Dunn’s test for non-normal variables), and dose–response curve fitting were applied. Segmented regression was used to explore potential dose–response patterns. Results: Compared with the non-addicted group, the short-video viewing group had significantly shorter sleep duration, higher HADS, VDAS, OSDI, IAT, CIAS-R, and MAPI scores, and lower SF-36 scores (all p < 0.0001). Clear dose–response relationships were observed: as daily viewing duration increased, sleep duration decreased linearly (r = −0.73, p < 0.001), while OSDI (r = 0.89, p < 0.001) and VDAS (r = 0.68, p < 0.001) increased. Among participants viewing >6 h/day, all (100%) had moderate-to-severe dry eye (OSDI ≥ 23), and 71% (12/17) had probable anxiety/depression (HADS ≥ 11). Notably, MAPI showed the strongest correlation with VDAS (r = 0.77, p < 0.001), indicating that mobile phone addiction was closely associated with nightmare-related anxiety. The SF-36 physical component summary (PCS) was negatively correlated with daily short-video viewing duration (r = −0.62, p < 0.001). Exploratory threshold analyses suggested that viewing > 3 h/day was associated with greater severity of sleep and ocular surface complaints. The dose–response thresholds identified in this study are exploratory, as the number of participants in the higher-duration categories was limited (3–4 h: n = 29; 5–6 h: n = 22; >6 h: n = 17). These breakpoints should be interpreted with caution and validated in future large-scale studies. Conclusions: Short-video viewing is associated in a dose-dependent manner with sleep quality, ocular surface health, and psychological well-being, with effect sizes generally comparable to, and in some domains (e.g., dry eye and dream anxiety) somewhat larger than, those reported for gaming addiction. The strong association between mobile phone addiction (MAPI) and dream anxiety (VDAS) highlights the distinctive association pattern of pre-sleep short-video use. Future interventional studies are warranted to determine the optimal duration limit. Our exploratory thresholds (approximately 3.2 h/day for sleep and 4.0 h/day for OSDI) provide preliminary reference points, but the specific target duration remains to be established through adequately powered studies designed to compare multiple cut-off levels. Full article

Background: Food noise describes persistent, intrusive thoughts about food, eating, and cravings that occur in the absence of physiological hunger. Its occurrence among healthcare students and professionals in Saudi Arabia is unknown. This study measured food noise in this group in Al-Ahsa, described the proportion meeting study-defined severity thresholds, and identified its main correlates. Methods: In this cross-sectional study, healthcare students and professionals in Al-Ahsa completed a bilingual (Arabic–English) electronic questionnaire capturing demographic and lifestyle characteristics, a 14-item food noise scale adapted from the Food Thought Suppression Inventory (each item rated 1–5; total range 14–70), the SCOFF eating disorder screen, and the four-item Perceived Stress Scale. The factor structure of the food noise scale was examined by exploratory factor analysis with parallel analysis and random split-half replication. Severity was graded from the mean item score as low, moderate, or high using exploratory thresholds, and associations were tested using t-tests, one-way analysis of variance, the Pearson correlation, and complete-case multivariable linear regression with robust standard errors and six sensitivity analyses. Results: Among 593 participants (mean age 25.7 years; 67.5% women; 60.0% students), the food noise scale was unidimensional (Kaiser–Meyer–Olkin 0.95; one eigenvalue above both unity and the parallel analysis threshold; 41.8% of variance explained; loadings 0.50 to 0.74) and internally consistent (Cronbach alpha 0.91). The mean total score was 41.9 (standard deviation 12.7). At least moderate food noise was present in 75.9% of participants (95% CI 72.3 to 79.2) and high food noise in 29.0% (95% CI 25.5 to 32.8). A positive SCOFF screen was recorded in 70.2% (95% CI 66.3 to 73.7), and the mean perceived stress score was 8.1 (standard deviation 2.8). In the adjusted model (n = 573; unadjusted R-squared 0.279, adjusted R-squared 0.266), food noise was independently associated with the SCOFF score (B 3.85 per point) and perceived stress (B 0.69 per point), both of which held across every sensitivity analysis, although both relationships proved concave rather than linear. Weaker associations with age (B 0.19 per year) and any night shift work (B 2.45) did not survive alternative model specifications, and crude differences by sex, role, weekly hours, and fasting did not persist after adjustment. Conclusions: Food noise was common in this sample and tracked eating disorder risk and perceived stress more closely than demographic or occupational characteristics. Because recruitment was by convenience and the severity thresholds are exploratory rather than validated, the proportions reported here describe this sample and should not be read as population prevalence. The findings provide a first benchmark for the construct in this population and support attention to the cognitive dimension of eating within health professions settings. Full article

The problem of antimicrobial resistance (AMR) is a significant worldwide health risk, which is why experts are interested in using artificial intelligence (AI) or machine learning (ML) to employ antibiotics more wisely. Diagnostic, empiric antibiotic choices, dosing, and surveillance in stewardship programs are AI-driven promises to make the process straightforward. This narrative review is a synthesis of the recent evidence (within the last 10 years) on the use of AI in antibiotic stewardship. It analyzed the literature on AI-based diagnostic systems, prescribing decision-support systems, resistance prediction models, real-time surveillance systems, and dose algorithms. The use of AI tools by clinicians and stewardship programs must be approached with discretion and human supervision and assessment. Full article

Background: Iodine is an essential micronutrient required for foetal development, cognitive function, and metabolic regulation; however, suboptimal iodine status remains a public health concern in Europe and other regions. Improving food literacy related to iodine may support healthier dietary choices during adolescence, a critical life stage for establishing long-term habits. This intervention development study describes the development of The ABC of Iodine Teaching Programme within the EUthyroid2 project, designed to enhance iodine-related knowledge and awareness among adolescents aged 13–17 years across six regions (UK, Republic of Cyprus, Slovenia, Germany, Bangladesh, and Pakistan). Methods: The intervention was developed according to the Behaviour Change Wheel, targeting capability, opportunity, and motivation, and informed by guidance for complex interventions. The programme was comprised of three flexible, culturally adapted modules integrating lectures on iodine physiology, deficiency risks, WHO recommendations, and locally relevant dietary sources. Active learning strategies, including collaborative tasks and personalised feedback through an Iodine Feedback Tool, were included. Materials were translated and adapted to local contexts and implemented in a hybrid format combining printed booklets with QR-linked digital resources. Results: The primary outcome of the intervention development process was The ABC of Iodine Teaching Programme, a multi-component, scalable educational intervention aligned with principles of food literacy, active learning and behaviour change theory. It incorporated behaviour change techniques and context-specific adaptations to facilitate engagement and knowledge acquisition in school settings. The programme is currently under evaluation in participating regions. Conclusions: This study presents the systematic development of a complex teaching programme. By combining behaviour change theory with innovative and context-sensitive educational strategies, The ABC of Iodine Teaching Programme provides a flexible and scalable framework for improving iodine-related food literacy among adolescents. Its effectiveness will be determined through the ongoing evaluation studies. Full article

The gut microbiome is positioned at the center of a hub that contributes to both the physiology and pathology of multiple distant organs. It does this by releasing beneficial signaling molecules that are synthesized by various microbial species. Beneficial metabolites that cross from the gut lumen into the circulation include the short-chain fatty acids (SCFAs), a range of tryptophan metabolites (TRPMs), the major polyamines, and certain secondary bile acids. The SCFAs act on G-protein-coupled receptors (GPRs) and on histone deacetylases (HDACs) and, in so doing, suppress inflammation. Tryptophan metabolites act mainly through the nuclear receptor AhR, enhancing gut barrier and blood–brain barrier integrity. The polyamines stabilize nucleic acids and regulate cell proliferation. The secondary bile acids have varied effects on the liver, brain, and lung. In addition, the microbiome contributes to deleterious cometabolites, such as trimethylamine N-oxide, p-cresyl sulfate, and indoxyl sulfate. We predict that clinical laboratories in the future will assay patient samples for an amalgamation of beneficial and detrimental microbiota metabolites as biomarkers of both health and disease risk. Full article

Background: Parental health literacy may be associated with treatment adherence and clinical outcomes in adolescents with allergic rhinitis (AR), but evidence regarding these relationships remains limited. Objective: To evaluate the associations of parental health literacy with treatment adherence and clinical outcomes in adolescents with AR and to compare parental health literacy and baseline sleep-related symptom burden between adolescents with AR and healthy controls. Methods: In this controlled longitudinal observational study, 132 adolescents with AR and 120 healthy controls were enrolled. Parental health literacy was assessed using the Turkish Health Literacy Scale-32 (TSOY-32). Adolescents with AR were evaluated at baseline (T0), week 4 (T1), and week 8 (T2). Nasal symptoms were assessed using the Total Nasal Symptom Score (TNSS) and Visual Analog Scale (VAS), and sleep-related symptoms using the Pediatric Sleep Questionnaire (PSQ). Treatment adherence was classified at T2 as a single binary measure covering the entire 8-week follow-up period. Multivariable linear regression and Firth penalized logistic regression analyses were performed. Results: Adolescents with AR had significantly higher PSQ total and subscale scores and a greater prevalence of PSQ-defined high risk than healthy controls (all p < 0.001). During follow-up, PSQ, TNSS, and VAS scores decreased significantly (all p < 0.001), with greater improvements among treatment-adherent adolescents. Parental health literacy was associated with treatment adherence (p < 0.001) and with improvements in TNSS and VAS. However, after adjustment, treatment adherence—but not parental health literacy—remained independently associated with T2 PSQ, TNSS, and VAS scores. The multivariable adherence model showed high apparent discrimination within the study sample (AUC = 0.969). Conclusions: Higher treatment adherence was consistently associated with more favorable clinical outcomes in adolescents with AR. Parental health literacy was associated with treatment adherence but was not independently associated with T2 clinical outcomes after multivariable adjustment. Whether treatment adherence represents a pathway linking parental health literacy to clinical outcomes cannot be determined from the present observational study. Full article

Soil metal contamination poses potential risks to ecosystem health, yet its vertical distribution and impacts on microbial communities in protected wildlife habitats remain poorly understood. This study investigated the vertical variation (0–80 cm) in seven metals or metalloids (Zn, Cr, Cu, Co, Ni, As, and Pb) and their correlations with soil bacterial communities in the Chinese Changxing Alligator Nature Reserve, Zhejiang Province, China. Soil samples were collected from two functional zones—the Reserved Breeding Zone (FY) and Reintroduction Zone (FG)—at four depth intervals. The results revealed distinct vertical stratification for both soil elements (metals and metalloids) and bacterial communities. Soil element concentrations exhibited depth-dependent variations, with surface layers showing higher accumulation of Zn, Ni, Cu, Cr and Pb, while As was enriched in deeper horizons. Bacterial alpha diversity declined with depth, and community composition shifted markedly: Pseudomonadota and Actinomycetota dominated surface soils, whereas Acidobacteriota and Chloroflexota increased in deeper layers. Network analysis revealed that microbial co-occurrence network complexity decreased with soil depth, indicating greater stability and environmental adaptability of surface soil microbial communities. Pearson correlation and Mantel analyses revealed significant depth-related variation in soil element concentrations (Zn, Co, Ni, Cu, Pb, Cr, and As), and these patterns were closely associated with shifts in soil bacterial community structure. This study provides systematic evidence of vertical differentiation in soil element–microbe interactions within reserve soil profiles, offering a scientific basis for habitat quality assessment, ecological risk warning, and Chinese alligator habitat conservation and management. Full article

Background/Objective: Maternal obesity is an established risk factor for adverse obstetric outcomes. However, its association with oligohydramnios remains unclear and has been examined using body mass index (BMI) alone. We assessed pre-pregnancy general and abdominal obesity in relation to oligohydramnios. Methods: We analyzed 762,104 women who delivered between 2010 and 2018 and had undergone a national health examination within two years before conception. Women were classified into four phenotypes by BMI (general obesity: ≥25 kg/m²) and waist circumference (abdominal obesity: ≥85 cm). Odds ratios were estimated by logistic regression adjusted for pre-pregnancy characteristics, and interaction was tested on the additive and multiplicative scales. Results: Oligohydramnios occurred in 13,860 women (1.82%). Relative to women with neither phenotype, adjusted odds were increased for abdominal obesity alone (1.163; 95% CI 1.013–1.336), general obesity alone (1.125; 95% CI 1.051–1.204), and both (1.336; 95% CI 1.241–1.438). Absolute risk was 2.19% among women with both phenotypes and 1.79% among those with neither, with no interaction on either scale (p = 0.811). Conclusions: General and abdominal obesity were each associated with oligohydramnios. Because nearly one in four women with abdominal obesity had a BMI below the obesity threshold, assessment by BMI alone leaves part of this risk unrecognized. Full article

Background/Objectives: Trauma remains a leading global cause of mortality and morbidity, particularly in low- and middle-income countries. Multitrauma patients often require intensive care and exhibit high mortality rates. Prognostic scoring systems such as the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Revised Trauma Score (RTS) are widely used to predict outcomes; however, their performance in middle-income settings like Turkey has not been well established. This study aimed to evaluate the prognostic accuracy of APACHE II and RTS in predicting intensive care unit (ICU) mortality among multitrauma patients. Methods: This retrospective observational study was conducted in the General ICU of Diyarbakır Gazi Yaşargil Training and Research Hospital between January 2022 and December 2024. Adult patients (≥18 years) with multitrauma involving at least two anatomical regions were included. Demographic data, clinical scores (APACHE II, RTS, Sequential Organ Failure Assessment [SOFA], Injury Severity Score [ISS], Trauma and Injury Severity Score [TRISS]), laboratory parameters, complications, and outcomes were recorded. Univariate and multivariate logistic regression analyses identified independent predictors of ICU mortality. Receiver operating characteristic (ROC) analysis assessed the discriminatory ability of prognostic scores. Results: A total of 145 patients were analyzed, with an ICU mortality rate of 13.1%. Non-survivors had significantly higher APACHE II (27 ± 4 vs. 13 ± 6, p < 0.001) and SOFA scores (7 [4–13] vs. 2 [1–6], p < 0.001) and lower RTS (4.2 ± 1.7 vs. 7.2 ± 1.1, p < 0.001). Acute kidney injury, sepsis, septic shock, and mechanical ventilation were more frequent among non-survivors (p < 0.01 for all). In multivariate analysis, APACHE II (odds ratio [OR]= 1.54, 95% confidence interval [CI] 1.16–2.04, p = 0.003) and RTS (OR = 0.36, 95% CI 0.16–0.81, p = 0.013) were independent predictors of ICU mortality. ROC analysis showed excellent prognostic performance for APACHE II (area under the curve [AUC] = 0.959) and RTS (AUC = 0.888). Conclusions: In this retrospective single-center cohort, APACHE II and RTS were independently associated with ICU mortality and demonstrated good discriminatory performance for early risk stratification in critically ill multitrauma patients. The lower mortality observed in our cohort should be interpreted cautiously, as it may also reflect differences in case-mix, injury severity, ICU admission practices, and referral patterns. These findings require external validation in larger multicenter cohorts before broader generalization. Future studies should also validate the identified cut-off values and further investigate the prognostic role of biomarkers such as procalcitonin. Full article

The case of common ragweed (Ambrosia artemisiifolia) stands as a prime example of an invasive plant that links global change, biological invasion, aeroallergen exposure, and allergic airway disease. However, evidence remains fragmented across invasion biology, aerobiology, molecular allergology, and respiratory medicine. By separating plant occurrence, pollen abundance, molecular allergen dose, sensitisation, and airway disease, this review develops an integrated invasion–exposure–disease logic for interpreting ragweed-related health risk. We examine how climate change, land-use disturbance, repeated introductions, rapid adaptation, and air pollution influence plant distribution, flowering phenology, pollen production, airborne allergen load, and respiratory outcomes. Attention is given to Amb a 1 as the principal marker of genuine ragweed sensitisation, cross-reactivity with Artemisia and other weed pollens, allergen-bearing respirable particles, and the diagnostic limitations of extract-based immunoglobulin E (IgE) testing. The literature indicates that ragweed sensitisation follows a pronounced hotspot–gradient pattern in Europe, whereas patterns in other invaded regions remain more heterogeneous and incompletely characterised. Clinically relevant exposure depends not only on pollen concentration but also on airborne allergen load, pollen allergen potency, atmospheric transport, respirable particle fractions, meteorological conditions, and pollution. Ragweed-related airway disease is mediated by IgE-dependent type 2 immunity and amplified by epithelial danger signals, oxidative stress, protease activity, and innate immune pathways. Based on current evidence, we propose that an integrated surveillance framework linking plant distribution, pollen and airborne-allergen exposure, molecular sensitisation, symptoms, lung function, and asthma outcomes could strengthen risk forecasting, source attribution, prevention, and invasion control of the common ragweed. Full article

Background: Gastric cancer is often diagnosed in advanced stages for patients in countries without organized screening processes. Non-invasive biomarkers have been proposed to risk-stratify and identify those who should undergo endoscopy. Methods: We searched PubMed/MEDLINE, Scopus, and Google Scholar for studies published between January 2006 and May 2026 reporting diagnostic accuracy or health–economic outcomes for gastric cancer detection in asymptomatic adults or patients with precursor mucosal lesions. Twenty-five studies met eligibility criteria and were synthesized narratively, with reporting informed by PRISMA-DTA and Ferrari guidance. Results: Systemic inflammatory indices derived from routine blood counts are inexpensive but non-specific, with individual areas under the receiver operating characteristic curve (AUC) between 0.65 and 0.83. Serological markers of mucosal atrophy have a clearer biological basis and carry the review’s only large Western validation dataset but preferentially detect corpus-predominant disease. Liquid biopsy platforms report the highest accuracy, up to an AUC of 0.968, though sensitivity falls to 62.4% for precancerous lesions and to 44% for stage I disease on some platforms. Magnifying narrow-band imaging reported the highest accuracy among the endoscopic modalities reviewed, with an AUC of 0.97. In low-incidence Western settings, one-time serum pepsinogen screening with endoscopy reserved for positive results is cost-effective at USD 4913 per QALY gained. Conclusions: Reported accuracy is encouraging across all four classes of gastric cancer markers but derives mainly from retrospective East Asian case–control cohorts and declines at the earliest stages of disease. The evidence supports using these markers to triage toward endoscopy rather than to diagnose directly. Validation in Western populations remains a gap. Full article