An assessment of the impact of traditional rice cooking practice and eating habits on arsenic and iron transfer into the food chain of smallholders of Indo-Gangetic plain of South-Asia: Using AMMI and Monte-Carlo simulation model.

The current study was designed to investigate the consequences of rice cooking and soaking of cooked rice (CR) with or without arsenic (As) contaminated water on As and Fe (iron) transfer to the human body along with associated health risk assessment using additive main-effects and multiplicative interaction (AMMI) and Monte Carlo Simulation model. In comparison to raw rice, As content in cooked rice (CR) and soaked cooked rice (SCR) enhanced significantly (at p < 0.05 level), regardless of rice cultivars and locations (at p < 0.05 level) due to the use of As-rich water for cooking and soaking purposes. Whereas As content in CR and SCR was reduced significantly due to the use of As-free water for cooking and soaking purposes. The use of As-free water (AFW) also enhanced the Fe content in CR. The overnight soaking of rice invariably enhanced the Fe content despite the use of As-contaminated water in SCR however, comparatively in lesser amount than As-free rice. In the studied area, due to consumption of As-rich CR and SCR children are more vulnerable to health hazards than adults. Consumption of SCR (prepared with AFW) could be an effective method to minimize As transmission and Fe enrichment among consumers.

Assessing malathion residue impact on poultry health, human safety, and production performance.

Over the past decade, food safety has become a major concern due to the intensive use of pesticides. Pesticide contamination has been observed in poultry products when seeds are coated with pesticides or when stored products are exposed to pesticides in warehouses. In this experiment, the residue levels of malathion transferred from corn grain to the different parts of the chicken product, its transfer factors (TFs) and the human dietary risk for consumers were evaluated. Growth performance and carcass parameters of the chicken samples were also determined after different doses of malathion exposure. Malathion residues from different parts of chicken meat (breast, thigh, wing, liver and skin) were extracted by the QuEChERS method and analyzed by liquid chromatography-mass spectrophotometry (LC-MS/MS). A deterministic approach was used to calculate the acute and chronic risk assessment. Body weight, feed conversion ratio and feed intake decreased with increasing malathion dose. In addition to reduced feed intake, cold carcass and liver weights of the chicks were also decreased. The highest residues were found in the skin of the chicken followed by the breast, thigh, wing and liver. The TFs of malathion varied between 0.00 and 0.05 according to the different doses applied (4 mg/kg, 8 mg/kg, 16 mg/kg, 32 mg/kg). The chronic exposure assessment (HQ) showed that consumers of all ages and genders consumed 0.008-0.604% of the acceptable daily intake (0.3 mg/kg body weight (bw)/day) of malathion from chicken products. The acute intake assessment (aHQ) of consumers ranged from 0.00015 to 0.0135% of the acute reference dose (0.3 mg/kg bw). In conclusion the results suggest that the risk associated with the malathion residues in chicken meat was found to be low but the residue levels in meat should not be ignored.

A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice.

Since the 2019 National Lipid Association (NLA) Scientific Statement on Use of Lipoprotein(a) in Clinical Practice was issued, accumulating epidemiological data have clarified the relationship between lipoprotein(a) [Lp(a)] level and cardiovascular disease risk and risk reduction. Therefore, the NLA developed this focused update to guide clinicians in applying this emerging evidence in clinical practice. We now have sufficient evidence to support the recommendation to measure Lp(a) levels at least once in every adult for risk stratification. Individuals with Lp(a) levels <75 nmol/L (30 mg/dL) are considered low risk, individuals with Lp(a) levels ≥125 nmol/L (50 mg/dL) are considered high risk, and individuals with Lp(a) levels between 75 and 125 nmol/L (30-50 mg/dL) are at intermediate risk. Cascade screening of first-degree relatives of patients with elevated Lp(a) can identify additional individuals at risk who require intervention. Patients with elevated Lp(a) should receive early, more-intensive risk factor management, including lifestyle modification and lipid-lowering drug therapy in high-risk individuals, primarily to reduce low-density lipoprotein cholesterol (LDL-C) levels. The U.S. Food and Drug Administration approved an indication for lipoprotein apheresis (which reduces both Lp(a) and LDL-C) in high-risk patients with familial hypercholesterolemia and documented coronary or peripheral artery disease whose Lp(a) level remains ≥60 mg/dL [∼150 nmol/L)] and LDL-C ≥ 100 mg/dL on maximally tolerated lipid-lowering therapy. Although Lp(a) is an established independent causal risk factor for cardiovascular disease, and despite the high prevalence of Lp(a) elevation (∼1 of 5 individuals), measurement rates are low, warranting improved screening strategies for cardiovascular disease prevention.

Suicide Screening, Risk Assessment, and Lethal Means Counseling During Zero Suicide Implementation.

OBJECTIVE: The authors measured implementation of Zero Suicide (ZS) clinical practices that support identification of suicide risk and risk mitigation, including screening, risk assessment, and lethal means counseling, across mental health specialty and primary care settings. METHODS: Six health care systems in California, Colorado, Michigan, Oregon, and Washington participated. The sample included members ages ≥13 years from 2010 to 2019 (N=7,820,524 patients). The proportions of patients with suicidal ideation screening, suicide risk assessment, and lethal means counseling were estimated. RESULTS: In 2019, patients were screened for suicidal ideation in 27.1% (range 5.0%-85.0%) of mental health visits and 2.5% (range 0.1%-35.0%) of primary care visits among a racially and ethnically diverse sample (44.9% White, 27.2% Hispanic, 13.4% Asian, and 7.7% Black). More patients screened positive for suicidal ideation in the mental health setting (10.2%) than in the primary care setting (3.8%). Of the patients screening positive for suicidal ideation in the mental health setting, 76.8% received a risk assessment, and 82.4% of those identified as being at high risk received lethal means counseling, compared with 43.2% and 82.4%, respectively, in primary care. CONCLUSIONS: Six health systems that implemented ZS showed a high level of variation in the proportions of patients receiving suicide screening and risk assessment and lethal means counseling. Two opportunities emerged for further study to increase frequency of these practices: expanding screening beyond patients with regular health care visits and implementing risk assessment with lethal means counseling in the primary care setting directly after a positive suicidal ideation screening.

Evaluating of Existing VTE Risk Scales in Glioma Patients.

INTRODUCTION: Postoperative venous thromboembolism (VTE) is a frequently occurring complication among glioma patients. Several risk assessment models (RAMs), including the Caprini RAM, the IMPROVE Risk Score, the IMPROVED VTE Risk Score, and the Padua Prediction Score, have not been validated within the glioma patient population. The purpose of this study was to assess the predictive accuracy of established VTE risk scales in patients with glioma. MATERIALS AND METHODS: A single-center, retrospective, observational cohort study was conducted on 265 glioma patients who underwent surgery at the Almazov Medical and Research Centre between 2021 and 2022. VTE detection followed the current clinical guidelines. Threshold values for the Caprini, IMPROVE VTE, IMPROVEDD, and Padua scales were determined using ROC analysis methods, with cumulative weighting for sensitivity and specificity in predicting VTE development. The areas under the ROC curves (AUC) were calculated, and comparisons were made using the DeLong test. RESULTS: The area under the curve for the Caprini risk assessment model was 80.41, while the IMPROVEDD VTE risk score was 75.38, the Padua prediction score was 76.9, and the IMPROVE risk score was 72.58. No significant differences were observed in the AUC values for any of the scales. The positive predictive values of all four scales were low, with values of 50 (28-72) for Caprini, 48 (28-69) for IMPROVEDD VTE, 50 (30-70) for Padua, and 64 (35-87) for IMPROVE RAM. No significant differences were found in terms of PPV, NPV, positive likelihood ratio, and negative likelihood ratio among the analyzed scales. CONCLUSIONS: The Caprini Risk Assessment Model, the IMPROVE Risk Score, the IMPROVED VTE Risk Score, and the Padua Prediction Score exhibit acceptable specificity and sensitivity for glioma patients. However, their low positive predictive ability, coupled with the complexity of interpretation, limits their utility in neurosurgical practice.

Implications of variability on medical device chemical equivalence assessment.

Chemical equivalence testing can be used to assess the biocompatibility implications of a materials or manufacturing change for a medical device. This testing can provide a relatively facile means to evaluate whether the change may result in additional or different toxicological concerns. However, one of the major challenges in the interpretation of chemical equivalence data is the lack established criteria for determining if two sets of extractables data are effectively equivalent. To address this gap, we propose a two-part approach based upon a relatively simple statistical model. First, the probability of a false positive conclusion, wherein there is an incorrectly perceived increase for a given analyte in the comparator relative to the baseline device, can be reduced to a prescribed level by establishing an appropriate acceptance criterion for the ratio of the observed means. Second, the probability of a false negative conclusion, where an actual increase in a given analyte cannot be discerned from the test results, can be minimized by specifying a limiting value of applicability based on the margin of safety (MoS) of the analyte. This approach provides a quantitative, statistically motivated method to interpret chemical equivalence data, despite the relatively high intrinsic variability and small number of replicates typically associated with a chemical characterization evaluation.

Carcinogenic, non-carcinogenic risk, and attributable cases to organochlorine pesticide exposure in women from Northern Mexico.

This study aimed to estimate the carcinogenic and non-carcinogenic risk as well as the attributable cases due to exposure to organochlorine pesticides (OCPs): hexachlorobenzene (HCB), dichlorophenyltrichloroethane (DDT), hexachlorocyclohexane (HCH), heptachlor, and chlordane. From serum concentrations of pesticides of interest in a sample of 908 women from Northern Mexico, the risk for both cancer and non-cancer health effects was evaluated. The population attributable fraction (PAF) was also calculated based on summary association estimates between exposure to OCPs and different health events. Findings revealed that due to their OCP exposure slightly less than half of the women in the sample were at increased risk of developing non-cancerous diseases. Moreover, approximately 25% and 75% of participants were at risk of develop some type of cancer associated with their HCB and DDE concentrations, respectively. In addition, it was estimated that 40.5% of type 2 diabetes, 18.7% of endometriosis, and 23.1% of non-Hodgkin's lymphoma cases could have been prevented if women had not been exposed to these OCPs. Results suggest that the use of OCPs may have contributed to the disease burden in the study area and, based on the time required for these substances to be eliminated from the body, there are probably some women who are still at elevated risk of developing diseases associated to OCPs.

Spatiotemporal variations, health risk assessment, and sources of potentially toxic elements in potamic water of the Anday Stream Basin (Türkiye), Black Sea Region.

Monitoring and protecting freshwater habitats are paramount for a sustainable water management perspective. This study investigated potentially toxic elements (PTEs) in the potamic water of the Anday Stream Basin (Türkiye), Black Sea Region, for a hydrological year (from May 2020 to April 2021). Among PTEs, the highest average values were recorded for sodium (Na) at 41.3 mg/L and the lowest for mercury (Hg) at 0.009 µg/L and noted under quality guidelines. The stream was found to be at the level of "Low Heavy Metal Pollution" and "Low Contamination" based on the ecotoxicological risk indices. The highest calculated hazard quotient (HQ) value of 1.21E-02 for Cd was noted in the children via the dermal pathway and the lowest of 6.91E-06 for Fe in adults via the ingestion pathway. Results revealed a higher hazard index (HI) value of 1.50E-02 for Cd to children and the lowest of 1.98E-05 for Fe to adults. As a result of applying agricultural risk indices, the stream showed sodium adsorption ratio values less than 6 and was found to be "Excellent" for agriculture. However, the sodium percentage values were less than 20 and found "Permissible" and the magnesium hazard > 50 and noted as "Unsuitable" for agriculture. Statistical analysis revealed that natural factors mainly attributed to PTE contamination of the Anday Stream Basin.

Health risk assessment of heavy metals in some vegetables-Erbil City-Kurdistan Region of Iraq.

Heavy metals can have significant impacts on human health due to their toxicity and potential to accumulate in the body over time. Some heavy metals, such as lead, cadmium, mercury, and arsenic, are particularly harmful even at low concentrations. The estimation of hazards of vegetable intake to human health as well as explore the of heavy metals accumulation in different vegetables (cucumbers, tomato, eggplant, and bell peppers) collected in Erbil city from different source locally and imported from nearby country are conducted. The heavy metals concentration (cooper, zinc, lead and cadmium) was measured and analyzed by inductively coupled plasma-optical emission spectrophotometry. The maximum concentration of Pb was 27.95 mg/kg and the minimum was 6.49 mg/kg; for Cd, the concentration was 1.43 and 0.99 mg/kg, 74.94 and 5.14 mg/kg for Zn; and for Cu, the result was 56.25 and 8.2 mg/kg for the maximum and minimum, which they are within limits described by Food Agricultural Organization, but more than health limits and health risks calculated by mean of hazard quotient (HQ) techniques for Cu and Pb which they are more than 1. The local sample that collected in Erbil city show less concentration of heavy metals and low HQ in comparison with imported samples. The carcinogenic risk study shows elevated risk of accumulative consuming of edible part of those plant which they exceed the permissible limit that is 10-6.

Metabolic change in monocytes and postoperative morbidity after major abdominal surgery in elderly patients: A prospective cohort study.

Background: Postoperative complications in aging patients remain a significant cause of increased costs, hospital length of stay, and patient distress. Although alterations in energy metabolism have been closely linked to aging process and surgery, it is still unclear whether metabolic changes during surgery is associated with postoperative complications in elderly patients. This study was conducted to investigate whether metabolic changes during surgery predicts postoperative complications in elderly patients. Methods: We conducted a prospective single-center observational cohort study. 244 adults (aged ≥65 years) who were scheduled for elective major non-cardiac surgery were recruited. Blood samples for each patient were taken before and after surgery. All patients were randomly divided into two groups (122 in each group), then oxygen consumption rate (OCR) or extracellular acidification rate (ECAR) was measured on isolated monocytes in each group. Results: 14 of 110 (12.7%) patients went through OCR measurement and 15 of 122 patients (12.3%) went through ECAR measurement experienced moderate to severe complications. Overall, there was an intensification of glycolysis in monocytes after surgery. Among all variables, only the change (preoperative -postoperative) of glycolytic reserve (GR)/glycolysis (G) and GR/non-glycolytic acidification (NG) were predictors of moderate to severe complications (AUC = 0.70; 95% CI, 0.56-0.81; P = 0.019 and AUC = 0.67; 95% CI, 0.55-0.80; P = 0.031). Decreased postoperative GR/G were associated with worse postoperative complications (RR = 9.08; 95% CI, 1.23-66.81; P = 0.024). Conclusions: Compared with mitochondria function, the change of glycolytic function in monocyte was more valuable in predicting postoperative complications after major abdominal surgery. Our study gave us a new insight into identifying patients at high risk in aging patients.

Novel clinical phenotypes, drug categorization, and outcome prediction in drug-induced cholestasis: Analysis of a database of 432 patients developed by literature review and machine learning support.

BACKGROUND: Serum transaminases, alkaline phosphatase and bilirubin are common parameters used for DILI diagnosis, classification, and prognosis. However, the relevance of clinical examination, histopathology and drug chemical properties have not been fully investigated. As cholestasis is a frequent and complex DILI manifestation, our goal was to investigate the relevance of clinical features and drug properties to stratify drug-induced cholestasis (DIC) patients, and to develop a prognosis model to identify patients at risk and high-concern drugs. METHODS: DIC-related articles were searched by keywords and Boolean operators in seven databases. Relevant articles were uploaded onto Sysrev, a machine-learning based platform for article review and data extraction. Demographic, clinical, biochemical, and liver histopathological data were collected. Drug properties were obtained from databases or QSAR modelling. Statistical analyses and logistic regressions were performed. RESULTS: Data from 432 DIC patients associated with 52 drugs were collected. Fibrosis strongly associated with fatality, whereas canalicular paucity and ALP associated with chronicity. Drugs causing cholestasis clustered in three major groups. The pure cholestatic pattern divided into two subphenotypes with differences in prognosis, canalicular paucity, fibrosis, ALP and bilirubin. A predictive model of DIC outcome based on non-invasive parameters and drug properties was developed. Results demonstrate that physicochemical (pKa-a) and pharmacokinetic (bioavailability, CYP2C9) attributes impinged on the DIC phenotype and allowed the identification of high-concern drugs. CONCLUSIONS: We identified novel associations among DIC manifestations and disclosed novel DIC subphenotypes with specific clinical and chemical traits. The developed predictive DIC outcome model could facilitate DIC prognosis in clinical practice and drug categorization.

On the Chemical Pathways Influencing the Effective Global Warming Potential of Commercial Hydrofluoroolefin Gases.

The enforcement of a global hydrofluorocarbon (HFC) refrigerant phase down led to the introduction of hydrofluoroolefins (HFOs) as a low Global Warming Potential (GWP) substitute, given their low atmospheric lifetime. However, to this date it is not fully clear the long-term atmospheric fate of HFOs primary degradation products: trifluoro acetaldehyde (TFE), trifluoro acetyl fluoride (TFF), and trifluoroacetic acid (TFA). It particularly concerns the possibility of forming HFC-23, a potent global warming agent. Although the atmospheric reaction networks of TFE, TFF, and TFA have a fair level of complexity, the relevant atmospheric chemical pathways are well characterized in the literature, enabling a comprehensive hazard assessment of HFC-23 formation as a secondary HFO breakdown product in diverse scenarios. A lower bound of the HFOs effective GWP in a baseline scenario is found above regulatory thresholds. While further research is crucial to refine climate risk assessments, the existing evidence suggests a non-negligible climate hazard associated with HFOs.

Examining Trajectories of Change on the Dynamic Risk Assessment for Offender Re-Entry (DRAOR).

Dynamic risk scales have largely been evaluated using singular assessment scores, including those obtained at the start of supervision. While this approach includes assessment of dynamic factors, it ignores changes with reassessment, failing to examine whether an instrument is truly dynamic in nature. This is problematic, as proximal risk assessments have consistently outperformed baseline assessments in the prediction of recidivism. In the current study, we examined the dynamic properties of the Dynamic Risk Assessment for Offender Reentry (DRAOR) in 4,736 adults on community supervision in Iowa, United States (N = 33,965 assessments). As expected, while clients demonstrated statistically significant changes on the DRAOR domains over time, changes were small in magnitude. We also examined the predictive validity of baseline and proximal DRAOR total and domain scores on criminal recidivism and revocation in a larger sample of 11,421 adults in the same jurisdiction. While DRAOR baseline scores did predict both outcomes, prediction did not improve with proximal scores. This conflicted with expected findings from previous research on the DRAOR in New Zealand. The results of both of these research questions indicate there was an overall lack of change reflected in this sample. Potential issues regarding implementation fidelity are discussed. Additional research is needed to examine the dynamic properties of the DRAOR in Iowa given the importance of reassessment data in community corrections.

Advances and current research in primary thromboprophylaxis to prevent hospital-associated venous thromboembolism.

Hospital-associated venous thromboembolism (VTE) is defined as any case of VTE occurring during hospital admission and for up to 90 days post discharge. It accounts for over 50% of all cases of VTE internationally; indeed, there are an estimated 10 million cases of hospital-associated VTE annually. Over the last decade, there has been increasing interest in improving VTE risk assessment and thromboprophylaxis. This review summarises all the recent and ongoing major research studies and future challenges in the different areas, including medical, surgical and obstetric patients, as well as special areas such as lower limb immobilisation. We include sections on both pharmacological and mechanical thromboprophylaxis.

Prey-mediated effects of Mpp51Aa2-producing cotton on longevity and reproduction of Orius majusculus.

Genetically engineered (GE) cotton event MON 88702, producing Mpp51Aa2 (previously mCry51Aa2) from Bacillus thuringiensis (Bt), controls sucking pests, such as Lygus spp. (Hemiptera: Miridae) and thrips (Thysanoptera). Ingesting high doses of the insecticidal protein resulted in adverse effects on life table parameters of beneficial, predatory Orius spp. (Hemiptera: Anthocoridae). This triggered laboratory studies with more realistic food treatments, including different combinations of prey types with and without Bt protein to further characterize risks to this important group of non-target organisms. In this work, exclusive feeding of frozen spider mites (Tetranychus urticae, Acari: Tetranychidae) from Bt cotton confirmed adverse effects on longevity and fecundity of O. majusculus adults. Alternate feeding of Bt protein-containing spider mites and Bt-free Ephestia kuehniella (Lepidoptera: Pyralidae) eggs mitigated effects on longevity, but not on fecundity. When living larvae of Spodoptera littoralis (Lepidoptera: Noctuidae) from Bt cotton were fed to the predators, however, no effects on longevity and reproduction of female O. majusculus were observed, despite the fact that Bt protein concentrations in larvae were almost as high as concentrations in spider mites. When a diverse mix of prey species with various Bt protein concentrations is consumed in the field, it is unlikely that exposure of Orius spp. to Mpp51Aa2 is high enough to exert adverse effects on predator populations. MON 88702 cotton may thus be a valuable tool for integrated management of sucking pests.

Modification of the existing maximum residue levels for fluxapyroxad in kaki/Japanese persimmons and cultivated mushrooms.

In accordance with Article 6 of Regulation (EC) No 396/2005, the applicant BASF SE submitted two requests to the competent national authority in Spain and Ireland to modify the existing maximum residue levels (MRLs) for the active substance fluxapyroxad in kaki/Japanese persimmons and in cultivated fungi, respectively. The data submitted in support of the requests were found to be sufficient to derive MRL proposals for kaki/Japanese persimmons and cultivated fungi. Adequate analytical methods for enforcement are available to control the residues of fluxapyroxad on the commodities under consideration at the validated LOQ of 0.01 mg/kg. Based on the risk assessment results, EFSA concluded that the short-term and long-term intake of residues resulting from the use of fluxapyroxad, according to the reported agricultural practices, is unlikely to present a risk to consumer health. The long-term consumer risk assessment is indicative, pending the submission of the confirmatory data requested under the MRL review.

Bioaccumulation, trophic transfer and risk assessment of polycyclic musk in marine food webs of the Bohai Sea.

Galaxolide (HHCB) and tonalide (AHTN) are dominant musks added to personal care products. However, the accumulate and trophic transfer of SMs through the marine food chain are unclear. In this study, organisms were collected from three bays in Bohai Sea to investigate the bioaccumulation, trophic transfer, and health risk of SMs. The HHCB and AHTN concentrations in the muscles range from 2.75 to 365.40 µg/g lw and 1.04-4.94 µg/g lw, respectively. The median HHCB concentrations in muscles were the highest in Bohai Bay, followed by Laizhou Bay and Liaodong Bay, consistent with the HHCB concentrations in sediments. The different fish tissues from Bohai Bay were analyzed, and the HHCB and AHTN concentrations followed the heart > liver > gill > muscles. The trophic magnification factors (TMF) were lower than 1 and the health risk assessment showed no adverse health effects. The results provide insights into the bioaccumulation and trophic transfer behavior of SMs in marine environments.

Comparison of V-RISK-Y and V-RISK-10 for risk of violence: A one-year study from a psychiatric emergency department for adolescents.

There has been a lack of short and simple screening instruments to assess the risk of violence in youth. Many acute youth departments have used the V-RISK-10, a risk screener for adults. V-RISK-Y is a risk screener based on the V-RISK-10 and adapted to youths. Our aim was to compare the predictive validity between V-RISK-Y and VRISK-10 in an emergency psychiatric adolescent ward. Target population were all 92 patients admitted within one year, and study population consisted of 49 (53 %) patients who had completed data. V-RISK-10 and V-RISK-Y were scored at admission and compared with recorded episodes of violence during the hospitalization. V-RISK-Y showed higher AUC values for recorded violence and some of the individual items also showed better results. Most differences were not significant, but results may still be of clinical interest.