Search Results (637)

(1) Background: Dioxins and dioxin-like polychlorinated biphenyls (dl-PCBs) are persistent organic pollutants (POPs), characterized by high toxicity and strong lipophilicity, which promote their bioaccumulation in human tissues. Their detection in breast milk raises concerns about early-life exposure during lactation. Although dietary intake is the primary route of maternal exposure, environmental pathways—including inhalation, dermal absorption, and residential proximity to contaminated sites—may also significantly contribute to the maternal body burden. (2) Methods: This narrative review examined peer-reviewed studies investigating maternal and environmental determinants of dioxin and dl-PCB concentrations in human breast milk. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science (2000–2024), identifying a total of 325 records. Following eligibility screening and full-text assessment, 20 studies met the inclusion criteria. (3) Results: The included studies consistently identified key exposure determinants, such as high consumption of animal-based foods (e.g., meat, fish, dairy), living near industrial facilities or waste sites, and maternal characteristics including age, parity, and body mass index (BMI). Substantial geographic variability was observed, with higher concentrations reported in regions affected by industrial activity, military pollution, or inadequate waste management. One longitudinal study from Japan demonstrated a declining trend in dioxin levels in breast milk, suggesting the potential effectiveness of regulatory interventions. (4) Conclusions: These findings highlight that maternal exposure to dioxins is influenced by identifiable environmental and behavioral factors, which can be mitigated through public health policies, targeted dietary guidance, and environmental remediation. Breast milk remains a critical bioindicator of human exposure. Harmonized, long-term research is needed to clarify health implications and minimize contaminant transfer to infants, particularly among vulnerable populations. Full article

Background: Hip fractures represent a major clinical challenge, particularly in elderly and frail patients, where postoperative pain control must balance effective analgesia with motor preservation to facilitate early mobilization. Various regional anesthesia techniques are used in this setting, including the pericapsular nerve group (PENG) block, fascia iliaca compartment block (FICB), femoral nerve block (FNB), and quadratus lumborum block (QLB), yet optimal strategies remain debated. Objectives: To systematically review the efficacy, safety, and clinical applicability of major regional anesthesia techniques for pain management in hip fractures, including considerations of fracture type, surgical approach, and functional outcomes. Methods: A systematic literature search was conducted following PRISMA 2020 guidelines in PubMed, Scopus, Web of Science, and the virtual library of the Hospital Central de la Defensa “Gómez Ulla” up to March 2025. Inclusion criteria were RCTs, systematic reviews, and meta-analyses evaluating regional anesthesia for hip surgery in adults. Risk of bias in RCTs was assessed using RoB 2.0, and certainty of evidence was evaluated using the GRADE approach. Results: Twenty-nine studies were included, comprising RCTs, systematic reviews, and meta-analyses. PENG block demonstrated superior motor preservation and reduced opioid consumption compared to FICB and FNB, particularly in intracapsular fractures and anterior surgical approaches. FICB and combination strategies (PENG+LFCN or sciatic block) may provide broader analgesic coverage in extracapsular fractures or posterior approaches. The overall risk of bias across RCTs was predominantly low, and certainty of evidence ranged from moderate to high for key outcomes. No significant safety concerns were identified across techniques, although reporting of adverse events was inconsistent. Conclusions: PENG block appears to offer a favorable balance of analgesia and motor preservation in hip fracture surgery, particularly for intracapsular fractures. For extracapsular fractures or posterior approaches, combination strategies may enhance analgesic coverage. Selection of block technique should be tailored to fracture type, surgical approach, and patient-specific functional goals. Full article

Background/Objectives: Military Service Members (SMs) require optimal nutrition to support health, readiness, and job performance. However, they often fall short of meeting nutrition guidelines. This study aimed to determine the impact and feasibility of implementing the U.S. Marine Corps (USMC) “Fueled to Fight^®” (F2F) nutrition program in non-appropriated fund (NAF) food venues. Objectives included evaluating changes in Military Nutrition Environment Assessment Tool (mNEAT) scores, feasibility of implementing and maintaining F2F strategies, and influence on customer purchasing patterns. Methods: Researchers conducted a pre-post interventional study from January to December 2024 at three NAF food venues across two USMC bases. F2F strategies, including identifying items using a stoplight color coding system (Green = healthy, Yellow = less healthy, Red = least healthy), menu revisions, food placement, promotion, and marketing, were implemented. Data included mNEAT assessments, sales reports, and stakeholder focus groups. Generalized Estimating Equations models were used to analyze sales data. Results: mNEAT scores increased across all venues post-intervention. Availability and sales of Green items increased, while sales of Red items decreased in some venues. Profit increased at all three food venues. Focus groups revealed feasibility and provided insights for future interventions. Conclusions: F2F interventions in NAF food venues are feasible and can positively impact the food environment and customer purchasing patterns without negatively affecting profit. This study highlights the importance of integrating nutrition programs into all military food venues, not just government-funded dining facilities, to support the nutritional fitness and readiness of SMs. Full article

Over the years, macromycete fungi have been used as a source of food, part of religious rites and rituals, and as a medicinal remedy. Species with strong health-promoting potential include Hericium erinaceus, Cordyceps militaris, Ganoderma lucidum, Pleurotus ostreatus, Flammulina velutipes, and Inonotus obliquus. These species contain many bioactive compounds, including β-glucans, endo- and exogenous amino acids, polyphenols, terpenoids, sterols, B vitamins, minerals, and lovastatin. The level of some biologically active substances is species-specific, e.g., hericenones and erinacines, which have neuroprotective properties, and supporting the production of nerve growth factor in the brain for Hericium erinaceus. Due to their high health-promoting potential, mushrooms and substances isolated from them have found applications in livestock nutrition, improving their welfare and productivity. This phenomenon may be of particular importance in the nutrition of laying hens and broiler chickens, where an increase in pathogen resistance to antibiotics has been observed in recent years. Gallus gallus domesticus is a key farm animal for meat and egg production, so the search for new compounds to support bird health is important for food safety. Studies conducted to date indicate that feed supplementation with mushrooms has a beneficial effect on, among other things, bird weight gain; bone mineralisation; and meat and egg quality, including the lipid profile and protein content and shell thickness, and promotes the development of beneficial microbiota, thereby increasing immunity. Full article

Background: Since the election of Hamas in 2006, Gaza has endured eight major military conflicts, culminating in the ongoing 2023–2025 war, now surpassing 520 days. This protracted violence, compounded by a 17-year blockade, has resulted in the near-total collapse of Gaza’s health system. Over 49,000 deaths, widespread displacement, and the destruction of more than 60% of health infrastructure have overwhelmed both local capacity and international humanitarian response. Objectives: This narrative review aims to examine and synthesize the current literature (October 2023–April 2025) on the health crisis in Gaza, with a specific focus on identifying key themes and knowledge gaps relevant to rebuilding a sustainable health system. The review also seeks to outline strategic pathways for recovery in the context of ongoing conflict and systemic deprivation. Methods: Given the urgency and limitations of empirical data from conflict zones, a narrative review approach was adopted. Fifty-two sources—including peer-reviewed articles, editorials, reports, and correspondence—were selected through targeted searches using Medline and Google Scholar. The analysis was framed within a public health and political economy perspective, also taking health system building blocks into consideration. Results: The reviewed literature emphasizes emergency needs: trauma care, infectious disease control, and supply chain restoration. Innovations such as mobile clinics and telemedicine offer interim solutions. Gaps include limited attention to mental health (including that of health workers), local governance, and sustainable planning frameworks. Conclusions: Sustainable reconstruction requires a durable ceasefire; international stewardship aligned with local ownership; and a phased, equity-driven strategy emphasizing primary care, mental health, trauma management, and community engagement. Full article

Background/Objectives: This scoping review critically evaluated existing literature and summarized the impact of occupational, physiological, and psychological stressors on adrenal and neuroendocrine responses, body composition, and physical performance amongst women in tactical occupations. Methods: Boolean searches identified potentially qualifying reports involving: (1) adult women (≥19 y) currently employed or completing their training for a tactical profession; (2) ≥1 marker of “stress”; and (3) ≥1 adrenal, neuroendocrine, body composition, or fitness/performance outcome. Quantitative data (e.g., sample characteristics, outcomes of interest) were extracted and summarized. The completeness of reporting for each study was documented using existing checklists and quantified as: low (<50%), moderate (50–79%), or high (≥80%). Results: 40 studies (k) of moderate reporting quality (~64%) were included in the final sample (3693 women); 11 studies (28%) focused on women exclusively, and 16 studies identified sex differences in ≥1 outcome. Most studies involved military trainee populations (80%, k = 32). Occupation-related stress tended to negatively impact adrenal, neuroendocrine, body composition, and performance outcomes. Conclusions: This review highlights progress in assessing occupational performance in female tactical personnel exposed to diverse stressors; however, our understanding remains incomplete due to methodological and conceptual limitations in the literature. Holistic research strategies are needed to capture the complexity of performance readiness in women, integrating how stress affects key tactical performance aspects such as muscle physiology, reproductive health, and energy and nutrient balance in realistic operational contexts. Integrating such data is vital for informing policy, improving readiness, and enhancing the health and career longevity of female tactical personnel. Full article

Military personnel deployed to Iraq and Afghanistan were exposed to emissions from open-air burn pits, where plastics, metals, and medical waste were incinerated. These exposures have been linked to deployment-related respiratory diseases (DRRD) and may also impact neurological health via the lung–brain axis. To investigate molecular mechanisms, adult male rats were exposed to filtered air, naphthalene (a representative volatile organic compound), or a combination of naphthalene and carbon black (surrogate for particulate matter; CBN) via whole-body inhalation (six hours/day, three consecutive days). Lung, brain, and plasma samples were collected 24 h after the final exposure. Pro-inflammatory biomarkers were assessed using multiplex electrochemiluminescence and western blot. Differentially expressed genes (DEGs) were identified by RNA sequencing, and elastic net modeling was used to define exposure-predictive gene signatures. CBN exposure altered inflammatory biomarkers across tissues, with activation of nuclear factor kappa B (NF-κB) signaling. In the lung, gene set enrichment revealed activated pathways related to proliferation and inflammation, while epithelial–mesenchymal transition (EMT) and oxidative phosphorylation were suppressed. In the brain, EMT, inflammation, and senescence pathways were activated, while ribosomal function and oxidative metabolism were downregulated. Elastic net modeling identified a lung gene signature predictive of CBN exposure, including Kcnq3, Tgfbr1, and Tm4sf19. These findings demonstrate that inhalation of a surrogate burn pit mixture induces inflammatory and metabolic gene expression changes in both lung and brain tissues, supporting the utility of this animal model for understanding systemic effects of airborne military toxicants and for identifying potential biomarkers relevant to DRRD and Veteran health. Full article

Background/Objectives: Oral health has specific importance and consequences from a military and Navy standpoint. The aim of this study was to determine and compare caries prevalence and dental care in Spanish Navy personnel. Methods: A retrospective observational study was carried out with a sample size of 1318 individuals (34.65 ± 8.82 years old) stationed at the Rota naval base in Spain, whose dental charts were examined. Caries prevalence was assessed using the Decayed, Missing, Filled Teeth (DMFT) index; dental care was evaluated using the care index (CI); and demographic and occupational factors were recorded. Results: The population of this study had a mean DMFT index of 5.99 ± 4.71 and a CI of 79%. Through the results of the DMFT index and CI, the statistical significance of the age and rank variables (p < 0.01) was confirmed, with personnel >45 years old and non-commissioned officers (NCOs) having the highest mean DMFT values and the youngest and officer groups having the greatest CI variable. Comparing the DMFT index across genders and ages and between age and rank also revealed significant differences. Conclusions: This study’s findings show a low prevalence of cavitated caries (14.5%), with intermediate DMFT values and higher CIs compared to those in previous published data. Full article

Background/Objectives: This study examines the academic discourse surrounding Critical Incident Stress Debriefing (CISD) and Critical Incident Stress Management (CISM) for first responders using Latent Dirichlet Allocation (LDA) topic modeling. It aims to uncover latent topical structures in the literature and critically evaluate assumptions to identify gaps and limitations. Methods: A corpus of 214 research article abstracts related to CISD/M was gathered from the Web of Science Core Collection. After preprocessing, we used Orange Data Mining software’s LDA tool to analyze the corpus. We tested models ranging from 2 to 10 topics. To guide interpretation and labeling, we evaluated them using log perplexity, topic coherence, and LDAvis visualizations. A four-topic model offered the best balance of detail and interpretability. Results: Four topics emerged: (1) Critical Incident Stress Management in medical and emergency settings, (2) psychological and group-based interventions for PTSD and trauma, (3) peer support and experiences of emergency and military personnel, and (4) mental health interventions for first responders. Key gaps included limited focus on cumulative trauma, insufficient longitudinal research, and variability in procedural adherence affecting outcomes. Conclusions: The findings highlight the need for CISD/M protocols to move beyond event-specific interventions and address cumulative stressors. Recommendations include incorporating holistic, proactive mental health strategies and conducting longitudinal studies to evaluate long-term effectiveness. These insights can help refine CISD/M approaches and enhance their impact on first responders working in high-stress environments. Full article

Cordycepin, a bioactive adenosine analog, holds promise in pharmaceutical and health product development. However, large-scale production remains constrained by the limitations of natural producers, Cordyceps spp. Herein, we report the reconstruction of the first genome-scale metabolic model (GSMM) for a cordycepin-producing strain of recombinant Aspergillus oryzae. The model, iNR1684, incorporated 1684 genes and 1947 reactions with 93% gene-protein-reaction coverage, which was validated by the experimental biomass composition and growth rate. In silico analyses identified key gene amplification targets in the pentose phosphate and one-carbon metabolism pathways, indicating that folate metabolism is crucial for enhancing cordycepin production. Nutrient optimization simulations revealed that chitosan, D-glucosamine, and L-aspartate preferentially supported cordycepin biosynthesis. Additionally, a carbon-to-nitrogen ratio of 11.6:1 was identified and experimentally validated to maximize production, higher than that reported for Cordyceps militaris. These findings correspond to a faster growth rate, enhanced carbon assimilation, and broader substrate utilization by A. oryzae. This study demonstrates the significant role of GSMM in uncovering rational engineering strategies and provides a quantitative framework for precision fermentation, offering scalable and sustainable solutions for industrial cordycepin production. Full article

Infectious disease outbreaks amplify the influence of stressors on psychological conditions. The purpose of this study was to analyze the disturbing influence of COVID-19 outbreak-related information and the influence of trust on the Serbian healthcare system and COVID-19 preventive measures on anxiety and depression. An anonymous online questionnaire assessing the demographic information, disturbance level and causes, and levels of anxiety and depression has been distributed to the participants, divided into student and non-student groups. The non-student group was further divided into healthcare, military, and education workers. Anxiety and depression levels, as well as the level of decreased trust in COVID-19-related preventive measures, were higher among students compared to non-students (p = 0.011). Higher anxiety and depression levels, and higher influence of the COVID-19 outbreak on those levels, were observed in education and healthcare workers, compared to military personnel. Medical doctors reported a higher level of trust in the healthcare system compared to nurses (p = 0.023). Trust in the healthcare system increased more frequently compared to the pre-vaccination period among medical doctors, compared to nurses (p = 0.040). Higher anxiety and depression and lower public trust levels in students and workers in education and the healthcare sector indicate a need to focus on these important society members during public health emergencies. Full article

The management of public health projects in a BANI (brittle, anxious, non-linear, incomprehensible) environment, exemplified by the ongoing war in Ukraine, presents unprecedented challenges due to fragile systems, heightened uncertainty, and complex socio-political dynamics. This study proposes an AI-driven framework to enhance the resilience and effectiveness of public health interventions under such conditions. By integrating a coupled SEIR–Infodemic–Panicdemic Model with war-specific factors, we simulate the interplay of infectious disease spread, misinformation dissemination, and panic dynamics over 1500 days in a Ukrainian city (Kharkiv). The model incorporates time-varying parameters to account for population displacement, healthcare disruptions, and periodic war events, reflecting the evolving conflict context. Sensitivity and risk–opportunity analyses reveal that disease transmission, misinformation, and infrastructure damage significantly exacerbate epidemic peaks, while AI-enabled interventions, such as fact-checking, mental health support, and infrastructure recovery, offer substantial mitigation potential. Qualitative assessments identify technical, organisational, ethical, regulatory, and military risks, alongside opportunities for predictive analytics, automation, and equitable healthcare access. Quantitative simulations demonstrate that risks, like increased displacement, can amplify infectious peaks by up to 28.3%, whereas opportunities, like enhanced fact-checking, can reduce misinformation by 18.2%. These findings provide a roadmap for leveraging AI to navigate BANI environments, offering actionable insights for public health practitioners in Ukraine and other crisis settings. The study underscores AI’s transformative role in fostering adaptive, data-driven strategies to achieve sustainable health outcomes amidst volatility and uncertainty. Full article

Advancements in biosensing technologies have introduced opportunities for non-invasive, real-time monitoring of salivary biomarkers, enabling progress in fields ranging from personalized medicine to public health. Identifying and prioritizing the most critical analytes to measure in saliva is essential for estimating physiological status and forecasting performance in applied contexts. This study examined the value of 12 salivary analytes, including hormones, metabolites, and enzymes, for predicting cognitive and physical performance outcomes in military personnel (N = 115) engaged in stressful laboratory and field tasks. We calculated a series of features to quantify time-series analyte data and applied multiple regression techniques, including Elastic Net, Partial Least Squares, and Random Forest regression, to evaluate their predictive utility for five outcomes of interest: the ability to move, shoot, communicate, navigate, and sustain performance under stress. Predictive performance was poor across all models, with R-squared values near zero and limited evidence that salivary analytes provided stable or meaningful performance predictions. While certain features (e.g., post-peak slopes and variance metrics) appeared more frequently than others, no individual analyte emerged as a reliable predictor. These results suggest that salivary biomarkers alone are unlikely to provide robust insights into cognitive and physical performance outcomes. Future research may benefit from combining salivary and other biosensor data with contextual variables to improve predictive accuracy in real-world settings. Full article

Moral injury is increasingly recognized as a significant concern among medical personnel and first responders, particularly in high-stress healthcare and emergency settings. This review aims to synthesize current evidence on the prevalence, risk factors, and outcomes of moral injury among medical personnel and first responders across diverse healthcare and emergency response environments. We included peer-reviewed studies reporting on moral injury among medical personnel or first responders in any healthcare or emergency response setting, excluding studies that did not report original data or focused solely on military populations. We systematically searched PubMed, Google Scholar, and Central, up to April 2025. Risk of bias was assessed directly from the manuscripts. Data were synthesized narratively and, where possible, pooled using random-effects meta-analysis. A total of 41 studies involving 14,500 participants were included. The prevalence of moral injury ranged from 4.1% to 69.44% across settings. Key risk factors identified included exposure to traumatic events, organizational constraints, and lack of support. Meta-analysis indicated a significant association between moral injury and symptoms of PTSD. The evidence is limited by heterogeneity in measurement tools and study designs, as well as a moderate risk of bias in several included studies. In conclusion, moral injury is prevalent among medical personnel and first responders, with important implications for mental health interventions and organizational policy. This review was not funded externally, and is registered in PROSPERO (CRD420251019492). Full article

Vegetable intake among military Service Members (SMs) is well below public health guidelines, with only 12.9% meeting the Dietary Guidelines for Americans (DGAs). Low vegetable consumption negatively impacts diet quality as measured by the Healthy Eating Index (HEI), and poses risks to health and performance. Given the high physical and mental demands of military life, improving diet quality, including through increased vegetable intake, is crucial for optimizing health and readiness. Providing meal kits may help improve vegetable intake by reducing access-related barriers for SMs living or working on a military base. Furthermore, the addition of spices and herbs is a readily modifiable accompanying approach to address taste-related barriers and increase intake that has shown promise in other populations with poor diet quality. Background/Objectives: This study aimed to evaluate whether heat-and-serve meal kits with spices and herbs could increase vegetable intake and liking among active-duty SM by simultaneously targeting barriers to healthy eating and modifiable sensory factors. Methods: Conducted at Naval Support Activity Bethesda, the study randomly distributed heat-and-serve meal kits (n = 400) featuring either spiced (n = 200) or plain versions (n = 200) of four vegetables (broccoli, carrots, cauliflower, and kale). Each kit contained a quick response (QR) code for participants to upload post-consumption photos and rate vegetable liking on a nine-point Likert scale. Food photography (SmartIntake^®) was used to estimate vegetable consumption. Paired t-tests were used to determine differences between the intake of plain and spiced vegetables. Results: Intake of the heat-and-serve vegetables was very high for both the spiced and plain preparations (1.73 out of 2 cups, 87%). There was minimal difference (p = 0.87) between the consumption of spiced (1.75 cups) and plain (1.725 cups) vegetables, suggesting that both were well accepted. Overall, convenient and accessible meal options, alongside sensory-driven strategies, appear to improve some barriers to vegetable consumption in SM populations. Conclusions: Future studies should explore long-term outcomes and adaptability across different military environments, while considering additional factors, including convenience and time constraints, that influence dietary choices in the military. Full article