Search Results (1,404)

Freshwater quality criteria (FWQC) are essential scientific thresholds established to protect human health and aquatic ecosystems, serving as the foundation for water quality standards, environmental risk management, and pollution control. The latest research advancements were summarized, including the screening of priority pollutants for FWQC and the theory and methodology for environmental criteria in China in the last decade. The potential work has been meticulously analyzed and discussed concerning FWQC to be conducted in the short-term future. The possible prioritized list of pollutants for FWQC should be concerned with including nine categories of heavy metal ions, three categories of non-metal ions, and five categories of organic compounds in the short-term future research. The guidelines for deriving FWQC for the protection of human health for organoleptic effects and for sediment need to be modified and emphasized to ensure the safety of drinking water sources, address issues related to black and odorous surface water, and protect the biodiversity of benthic organisms. Toxicity data, water quality parameters, exposure data, and the geographical distribution of freshwater species should be systematically collected to support the development of FWQC in China. The potential applications of FWQC were also explored in the evaluation and formulation of WQS, ecological risk assessments, and the management of environmental emergencies and damage assessments to support environmental protection and management in China. Full article

Background: Beverage intake is a consequential yet underappreciated driver of health in Mediterranean settings. Comparative evidence for Spain and Italy based on harmonised measures is scarce. This study addresses that gap by profiling beverage portfolios and their sociodemographic correlates in parallel adult samples from both countries. Methods: We conducted a cross-sectional analysis of adults in Spain (n = 483) and Italy (n = 403) using aligned, validated instruments (NutSo-HH; NutSo-HH-Ita). Outcomes were water (Wtr), sugar-sweetened soft drinks (Sfd), juice (Juc), energy drinks (End), coffee (Cff), alcohol (Alc), and episodes of intoxication (Gtd). Associations were assessed via non-parametric tests, multivariable linear models, and an EBIC-selected Gaussian graphical model (GGM). Main results: Italians reported higher Alc and Gtd; Spaniards reported higher Sfd and Juc. Wtr was comparable across countries, and Cff differences were marginal. Age and sex emerged as the most consistent correlates (older age and male sex with higher Alc; younger age with higher Sfd), whereas education and income were not stable determinants. The GGM suggested behavioural clustering of Sfd–Juc–End, with weak partial correlations for other beverages after adjustment. Implications: Distinct country profiles imply differentiated priorities. In Spain, interventions could prioritise reducing sugar-sweetened beverage intake among younger adults through age-targeted primary care counselling, mandatory water (and unsweetened milk) availability in schools, tiered excise taxes on sugar-sweetened drinks, and restrictions on child- and youth-directed marketing of high-sugar beverages. In Italy, primary care and community health services could routinely screen adults for risky alcohol use and deliver brief, culturally attuned advice that promotes lower-risk patterns of wine consumption during meals. Given the cross-sectional design, self-report measures, and non-probabilistic sampling, findings should be interpreted as context-sensitive markers rather than causal determinants; nevertheless, they highlight concrete prevention approaches and regulatory levers for each country’s beverage-related health risks. Full article

Background/Objectives: Psychosocial factors (e.g., adherence, substance use) contribute to increased morbidity and mortality after heart transplantation. We investigated alcohol consumption patterns and their associations with psychosocial factors in adults, who underwent heart transplantation surgery (HTX recipients). Methods: Our cross-sectional study was conducted at the Semmelweis University Heart and Vascular Centre between 2023 and 2025. In total, 201 HTX recipients (75.6% male, mean age: 56.33 ± 11.46 years) completed the Alcohol Use Disorders Identification Test (AUDIT), Brief Health Literacy Screening Tool (BRIEF), Medication Adherence Report Scale (MARS-5) modified to immunosuppressive medication, and 9-item Beck Depression Inventory (BDI-9). Statistical analysis included Pearson’s correlation tests and Multivariate Regression Analyses. Results: The AUDIT had a higher proportion of non-evaluable responses than other questionnaires (AUDIT 19.9% vs. 5.5–9%), with 41.0% of the participants abstinent, 54.7% low-risk, 4.3% medium-risk, and 6.5% at-risk drinkers. AUDIT correlated negatively with MARS-5 (r = −0.326; p = 0.000) and positively with BDI-9 (r = 0.208; p = 0.010). At-risk drinking was associated with a lower MARS-5 (r = −0.231; p = 0.002). Multivariate regression models significantly predicted the AUDIT (F = 5.106; p < 0.001, R² = 0.216) and AUDIT-C (F = 3.804; p = 0.002; R² = 0.146), with sex and adherence as independent predictors. Conclusions: The high proportion of non-evaluable AUDIT responses suggests limitations in multi-questionnaire use but does not diminish its clinical relevance. The presence of 6.5% at-risk and 4.3% medium-risk drinkers highlights the relevance of consumption pattern screening, beyond diagnosing alcohol use disorder. Associations between AUDIT, MARS-5, and BDI-9 emphasize the necessity for multidisciplinary care. Full article

Binge drinking (BD) is defined as a pattern of alcohol consumption that results in a blood alcohol concentration of 0.08 g/dL or higher, typically achieved after consuming approximately 70 g of pure alcohol (about five drinks for men) or 56 g (about four drinks for women) within roughly two hours. It is highly prevalent among adolescents and young adults and has significant physical, psychological, and social consequences. Despite numerous interventions to reduce BD, there is limited systematic evidence on their effectiveness. This study presents a systematic review of randomized controlled trials (RCTs) evaluating interventions to reduce BD, focusing on their impact on frequency, intensity, and associated physical, psychological, or social outcomes. The review followed PRISMA 2020, and the protocol was registered with PROSPERO (CRD42024623481). A comprehensive search was conducted in multidisciplinary and specialized databases. Included studies were RCTs targeting BD in clinical or community populations of any age. Non-empirical and observational studies, or studies not specifically focused on BD were excluded. The risk of bias was assessed using RoB 2, and a total of 21 studies (N = 14,754 participants) were included, showing high variability in design, format, and theoretical basis. Brief, individual digital interventions predominated, although face-to-face group and multimodal interventions proved more effective. Eleven studies reported significant reductions in BD frequency or prevalence; fewer addressed intensity. Interventions based on motivational and cognitive behavioral approaches, especially in structured programmes with prolonged follow-up, were the most effective. Improvements were observed in psychosocial variables (e.g., negative consequences, self-efficacy, expectations, social norms, and intention to consume), but not in physical health or consumption of other substances. Most studies had a moderate risk of bias, and few demonstrated long-term effects. More robust, comparative, and longitudinal studies are needed. Full article

Background: A wide percentage (25–40%) of patients affected by head and neck squamous cell carcinoma (HNSCC) are over 70 years old, and they present with different characteristics if compared to younger patients. Elderly patients often receive less intensive, non-surgical, and non-multimodal treatments. Although age does not mean frailty, the elderly are at a higher risk of developing toxicity. In fact, several studies enrolling patients treated with cisplatin + radiotherapy (CISPLATIN + RT) or cetuximab + radiotherapy (Cet + RT) showed reduced efficacy over 65 years. Methods: We conducted a multicenter retrospective analysis in patients with Locally Advanced HNSCC aged over 65 years, who underwent Cet-RT, diagnosed in the period between 2017 and 2024. The primary endpoint was to describe Overall Survival (OS), the secondary endpoints were Progression Free Survival (PFS) and the percentage and type of Adverse Events (AEs). Patients received a geriatric assessment using the G8 questionnaire. Results: Data regarding Eighty-Two (82) patients were analyzed, median age was 74 years (range 65–84), most patients had oral cavity (26.8%) and laryngeal cancer (37.8%). Fifty-six point one (56.1%) of patients were smokers, and 17.1% reported alcohol consumption. All patients completed radiotherapy, and 80.5% of them developed AEs, which in 25.6% of cases were G3–4 toxicities. No relationship was found between G3–4 AEs and age (p = 0.596), G8score < 14 (p = 0.804), and smoking (p = 0.245)/drinking habits (p = 0.341). Median OS was 58 months, with a slightly non-significant positive trend in OS for patients who were non-smokers and those who did not develop G3–4 AEs (p = 0.786 and 0.799, respectively). Association between folliculitis and OS was statistically significant (p = 0.001). Conclusions: In elderly patients, Cet-RT represents a feasible, well-tolerated option, although further prospective studies are needed. Full article

Parental permissiveness toward alcohol use is associated with increased drinking among college students. In the U.S., Greek-affiliated students drink more and experience more negative consequences than other students. This study explored associations among student Greek affiliation, parental permissiveness toward heavy episodic drinking (HED), and alcohol use outcomes among first-year college students. Parent-student dyads (n = 294) completed surveys during high school and the first semester of college at a large public university in the U.S. Paired- and independent-samples t-tests and regression analyses were conducted. Parental permissiveness toward HED was higher among Greek-affiliated students than non-Greek-affiliated students, from parent and student perspectives, before and during college. In regression analyses, student Greek affiliation and perceived parental permissiveness were associated with greater alcohol use and HED. Greek status moderated associations between perceived parental permissiveness of HED and alcohol use (but not HED) such that the relationship was less pronounced for Greek-affiliated students compared to non-Greek-affiliated students. Our results suggest that interventions that aim to reduce perceived parental permissiveness toward HED, such as parent-based normative feedback interventions, may be an effective strategy to reduce drinking among first-year Greek-affiliated students. Full article

Background: Energy drink [ED] consumption is common among young adults and has been linked to adverse health effects and risky behaviors. This study compared medical and non-medical university students to assess whether health education influences knowledge, consumption, and attitudes toward EDs. Although medical and non-medical students are not minors, their opinions on the national ban on EDs sales to individuals under 18 provide valuable insight into attitudes toward regulation. Material and Methods: A cross-sectional online survey was conducted among 871 students (42.1% medical, 57.9% non-medical). The questionnaire assessed demographics, ED consumption, knowledge, motivations, and regulatory attitudes. It was pilot-tested on 30 students to ensure clarity, and internal consistency was confirmed (Cronbach’s α = 0.78 for knowledge; α = 0.81 for attitudes). Non-parametric tests (Mann–Whitney U, Kruskal–Wallis) and chi-square analyses compared groups. Results: Participants’ mean age was 22.1 years; most were female (73.2%). Medical students demonstrated significantly better knowledge of ED ingredients (simple sugars, B vitamins, L-carnitine, electrolytes; p < 0.01) and adverse effects (e.g., irritability, dizziness, nausea; p < 0.05). However, ED consumption frequency did not differ between medical and non-medical students. The main reasons for ED use were energy and concentration; social motives were less frequent. Female students more often supported the ban on ED sales to minors and additional advertising restrictions (p < 0.001), while overall confidence in enforcement was low. Conclusions: Despite greater awareness, medical students consume EDs at rates comparable to non-medical students. Educating medical students on safe caffeine use is crucial, since shift work may promote stimulant intake. Combining targeted education with stronger enforcement could enhance the impact of regulatory policies and reduce risky consumption among young adults. Full article

Objectives: The impact of combining animal and plant protein sources on digestibility is unclear, despite their increasing clinical use. Using a non-invasive dual stable isotope tracer approach, we assessed the digestibility, bioavailability and utilization of distinct protein blends in older adults, and associated plasma amino acid profiles and muscle protein synthesis (MPS) rates. Methods: Thirty-two older men (69 ± 3 y) consumed one of four protein blends (A (51:49, casein/soy); B and C (35:25:20:20, whey/casein/soy/pea); D (80:20, casein/whey)) alongside primed constant infusions of [1,2-¹³C₂] leucine for 8 h. Arterialized blood and vastus lateralis muscle biopsies were collected during a trickle feed protocol with all blends providing 20 g total protein, universally labeled ¹³C-spirulina, and ²H-cell free amino acid mix to determine digestibility. This trial was registered at Clinicaltrials.gov (ID-NCT07038655). Results: No differences (¹³C:²H ratios) were found in digestibility between the protein blends (p > 0.05). Mean (±SEM) fed state MPS at 2.5 h was 0.078 ± 0.009%/h, 0.075 ± 0.012%/h, 0.085 ± 0.007%/h and 0.065 ± 0.011%/h for drinks A, B, C and D, respectively, with a main time effect observed (p < 0.01), but no significant differences between drinks. Plasma essential amino acids (EAAs) increased significantly from baseline for all blends by 40 min (p < 0.05), with no differences between blends at any time point. Conclusions: These findings suggest that protein quantity (and/or leucine content), rather than composition, appears to be the most important factor driving MPS. Future work should focus on clinical populations where protein requirements and digestibility characteristics may differ. Full article

Hurricanes are increasingly impacting inland water systems, yet their role in mobilizing anthropogenic contaminants remains insufficiently characterized. This study presents a preliminary assessment of organic contaminant loading in the French Broad River, North Carolina, 15 days after flooding from Hurricane Helene. Surface water samples from five sites were analyzed using liquid chromatography–high-resolution mass spectrometry. Targeted analysis quantified 11 per- and polyfluoroalkyl substances (PFASs), with summed concentrations ranging from 1.49 to 70.8 ng/L. One downstream site exhibited the highest burden, where PFOSs and PFOA exceeded U.S. EPA drinking water maximum contaminant levels. Non-targeted analysis (NTA) and suspect screening identified 468 compounds, with 96 structurally annotated at high confidence. Of these, a large proportion were associated with medium to high hazard potential, particularly for acute aquatic toxicity (69%), developmental toxicity (64%), mutagenic genotoxicity (49%), endocrine disruption (35%), skin irritation (27%), eye irritation (26%), and carcinogenicity (17%). Four EPA priority pollutants—4-nitrophenol, 2,4,6-trichlorophenol, pentachlorophenol, and dibutyl phthalate—were also detected. Site-specific chemical profiles suggested inputs from flood-damaged wastewater infrastructure and plastic debris. These findings highlight the susceptibility of freshwater systems to contaminant mobilization during extreme flooding and demonstrate the value of combining NTA and cheminformatics for post-disaster monitoring. Full article

Background: Despite guidelines recommending lower alcohol limits for individuals who flush, some still drink at unhealthy levels. This study investigates whether drinking motives are differentially associated with alcohol consumption based on self-reported flushing status among U.S. Asian young adults. Asian American youth report alcohol use at rates comparable to other high-risk groups, identifying the need to understand factors shaping these behaviors. Methods: The current analysis drew participants from a longitudinal multi-cohort study examining the emotional and behavioral health of college students. Freshmen were recruited, all aged 18 years and older, to complete a baseline survey and follow up surveys over a four-year period. The analytic sample (Mean age = 19.4; 70.5% female) included 244 students who self-identified as Asian. Participants self-reported whether they experience facial flush when consuming alcohol and rated their endorsement of various drinking motives. Negative binomial regression models tested main effects and interaction effects between flushing status (flushers, non-flushers) and drinking motives (coping, enhancement, conformity, social). Results: Facial flushing moderated enhancement, conformity, and social drinking motives, but not coping. Among flushers, enhancement and social motives were more strongly associated with greater alcohol consumption. Among non-flushers, conformity motives were stronger and associated with greater drinking, at a trend level. Overall, flushing or higher coping motives were associated with lower alcohol consumption. Peer drinking was associated with higher consumption in both flushing-status groups. Conclusions: The current study extends prior international research on drinking motives and flushing status to U.S. Asian young adults. Findings support the need for prevention strategies that address individual drinking motives and the modeling of alcohol use by peers. Reducing alcohol use among individuals who experience alcohol-induced flushing is a public health priority, given their heightened risk for alcohol-related cancers and other negative health outcomes. Full article

Effect-based toxicity assessments are crucial for evaluating the risks of disinfection byproducts (DBPs), particularly unknown species, generated during drinking water chlorination. However, the accuracy of this approach is highly dependent on unbiased sample extraction. Conventional methods often employ single, low-pH extraction, which may fail to recover pH-sensitive amphoteric DBPs derived from amphoteric precursors (e.g., nitrogenous compounds). This study investigated how extraction pH affects the measured biotoxicity of DBPs formed from three model precursors: biopterin (Bip), cytosine (Cyt), and tryptophan (Trp). Under excess chlorine conditions, all three precursors degraded rapidly. The formation of aliphatic DBPs followed the order Trp > Cyt > Bip, and the maximum toxicity of the non-volatile extracts, assessed via a Vibrio fischeri bioassay, followed the reverse order: Bip > Trp > Cyt. This toxicity profile was significantly influenced by extraction pH, with maximum toxicity observed for Bip at around pH 4.0, under weakly acidic conditions for Trp, and under neutral to alkaline conditions for Cyt. For all precursors, the total organic carbon concentration remained constant throughout chlorination, indicating negligible mineralization and the predominant formation of non-aliphatic, likely heteroaromatic, products. These findings demonstrate that conventional extractions at a single low pH can lead to the incomplete recovery of toxic DBPs from amphoteric precursors. Therefore, pH-optimized extraction protocols are necessary for a more accurate risk assessment of chlorinated drinking water. Full article

Alcoholic beverages held significant importance in global dietary cultures. Their consumption was subject to the combined influence of sociocultural, economic, and psychological factors. As one of the world’s major alcohol consumption markets, China exhibited increasingly diverse drinking patterns, yet research on drinking behaviors based on the Chinese population remained relatively limited. This study employed a questionnaire-based survey to collect data. A total of 2119 Chinese adult alcohol consumers were recruited between October 2024 and April 2025. The sample encompassed individuals with diverse demographic backgrounds, including variations in gender, age, education level, monthly income, and occupation. Based on this dataset, multivariate logistic regression analysis was applied to systematically examine the key factors influencing drinking frequency among Chinese adult drinkers. The study found that the majority of drinkers in China engaged in low- to moderate-frequency drinking, with significant variations observed across different demographic groups: women aged 31–50 showed a higher proportion of high-frequency drinking, while individuals over 50 experienced a notable decline in drinking frequency. Individuals with smoking habits and higher stress levels were more likely to engage in high-frequency drinking. In contrast, those who report higher subjective well-being tended to exhibit moderate-frequency drinking patterns, characterized by moderate but non-excessive consumption. This study constructed a multi-dimensional profile of alcohol consumption behavior in China, thereby providing precise guidance for future product positioning and development, promoting high-quality development in the alcoholic beverage industry, and offering a scientific basis for advocating a culture of moderate and healthy drinking. Full article

The quality of groundwater, a crucial freshwater resource in cold regions, directly affects human health. This study used groundwater quality monitoring data collected in the central Songnen Plain in 2014 and 2022 as a case study. The improved DRASTICL model was used to assess the vulnerability index, while water quality indicators were selected using a random forest algorithm and combined with the entropy-weighted groundwater quality index (E-GQI) approach to realize water quality assessment. Furthermore, self-organizing maps (SOM) were used for pollutant source analysis. Finally, the study identified the synergistic migration mechanism of NH₄⁺ and Cl⁻, as well as the activation trend of As in reducing environments. The uncertainty inherent to health risk assessment was considered by developing a kernel density estimation–trapezoidal fuzzy number–Monte Carlo simulation (KDE-TFN-MCSS) model that reduced the distribution mis-specification risks and high-risk misjudgment rates associated with conventional assessment methods. The results indicated that: (1) The water chemistry type in the study area was predominantly HCO₃⁻–Ca²⁺ with moderately to weakly alkaline water, and the primary and nitrogen pollution indicators were elevated, with the average NH₄⁺ concentration significantly increasing from 0.06 mg/L in 2014 to 1.26 mg/L in 2022, exceeding the Class III limit of 1.0 mg/L. (2) The groundwater quality in the central Songnen Plain was poor in 2014, comprising predominantly Classes IV and V; by 2022, it comprised mostly Classes I–IV following a banded distribution, but declined in some central and northern areas. (3) The results of the SOM analysis revealed that the principal hardness component shifted from Ca²⁺ in 2014 to Ca²⁺–Mg²⁺ synergy in 2022. Local high values of As and NH₄⁺ were determined to reflect geogenic origin and diffuse agricultural pollution, whereas the Cl⁻ distribution reflected the influence of de-icing agents and urbanization. (4) Through drinking water exposure, a deterministic evaluation conducted using the conventional four-step method indicated that the non-carcinogenic risk (HI) in the central and eastern areas significantly exceeded the threshold (HI > 1) in 2014, with the high-HI area expanding westward to the central and western regions in 2022; local areas in the north also exhibited carcinogenic risk (CR) values exceeding the threshold (CR > 0.0001). The results of a probabilistic evaluation conducted using the proposed simulation model indicated that, except for children’s CR in 2022, both HI and CR exceeded acceptable thresholds with 95% probability. Therefore, the proposed assessment method can provide a basis for improved groundwater pollution zoning and control decisions in cold regions. Full article

Short sleep duration (≤6 h) is a public health concern linked to cardiometabolic disease and premature mortality. However, persistent disparities across sociodemographic, psychosocial, and structural domains remain underexplored in recent nationally representative samples. We analyzed 2022 Behavioral Risk Factor Surveillance System (BRFSS) data, including 228,463 adults (weighted N ≈ 122 million). Sleep duration was dichotomized as short (≤6 h) versus adequate (≥7 h). Complex samples logistic regression estimated associations between sociodemographic, psychosocial, behavioral, and structural determinants and short sleep, accounting for survey design. The weighted prevalence of short sleep was 33.2%. Non-Hispanic Black (AOR = 1.56, 95% CI: 1.46–1.65) and American Indian/Alaska Native adults (AOR = 1.46, 95% CI: 1.29–1.65) were disproportionately affected compared with non-Hispanic White adults. Psychosocial factors contributed strongly: life dissatisfaction, limited emotional support, and low social connectedness increased odds, whereas high connectedness was protective. Food insecurity and smoking were significant structural and behavioral risks, while binge drinking and urbanicity were not. One-third of U.S. adults report short sleep, with marked disparities across demographic, socioeconomic status, psychosocial stressors, and structural barriers. Findings highlight the multifactorial nature of sleep health inequities and the need for multilevel interventions addressing both individual behaviors and upstream determinants. Full article

Fermented beverages have been highlighted for their beneficial effects on health, especially due to the presence of probiotic microorganisms. This study aimed to develop and characterize a beverage fermented from the aqueous extract of licuri (Syagrus coronata) with grains of milk kefir and water kefir. Physical–chemical properties, microbial viability, storage stability, and in vitro resistance to the gastrointestinal tract (GIT), as well as microbiological safety and identification of isolated bacteria, were evaluated. The grains were fermented in licuri for 24 and 48 h, and the samples were compared with their respective controls. The analyses revealed that the licuri drink favored the growth of kefir grains, maintaining adequate microbial viability (>7 log CFU mL⁻¹ for lactic acid bacteria and >4 log CFU mL⁻¹ for yeasts), with good resistance to GIT (>60%) and physical–chemical properties for 20 days. The bacterial isolate was identified as Lacticaseibacillus paracasei, with a satisfactory safety profile. Licuri extract is therefore a promising matrix for the development of non-dairy functional beverages with potential probiotic properties. Full article