Search Results (8,367)

Lung cancer remains a major public health challenge due to high incidence and mortality. The chemokine receptor CXCR4 and its ligand CXCL12 (SDF-1) constitute a critical axis in tumor biology, influencing tumor cell proliferation, invasion, angiogenesis, and immune evasion. Aberrant CXCR4 expression is frequently observed in lung cancer and is closely associated with adverse prognosis, enhanced metastatic potential, and therapeutic resistance. Mechanistically, CXCR4 activates signaling pathways including PI3K/AKT, MAPK/ERK, JAK/STAT, and FAK/Src, promoting epithelial–mesenchymal transition, stemness, and survival. The CXCL12/CXCR4 axis also orchestrates interactions with the tumor microenvironment, facilitating chemotaxis toward CXCL12-rich niches (e.g., bone marrow and brain) and modulating anti-tumor immunity via regulatory cells. Regulation of CXCR4 occurs at transcriptional, epigenetic, and post-transcriptional levels, with modulation by hypoxia, inflammatory signals, microRNAs, and post-translational modifications. Clinically, high CXCR4 expression correlates with metastasis, poor prognosis, and reduced response to certain therapies, underscoring its potential as a prognostic biomarker and therapeutic target. Therapeutic strategies targeting CXCR4 include small-molecule antagonists (e.g., AMD3100/plerixafor; balixafortide), anti-CXCR4 antibodies, and CXCL12 decoys, as well as imaging probes for patient selection and response monitoring (e.g., 68Ga-pentixafor PET). Preclinical and early clinical studies suggest that CXCR4 blockade can impair tumor growth, limit metastatic spread, and enhance chemotherapy and immunotherapy efficacy, although hematopoietic side effects and infection risk necessitate careful therapeutic design. This review synthesizes the molecular features, regulatory networks, and translational potential of CXCR4 in lung cancer and discusses future directions for precision therapy and biomarker-guided intervention. Full article

Background/Objectives: Institutional catering serves vulnerable populations, including schoolchildren. Surfaces in food preparation environments are key control points for food safety and reservoirs and transmission routes for antimicrobial-resistant (AMR) bacteria. This study characterized the hygienic status of food-contact surfaces (FCS) and non-food-contact surfaces (NFCS) in Hungarian school kitchens, identified contamination hotspots, and examined how routine monitoring can support AMR prevention. Methods: We retrospectively analyzed routine environmental hygiene monitoring records from 96 school kitchens (2019–2024). In total, 8412 swab samples were collected, 8407 had quantifiable counts, 6233 from FCS (e.g., plates, trays, boards, utensils), and 2174 from NFCS (e.g., sinks, fridges, workers’ hands). Total aerobic mesophilic counts were measured with a redox-potential method and expressed as CFU/100 cm²; 250 CFU/100 cm² (2.4 log₁₀) was the hygienic threshold. Results: Overall, 12.4% of surfaces exceeded the threshold. Non-food-contact surfaces were more likely to be non-compliant than food-contact surfaces (OR 2.77, 95% CI 2.43–3.17; p < 0.001). Hotspots included transport-container lids (67.2% non-compliant; OR 43.82), sink basins (32.8%; OR 10.46), and cutting boards (21.6%; OR 5.89). Seasonally, non-compliance was highest in summer (16.5%) and lowest in winter (9.0%; p < 0.001). Conclusions: Multi-year monitoring revealed substantial contamination concentrated in a few hotspots that, within a One Health framework—which recognizes the interconnectedness of human, animal, and environmental health—may represent environmental reservoirs and cross-contamination nodes relevant to AMR prevention. Targeted optimization of cleaning and disinfection for these surfaces, combined with trend analysis of indicator data and periodic AMR-focused environmental sampling, could reduce foodborne and AMR-related risks in public catering. Full article

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used analgesics. However, their inappropriate or excessive use may lead to serious adverse effects. The aim of the study was to analyze behavioral patterns and attitudes toward the use of over-the-counter (OTC) NSAIDs, as well as the perception of risks associated with their use. Methods: A cross-sectional survey was conducted among 567 respondents. An anonymous questionnaire consisting of 26 items was used, addressing sociodemographic characteristics, frequency of reading drug information leaflets, frequency of NSAID use, and awareness of potential adverse effects associated with these medications. Results: The demographic factors significantly influenced NSAID-related behaviors. Women were significantly more likely than men to read drug information leaflets and reported more frequent use of OTC NSAIDs. Older respondents exhibited greater adherence to the principles of responsible NSAID use. Higher educational attainment was associated with more frequent and attentive reading of drug information leaflets. Urban residents reported higher median frequencies of NSAID use, whereas students demonstrated greater awareness of potential NSAID adverse effects compared with non-students. Conclusions: The results reveal complex patterns of NSAID consumption and underscore the need for implementing targeted public health interventions. Full article

Antimicrobial resistance (AMR) in hospital wastewater is a recognized public health concern, yet the dynamics of its emergence remain poorly understood. This study aimed to characterize the quantitative and qualitative changes in the microbial community of a newly built internal medicine intensive care hospital wing following the start of patient treatment. Wastewater samples were collected regularly from eight relevant sites, including seven patient-associated locations within the intensive care ward and the central sanitary sewer where all effluent converged. Culture-based analyses targeted the “ESCAPE-SO” bacterial and fungal groups (“Enterococci”, “Staphylococci”, “Candida”, “Acinetobacter”, “Pseudomonas”, “Enterobacteriaceae”, “Stenotrophomonas”, “Others”). Comparisons were made between a 12-month pre-operation period (only flushing every 72 h to prevent contamination of the drinking water system) and the first 12 months of patient treatment. The results showed a significant increase in mean bacterial concentrations from 53 [0–349] CFU/mL before patient treatment to 8423 [3054–79,490] CFU/mL during patient treatment (p = 0.0224) with a particular focus on Pseudomonas spp. as the dominant genus. Resistance against all four main antibiotic classes of the WHO AWaRe essential “watch” list (carbapenems, third-generation cephalosporins, broad-spectrum penicillin and ciprofloxacin) emerged within the first twelve months and depended on the amount of prescribed antibiotics and the number of patients treated. These findings indicate that hospital activity drives rapid development of antimicrobial resistance in wastewater microbial communities, highlighting the critical role of clinical antibiotic use in shaping environmental resistomes. This study provides quantitative evidence that resistance can emerge within months of hospital operation, emphasizing the need for early monitoring and targeted interventions to mitigate the spread of AMR from hospital effluents into broader environmental systems. Full article

Groundwater, a critical resource for regional water security and public health, faces escalating threats from heavy metal contamination—a pressing environmental challenge worldwide. This study focuses on the central-south Hunan region of China, a mineral-rich, densely populated area characterized predominantly by non-point-source pollution, aiming to systematically unravel the spatial patterns, source contributions, and associated health risks of heavy metals in local groundwater. Based on 717 spring and well water samples collected in 2024, we determined pH and seven heavy metals (As, Cd, Pb, Zn, Fe, Mn, and Tl). By integrating hydrogeological zoning, lithology, topography, and river networks, the study area was divided into 11 assessment units, clearly revealing the spatial heterogeneity of heavy metals. The results demonstrate that exceedances of Cd, Pb, and Zn were sporadic and point-source-influenced, whereas As, Fe, Mn, and Tl showed regional exceedance patterns (e.g., Mn exceeded the standard in 9.76% of samples), identifying them as priority control elements. The spatial distribution of heavy metals was governed the synergistic effects of lithology, water–rock interactions, and hydrological structure, showing a distinct “acidic in the northeast, alkaline in the southwest” pH gradient. Combined application of the APCS-MLR and PMF models resolved five principal pollution sources: an acid-reducing-environment-driven release source (contributing 76.1% of Fe and 58.3% of Pb); a geogenic–anthropogenic composite source (contributing 81.0% of Tl and 62.4% of Cd); a human-perturbation-triggered natural Mn release source (contributing 94.8% of Mn); an agricultural-activity-related input source (contributing 60.1% of Zn); and a primary geological source (contributing 89.9% of As). Monte Carlo simulation-based health risk assessment indicated that the average hazard index (HI) and total carcinogenic risk (TCR) for all heavy metals were below acceptable thresholds, suggesting generally manageable risk. However, As was the dominant contributor to both non-carcinogenic and carcinogenic risks, with its carcinogenic risk exceeding the threshold in up to 3.84% of the simulated adult exposures under extreme scenarios. Sensitivity analysis identified exposure duration (ED) as the most influential parameter governing risk outcomes. In conclusion, we recommend implementing spatially differentiated management strategies: prioritizing As control in red-bed and granite–metamorphic zones; enhancing Tl monitoring in the northern and northeastern granite-rich areas, particularly downstream of the Mishui River; and regulating land use in brick-factory-dense riparian zones to mitigate disturbance-induced Mn release—for instance, through the enforcement of setback requirements and targeted groundwater monitoring programs. This study provides a scientific foundation for the sustainable management and safety assurance of groundwater resources in regions with similar geological and anthropogenic settings. Full article

Spray-induced gene silencing (SIGS) represents a transformative paradigm in sustainable pest management, utilizing the exogenous application of double-stranded RNA (dsRNA) to achieve sequence-specific silencing of essential genes in arthropod pests. Unlike transgenic approaches, sprayable RNA interference (RNAi) biopesticides offer superior versatility across crop systems, flexible application timing, and a more favorable regulatory and public acceptance profile. The 2023 U.S. EPA registration of Ledprona, the first sprayable dsRNA biopesticide targeting Leptinotarsa decemlineata, marks a significant milestone toward the commercialization of non-transformative RNAi technologies. Despite the milestone, large-scale field deployment faces critical bottlenecks, primarily environmental instability, enzymatic degradation by nucleases, and variable cellular uptake across pest taxa. This review critically analyzes the mechanistic basis of spray-applied RNAi and synthesizes the recent technological breakthroughs designed to overcome physiological and environmental barriers. We highlight advanced delivery strategies, including nuclease inhibitor co-application, liposome encapsulation, and nanomaterial-based formulations that enhance persistence on plant foliage and uptake efficiency. Furthermore, we discuss how innovations in microbial fermentation have drastically reduced synthesis costs, rendering industrial-scale production economically viable. Finally, we outline the roadmap for broad adoption, addressing essential factors such as biosafety assessment, environmental fate, resistance management protocols, and the path toward cost-effective manufacturing. Full article

With the global increase in population aging, allergic diseases in older adults are becoming an increasingly relevant clinical and public health challenge. Age-related molecular and cellular alterations significantly affect the pathophysiology, clinical manifestations, diagnosis, and management of major allergic diseases in the elderly. This review focuses on immunosenescence in major allergic conditions, including asthma, chronic urticaria and angioedema, dermatitis, food and drug allergies, and hymenoptera venom hypersensitivity. Particular emphasis is placed on molecular mechanisms underlying immune aging, such as inflammaging, dysregulation of innate and adaptive immune responses, epithelial barrier dysfunction, microbiota alterations, neuro-immune interactions, and age-related comorbidities. Sex-related differences in immune responses are also addressed, together with current diagnostic and therapeutic strategies, including the opportunities and limitations of biologic therapies in aging populations. Despite growing interest in this field, a major limitation remains the paucity of studies specifically targeting geriatric populations, underscoring the need for age- and sex-specific research and dedicated clinical trials. A personalized approach integrating frailty assessment and immune profiling is essential to optimize the management of allergic diseases in older adults. Full article

As the global transportation sector accelerates toward net-zero targets, the rapid deployment of alternative fuels like hydrogen, ammonia, and batteries introduces complex and novel safety challenges. This study systematically maps the intellectual structure of safety and risk research on zero-emission transportation systems to evaluate field maturity and identify critical knowledge gaps. We conducted a comprehensive bibliometric analysis of 151 core publications retrieved from the Web of Science from 2000 to 2025. By integrating quantitative performance analysis with qualitative science mapping techniques, the results identify that the domain is nascent and rapidly expanding, and a distinct inflection in publication occurred in 2020. However, science mapping reveals a fragmented intellectual structure. Among the four identified research clusters, two dominant streams emerge as the primary drivers of the field. The first is a “motor theme” focused on lithium-ion battery reliability and thermal runaway, while the second is a “basic theme” focused on hydrogen dispersion and toxicity risks. The analysis exposes a blind spot regarding the lack of cross-modal research addressing the physical safety interactions between different fuel systems operating in the shared infrastructure. Finally, this study proposes a future research agenda focusing on gathering real-world accident data and using system-theoretic approaches to manage integrated alternative fuel risks. Full article

Community public sport facilities are core carriers of the national fitness public service system, with their supply–demand alignment directly linked to megacity governance efficiency and residents’ well-being. To address structural issues, such as “human–land imbalance” in facility layout, this study uses the 2010–2024 panel data from Shanghai’s 16 districts, applies supply–demand equilibrium theory, and integrates quantitative methods to analyze spatio-temporal supply–demand coupling and identify key influencing factors. The study yields four key findings: (1) The spatial distribution of facilities and population demonstrates a differentiated evolutionary trajectory marked by “central dispersion and suburban stability”. (2) Supply–demand alignment has continuously improved, as evidenced by the increase in coordinated administrative districts from six to thirteen. Nonetheless, the distance between sports facilities and population centers widened, suggesting that spatial adaptation remains incomplete. (3) Urban population growth exerts a significant positive impact on facility supply. Elasticity coefficients are generally high in suburban areas, while negative elasticity is detected in some central urban areas due to population outflow. (4) Facility construction intensity and residential activity intensity are core driving factors, with economic conditions, transportation infrastructure, and housing prices acting as key supporting factors. This study overcomes traditional aggregate-quantity research limitations, reveals megacity facility supply–demand “spatial mismatch” dynamics, and provides a scientific basis for targeted public sports facility layout and refined governance. Full article

Paralytic shellfish toxins (PSTs) are produced by several toxic species of the dinoflagellate genera Alexandrium and Gymnodinium, and they pose significant threats to marine ecosystems and public health. Rapid and accurate detection of harmful algal blooms (HABs) is essential for effective management. In this study, we developed a multiplex quantitative real-time PCR (qPCR) assay targeting the 28S ribosomal DNA region to simultaneously detect three PST-producing dinoflagellates, Alexandrium catenella, A. pacificum, and Gymnodinium catenatum, in the East China Sea off southern Korea. Species-specific primers and hydrolysis probes labeled with distinct fluorophores were validated for simultaneous detection. The standard curves showed strong linearity (R² > 0.99) and high amplification efficiencies (95.268–99.325%). No cross-reactivity was observed among the 20 non-target microalgal species. Field application of the assay using environmental DNA (eDNA) samples collected during spring successfully detected A. catenella and A. pacificum, whereas G. catenatum was not detected during the survey period. This multiplex qPCR assay provides a rapid and reliable molecular tool for early detection and spatial monitoring of potentially PST-producing dinoflagellates, supporting sustainable HAB management in East Asian coastal ecosystems. Full article

Background/Objectives: Drug-induced sleep endoscopy (DISE) is used in obstructive sleep apnea (OSA) to visualize dynamic upper airway collapse, but sedation protocols vary widely with no consensus on the optimal agent or technique. This narrative review aims to clarify current sedation strategies for DISE in OSA and their clinical implications. Methods: We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library for English-language publications on DISE sedation (2000–2025). Relevant clinical studies, guidelines, and reviews were included. Data were qualitatively synthesized due to heterogeneity among studies. Results: Sedation approaches in DISE varied considerably. Propofol, dexmedetomidine, and midazolam were the primary agents identified. Propofol provided rapid, titratable sedation but increased airway collapsibility at higher doses; dexmedetomidine produced a more natural sleep-like state with minimal respiratory depression; midazolam was less favored due to prolonged effects. Use of target-controlled infusion (TCI) and pharmacokinetic–pharmacodynamic (PK–PD) models improved control of propofol sedation. Co-sedative adjuncts (e.g., opioids) reduced the required sedative dose but added risk of respiratory depression. Careful titration to the lowest effective dose-often guided by bispectral index (BIS) monitoring—was emphasized to achieve adequate sedation without artifactual airway collapse. No universal DISE sedation protocol was identified. Conclusions: Optimal DISE sedation balances adequate depth with patient safety to ensure reliable findings. Using the minimum effective dose, guided by objective monitoring (e.g., BIS), is recommended. There is a need for standardized sedation protocols and further research (e.g., in obese patients) to resolve current controversies and improve DISE’s utility in OSA management. Full article

Background/Objectives: Lithium (Li), silicon (Si), and boron (B) are proposed nutritional trace elements with potential roles in metabolic, neurobiological, endocrine, inflammatory, and bone-related processes. This review provides a critical synthesis of data on Li–Si–B, emphasizing (i) physiological and mechanistic pathways, (ii) human clinical relevance, (iii) shared biological domains, and (iv) safety considerations. Methods: A narrative review was conducted across PubMed, Scopus, and Web of Science from inception to January 2025. Predefined search strings targeted dietary, environmental, and supplemental exposures of lithium, silicon, or boron in relation to metabolism, endocrine function, neurobiology, inflammation, bone health, and the gut microbiome. Inclusion criteria required peer-reviewed studies in English. Data extraction followed a structured template, and evidence was stratified into human, animal, cellular, and ecological tiers. Methodological limitations were critically appraised. Results: Li, Si, and B influence overlapping molecular pathways including oxidative stress modulation, mitochondrial stability, inflammatory signaling, endocrine regulation, and epithelial/gut barrier function. Human evidence remains limited: Li is supported primarily by small trials; Si by bone-related observational studies and biomarker-oriented interventions; and B by metabolic, inflammatory, and cognitive studies of modest sample size. Convergence across elements appears in redox control, barrier function, and neuroimmune interactions, but mechanistic synergism remains hypothetical. Conclusions: Although Li–Si–B display compelling mechanistic potential, current human data are insufficient to justify dietary recommendations or supplementation. Considerable research gaps—including exposure assessment, dose–response characterization, toxicity thresholds, and controlled human trials—must be addressed before translation into public health policy. Full article

Gender-Based Violence (GBV) represents a major public health and social concern, with evidence linking persistent sexist beliefs to a higher likelihood of experiencing or perpetrating GBV, particularly among young adults. This study aimed to examine attitudes towards GBV among university students in Castilla-La Mancha, providing insight into ongoing gender inequalities within higher education. A total of 399 undergraduate and double-degree students at the University of University of Castilla-La Mancha completed the 47-item Gender and Violence Attitudes Questionnaire (GVAQ), and data were analyzed using descriptive and correlational methods. The results indicate the persistence of sexist beliefs and justifications for violence, with significant differences according to sex, age, and academic discipline: men scored higher overall on the GVAQ (M = 101.69) than women (M = 83.82), students in Engineering and Architecture scored higher (M = 100.89) than those in Arts and Humanities (M = 83.22), and younger students (≤25 years) scored slightly higher (M = 89.63) than older students (≥26 years) (M = 85.91). These findings highlight the urgent need for targeted educational programmes integrating a gender perspective to challenge entrenched sexist attitudes and reduce GBV in university contexts, fostering safer and more equitable learning environments. Full article

Background/Objectives: In England, gay, bisexual, and other men who have sex with men (GBMSM) are eligible for vaccination at NHS sexual health services, including human papillomavirus (HPV), hepatitis A virus (HAV), and hepatitis B virus (HBV) vaccines. However, current research shows limited understanding of the factors influencing vaccination uptake among GBMSM. This study aimed to examine the barriers and facilitators affecting the offer and uptake of these vaccination programmes. Methods: A qualitative interview study following the Person-Based Approach (a systematic method for developing and optimising health interventions) involving GBMSM and sexual health service staff from two regions of England. Purposive sampling aimed to include GBMSM with diverse backgrounds and engagement with sexual health services. Patient and public involvement shaped the study design and interview topic guides. The interviews were recorded, transcribed, and thematically analysed to identify barriers and facilitators which were interpreted using the COM-B model of behaviour change. Results: Twenty GBMSM and eleven staff took part. The findings showed that opportunistic delivery of HPV, HAV, and HBV vaccination within sexual health services is mostly acceptable and feasible for GBMSM and staff, while also highlighting areas for optimization. Despite low knowledge of these viruses and their associated risks, willingness to be vaccinated was high, with healthcare provider recommendations and the convenience of vaccine delivery during routine clinic visits acting as important facilitators. However, the reach of opportunistic models was limited, particularly for individuals underserved by sexual health services or disengaged from GBMSM social networks. System-level barriers such as complex vaccine schedules (particularly when multiple schedules are combined), inconsistent access to vaccination histories, and limited system-level follow-up processes (e.g., automated invites and reminders) were also found to act as obstacles to vaccination uptake and delivery. Conclusions: To improve equitable uptake, sexual health services should explore the feasibility of addressing both individual and structural barriers through additional strategies, including targeted and persuasive communication to increase knowledge, leveraging regular contact with GBMSM to promote uptake, and implementing enhanced approaches to support vaccination completion (e.g., automated prompts or reminders). Full article

Background and Objectives: Celiac disease (CD) is a major global public health problem that can occur at any age. Pediatric CD can be typical, atypical, or even asymptomatic. Early diagnosis and early initiation of treatment are essential for improving patients’ quality of life and preventing serious complications later in life. However, it is impossible to identify asymptomatic children and adolescents without screening. In this systematic review, we attempted to identify different mass screening programs that have been reported for CD in apparently healthy children and adolescents across the world, to highlight the advantages and disadvantages of such strategies, and to collect and synthesize data from these studies reporting the prevalence of CD. In addition, where data were available, we also attempted to evaluate the diagnostic accuracy of the tests used, their cost-effectiveness, the reported clinical benefits, and follow-up data from individuals identified through screening. Materials and Methods: Electronic databases, including PubMed and Scopus, were systematically searched. Initially, a total of 316 studies were retrieved. Finally, 55 studies met all inclusion criteria and were included in this review. The included studies were published between 1996 and 2023. Results: The reported age of participants ranged from 6 months to 23 years. Confirmation of CD by biopsy was reported in all but six studies. According to the studies that provided data, the (tTG IgA) seroprevalence of CD in apparently healthy children and adolescents, detected through different mass screening methods around the world, ranged from 0.20% (Turkey) to 3.11% (Italy). In addition, the prevalence of biopsy-confirmed CD ranged from 0.036% (Vietnam) to 3% (Sweden and Spain). Studies from 17 countries reported mass screening strategies based on finger-prick rapid tests. All rapid tests detected CD antibodies, except two, which detected HLA DQ2/DQ8 haplotypes. Rapid tests appeared to be no less sensitive and specific than other screening tests for CD and were probably less expensive, but further studies are needed for more reliable conclusions. Of the 55 studies in the review, only 10 reported follow-up data. After 3 months of a gluten-free diet, the general condition of the patients improved; after 6 months, tTG IgA and EMA IgA levels decreased and hemoglobin values increased; while after 1 year, tTG IgG levels also decreased, symptoms subsided, the children’s weight and height increased, school performance improved, episodes of upper respiratory tract infections decreased, and thyreoperoxidase antibodies that were positive at screening became negative. Conclusions: Mass screening for CD in asymptomatic children and adolescents is a challenge. Future research should provide more answers regarding the most appropriate target age, the frequency of screening, the optimal screening method, the cost-effectiveness, the clinical utility, and the long-term impact of mass screening on patients’ quality of life. Full article