A probabilistic health risk assessment of potentially toxic elements in edible vegetable oils consumed in Hamadan, Iran.

In this study, potential toxic element (PTEs) including lead (Pb), arsenic (As), cadmium(Cd), iron (Fe) and zinc (Zn) in traditional and industrial edible vegetable oils (peanut, sunflower, olive and sesame) collected from Hamadan, west of Iran were determined using Inductivity Coupled Plasma Optical Emission Spectrometry (ICP-OES). Besides, probabilistic health risk assessment (non-carcinogenic and carcinogenic risks) was identified via total target hazard quotient (TTHQ) and cancer risk (CR) by the Monte Carlo Simulation (MCS) model. The ranking of concentration PTEs in traditional and industrial edible vegetable oils was Fe > Zn > As > Pb > Cd. The in all samples, content of PTEs in industrial oils were upper than traditional oils (p < 0.001). The level of PTEs in most of vegetable oils was lower than permissible concentration regulated by Codex and national standard. In term of non-carcinogenic, consumers were at acceptable range (TTHQ < 1) due to ingestion both traditional and industrial vegetable oils content of PTEs. In term of carcinogenic, CR the both adults and children was higher than acceptable range (CR < 1E-6), Hence consumer are at unacceptable risk due to ingestion industrial vegetable oils content of inorganic As. Therefore, it is recommended to implement control plans for PTEs in vegetable oils consumed in Hamadan, Iran.

Concentration and non-dietary human health risk assessment of pesticide residues in soil of farms in Golestan province, Iran.

Detection of pesticide residues in soil samples was conducted using UHPLC-MS/MS. Non-dietary health risk assessment was conducted using calculate chronic daily intake (CDI) from ingestion, inhalation and dermal contact pathways and following non-carcinogenic and carcinogenic risks in the adults and adolescent. The rank order of pesticide in soil based on their concentration was malathion (0.082 mg kg-1)> cyproconazole (0.019 mg kg-1)> propargite (0.018 mg kg-1)> butachlor (0.016 mg kg-1) > chlorpyrifos (0.0067 mg kg-1)> diazinon (0.0014 mg kg-1)> imidacloprid (0.0007 mg kg-1). Hazard index (HI) values obtained of exposure to pesticides in soil in adults and adolescent were 0.0012 and 0.0035, respectively. Hence, exposed population are at the acceptable range of non-carcinogenic risk (HI < 1). Cancer risk (CR) values due to propargite in soil via ingestion pathway in adults and adolescent were 2.03E-09 and 2.08E-09, respectively; therefore, carcinogenic risk due to the exposure to pesticide contaminated soil was safe range (CR < 1E-06).

The concentration of pesticides in onion samples from Iran: a non-carcinogenic health risk assessment.

Pesticide residues were extracted using the QuEChERS method, followed by detection by ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). The non-carcinogenic health risk in adult and child consumers was calculated by target hazard quotient (THQ) and total target hazard quotient (TTHQ) in the Monte Carlo Simulation (MCS) method. The rank order of pesticides detected by UHPLC-MS/MS based on median concentration in onion was tebuconazole (0.004551 mg/kg) > imidacloprid (0.00233 mg/kg) > boscalid (0.00211 mg/kg) > diazinon (0.00079 mg/kg) > thiabendazole (0.00075 mg/kg) > acetamiprid (0.00052 mg/kg) > thiophanate-methyl (0.00052 mg/kg) > dichlorvos (0.000349 mg/kg) > fenitrothion (0.000132 mg/kg) > penconazole (0.00005 mg/kg). The median of TTHQ in adults and children's consumers were 4.00E-3 and 2.00E-2, respectively. TTHQ in adults and children's consumers was lower than 1 value. Hence, consumers were in the acceptable range (TTHQ <1). Consequently, onion consumption cannot endanger consumers' health status due to the pesticide residues.

Potentially toxic elements (PTEs) in coastal sediments of Bandar Abbas city, North of Persian Gulf: An ecological risk assessment.

The concentration of potentially toxic elements (PTEs; Lead (Pb), Nickel (Ni), and Cadmium (Cd) Pb, Ni, and Cd), using flame atomic absorption spectrometry (FAAS) was measured in fifty surface coastal sediment samples collected from 5 points coastal sediment of Bandar Abbas city, Iran besides the potential ecological risk index (RI) estimated the environmental health risk. The rank order of PTEs was Pb (52.090 ± 4.113 mg/kg dry weight) > Ni (34.940 ± 8.344 mg/kg dry weight) > Cd (2.944 ± 0.013 mg/kg dry weight). RI due to PTEs in sediments for A, B, C, D, and E points were 187.655, 190.542, 191.079, 189.496, and 192.053, respectively. RI for sampling points A to E was at moderate risk (150 ≤ RI < 300). Therefore, it is recommended to carry out control programs to reduce the amount of PTEs in the coastal sediment of the Persian Gulf.

The concentration of radioisotopes (Potassium-40, Polonium-210, Radium-226, and Thorium-230) in fillet tissue carp fishes: A systematic review and probabilistic exposure assessment.

Chemical contamination of seafood has become a global health concern. Carp fish is one of the most widely consumed globally, and several studies have been conducted on the contamination of carp fish with radioisotopes. In the current study, a meta-analysis and probabilistic exposure assessment regarding the Potassium-40 (40K), Polonium-210 (210Po), Radium-226 (226Ra), and Thorium-230 (230Th) in the fillet tissue of carp fish were performed. In this regard, Scopus and PubMed were screened to retrieve the associated citations with on the concentration of radioisotopes in the fillet tissue of carp fish until October 2021. The rank order of radioisotopes in fillet tissue carp fish was 40K (103.49 Bq kg-1) > 210Po (9.39 Bq kg-1) > 226Ra (0.62 Bq kg-1) > 230Th (0.39 Bq kg-1). The highest effective dose due to 210Po ingestion was observed in Spain (male; 4.44E-05 Sv y-1, female; 2.67E-06 Sv y-1); 40K (female, 5.07E-07 Sv y-1); 226Ra (male, 9.93E-09 Sv y-1). The mean of effective dose (ED) in the male and females in India due to ingestion of 230Th as result of carp fish consumption was (1.70E-06 Sv y-1) and (7.01E-08 Sv y-1), respectively. The probabilistic exposure assessment by the Monte Carlo simulation method revealed that consumers of fillet tissue carp fish content of radioisotopes are at a safe range (0.001 Sv y-1).

The concentration of Potentially Toxic elements (PTEs) in the muscle of crabs: a global systematic review, meta-analysis, and health risk assessment.

The concentration of PTEs in the muscle of crabs, was meta-analyzed using a random-effects model based on countries' subgroups. The non-carcinogenic and carcinogenic risks related to the ingestion of PTEs via the consumption of crab fish were estimated. The meta-analysis included one hundred and eight papers with 109 data reports. The rank order of PTEs based on pooled (mean) concentration in the muscle of crabs was Ni (4.490 mg/kg-ww) > Pb (1.891 mg/kg-ww) >As (1.601 mg/kg-ww) > Cd (1.101 mg/kg-ww). The results showed that adults and children consumers in many countries are at risk of non-carcinogenicity due to ingestion of Ni, Pb, As, and Cd and carcinogenicity risk due to As. Therefore, the bioaccumulation of PTEs in the muscle of crabs can be considered a global health risk. Hence, to decrease the health risk of PTEs in the muscle of crabs, continuous monitoring and reducing the emission of PTEs in aquatic environments are recommended.

A systematic review of the relationship between household food insecurity and childhood undernutrition.

BACKGROUND: This systematic review aims to investigate the association between household food insecurity (HFIS) and undernutrition in children under 5 years old, thereby informing policymakers on the vital factors needed to be considered in tailoring an effective strategy to tackle childhood undernutrition and ultimately HFIS. METHODS: We performed a systematic review that examined household food insecurity among the undernourished under-five children. PubMed, Cochrane, EBSCO Host, Web of Science and Cumulative Index to Nursing and Allied Health Literature were searched from 1 January 2012 to 1 April 2022, for relevant articles. Outcome measures were stunting, underweight or wasting. Of the 2779 abstracts screened, 36 studies that fulfilled the inclusion and exclusion criteria were included. A range of tools had been used to measure HFIS, the most common being Household Food Insecurity Access Scale. HFIS has been found to be significantly associated with undernutrition, particularly stunting and underweight. This is observed proportionately across all national income levels. CONCLUSIONS: Sustainable and inclusive economic growth, which aims to reduce income, education and gender inequality, should be a key policy goal in the minimizing food insecurity and childhood undernutrition. Multisectoral interventions are needed to address these issues.

Toxicity prediction: An application of alternative testing and computational toxicology in contaminated groundwater sites in Taiwan.

Groundwater contamination remains a global threat due to its toxic effects to humans and the environment. The remediation of contaminated groundwater sites can be costly, thus, identifying the priority areas of concern is important to reduce money spent on resources. In this study, we aimed to identify and rank the priority groundwater sites in a contaminated petrochemical district by combining alternative, non-animal approaches - chemical analysis, cell-based high throughput screening (HTS), and Toxicological Priority Index (ToxPi) computational toxicology tool. Groundwater samples collected from ten different sites in a contaminated district showed pollutant levels below the detection limit, however, hepatotoxic bioactivity was demonstrated in human hepatoma HepaRG cells. Integrating the pollutants information (i.e., pollutant characteristics and concentration data) with the bioactivity data of the groundwater samples, an evidence-based ranking of the groundwater sites for future remediation was established using ToxPi analysis. The currently presented combinatorial approach of screening groundwater sites for remediation purposes can further be refined by including relevant parameters, which can boost the utility of this approach for groundwater screening and future remediation.

Concentration of potential toxic elements in canned tuna fish: systematic review and health risk assessment.

The health risks (non-carcinogenic and carcinogenic risk) were calculated in both adults and children, using target hazard quotient (THQ) and carcinogenic risk (CR). The concentrations of Cd, Pb, and Ni were higher than the standard limits but they did not pose any non-carcinogenic health risks in adult and children's consumers (THQ <1). Meanwhile, the risk assessment of iAs indicates THQ > 1 for children in Egypt. Moreover, the THQ value due to Me Hg for adult in Tunisia and for children in Tunisia, Malta, Portugal, Latvia, Cambogia, Peru, South Korea, Romania, Hong Kong, United Arab Emirates, Morocco, and Egypt was higher than 1 value. In addition, the calculated CR values of iAs for the adults and children were within the threshold risk of developing cancer (Between 1.00E-4 to 1.00E-6). Therefore, it is recommended to continuously monitor the concentration of PTEs in canned tuna.

Nutrient pattern analysis of mineral based, simple sugar based, and fat based diets and risk of metabolic syndrome: a comparative nutrient panel.

BACKGROUND: Although there is growing evidence on the association between nutrient patterns and metabolic risk factors, very little is known about the relationship between nutrient patterns and metabolic syndrome (MetS). The aim of this study was to examine the associations of nutrient patterns with MetS among apparently healthy obese adults living in Tabriz, Iran. METHODS: Three hundred and forty-seven apparently healthy obese (BMI ≥ 30 kg/m2) adults aged 20-50 years were included in this cross-sectional study. Dietary intake of 38 nutrients was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) of 132 food items. Nutrient patterns were determined using factor analysis. The MetS was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III). RESULTS: Three major nutrient patterns were extracted: "Mineral based pattern", "Simple sugar based pattern" and "Fat based pattern". There was no significant association between nutrient patterns and MetS, in the crude model even after adjusting for confounders. There was a significant difference between quartiles in the mineral based pattern for free mass (FFM), diastolic blood pressure (DBP), large Waist circumference (WC) and Waist-to-hip ratio (WHR). In the simple sugar based pattern, we observed a significant association for SBP, DBP, and triglyceride (TG) levels. In addition, the fat based pattern was positively associated with BMI, and weight. CONCLUSIONS: We did not observe any significant association of nutrient patterns with the risk of MetS amongst the apparently healthy obese adult's population. Whereas we confirmed the deleterious effect of the simple sugar and fat based patterns on several metabolic risk factors, our findings also showed that the mineral based pattern is related to healthier metabolic factors in an Iranian population. These results should be approved by future studies to recognize any causal relationship between adherence to specific nutrient patterns and MetS.

Self-care behaviors mediates the relationship between resilience and quality of life in breast cancer patients.

Previous studies have shown that resilience could play an important role in enhancing the quality of life in women with breast cancer; however, the mediating role of self-care behaviors have not been studied. This study aims to explore the mediating role of self-care behaviors in the relationship between resilience and quality of life in breast cancer patients. A sample of 195 women with breast cancer (aged from 21 to 60 years; M = 45.32 ± 8.2) from three hospitals in Tehran, Iran completed online questionnaires measuring resilience, self-care and quality of life. The results of structural equation modeling showed that resilience (ß = 0.546, p < .01) and self-care behaviors (ß = 0.621, p < .01) positively predicted the quality of life in breast cancer patients. The bootstrapping analysis showed that self-care behaviors acted as a partial mediator between resilience and quality of life. The present study brings to light an underlying mechanism of the relationship between resilience and quality of life via the mediating variable of self-care behaviors for patients with breast cancer.

Molecular Characterization, Virulence Determinants, and Antimicrobial Resistance Profile of Methicillin-Resistant Staphylococcus aureus in the North of Iran; a High Prevalence of ST239-SCCmec III/t037 Clone.

OBJECTIVES: Emergence and prevalence of methicillin-resistant Staphylococcus aureus (MRSA) have become a major universal health concern, limiting therapeutic options. METHODS: A total number of 37 MRSA isolates, including 19 clinical isolates from hospitalized patients and 18 colonizing isolates from health care workers were identified from 3 hospitals, in Gorgan, North of Iran. Antimicrobial susceptibility test was performed using the disk diffusion method and E-test. The presence of virulence and antibiotic resistance determinants were evaluated by PCR. The genotypical characterization was further analyzed using multi-locus sequence, spa, staphylococcal cassette chromosome, mec (SCCmec), and agr typing. RESULTS: The frequency of MRSA among S. aureus isolates was 38.14% (37/97). The most frequent S. aureus resistant isolates were found to be obstinate against penicillin (98%) and gentamicin (82.5%). Additionally, the lowest resistance rates were found against daptomycin (0%), vancomycin (2.7%), and quinupristin-dalfopristin (5.4%). All MRSA isolates were susceptible to daptomycin with minimum inhibitory concentration (MIC)50/MIC90 of 0.25/0.5 µg/mL. One isolate belonging to sequence type 239 (ST239)-SCCmecIII/t037 clone (MIC ≥16 µg/mL) was resistant to vancomycin. All but 1 isolate that shares ST22-SCCmec IV/t790 strain were positive for both tsst and pvl genes. The most predominant MRSA isolates (27%) were associated with ST239-SCCmec III/t037, and ST239-SCCmec III/t924 (16.2%) clones, subsequently. In our study, circulating MRSA strains were genetically diverse with a high prevalence of ST239-SCCmec III/t037 clone. CONCLUSION: These findings emphasize the need for future and continuous surveillance studies on MRSA to prevent the dissemination of existing multidrug resistance MRSA clones in an effective manner.

The clusters of health-risk behaviours and mental wellbeing and their sociodemographic correlates: a study of 15,366 ASEAN university students.

BACKGROUND: This study investigated, through cluster analysis, the associations between behavioural characteristics, mental wellbeing, demographic characteristics, and health among university students in the Association of Southeast Asian Nations (ASEAN) University Network - Health Promotion Network (AUN-HPN) member universities. METHODS: Data were retrieved from a cross-sectional self-administered online survey among undergraduate students in seven ASEAN countries. A two-step cluster analysis was employed, with cluster labels based on the predominant characteristics identified within the clusters. The 'healthy' cluster was assigned as the reference group for comparisons using multinomial logistic regression analysis. RESULTS: The analytic sample size comprised 15,366 university students. Five clusters of student-types were identified: (i) 'Healthy' (n = 1957; 12.7%); (ii) 'High sugary beverage consumption' (n = 8482; 55.2%); (iii) 'Poor mental wellbeing' (n = 2009; 13.1%); (iv) 'Smoker' (n = 1364; 8.9%); and (v) 'Alcohol drinker' (n = 1554; 10.1%). Being female (OR 1.28, 95%CI 1.14, 1.45) and being physically inactive (OR 1.20, 95%CI 1.04, 1.39) increased the odds of belonging to the 'High sugary beverage consumption' cluster. Being female (OR 1.21, 95%CI 1.04, 1.41), non-membership in a sports club (OR 1.83, 95%CI 1.43, 2.34) were associated with 'Poor mental wellbeing'. Obesity (OR 2.03, 95%CI 1.47, 2.80), inactively commuting to campus (OR 1.34, 95%CI 1.09, 1.66), and living in high-rise accommodation (OR 2.94, 95%CI 1.07, 8.07) were associated with membership in the 'Smoker' cluster. Students living in The Philippines, Singapore, Thailand, and Vietnam had a higher likelihood of being alcohol drinkers, compared with those who lived in Brunei. CONCLUSIONS: ASEAN university students exhibited health-risk behaviours that typically clustered around a specific health behaviour and mental wellbeing. The results provided support for focusing interventions on one dominant health-risk behaviour, with associated health-risk behaviours within clusters being potential mediators for consideration.

Effects of licorice root supplementation on liver enzymes, hepatic steatosis, metabolic and oxidative stress parameters in women with nonalcoholic fatty liver disease: A randomized double-blind clinical trial.

This study aimed to evaluate the effects of licorice root supplementation on liver enzymes, hepatic steatosis, metabolic and oxidative stress parameters in women with nonalcoholic fatty liver disease (NAFLD). In this randomized double-blind, placebo-controlled trial, 60 women with NAFLD were selected and randomly assigned into 2 groups to take 1,000 mg/day powder of licorice root extract or placebo for 12 weeks. In addition, all the patients were advised to follow a weight loss diet and healthy lifestyle. The plasma levels of liver enzymes, glycemic indices, lipid profile, oxidative stress parameters, as well as hepatic steatosis were measured at the beginning and end of the study. Through the 12-weeks period of supplementation, women who received powder of licorice root experienced a statistically significant improvement in alanine aminotransferase (p < .001), insulin (p = .002), insulin resistance (p = .003), malondialdehyde (p < .001) serum levels, and ultrasonographic findings of liver steatosis (p < .001), compared to the placebo group. In conclusion, licorice root supplementation in addition to gradual weight loss and lifestyle modification is superior to lifestyle modification alone for the treatment of NAFLD.

The effect of flaxseed oil consumtion on blood pressure among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized clinical trials.

We systematically reviewed randomized clinical trials (RCTs) to elucidate the overall effects of flaxseed oil consumption on blood pressure (BP) in patients with metabolic syndrome and related disorders. PubMed, Scopus, Cochrane Library, and ISI Web of Science databases were systematically searched until March 31, 2020, to find RCTs that examined the effect of flaxseed oil consumption on BP. Weighed mean difference (WMD) was pooled using a random-effects model. Standard methods were used for the assessment of heterogeneity, sensitivity analysis, and publication bias. Meta-analysis of five trials (6 arms) showed significant reductions in systolic (WMD: -3.86 mmHg, 95% CI: -7.59 to -0.13, p = .04) BP (SBP) after flaxseed oil consumption. However, the overall effect illustrated no significant change in diastolic (WMD: -1.71 mmHg, 95% CI: -3.67 to 0.26, p = .09) BP (DBP) in the intervention group compared with the control group. Our findings revealed that flaxseed oil consumption has favorable effects on SBP in patients with metabolic syndrome and related disorders. However, further investigations are needed to provide more reliable evidence.

Concentration and probabilistic health risk assessment of benzo(a)pyrene in extra virgin olive oils supplied in Tehran, Iran.

One hundred and sixteen samples of extra virgin olive oils (VOOs) from markets of Tehran were analyzed by high-performance liquid chromatography (HPLC) to detect the amount of benzo (a)pyrene. The values of LOD and LOQ were calculated as 0.03 and 0.05 µg/kg, respectively. The concentration of benzo (a) pyrene was from 0.03 to 0.95 µg/kg. The results indicate that the levels of benzo (a) pyrene are lower than the limits approved. Target Hazard quotient (THQ) and Margin of Exposure (MOE) were estimated. The mean of THQ for adults and children was 0.0006 and 0.0028 and also mean of MOE for adults and children was 43,503 and 9438, respectively. The probabilistic health risk shows that THQ is less than 1 value; hence consumers are not at non-cancer risk. The mean of MOE value for adults was more than 10,000 but for children was less than 10,000. Hence, children are at health risk borderline.

Probabilistic health risk assessment of heavy metals (Cd, Pb, and As) in Cocoa powder (Theobroma cacao) in Tehran, Iran market.

The concentrations of toxic elements were analyzed by using Flame Atomic Absorption Spectrophotometer (FAAS). Moreover, the human health risk was estimated by Total Target Hazard Quotient (TTHQ) and Cancer Risk (CR) in Monte Carlo Simulation (MCS) technique. The mean concentrations (mg/kg) of Cd (0.08 ± 0.08), Pb (0.23 ± 0.46), and As (0.06 ± 0.04), were in a good compliance with ISO (Iranian standard organization). TTHQ for adults and children was equal to 0.009 and 0.042, respectively and also mean CR in adults and children consumers was equal to 9.73E-7 and 9.08E-7, respectively. Consequently, the concentration of toxic elements (Cd, Pb, and As) in cocoa powder did not pose any safety concerns. Moreover, probabilistic health risk assessment revealed that both adults and children were not at considerable non-carcinogenic (THQ and/or TTHQ ≤ 1) and carcinogenic risk (CR ≤ 1E-6). Even though, seeking for mitigating solutions and applying them to suppress the dangers of food containing toxic elements is a critical subject.

The effectiveness of nutrition education for overweight/obese mothers with stunted children (NEO-MOM) in reducing the double burden of malnutrition in Indonesia: study protocol for a randomized controlled trial.

BACKGROUND: Nutrition transition in developing countries were induced by rapid changes in food patterns and nutrient intake when populations adopt modern lifestyles during economic and social development, urbanization and acculturation. Consequently, these countries suffer from the double burden of malnutrition, consisting of unresolved undernutrition and the rise of overweight/obesity. The prevalence of the double burden of malnutrition tends to be highest for moderate levels (third quintile) of socioeconomic status. Evidence suggests that modifiable factors such as intra-household food distribution and dietary diversity are associated with the double burden of malnutrition, given household food security. This article describes the study protocol of a behaviorally based nutrition education intervention for overweight/obese mothers with stunted children (NEO-MOM) in reducing the double burden of malnutrition. METHODS: NEO-MOM is a randomized controlled trial with a three-month behavioral intervention for households involving pairs of 72 stunted children aged 2-5 years old and overweight/obese mothers (SCOWT) in urban Indonesia. The SCOWT pairs were randomly assigned to either an intervention group or to a comparison group that received usual care plus printed educational materials. The intervention consisted of six classroom sessions on nutrition education and home visits performed by trained community health workers using a motivational interviewing approach. The primary outcomes of this study are the prevalence of double burden of malnutrition as measured in SCOWT, child's height-for-age z-score (HAZ) and maternal body mass index (BMI). DISCUSSION: Because previous studies are mainly observational in nature, this study advances understanding of the double burden of malnutrition through a fully powered randomized controlled trial. The intervention assists participants in self-administered goal setting to improve diet and child feeding behaviors by improving self-efficacy. Maternal self-efficacy may be enhanced through vicarious and active mastery of experiences gained during six sessions of nutrition education and verbal persuasion during home visits. TRIAL REGISTRATION: The Universal Trial Number (UTN) for this study is U1111-1175-5834. This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) and is allocated the registration number: ACTRN12615001243505 on 12 November 2015.

Concentration of Heavy Metals in Traditional and Industrial Fruit Juices from Iran: Probabilistic Risk Assessment Study.

Exposure to heavy metals can endanger the health of exposed people in the long term. The consumption of fruit juice is increasing; it is important to estimate the health risk of consumers due to heavy metals. The current study was carried out for the analysis of toxic metals (lead (Pb), arsenic (As), and cadmium (Cd)) and essential elements (copper (Cu) and zinc (Zn)) in 60 samples of traditional and industrial fruit juices (10 samples of different brands of apple, orange, grape, peach, mango, and pineapple) in Hamadan, West Iran, using inductivity coupled plasma optical emission spectrometry (ICP-OES) method. The validation protocol included precision of the analytical method; recovery, the determination of the limit of detection (LOD), the limit of quantification (LOQ), and linearity were measured. Moreover, risk assessment was detected using target hazard quotient (THQ) and cancer risk (CR) by the Monte Carlo simulation (MCS) model. The ranking of metal concentration in traditional and industrial fruit juices was Zn > Cu > As > Pb > Cd. In all samples, concentrations of heavy metals in industrial fruit juices were higher than traditional fruit juices p < < 0.001. The level of metals in all samples was lower of the US Environmental Protection Agency (USEPA), the World Health Organization (WHO), and the Iran Standard (IS) permissible limit set for drinking water. In terms of non-carcinogenic, values of toxic elements for children and adult in traditional and industrial fruit juices were 1.6E-3 and 1.72E-3 and 2.6E-3 and 1.85E-3, respectively. The 95th percentile of CR in adults and children due to both industrial and traditional fruits juices was higher than 1E-6; hence, reducing the concentration of As in fruit juices should be conducted. Consumption of fruit juice can increase carcinogenic risk of consumers. Therefore, it is recommended to consume it with caution.

Exploring global mothers' knowledge, attitudes, and practice of complementary feeding: A scoping review.

Complementary feeding refers to the practice of providing solid foods and liquids in addition to breast milk when a baby reaches 6 mo of age. This becomes necessary to meet a baby's nutritional needs because of the potential nutrient insufficiency of breast milk alone. This review serves as an effective means to comprehensively understand the intricate and evolving nature of complementary feeding practices, often influenced by cultural, regional, and parental factors, from a literature perspective that acknowledges the dynamic aspects of complementary feeding. The data in this study were extracted and presented according to the recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews, as guidelines. The studies were conducted using digital databases such as PubMed, Springer Link, and Science Direct from 2014 to 2022. A total of 1205 eligible studies were retrieved from the three databases searched, with 17 articles finally reviewed for data extraction. Overall, there remains a gap between mothers' knowledge, attitudes, and practices regarding complementary feeding. Addressing these disparities within and between countries necessitates targeted interventions and educational programs to enhance mothers' understanding, align attitudes with guidelines, and promote healthier practices for the well-being of children.