Search Results (15,876)

Selenium (Se) is an antioxidant essential trace element influencing inflammatory and immune pathways. This systematic review aimed to evaluate the role of maternal Se status during pregnancy in miscarriage risk. A systematic search of PubMed and Embase up to July 2024 was conducted to identify relevant original research studies in English. Available evidence was qualitatively synthesized and predefined sources of bias were assessed. Of 2345 studies identified, 421 full texts were assessed and 14 were included, encompassing 2309 pregnancies. Despite notable methodological limitations across several studies, current evidence indicates that maternal blood Se concentrations are lower among women who experience miscarriage compared to those with uncomplicated pregnancies. Findings regarding placental Se levels were inconsistent, but important methodological issues were noted. Environmental Se exposure was investigated in a single low-powered study, which did not demonstrate a statistically significant association. Potential interactions between Se status, co-exposure to other environmental or lifestyle factors, and effect modification remain insufficiently explored. Adequate maternal Se status during early gestation may reduce miscarriage risk by mitigating oxidative stress and ferroptosis, supporting immune regulation, and modulating thyroid autoimmunity and function. However, causal inference cannot be established due to the absence of randomized interventional evidence. Full article

Background: Children of mothers exposed to adverse childhood experiences (ACEs) may be at increased risk of sleep disruptions, such as night waking, due to potential suboptimal caregiving or living conditions. Mothers’ ACEs are also associated with maternal depressive symptoms, which in turn are associated with children’s screen time and sleep disruptions, revealing relevant, but unexplored, mediation pathways. This Canadian study investigated if mothers’ ACEs were associated with their 5-year-old children’s sleep disruptions (1) directly and (2) indirectly through independent or serial mediation via maternal depressive symptoms and/or children’s screen time. Methods: Data (n = 622; maternal mean age 32.3 years, 88.4% white) came from the longitudinal APrON Study. ACEs were measured 1 year postpartum. Mother’s depressive symptoms were measured across prenatal and postnatal timepoints. Children’s evening screen time (i.e., number of days in a week children engaged in one hour of screen time before bedtime) and sleep disruptions (number of days in a week their child wakes up multiple times) were measured at 5 years postpartum using adapted scales (52.9% male). PROCESS was used to assess for mediation. Results: Mothers’ ACEs had an indirect effect on their children’s sleep disruptions through mothers’ mean depressive symptoms (effect = 0.018, 95% CI [0.006, 0.034]), but not through children’s screen time. No other effects (i.e., direct, total) were observed. Conclusions: Although replication studies are warranted, this novel study reveals that the effects of maternal ACEs on children’s sleep disruptions may operate indirectly with effects potentiated through maternal depressive symptoms, thus serving as a target for intervention. Full article

Background/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity of care. This systematic review aimed to evaluate the efficacy of technology-enabled (p)rehabilitation on perioperative and patient-reported outcomes among individuals undergoing thoracic and/or abdominopelvic cancer surgery. Methods: Six databases were search from inception to October 2024. Eligible studies were randomised controlled trials (RCTs) comparing technology-enabled (p)rehabilitation with usual care, placebo, or non-technology-based interventions in adults undergoing thoracic and/or abdominopelvic cancer surgery. Outcomes included postoperative complications, hospital readmissions, hospital length of stay (LOS), quality of life (QoL), pain, anxiety, depression, fatigue, distress, and satisfaction. Higher scores indicated improved QoL or worse symptom severity. Risk of bias was assessed using the revised Cochrane tool, and evidence strength was determined using GRADE methodology. Relative risks (RR) and mean differences (MD) were calculated using random-effects meta-analysis. Results: Seventeen RCTs (18 publications, n = 1690) were included. Trials most commonly evaluated application-based platforms (n = 8) and the majority exhibited some risk of bias. Technology-enabled (p)rehabilitation was associated with a significant reduction in LOS (MD = 1.33 days; 95% CI: 0.59–2.07; seven trials), and improvements in pain (MD = 6.12; 95% CI: 3.40–8.84; four trials), depression (MD = 2.82; 95% CI: 0.65–4.99; five trials), fatigue (MD = 10.10; 95% CI: 6.97–13.23; three trials) and distress (MD = 1.23; 95% CI: 0.30–2.16; single trial) compared with controls. Conclusions: Technology-enabled (p)rehabilitation shows promise in reducing LOS and improving selected patient-reported outcomes following thoracic and abdominopelvic cancer surgery. Although evidence is limited due to the small number of studies, modest sample sizes, methodological heterogeneity, and intervention variability, the overall findings justify further investigation. Large-scale, adequately powered clinical trials are required to confirm efficacy and guide clinical effectiveness and implementation studies. Full article

Background: Oral food challenges (OFCs) are still the reference standard for confirming food allergy, yet the influence of previous anaphylaxis on challenge outcomes remains uncertain. Patients with a history of anaphylaxis are often considered at higher risk, which may affect the clinical decision-making process. This study aimed to identify predictors of OFC failure stratified by a history of anaphylaxis, given that prior investigations have predominantly considered anaphylaxis as an overall risk factor, without delineating distinct risk factor profiles according to anaphylaxis history. Methods: We conducted a retrospective evaluation of standard-of-care pediatric OFCs to cow’s milk and hen’s egg white. Eligible children had suspected or confirmed IgE-mediated allergy to cow’s milk protein (CMP) or hen’s egg white protein (HEWP) and were stratified by the presence or absence of previous anaphylaxis to the challenged food. Clinical data were compared between groups. Open OFCs were conducted under inpatient supervision with full emergency support. Logistic regression models were used to assess the relationship between comorbidities, specific IgE (sIgE) concentrations and OFC outcomes. Receiver operating characteristic (ROC) analysis evaluated diagnostic accuracy of sIgE concentrations in predicting OFC outcomes. Results: The analysis included 192 pediatric patients undergoing OFCs: 106 to CMP and 86 to HEWP. Six challenges (3.1%) were inconclusive, giving 186 valid results. The overall OFC failure rate was 32.3%. Patients with a past history of anaphylaxis more frequently underwent cow’s milk challenges (p = 0.01). Atopic dermatitis was a more common comorbidity in those without prior anaphylaxis (p = 0.04), regardless of the trigger. In hen’s egg challenges, children with a history of anaphylaxis reacted to significantly lower cumulative doses (p = 0.03) than patients without. Atopic dermatitis was identified as a predictor of OFC failure in children without prior anaphylaxis (p = 0.02), and asthma as a borderline predictor in those with previous systemic reactions (p = 0.05). Specific IgE concentrations correlated with OFC outcomes across allergens, with casein-sIgE showing the highest discriminative performance (AUC = 0.81) in children without previous anaphylaxis. Conclusions: Atopic dermatitis and asthma were identified as potential risk factors influencing OFC outcomes, depending on the patient’s history of anaphylaxis. The predictive accuracy of sIgE was different in groups stratified by presence of prior anaphylaxis, and the relationship between sIgE concentration and clinical reactivity was not identical across the two subpopulations. Casein-sIgE showed the highest diagnostic accuracy in children without previous severe reactions to CMP. Presence of anaphylactic reactions in the past is an important consideration when selecting children for OFCs to CMP and HEWP, since it delineates distinct risk factors for challenge failure in these patient populations. Full article

Coral reef ecosystems represent one of the most biodiverse and productive marine habitats, yet they are increasingly threatened by a range of anthropogenic stressors. Among these, emerging contaminants including pharmaceutical and personal care products (PPCPs) have started to feature as contaminants of concern due to their persistence, bioaccumulation potential, and complex interactions within reef environments. This review synthesizes current research on the occurrence, transport pathways, and ecological impacts of emerging contaminants, specifically focusing on PPCPs on coral reef systems. Evidence indicates that compounds such as UV filters, antibiotics, and endocrine-disrupting chemicals can impair coral physiology, disrupt symbiotic relationships with zooxanthellae, and contribute to bleaching events. The review further highlights the variability in coral species’ sensitivity to these contaminants, with documented effects ranging from oxidative stress to reduced growth and reproductive capacity. Despite advances in detection and risk assessment, significant knowledge gaps remain regarding long-term exposure, mixture effects, and the influence of local environmental conditions on contaminant toxicity. By consolidating recent findings, this review underscores the urgent need for targeted research and policy action to mitigate the threat of emerging contaminants to coral reef ecosystems. Full article

Background: In adult spinal deformity (ASD) surgery, appropriate rod length determination is crucial, as excessive cranial rod length can lead to skin problems, especially in thin elderly patients if proximal junctional kyphosis (PJK) develops. In adolescent idiopathic scoliosis (AIS), correction is primarily performed in the coronal plane, and rod length changes are relatively predictable. Moreover, PJK is uncommon in AIS, making excess rod length rarely a clinical concern. In contrast, ASD correction involves more complex three-dimensional realignment, including restoration of lumbar lordosis (LL), which makes it challenging to predict postoperative changes in rod trace length (RTL). Furthermore, because PJK occurs more frequently in ASD surgery, appropriate rod length selection becomes clinically important. This study aimed to quantitatively evaluate changes in RTL before and after posterior correction. Method: Thirty patients with ASD who underwent staged lateral lumbar interbody fusion (LLIF) followed by posterior corrective fusion from T9 to the pelvis were retrospectively analyzed. RTL before posterior correction (Pre-RTL) was estimated from the planned screw insertional point on axial CT after LLIF, and postoperative RTL (Post-RTL) was measured from screw head centers on post-operative CT. LL and Cobb angle were assessed before and after posterior correction. Correlations between RTL change and alignment change were evaluated. Results: Postoperative RTL was shortened in all patients, with an average reduction of approximately 16–17 mm. RTL shortening demonstrated significant correlations with LL correction (R = 0.51, p = 0.003) and Cobb angle correction (R = 0.70, p = 0.00001). Greater shortening of RTL was observed on the convex side in patients with preoperative Cobb angle ≥ 10° (p = 0.04). Conclusions: Greater coronal deformity, particularly on the convex side, was associated with increased RTL shortening. These findings suggest that routine preparation of excessively long rods may be unnecessary. Consideration of anticipated RTL shortening may help avoid excessive cranial rod length and potentially reduce the risk of skin complications associated with PJK, particularly in thin elderly patients. Full article

Background/Objectives: Falls are a major global issue for older adults, and emotional stress may increase the risk due to its effects on postural control and balance. However, the immediate effects of a stressful stimulus on objective measures of balance and fall risk are unknown. The study aims to explore differences in older adults’ performance on the Timed Up and Go (TUG) test before and after such exposure. Methods: In this cross-sectional study, 31 older adults (71.6 ± 4.98 years) were exposed to an emotionally stressful stimulus using high-arousal images from the International Affective Picture System. Participants performed the TUG before (t1) and after (t2) exposure as the primary outcome measure. To assess the physiological and psychological impact of the stressful stimulus, heart rate variability (HRV) was recorded before and during image viewing. A visual analogue scale (VAS) of unease was completed both before and after the stimulus. Results: During the stressful stimulus, the HRV high-frequency (HF) band decreased significantly (p = 0.001), while the low-frequency (LF) band (p = 0.002) and the LF/HF ratio (p = 0.004) showed a significant increase. Similarly, after stressful stimulus, VAS scores demonstrated a statistically significant increase (p < 0.001). The time to complete the TUG showed a statistically significant increase at t2 (p < 0.001). Conclusions: The stressful stimulus triggered both physiological and subjective stress responses. Subsequently, TUG test performance declined (increased duration), suggesting that emotionally stressful stimuli could deteriorate functional balance performance in older adults, potentially increasing fall risk. Full article

Objectives: The study examined tear and serum alterations using the ferning test and quantified the number of branches formed during the controlled drying of these biological fluids (tears and serum), in order to identify a potential diagnostic patterning test in individuals with obesity. Methods: A total of 61 patients aged between 25 and 72 years were enrolled (median age [interquartile range] = 39.0 [26] years). BMI values ranged from 19.1 to 47.5 kg/m², with a median BMI (interquartile range) of 29.3 (12.1) kg/m². Results: The Kruskal–Wallis test showed statistically significant differences among at least two Schirmer classes with respect to the number of branches observed in dried tears at a brightness threshold of 220 (H(2) = 8.485, p = 0.014). According to the Dunn post hoc test, Schirmer Class 1 showed a markedly lower number of branches compared with Classes 2 and 3 (p < 0.031 and p < 0.021), whereas no significant difference was found between Classes 2 and 3. The Kruskal–Wallis test further suggested the presence of statistically significant differences in the number of branches in dried serum, quantified using ImageJ2 at a brightness threshold of 190, across visceral fat classes (H(2) = 9.583, p = 0.008). Dunn’s post hoc tests revealed that the number of branches in serum analyzed at a brightness threshold of 190 was significantly higher in visceral fat class 3 compared to class 1 (p_holm = 0.006), while no statistically significant differences were observed between classes 1 and 2 or between classes 2 and 3 (p_holm > 0.05). Conclusions: In addition to other obesity-specific complications patients with obesity exhibit an increased risk of developing dry eye syndrome. The combined assessment of DPT in both the tear film and serum may represent a new method for analyzing obesity-associated biomarkers. Further studies are required to determine the sensitivity and specificity of these approaches in diagnosing systemic alterations induced by excess adipose tissue. Full article

Northern Thailand experiences recurrent seasonal haze driven by biomass burning (BB), which results in hazardous PM2.5 exposure and elevated environmental health risks. To address the need for timely and spatially resolved emission information, this study developed and evaluated an operational near-real-time (NRT) biomass-burning PM2.5 emission estimation system using the Fire INventory from NCAR version 2.5 (FINNv2.5). The objectives of this study are threefold: (1) to construct a high-resolution (≤1 km) NRT biomass-burning PM2.5 emission inventory for Northern Thailand; (2) to assess its temporal and spatial consistency with ground-based PM2.5 measurements and satellite fire observations; and (3) to examine its potential utility for informing environmental health risk management. The developed system captured short-lived, high-intensity burning episodes that defined the haze crisis, revealing a distinct peak period from late February to early April. Cumulative emissions from January to April 2024 exceeded 250,000 tons, dominated by Chiang Mai (25.8%) and Mae Hong Son (25.5%), which together contributed 51.3% of regional emissions. Strong correspondence with MODIS/VIIRS FRP (r = 0.79) confirmed the reliability of the NRT emission signal, while regression against observed PM2.5 concentrations indicated a substantial background burden (intercept = 40.41 μg m⁻³) and moderate explanatory power (R² = 0.448), reflecting additional meteorological and transboundary influences. Translating these relationships into operational metrics, an Emission Control Threshold of 1518 tons day⁻¹ was derived to guide targeted burn permitting and reduce population exposure during peak-risk periods. This NRT biomass-burning PM2.5 emission estimation framework offers timely emissions information that may support decision makers in environmental health risk management, including the development of early warnings, adaptive burn-permit strategies, and more coordinated responses across Northern Thailand. Full article

Melamine, a nitrogen-rich industrial chemical, has raised increasing concern as an emerging environmental contaminant with potential reproductive toxicity. While its nephrotoxic effects are well established, the direct impact of melamine on human sperm remains poorly defined. In this study, we investigated the in vitro effects of melamine on human sperm, under both capacitating and non-capacitating conditions. Functional analyses revealed that the exposure to 0.8 mM melamine, the highest non-cytotoxic concentration in vitro, significantly compromised sperm motility and disrupted key capacitation processes, including tyrosine phosphorylation patterns, cholesterol efflux, and the acrosome reaction. Molecular assessments demonstrated melamine-induced mitochondrial dysfunction, characterized by COX4I1 downregulation, reduced mitochondrial membrane potential, and altered reactive oxygen species production. In parallel, gene expression analyses revealed the activation of apoptotic pathways, with the upregulation of BAX and downregulation of BCL2, changes that were more pronounced during capacitation. Furthermore, melamine exposure significantly increased sperm DNA fragmentation and denaturation, indicating genotoxic stress. Collectively, these findings demonstrate that even low, non-cytotoxic concentrations of melamine compromise sperm function by disrupting capacitation, mitochondrial activity, and genomic integrity. This study identifies capacitation as a critical window of vulnerability and underscores the need to consider melamine as a potential environmental risk factor for male reproductive health. Full article

Rice–crab co-culture systems (RC) represent promising sustainable intensification approaches, yet their nitrogen (N) cycling and optimal fertilization strategies remain poorly characterized. In this study, we compared RC with rice monoculture system (RM) across four N gradients (0, 150, 210, and 270 kg N·hm⁻²), assessing N dynamics in field water and N distribution in soil. The results showed that field water ammonium nitrogen (NH₄⁺-N) concentrations increased nonlinearly, showing sharp increases beyond 210 kg N·hm⁻². Notably, crab activity in the RC altered the N transformation and transport processes, leading to a prolonged presence of nitrate nitrogen (NO₃⁻-N) in field water for two additional days after tillering fertilization compared to RM. This indicates a critical window for potential nitrogen loss risk, rather than enhanced retention, 15 days after basal fertilizer application. Compared to RM, RC exhibited enhanced nitrogen retention capacity, with NO₃⁻-N concentrations remaining elevated for an additional two days following tillering fertilization, suggesting a potential critical period for nitrogen loss risk. Post-harvest soil analysis revealed contrasting nitrogen distribution patterns: RC showed enhanced NH₄⁺-N accumulation in surface layers (0–2 cm) with minimal vertical NO₃⁻-N redistribution, while RM exhibited progressive NO₃⁻-N increases in subsurface layers (2–10 cm) with increasing fertilizer rates. The 210 kg N·hm⁻² rate proved optimal for the RC, producing a rice yield 12.08% higher than that of RM and sustaining high crab yields, while avoiding the excessive aqueous N levels seen at higher rates. It is important to note that these findings are based on a single-site, single-growing season field experiment conducted in Panjin, Liaoning Province, and thus the general applicability of the optimal nitrogen rate may require further validation across diverse environments. We conclude that a fertilization rate of 210 kg N·hm⁻² is the optimal strategy for RC, effectively balancing productivity and environmental sustainability. This finding provides a clear, quantitative guideline for precise N management in integrated aquaculture systems. Full article

The accumulation of heavy metals in fish tissues is widely recognized as an indicator of aquatic environmental pollution, and the analysis of their content provides a basis for assessing ecological risk and the safety of aquatic food. The European eel (Anguilla anguilla) is a species frequently used as a bioindicator in environmental studies due to its wide geographic distribution, long life cycle, and high capacity for bioaccumulation of heavy metals in various tissues. The aim of this study was to assess the variation in the accumulation of heavy metals, i.e., mercury (Hg), lead (Pb), arsenic (As), and cadmium (Cd), in the tissues (muscle, liver, gonads, and gills) of European eels caught in two locations in Polish inland waters. The obtained results showed significant differences both in the concentration levels of individual elements and in their co-occurrence in the examined tissues. The statistical methods used, including correlation analysis, heat maps, and principal component analysis (PCA), allowed for a comprehensive assessment of the relationships between metals and the identification of factors differentiating the studied populations. The obtained results clearly indicate that fish residing in similar environments for long periods exhibit significant differences in heavy metal content in various fish tissues. Fish obtained from environments with potentially higher levels of heavy metal inputs, such as the Oder River EMU compared with the Vistula River EMU, showed higher levels of heavy metal accumulation in tissues. This study also found that the concentration of heavy metals tested did not exceed the safe standards for human fish consumption. Full article

Tillage and crop rotation alter soil environments, thereby influencing both crop yields and methane-cycling microbiomes, yet their combined effects on microbial diversity, assembly, and interaction networks remain unclear. Using a two-factor field experiment, we assessed the impacts of raised seedbed vs. flat cultivation and rice–oilseed rape vs. rice–faba bean rotations on crop productivity and the ecology of methanogen (mcrA) and methanotroph (pmoA) communities. Raised seedbed cultivation significantly increased yields: rice yields were 7.6–9.6% higher in 2020 and 4.7–5.8% higher in 2021 than under flat cultivation (p < 0.05). Faba bean and oilseed rape yields were also improved. Flat rice–bean plots developed more reduced conditions and higher organic matter, with a higher NCM goodness-of-fit for methanogens (R² = 0.466), indicating patterns more consistent with neutral (stochastic) assembly, whereas the lower fit for methanotrophs (R² = 0.269) suggests weaker neutrality and stronger environmental filtering, accompanied by reduced richness and network complexity. In contrast, raised seedbed rice–oilseed rape plots improved redox potential and nutrient availability, sustaining both mcrA and pmoA diversity and fostering synergistic interactions, thereby enhancing community stability and indicating a potential for methane-cycle regulation. Overall, raised seedbed cultivation combined with legume rotation offers yield benefits and ecological advantages, providing a sustainable pathway for paddy management with potentially lower greenhouse gas risks. Full article

Background/Objectives: Low back pain (LBP) is increasingly prevalent among children and adolescents and represents a growing public health concern due to its potential persistence into adulthood. Screen-based sedentary behavior has substantially increased in pediatric populations. However, evidence regarding its association with LBP remains inconsistent, and the existence of a dose–response relationship is not well established. Methods: A systematic review and meta-analysis of observational studies was conducted in accordance with PRISMA guidelines. Studies examining the association between screen-based sedentary behavior and LBP in children and adolescents aged 6–18 years were included. Random-effects meta-analyses were used to pool continuous exposure estimates, and a multivariate random-effects dose–response meta-analysis was performed to assess changes in LBP risk across increasing levels of daily screen time. Results: A total of 30 studies were included. The pairwise meta-analysis of continuous exposure showed no statistically significant association between screen time and LBP, with OR = 1.02 (95% CI 0.65 to 1.59). In contrast, the dose–response meta-analysis demonstrated a significant positive association, with a 26% (95% CI 8% to 48%) increase in the odds of LBP for each additional hour of daily screen time. High between-study heterogeneity was observed, and most studies relied on self-reported measures of screen exposure and LBP, which may have introduced recall and misclassification bias and warrants cautious interpretation of the findings. Conclusions: Higher levels of screen-based sedentary behavior were associated with an increased risk of LBP in children and adolescents when examined using a dose–response approach, whereas pairwise meta-analyses did not identify a significant association. Nevertheless, substantial between-study heterogeneity and high risk of bias limit causal inference and require cautious interpretation. Full article

Oral infections in neutropenic patients are an underestimated but likely fatal cause of infectious complications, with clinical manifestations often diminished or absent due to immune deficiency. The evaluation and management of these infections requires a personalized multidisciplinary strategy, including prevention through pre-therapy dental assessment, individualized oral hygiene protocols, and rapid treatment of dental lesions. Antimicrobial strategies should be adapted not only to the local resistance profile and individual risk, with a priority on antibiotic stewardship and rapid de-escalation when possible, but also to individual patterns of colonization and comorbidities. Dental procedures can be performed without risk in neutropenic patients with a low complication rate, but further studies are key to stratifying risk. Future research directions include the application of artificial intelligence for infectious risk stratification, the use of salivary or microbiome biomarkers for early detection, and the development of innovative technologies for targeted antimicrobial delivery. This narrative review aims to provide an overview of the common clinical manifestations in neutropenic patients and also the potential progression of dental infections into sepsis in this category of patients. Full article