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Objective To summarize the publications to date from a large obstetric cohort of nulliparous individuals. Study design We summarized all of the publications from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b). We descriptively summarized the most common outcomes and exposures reported in current publications. Results Fifty-six publications to date are discussed. The most common primary exposures reported are participant baseline characteristics such as body mass index (24%), sociodemographic characteristics (22%), and sleep factors (16%). These exposures were most commonly measured in the first trimester (77%). The most commonly reported primary outcomes were related to adverse pregnancy outcomes (APOs, 51.6%), with 25% using a composite of multiple APOs as the primary outcome. At least 8,000 participants were used in the analyses of over half of the publications. Conclusion The nuMoM2b study has generated a diverse array of publications and conclusions on factors associated with APOs. The publicly available data set from the nuMoM2b study continues to hold potential for considerable advances, new insights, and future research opportunities to optimize pregnancy and pregnancy-related health. Key Points The nuMoM2b pregnancy cohort has generated 56 publications thus far. The main findings of these publications are summarized and categorized in this work. The data and specimens from this cohort are available and can answer many clinical questions. [ABSTRACT FROM AUTHOR]

Despite robust evidence supporting exposure‐based interventions for anxiety disorders in youth, these treatments are often underutilized, implemented with low fidelity, and delivered in an unnecessarily cautious manner. Few studies have examined important implementation variables (e.g., knowledge, training, perceptions) related to using exposures in schools. A national sample of school psychologists (N = 318) working in K‐12 public schools reported on their knowledge, training, perceptions, confidence, and use regarding exposures. Over 50% of respondents reported they do not use exposures. Only slightly more than half of the respondents received training in exposures through graduate coursework. Eighty percent endorsed negative beliefs about exposures, with nearly 50% expressing concern about acceptability of the intervention by parents. Barriers to delivering exposures within schools endorsed included inadequate time (79% of sample), training (61%), and access to training materials (51%). Implications for training, practice, and research in school psychology are discussed. Practitioner Points: This study documents school psychologists' training in and experiences with using exposures, a critical intervention component to address anxiety.The majority of school psychologists in the sample reported at least some knowledge and training with exposures, though the quality of training was identified by many as suboptimal.The majority of school psychologists expressed limited confidence in their ability to effectively deliver exposures in school and more than half the sample endorsed never using exposures in schools. This study informs future directions for training of school psychologists. [ABSTRACT FROM AUTHOR]

Purpose of Review: The human commensal microbiota is now widely accepted as a key regulator of human health and disease. The composition of the mucosal associated microbiota has been shown to play a critical role in the lung health. The role of the mucosal microbiota in the development and severity of allergy, asthma, and occupational lung disease is only beginning to take shape. However, advances in our understanding of these links have tremendous potential to led to new clinical interventions to reduce allergy, asthma, and occupational lung disease morbidity. Recent Findings: We review recent work describing the relationship and role of the commensal microbiota in the development of allergy, asthma, and occupational lung disease. Our review primarily focuses on occupational exposures and the effects of the microbiome, both in composition and function. Data generated from these studies may lead to the development of interventions targeted at establishing and maintaining a healthy microbiota. We also highlight the role of environmental exposures and the effects on the commensal microbial community and their potential association with occupational lung disease. Summary: This review explores the current research describing the role of the human microbiome in the regulation of pulmonary health and disease, with a specific focus on the role of the mucosal microbiota in the development of allergy, asthma, and occupational lung disease. [ABSTRACT FROM AUTHOR]

Previously published analyses of suicide case investigations suggest that work or working conditions contribute to 10%–13% of suicide deaths. Yet, the way in which work may increase suicide risk is an underdeveloped area of epidemiologic research. In this Commentary, we propose a definition of work‐related suicide from an occupational health and safety perspective, and review the case investigation‐based and epidemiologic evidence on work‐related causes of suicide. We identified six broad categories of potential work‐related causes of suicide, which are: (1) workplace chemical, physical, and psychosocial exposures; (2) exposure to trauma on the job; (3) access to means of suicide through work; (4) exposure to high‐stigma work environments; (5) exposure to normative environments promoting extreme orientation to work; and (6) adverse experiences arising from work‐related injury or illness. We summarise current evidence in a schema of potential work‐related causes that can also be applied in workplace risk assessment and suicide case investigations. There are numerous implications of these findings for policy and practice. Various principle‐ and evidence‐based workplace intervention strategies for suicide prevention exist, some of which have been shown to improve suicide‐prevention literacy, reduce stigma, enhance helping behaviours, and in some instances maybe even reduce suicide rates. Prevailing practice in workplace suicide prevention, however, overly emphasises individual‐ and illness‐directed interventions, with little attention directed to addressing the working conditions that may increase suicide risk. We conclude that a stronger emphasis on improving working conditions will be required for workplace suicide prevention to reach its full preventive potential. [ABSTRACT FROM AUTHOR]

Wildland firefighters are exposed to airborne particulates, polycyclic aromatic hydrocarbons (PAHs), and other hazardous substances. Respiratory protection is indicated, but information is lacking on the tasks and conditions for which mask wearing should be advised. Studies to assess respiratory protection in wildland firefighters were carried out in western Canada in 2021 and 2023. Sampling pumps measured airborne exposures and urinary 1-hydroxypyrene (1-HP) was assayed to indicate PAH absorption. Participants in 2021 reported the time for which they wore the mask during each task. In 2023, the use of masks was reported, and firefighters rated the smoke intensity. In 2021, 72 firefighters were monitored over 164 shifts and, in 2023, 89 firefighters were monitored for 263 shifts. In 2021, mask wearing was highest for those engaged in initial attack and hot spotting. Urinary 1-HP at the end of rotation was highest for those reporting initial attack, working on a prescribed fire and mop-up. In 2023, firefighter ratings of smoke intensity were strongly associated with measured particulate mass and with urinary 1-HP, but masks were not worn more often when there was higher smoke intensity. The data from the literature did not provide a clear indication of high-exposure tasks. Better task/exposure information is needed for firefighters to make informed decisions about mask wearing. [ABSTRACT FROM AUTHOR]

The study examines the current scientific approach of non-performing loans through the prism of the regulations and guidelines for their management implemented after the Global financial and economic crisis by the European Central Bank and European Banking Authority. The approach for preparation a strategy for managing non-performing exposures and an operational plan for achieving short-term qualitative targets is presented. The recent NPL management model, including the so-called “Three lines of defense” is examined. The classification of non-performing loans according to the guidelines of the European Banking Authority is described in detail, as well as the restructuring and impairment of credit exposures. There are also outlined the methodology for accounting of financial assets implemented with International Financial Reporting Standard 9 – Financial Instruments in 2018 and the main criteria for applying the Definition of default from 2021. The causes that led to the bankruptcies of large banks in the USA and Europe in 2023 have been pointed out. Through a comparative analysis, the dynamics of nonperforming loans in the EU and Bulgaria have been studied. [ABSTRACT FROM AUTHOR]

This commentary addresses a series of articles in Prevention Science about environmental causes of attention deficit hyperactivity disorder (ADHD). It provides an overview of their key findings and places them in a broader context to facilitate their interpretation. Each of the articles included in the special issue is a meta-analysis assessing the association of ADHD with several environmental exposures. Each of the author teams systematically searched for articles and defined eligibility criteria. They assured that the measurement of risk factors preceded the measurement of ADHD. Most of the analyses are based on many studies with many participants in the constituent studies. As is typical of any observational epidemiologic study, the constituent studies could not correct for all possible confounds because some were not measured, and some are unknown. For this reason, these meta-analyses may have documented confounded associations, which calls for cautious interpretations. None of the constituent studies assessed what might be the most important type of confounding, familial, and genetic confounding, which occurs when the environmental exposure being studied is correlated with the genetic risk of the disorder being studied or other familial risk factors. Addressing familial/genetic confounding requires a genetically informed study. Because of these issues, the results presented here are intriguing but require further examination before one can conclude that the reported associations correspond to causal events for ADHD. A pathway forward is suggested by drawing parallels between genomic and exposure research. [ABSTRACT FROM AUTHOR]

Background: Exposures during pregnancy are common and most pregnant patients utilize at least one medication during pregnancy. The lack of reliable information on medication safety during pregnancy available to providers and patients is a stressor and obstacle to decision‐making about medication use in pregnancy. Previous studies showed that exposures in pregnancy are associated with guilt, worry, and decisional conflict. Although prior research has evaluated changes in patient knowledge after teratogen counseling, studies have not examined emotional outcomes or patients' decisional empowerment. This quasi‐experimental study measured changes in patients' feelings of guilt, anxiety, and decisional empowerment after receiving exposure counseling from trained teratogen information specialists. Methods: We administered pre‐ and post‐counseling surveys to patients referred to a perinatal exposure clinic in Tampa, Florida. Validated scales were used to measure anxiety and guilt, and the 'SURE' measure was used to assess decisional empowerment. Paired samples t‐tests evaluated changes in anxiety and guilt and a McNemar test assessed for changes in empowered decision making. Results: Among the 34 participants who completed both surveys, anxiety, and guilt scores decreased significantly (p <.001). While only 21% felt informed and empowered to make a decision related to their exposure(s) before counseling, this increased to 85% (p <.001) on the post‐survey. Conclusion: Comprehensive counseling with a trained teratogen information specialist improves patient emotional outcomes as well as feelings of empowerment to make an informed decision regarding medication use in pregnancy. This study highlights that patient‐centered teratogen counseling goes beyond simple changes in patient knowledge. [ABSTRACT FROM AUTHOR]

S U M M A R Y: Hepatitis B Virus (HBV) was recognized many decades ago as an important occupational hazard for Health Care Workers (HCWs) globally. HCWs who are directly involved in patient care and are in continuous contact with blood or body fluids have an increased risk of occupationally acquiring the virus. The risk of HCWs in highly endemic areas is greater due to the greater prevalence of infection in the general population. Recommendations are available to guide HBV prevention activities or practices among HCWs. These include the use of the hepatitis B vaccine as a preexposure prophylaxis and the use of hepatitis B immunoglobulin alone or hepatitis B immunoglobulin plus the vaccine as postexposure prophylaxis. The uptake of preexposure prophylaxis has been observed to be low in resource-poor settings where the disease is highly endemic. Postexposure prophylaxis has become the remedy for preventing occupational transmission of HBV in these settings.This review aimed to summarize the available evidence on the risk of transmission of HBV infection, the burden of infection and recommendations for pre- and postexposure prophylaxis for the prevention of occupational acquisition of HBV among HCWs. We conducted a narrative review to summarize the evidence available on the recommended steps of HBV exposure management and the utilization of post-exposure prophylaxis (PEP) for HBV. A comprehensive search was conducted in PubMed, Science Direct, Google Scholar, and Africa Journals Online (AJOL) databases. The keywords used were hepatitis B, hepatitis B virus postexposure prophylaxis, occupational exposures, and recommendations for postexposure to hepatitis B virus. We gleaned evidence from the literature sources and summarized the concepts related to exposure forms, postexposure prophylaxis management pathways and recommendations for the utilization of postexposure prophylaxis among exposed healthcare workers.From the synthesis of evidence, we conclude that HBV infection is a life-threatening condition. However, the disease is preventable by using the HBV vaccine as a preexposure prophylaxis measure. An effective postexposure prophylaxis management program is also available, and the last resort to preventing occupational transmission of HBV among HCWs who non-responders are, or who fail to vaccinate completely against HBV. Irrespective of the availability of these lifesaving interventions, the use of pre- and post-exposure prophylaxis among HCWs in highly endemic regions is suboptimal. Many barriers operating at the individual HCW and health facility levels have been identified as impacting the successful use of HBV preventive measures.

Cyanide represents a persistent threat for accidental or malicious misuse due to easy conversion into a toxic gas and access to large quantities through several industries. The high safety index of hydroxocobalamin is a cornerstone quality as a cyanide scavenger. Unfortunately, intravenous infusion of hydroxocobalamin limits the utility in a mass casualty setting. We previously reported platinum(II) [Pt(II)] complexes with trans-directing sulfur ligands as an efficacious alternative to hydroxocobalamin when delivered by a bolus intramuscular (IM) injection in mice and rabbits. Thus, to enable Pt(II) as an alternative to hydroxocobalamin, a high safety factor is needed. The objective is to maintain efficacy and mitigate the risk of nephrotoxicity. Platinum amino acid complexes with the ability to form 5- or 6-membered rings and possessing either carboxylates or carboxamides are evaluated in vitro for cyanide scavenging. In vivo efficacy wa s evaluated in the zebrafish and mice cyanide exposure models. In addition, Pt(II) complex toxicity and pharmacokinetics were evaluated in a cyanide naive Sprague Dawley model. Doses for toxicity are escalated to 5× from the efficacious dose in mice using a body surface area adjustment. The results show the carboxamide ligands display a time and pH dependence on cyanide scavenging in vitro and efficacy in vivo. Additionally, exchanging the carboxylate for carboxamide showed reduced indications of renal injury. A pharmacokinetic analysis of the larger bidentate complexes displayed rapid absorption by IM administration and having similar plasma exposure. These findings point to the importance of pH and ligand structures for methionine carboxamide complexes with Pt(II). [ABSTRACT FROM AUTHOR]

Mechanistic toxicology seeks to identify the molecular and cellular mechanisms by which toxicants exert their deleterious effects. One powerful approach is to generate mutations in genes that respond to a particular toxicant, and then test how such mutations change the effects of the toxicant. CRISPR is a rapid and versatile approach to generate mutations in cultured cells and in animal models. Many studies use CRISPR to generate short insertions or deletions in a target gene and then assume that the resulting mutation, such as a premature termination codon, causes a loss of functional protein. However, recent studies demonstrate that this assumption is flawed. Cells can compensate for short insertion and deletion mutations, leading toxicologists to draw erroneous conclusions from mutant studies. In this review, we will discuss mechanisms by which a mutation in one gene may be rescued by compensatory activity. We will discuss how CRISPR insertion and deletion mutations are susceptible to compensation by transcriptional adaptation, alternative splicing, and rescue by maternally derived gene products. We will review evidence that measuring levels of messenger RNA transcribed from a mutated gene is an unreliable indicator of the severity of the mutation. Finally, we provide guidelines for using CRISPR to generate mutations that avoid compensation. [ABSTRACT FROM AUTHOR]

Background: Sensorineural hearing loss (tinnitus) is common among young adults. There are different medical determinants which caused tinnitus symptoms, but lifestyle determinant is an important cause of tinnitus. This study determines the relationship between lifestyle determinants with tinnitus among adults through systematic review and meta-analysis. Methods: The study design for this study is a systematic review and meta-analysis; different search engines were used for the literature review: Web of Science, Scopus, and PubMed/MEDLINE. Those article in which tinnitus caused by tumors, syndrome and medical or surgical caused were excluded. Data synthesis was done, and a total of 10 studies were pooled. Results: Smoking more than four times (odds ratio [OR]: 4.11, 95% confidence interval [CI]: 1.01-4.45), alcohol consumption 27% less likely (OR: 0.73, 95% CI: 0.03-0.96), obesity two times more likely (OR: 2.30, 95% CI: 1.71-5.20), and leisure noise exposure more than one time more likely (OR: 1.62, 95% CI: 1.05-3.78) were significantly associated with tinnitus. Conclusion: There is enough evidence that lifestyle determinants (smoking, obesity, and leisure noise exposure) are related to tinnitus. This study highlights the knowledge gap in association of tinnitus with lifestyle determinants and it will help the future direction of research in this domain of tinnitus. [ABSTRACT FROM AUTHOR]

Background: It remains unclear whether exposure for planned fixation of distal radius fractrues is superior with any given approach, and whether a single utilitarian approach exists that permits reliable complete exposure of the volar distal radius. Methods: A cadaveric study was performed using 10 matched specimens. Group 1 consisted of 3 radially based approaches (standard flexor carpi radialis [FCR], standard FCR with radial retraction of FCR and flexor pollicis longus [FPL] tendons, extended FCR). Group 2 consisted of 2 ulnarly based approaches (volar ulnar, extended carpal tunnel). The primary outcome was total width of exposed distal radius at the watershed line. Mann-Whitney U and Wilcoxon rank testing was used to identify differences. Results: The standard FCR approach exposed 29 mm (90%), leaving on average 3 mm (10%) of the ulnar corner unexposed. Retracting the FCR and FPL tendons radially allows for an extra 1 mm of volar ulnar corner exposure. Finally, converting to an extended FCR approach provided 100% exposure in all specimens. The volar ulnar exposure however provided exposure to only 9 mm (37%), leaving 20 mm (62.5%) left unexposed radially. The extended carpal tunnel provided exposure to 21 mm (65%), leaving 11 mm (35%) radially unexposed. Differences between each group were statistically significant (P <.05). Conclusions: The extended FCR approach exposed 100% of the volar distal radius in our study and may serve as a utilitarian volar surgical approach for exposure and fixation of distal radius fractures. Additional knowledge of the limitations of alternative approaches can be helpful in surgical planning. [ABSTRACT FROM AUTHOR]

Wildland firefighters are exposed to airborne particulates, polycyclic aromatic hydrocarbons (PAHs), and other hazardous substances. Respiratory protection is indicated, but information is lacking on the tasks and conditions for which mask wearing should be advised. Studies to assess respiratory protection in wildland firefighters were carried out in western Canada in 2021 and 2023. Sampling pumps measured airborne exposures and urinary 1-hydroxypyrene (1-HP) was assayed to indicate PAH absorption. Participants in 2021 reported the time for which they wore the mask during each task. In 2023, the use of masks was reported, and firefighters rated the smoke intensity. In 2021, 72 firefighters were monitored over 164 shifts and, in 2023, 89 firefighters were monitored for 263 shifts. In 2021, mask wearing was highest for those engaged in initial attack and hot spotting. Urinary 1-HP at the end of rotation was highest for those reporting initial attack, working on a prescribed fire and mop-up. In 2023, firefighter ratings of smoke intensity were strongly associated with measured particulate mass and with urinary 1-HP, but masks were not worn more often when there was higher smoke intensity. The data from the literature did not provide a clear indication of high-exposure tasks. Better task/exposure information is needed for firefighters to make informed decisions about mask wearing.

BackgroundChronic obstructive pulmonary disease (COPD) has become one of the most significant chronic diseases in China. According to conventional wisdom, smoking is the pathogenic factor. However, current research indicates that the pathophysiology of COPD may be associated with prior respiratory system events (e.g., childhood hospitalization for pneumonia, chronic bronchitis) and environmental exposure (e.g., dust from workplace, indoor combustion particles). Dyspnea, persistent wheezing, and other respiratory symptoms further point to the need for pulmonary function tests in this population. Reducing the burden of chronic diseases in China requires a thorough understanding of the various factors that influence the occurrence of COPD.MethodsUsing a cohort from the natural population, this study used nested case-control analysis. We carried out a number of researches, including questionnaire surveys and pulmonary function testing, in the Northwest and Southeast cohorts of China between 2014 and 2021. After removing any variations in the baseline data between patients and control subjects using propensity score matching analysis, the risk factors were examined using univariate or multivariate regression.ResultIt was discovered that prior history of chronic bronchitis, long-term wheezing symptoms, and environmental exposure—including smoking and biofuel combustion—were risk factors for COPD. Dyspnea, symptoms of mobility limitation, organic matter, and a history of hospitalization for pneumonia at an early age were not significant in the clinical model but their incidence in COPD group is higher than that in healthy population.DiscussionCOPD screening effectiveness can be increased by looking for individuals with chronic respiratory symptoms. Smokers should give up as soon as they can, and families that have been exposed to biofuels for a long time should convert to clean energy or upgrade their ventilation. Individuals who have previously been diagnosed with emphysema and chronic bronchitis ought to be extra mindful of the prevention or advancement of COPD.

Simple Summary: Mosquito abundance data from vector surveillance programs can be used to help predict the incidence of Ross River virus (RRV). Climate, weather, geographical, and socio-economic variables also influence RRV incidence. In this study, we aimed to predict RRV incidence rates in three cities of Queensland, Australia (Brisbane, Redlands, and Mackay) and to assess the utility of mosquito data in prediction. Our findings demonstrated that mosquito abundance was a valuable predictor for RRV incidence in Brisbane and Redlands. The predictive results of Brisbane and Redlands were excellent, while for Mackay its prediction was less satisfactory. This study demonstrated the value of mosquito surveillance data for the prediction of RRV incidence in small geographical areas. Ross River virus (RRV) is the most common mosquito-borne disease in Australia, with Queensland recording high incidence rates (with an annual average incidence rate of 0.05% over the last 20 years). Accurate prediction of RRV incidence is critical for disease management and control. Many factors, including mosquito abundance, climate, weather, geographical factors, and socio-economic indices, can influence the RRV transmission cycle and thus have potential utility as predictors of RRV incidence. We collected mosquito data from the city councils of Brisbane, Redlands, and Mackay in Queensland, together with other meteorological and geographical data. Predictors were selected to build negative binomial generalised linear models for prediction. The models demonstrated excellent performance in Brisbane and Redlands but were less satisfactory in Mackay. Mosquito abundance was selected in the Brisbane model and can improve the predictive performance. Sufficient sample sizes of continuous mosquito data and RRV cases were essential for accurate and effective prediction, highlighting the importance of routine vector surveillance for disease management and control. Our results are consistent with variation in transmission cycles across different cities, and our study demonstrates the usefulness of mosquito surveillance data for predicting RRV incidence within small geographical areas. [ABSTRACT FROM AUTHOR]

Polybrominated diphenyl ethers (PBDEs) are a group of flame retardants used in plastics, textiles, polyurethane foam, and other materials. They contain two halogenated aromatic rings bonded by an ester bond and are classified according to the number and position of bromine atoms. Due to their widespread use, PBDEs have been detected in soil, air, water, dust, and animal tissues. Besides, PBDEs have been found in various tissues, including liver, kidney, adipose, brain, breast milk and plasma. The continued accumulation of PBDEs has raised concerns about their potential toxicity, including hepatotoxicity, kidney toxicity, gut toxicity, thyroid toxicity, embryotoxicity, reproductive toxicity, neurotoxicity, and immunotoxicity. Previous studies have suggested that there may be various mechanisms contributing to PBDEs toxicity. The present study aimed to outline PBDEs' toxic effects and mechanisms on different organ systems. Given PBDEs' bioaccumulation and adverse impacts on human health and other living organisms, we summarize PBDEs' effects and potential toxicity mechanisms and tend to broaden the horizons to facilitate the design of new prevention strategies for PBDEs-induced toxicity. [ABSTRACT FROM AUTHOR]

Smoking initiation is concentrated among young people which strongly influences future smoking prevalence. This study aimed to investigate the prevalence of smoking and other tobacco product use and potential determinants in a cross-sectional survey of 1 121 students aged 13 to 15 years in Dili, Timor-Leste. The prevalence of ever using a tobacco product was 40.4% (males 55.5%; females 23.8%) and of current use was 32.2% (males 45.3%; females 17.9%). In a logistic multivariable regression, factors associated with current use of any tobacco product were being male, ≥US$1 weekly pocket money, parents smoking, exposure at home, and exposure in other locations. The findings suggest that reducing the very high use of tobacco among adolescents in Timor-Leste will require new policy measures, enhanced enforcement of current legislation as well as a focused commitment to targeted smoke-free education campaigns, and community-based health promotion to support parents to quit smoking and not smoke around children. [ABSTRACT FROM AUTHOR]

Mounting evidence from epidemiological studies and animal models has linked exposures to environmental factors to changes in epigenetic markers, especially in DNA methylation. These epigenetic changes may lead to dysregulation of molecular processes and functions and mediate the impact of environmental exposures in complex diseases. However, detailed molecular events that result in epigenetic changes following exposures remain unclear. Here, we review the emerging evidence supporting a critical role of ten-eleven translocation 1 (TET1) in mediating these processes. Targeting TET1 and its associated pathways may have therapeutic potential in alleviating negative impacts of environmental exposures, preventing and treating exposure-related diseases.

Abstract Non-pharmacological interventions (e.g., stay-at-home orders, school closures, physical distancing) implemented during the COVID-19 pandemic are expected to have modified routines and lifestyles, eventually impacting key exposome parameters, including, among others, physical activity, diet and cleaning habits. The objectives were to describe the exposomic profile of the general Cypriot population and compliance to the population-wide measures implemented during March–May 2020 to lower the risk of SARS-CoV-2 transmission, and to simulate the population-wide measures’ effect on social contacts and SARS-CoV-2 spread. A survey was conducted in March–May 2020 capturing different exposome parameters, e.g., individual characteristics, lifestyle/habits, time spent and contacts at home/work/elsewhere. We described the exposome parameters and their correlations. In an exposome-wide association analysis, we used the number of hours spent at home as an indicator of compliance to the measures. We generated synthetic human proximity networks, before and during the measures using the dynamic- $${\mathbb{S}}$$ S 1 model and simulated SARS-CoV-2 transmission (i.e., to identify possible places where higher transmission/number of cases could originate from) on the networks with a dynamic Susceptible-Exposed-Infectious-Recovered model. Overall, 594 respondents were included in the analysis (mean age 45.7 years, > 50% in very good health and communicating daily with friends/family via phone/online). The median number of contacts at home and at work decreased during the measures (from 3 to 2 and from 12 to 0, respectively) and the hours spent at home increased, indicating compliance with the measures. Increased time spent at home during the measures was associated with time spent at work before the measures (β= -0.87, 95% CI [-1.21,-0.53]) as well as with being retired vs employed (β= 2.32, 95% CI [1.70, 2.93]). The temporal network analysis indicated that most cases originated at work, while the synthetic human proximity networks adequately reproduced the observed SARS-CoV-2 spread. Exposome approaches (i.e., holistic characterization of the spatiotemporal variation of multiple exposures) would aid the comprehensive description of population-wide measures’ impact and explore how behaviors and networks may shape SARS-CoV-2 transmission.

Air pollution is a significant health threat around the world. Young children are a more vulnerable population. Environmental Protection Agency (EPA) and World Health Organizations (WHO) guidelines may not adequately protect them. Given children's rapid growth, it is important to review studies, consider the weight of evidence, and identify knowledge gaps. Our purpose was to conduct a systematic literature review of epidemiological studies of adverse health outcomes not previously considered; specifically, we reviewed evidence for traffic-related air pollution (TRAP) CO, NO2, SO2, O3, PM10, and PM2.5 in children ≤ 5 years in age, with special attention to adverse effects occurring within current air pollutant guidelines. Data sources are electronic search of PubMed, MEDLINE, and Google Scholar. Articles on air pollutants and additional health outcomes in children (0–5 years), between Jan. 1997 and Dec. 2018. Search included terms such as "air pollution, children, and adverse effects". Fifty-two studies met the inclusion criteria. Seven (7) health outcome categories were identified: respiratory diseases; developmental disorders; allergies, eczema, and allergic rhinitis; ear infections; cancer; obesity; and others, with greatest associations for respiratory and developmental disorders. Strongest findings were for NO2, O3, PM10, and PM2.5, and most health effects reviewed occurred within WHO limits. Our findings are pertinent for health professionals, researchers, government officials, and others to collaboratively support policy efforts toward exposure reductions for pregnant women and children to prevent acute and chronic diseases. This is critical for building a culture of health and ensuring health equity for vulnerable populations. [ABSTRACT FROM AUTHOR]

Asthma-COPD overlap (ACO) is a respiratory condition with more severe respiratory symptoms, poorer quality of life, and increased hospital admissions compared with asthma or COPD alone. Estimate asthma, chronic obstructive pulmonary disease (COPD), and ACO prevalence among workers by industry and occupation and assess physical and mental health status, healthcare utilization, among workers with ACO. The 2014–2018 National Health Interview Survey (NHIS) data for working adults aged ≥18 years employed (sample n = 99,424) in the 12 months prior to the survey were analyzed. Age-adjusted ACO, COPD and asthma prevalence and prevalence ratios adjusted for age, sex, race and smoking status were estimated. During 2014–2018, of the estimated 166 million (annual average) US workers, age-adjusted asthma, COPD, and ACO prevalence was 6.9%, 4.0%, and 1.1%, respectively. ACO prevalence was highest among workers aged ≥65 years (2.0%), females (1.6%), current smokers (1.9%), those living below the federal poverty level (2.3%), and workers in the accommodation and food services (1.6%) industry and personal care and service (2.3%) occupations. Workers with ACO had more frequent (p < 0.05) physician office visits, emergency department visits; and were more likely to be in poorer mental health, obese, have more lost workdays, more bed days, and comorbidities compared to workers with asthma alone and workers with COPD alone. Conclusion: Higher ACO prevalence among worker groups and increased healthcare utilization underscores the need for early identification of asthma and COPD, assessment of potential workplace exposures, and implementation of tailored interventions to reduce ACO among working adults. [ABSTRACT FROM AUTHOR]

To examine pediatric exposure trends involving selected nonprescription analgesics/antipyretics, before and during the COVID-19 pandemic. Using descriptive and interrupted time-series analyses, we assessed monthly United States poison center data involving pediatric (<18 years) exposures to nonprescription paracetamol (acetaminophen), ibuprofen, acetylsalicylic acid, and naproxen before (January 2015-February 2020) and during (March 2020-April 2021) the pandemic. Statins and proton pump inhibitors (prescription or nonprescription) served as controls. Most nonprescription analgesic/antipyretic exposures (75–90%) were single-substance; unintentional exposures typically involved children <6 years (84–92%), while intentional exposures involved females (82–85%) and adolescents, 13–17 years (91–93%). Unintentional exposures among children <6 years, declined for all four analgesics/antipyretics immediately after the World Health Organization declared COVID-19 a pandemic (March 11, 2020), but most significantly for ibuprofen (30–39%). Most intentional exposures were classified as suspected suicide. Intentional exposures were relatively low and stable among males. Intentional exposures in females declined immediately after the pandemic was announced but subsequently increased to pre-pandemic levels for acetylsalicylic acid and naproxen and above pre-pandemic levels for paracetamol and ibuprofen. For paracetamol, female intentional exposures increased from 513 average monthly cases in the pre-pandemic to 641 average monthly cases during the pandemic; and reached 888 cases by the end of the study period in April 2021. While for ibuprofen, average monthly cases rose from 194 in the pre-pandemic, to 223 during the pandemic; and reached 352 cases in April 2021. Patterns were similar among females 6–12 and 13–17 years. Nonprescription analgesic/antipyretic unintentional exposure cases declined among young children, while intentional exposure cases increased among females, 6–17 years, during the pandemic. Findings highlight the importance of safely storing medications and being alert to signs that adolescents may be in need of mental health support services; caregivers should seek medical care or call poison control centers for any suspected poisoning event. [ABSTRACT FROM AUTHOR]

Paediatric poisoning is a major cause of childhood injury, and most poisonings are preventable. We aimed to describe hospitalisations resulting from poisoning and envenomation in Australian children, including demographics, cause of the exposure, hospital length of stay, rates of intensive care unit admission and in-hospital deaths. We also aimed to describe risk factors for increased length of stay and intensive care unit admission. A retrospective analysis was performed of hospitalised poisoning and envenomation cases of children (<15 years) in Australia from 1 July 2009 to 30 June 2019. A nationwide hospital admissions database was used for this study. During the 10-year study period 33,438 children were admitted to hospital due to a pharmaceutical or non-pharmaceutical poisoning/envenomation; an average of 74.8 cases per 100,000 population per year. Approximately 10 children were admitted to hospital each day for poisoning. Over 70% of these cases were due to pharmaceuticals (n = 23,628), most frequently non-opioid analgesics, anti-pyretics and anti-rheumatics (n = 8759, 37.1% of pharmaceutical exposures). The most common non-pharmaceutical exposure was contact with venomous animals and toxic plants (n = 4578, 46.7% of non-pharmaceuticals). Intentional self-harm occurred in 7833 (23.4%) of cases. Intensive care unit admission was required in 519 cases (2.5% of the 20,739 cases where this information was available), while 200 (0.96% of 20,739) needed ventilator support. Ten children (0.03%) died. Older age, female sex, poisoning with pharmaceuticals and metropolitan hospital location were associated with increased length of stay. Older age and poisoning with pharmaceuticals were also associated with intensive care unit admission. Approximately 10 children were admitted to hospital with poisoning every day in Australia. Most poisonings were due to pharmaceuticals, particularly simple analgesics that are found in most Australian homes. Severe outcomes (intensive care unit admissions and deaths) were rare. [ABSTRACT FROM AUTHOR]

Background . Phthalates are chemicals used to make plastics flexible and durable. They are found in clothes, varnishes, toys, pharmaceuticals, containers, and personal care products. Phthalates make their way into human bodies through ingestion, inhalation, and dermal absorption, and the breakdown of them within bodies can be measured as phthalate metabolites in urine. They pervade all aspects of the environment and our bodies, contributing to negative health outcomes. Education, SES, and gender influence where people live (their built environment), time-use patterns, occupation, treatment at healthcare facilities, and purchasing patterns; all affect phthalate exposures, and therefore phthalate metabolites in urine are also likely to vary by socio-demographic characteristics. Objectives . To study how levels of mono-ethyl phthalate (MEP) in urine samples of children and adults in the U S vary among key socio-demographic groups. We expect that disadvantaged groups will have the highest levels of phthalates. Methods . Using quantitative methods, we analyze levels of urinary MEP as a biomarker indicating exposure to phthalates. Within the National Health and Nutrition Examination Survey (NHANES) (1999–2018) participants, we compare MEP levels across the following socio-demographic groups: age, gender, education, race/ethnicity, family income to poverty level, citizenship status. We use multivariate regression models to adjust results for differences in other factors that potentially influence MEP levels. Results . Historically disadvantaged groups—women, Non-Hispanic Blacks, Mexican Americans, Other Hispanics, and those with lower educational attainment—have higher predicted phthalate levels, even when holding all covariates that could be related to differences in phthalate levels by socio-demographic factors constant. Discussion . Our results suggest differences in socio-demographic factors could be leading to unequal exposures to phthalates and MEP excretions in their urine. This research contributes to understanding health experiences outside of clinical definitions, drawing attention to structural vulnerabilities and the way that environmental toxicants are embodied in individuals and populations.

The San Joaquin Valley (SJV) of California has been consistently identified as having one of the highest levels of air pollution in the US. Despite federal and state standards, the SJV has been in non-attainment status for daily PM _2.5 concentrations, extreme non-attainment for 8 hr O _3 levels, and attainment for NO _2 . An epidemiological time-stratified case-crossover design was used to estimate the relationship between exposure to NO _2 , O _3 , PM _2.5 and adverse health outcomes in asthma and upper respiratory infections (URIs). This study compared pollutant exposure effects for each case during limited time intervals and adjusted for seasonality. Elevated concentrations of three criteria outdoor air pollutants are associated with increased asthma and URI-related ED visits and hospitalizations in the SJV for all ages. NO _2 exposure increased the odds of having an ED visit by 2.4% in lag 1 (95% CI: 1.017, 1.031). Lags 2, 3, 4, 5, 7, 9, and 14 were statistically significant. O _3 modestly increased the odds of ED visits by 0.3% (95% CI:1.000, 1.006) after immediate exposure in the warm season. In the cold season, PM _2.5 estimates were significant for all lags except for lags 4 and 12. The two-week lag increased the odds by 28% (95% CI:1.218, 1.345) for ED visits, and 16.5% (95% CI:1.009, 1.345) increased the odds of being hospitalized after cumulative exposure to PM _2.5 . Findings suggest that SJV residents experience adverse health effects due to elevated exposure to NO _2 despite attainment of federal and state pollutant standards. This study provides new evidence about the effects of three criteria air pollutants and adverse health outcomes in the SJV region. The air quality regulatory and public health governing bodies should consider revisions to regional pollutant thresholds and local public health strategies to prevent adverse health outcomes during short and prolonged periods of air pollution exposure.

Abstract Exposure prevalence studies (as here defined) record the prevalence of exposure to environmental and occupational risk factors to human health. Applying systematic review methods to the synthesis of these studies would improve the rigour and transparency of normative products produced based on this evidence (e.g., exposure prevalence estimates). However, a dedicated framework, including standard methods and tools, for systematically reviewing exposure prevalence studies has yet to be created. We describe the need for this framework and progress made towards it through a series of such systematic reviews that the World Health Organization and the International Labour Organization conducted for their WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates). We explain that existing systematic review frameworks for environmental and occupational health cannot be directly applied for the generation of exposure prevalence estimates because they seek to synthesise different types of evidence (e.g., intervention or exposure effects on health) for different purposes (e.g., identify intervention effectiveness or exposure toxicity or carcinogenicity). Concepts unique to exposure prevalence studies (e.g., “expected heterogeneity”: the real, non-spurious variability in exposure prevalence due to exposure changes over space and/or time) also require new assessment methods. A framework for systematic reviews of prevalence of environmental and occupational exposures requires adaptation of existing methods (e.g., a standard protocol) and development of new tools or approaches (e.g., for assessing risk of bias and certainty of a body of evidence, including exploration of expected heterogeneity). As part of the series of systematic reviews for the WHO/ILO Joint Estimates, the World Health Organization collaborating with partners has created a preliminary framework for systematic reviews of prevalence studies of exposures to occupational risk factors. This included development of protocol templates, data extraction templates, a risk of bias assessment tool, and an approach for assessing certainty of evidence in these studies. Further attention and efforts are warranted from scientific and policy communities, especially exposure scientists and policy makers, to establish a standard framework for comprehensive and transparent systematic reviews of studies estimating prevalence of exposure to environmental and occupational risk factors, to improve estimates, risk assessments and guidelines.

Aims/Hypothesis: Identifying risk factors for tinnitus could facilitate not only the recommendations for prevention measures, but also identifying potential pathways for new interventions. This study reports the first comprehensive systematic review of analytical observational studies able to provide information about causality (i.e., case–control and cohort designs). Methods: A literature search of four electronic databases identified epidemiological studies published on tinnitus and different exposures. Independent raters screened all studies, extracted data, and evaluated study quality using the Newcastle–Ottawa Scale. Reported relative risks (RR), hazard ratios (HR), odds ratios (OR), and prevalence ratios (PR) with 95% confidence intervals (CI) were used to compute crude estimates of RR for tinnitus risk factors. Results: From 2389 records identified, a total of 374 articles were read as full text (24 reviews, 301 cross-sectional studies, 42 cohort studies, and 7 case–control studies). However, from 49 case–control and cohort studies, only 25 adequately reported risk ratios. Using the findings from these studies, positive causal associations were found for various hearing-related factors (i.e., unspecified hearing loss, sensorineural hearing loss, occupational noise exposure, ototoxic platinum therapy, and otitis media). Evidence was also found for a number of non-otological risk factors including temporo-mandibular joint disorder, depression, chronic obstructive pulmonary disease, and hyperlipidemia. Negative associations indicating preventative effects were found for diabetes and high alcohol consumption. No associations were found for low alcohol consumption, body mass index, head injury, heart failure, hypertension, leisure noise exposure, migraine, rheumatoid arthritis, sex, smoking, stroke, and whiplash. However, with the exception of unspecified hearing loss, these findings resulted from pooling no more than 4 studies, illustrating that the vast majority of the associations still remain inconclusive. Conclusions: These systematic review and meta-analysis confirm a number of otological and non-otological risk factors for tinnitus. By highlighting major gaps in knowledge, our synthesis can help provide direction for future research that will shed light on the pathophysiology, improve management strategies, and inform more effective preventions. [ABSTRACT FROM AUTHOR]

Electronic nicotine delivery systems (ENDS) aerosols are complex mixtures of chemicals, metals, and particles that may present inhalation hazards and adverse respiratory health risks. Despite being considered a safer alternative to tobacco cigarettes, metal exposure levels and respiratory effects associated with device aging and vaping frequency have not been fully characterized. In this study, we utilize an automated multi-channel ENDS aerosol generation system (EAGS) to generate aerosols from JUUL pod-type ENDS using tobacco-flavored e-liquid. Aerosol puff fractions (1–50) and (101–150) are monitored and sampled using various collection media. Extracted aerosols are prepared for metal and toxicological analysis using human primary small airway epithelial cells (SAEC). ENDS aerosol-mediated cellular responses, including reactive oxygen species (ROS), oxidative stress, cell viability, and DNA damage, are evaluated after 24 h and 7-day exposures. Our results show higher particle concentrations in later puff fractions (0.135 mg/m3) than in initial puff fractions (0.00212 mg/m3). Later puff fraction aerosols contain higher toxic metal concentrations, including chromium, copper, and lead, which elicit increased levels of ROS followed by significant declines in total glutathione and cell viability. Notably, a 30% increase in DNA damage was observed after 7 days because of later puff fraction exposures. This work is consistent with ENDS aerosols becoming more hazardous across the use of pre-filled pod devices, which may threaten respiratory health. [ABSTRACT FROM AUTHOR]

Global warming can cause deep and extensive changes in the Earth's climate and changes in the time and place of climatic phenomena. The present trend analysis study assesses cold stress using the thermo-hygrometric index (THI) in the two seasons of autumn and winter in outdoor environments in Iran. The data related to the average of the two variables of daily air temperature and relative humidity from 60 synoptic meteorological stations for a statistical period of 30 years were obtained from the Iranian Meteorological Organization. The THI index was calculated for autumn and winter, and the level of thermal discomfort was determined for each station. The Mann–Kendall statistical test with the help of Minitab ver17.1.0 software was also used to investigate the changes in air temperature, relative humidity and THI index. The THI for autumn increased in 68% of the stations, and this increasing trend is statistically significant in 51% of these stations. The THI for winter increased in 83% of the stations, and this increasing trend is statistically significant in 51% of these stations. In autumn, 53% of the stations were in the range of thermal discomfort, and in winter only 5% were in the range of thermal comfort. The decreasing trend in THI in some climatic types, along with the increasing trend in air temperature, can indicate the decrease in relative humidity in the monitored stations during the studied years. It is recommended to know the temporal and spatial distribution and the probability of occurrence of cold stress through the use of THI in order to adopt preventive measures and policies in the outdoors in Iran. [ABSTRACT FROM AUTHOR]

Non-pharmacological interventions (e.g., stay-at-home orders, school closures, physical distancing) implemented during the COVID-19 pandemic are expected to have modified routines and lifestyles, eventually impacting key exposome parameters, including, among others, physical activity, diet and cleaning habits. The objectives were to describe the exposomic profile of the general Cypriot population and compliance to the population-wide measures implemented during March-May 2020 to lower the risk of SARS-CoV-2 transmission, and to simulate the population-wide measures' effect on social contacts and SARS-CoV-2 spread. A survey was conducted in March-May 2020 capturing different exposome parameters, e.g., individual characteristics, lifestyle/habits, time spent and contacts at home/work/elsewhere. We described the exposome parameters and their correlations. In an exposome-wide association analysis, we used the number of hours spent at home as an indicator of compliance to the measures. We generated synthetic human proximity networks, before and during the measures using the dynamic-[Formula: see text]1 model and simulated SARS-CoV-2 transmission (i.e., to identify possible places where higher transmission/number of cases could originate from) on the networks with a dynamic Susceptible-Exposed-Infectious-Recovered model. Overall, 594 respondents were included in the analysis (mean age 45.7 years, > 50% in very good health and communicating daily with friends/family via phone/online). The median number of contacts at home and at work decreased during the measures (from 3 to 2 and from 12 to 0, respectively) and the hours spent at home increased, indicating compliance with the measures. Increased time spent at home during the measures was associated with time spent at work before the measures (β= -0.87, 95% CI [-1.21,-0.53]) as well as with being retired vs employed (β= 2.32, 95% CI [1.70, 2.93]). The temporal network analysis indicated that most cases originated at work, while the synthetic human proximity networks adequately reproduced the observed SARS-CoV-2 spread. Exposome approaches (i.e., holistic characterization of the spatiotemporal variation of multiple exposures) would aid the comprehensive description of population-wide measures' impact and explore how behaviors and networks may shape SARS-CoV-2 transmission. [ABSTRACT FROM AUTHOR]

Nurses encounter unique and substantial challenges in professional practice. Nurses remain at the forefront of care but struggle with work-related fears and risk exposure. These challenges have significantly increased during unprecedented social unrest and the global pandemic making nurses less safe than in previous years. Nurses' fears and risks include patient harm, changing healthcare environments, and psychological and physical harm. This study reveals nurses' fears and highlights the significance of fear on the individual nurse and the profession. Healthcare leaders, administrators, educators, and practitioners must work on creating a culture of preparedness, support, and protection for healthcare workers in all areas. [ABSTRACT FROM AUTHOR]

Ross River virus (RRV) is the most common mosquito-borne disease in Australia, with Queensland recording high incidence rates (with an annual average incidence rate of 0.05% over the last 20 years). Accurate prediction of RRV incidence is critical for disease management and control. Many factors, including mosquito abundance, climate, weather, geographical factors, and socio-economic indices, can influence the RRV transmission cycle and thus have potential utility as predictors of RRV incidence. We collected mosquito data from the city councils of Brisbane, Redlands, and Mackay in Queensland, together with other meteorological and geographical data. Predictors were selected to build negative binomial generalised linear models for prediction. The models demonstrated excellent performance in Brisbane and Redlands but were less satisfactory in Mackay. Mosquito abundance was selected in the Brisbane model and can improve the predictive performance. Sufficient sample sizes of continuous mosquito data and RRV cases were essential for accurate and effective prediction, highlighting the importance of routine vector surveillance for disease management and control. Our results are consistent with variation in transmission cycles across different cities, and our study demonstrates the usefulness of mosquito surveillance data for predicting RRV incidence within small geographical areas.

AIM:We aim to study DNA methylation (DNAm) variations associated with childhood asthma. METHODS:Nasal DNAm was compared between sibling pairs discordant for asthma, 29 sib pairs for genome-wide association studies and 54 sib pairs for verification by pyrosequencing. Associations of methylation with asthma symptoms, allergy and environmental exposures were evaluated. In vitro experiments and functional genomic analyses were performed to explore biologic relevance. RESULTS:Three CpGs were associated with asthma. cg14830002 was associated with allergies in nonasthmatics. cg23602092 was associated with asthma symptoms. cg14830002 and cg23602092 were associated with traffic-related air pollution exposure. Nearby genes were transcriptionally regulated by diesel exhaust, house dust mite and 5-aza-2'-deoxycytidine. Active chromatin marks and transcription factor binding were found around these sites. CONCLUSION:We identified novel DNAm variations associated with childhood asthma and suggested new disease-contributing epigenetic mechanisms.

Cryptococcal meningitis is a life-threatening condition most commonly observed in immunocompromised individuals. We describe a daily cannabis smoker without evidence of immunodeficiency presenting with confirmed Cryptococcus neoformans meningitis. An investigation of cannabis samples from the patients preferred dispensary demonstrated contamination with several varieties of Cryptococcus, including C. neoformans, and other opportunistic fungi. These findings raise concern regarding the safety of dispensary-grade cannabis, even in immunocompetent users.

ABSTRACTAdequate levels of essential vitamins are important for the prevention of diabetes. While the main efforts to address this are currently focused on the intake of vitamin supplements, improving and maintaining intrinsic vitamin production capacity, which is determined by gut microbes, has received insufficient attention. In this study, we systematically investigated the relationship between gut microbial vitamin production and factors related to diabetes and cardiometabolic health in a deeply phenotyped cohort, Lifelines-DEEP (N = 1,135). We found that blood glucose–related factors, lipids, circulating inflammation, and fecal short-chain fatty acids are associated with gut microbial vitamin production. Use of laxatives and metformin are associated with increased levels of vitamin B1/B6 biosynthesis pathways. We further reveal a mediatory role for microbial vitamin B1/B2 production on the influence of fruit intake on diabetes risk. This study provides preliminary evidence for microbiome-targeted vitamin metabolism interventions to promote health.

Transmission of Ross River virus (RRV) is influenced by climatic, environmental, and socio-economic factors. Accurate and robust predictions based on these factors are necessary for disease prevention and control. However, the complicated transmission cycle and the characteristics of RRV notification data present challenges. Studies to compare model performance are lacking. In this study, we used RRV notification data and exposure data from 2001 to 2020 in Queensland, Australia, and compared ten models (including generalised linear models, zero-inflated models, and generalised additive models) to predict RRV incidence in different regions of Queensland. We aimed to compare model performance and to evaluate the effect of statistical overdispersion and zero-inflation of RRV surveillance data, and non-linearity of predictors on model fit. A variable selection strategy for screening important predictors was developed and was found to be efficient and able to generate consistent and reasonable numbers of predictors across regions and in all training sets. Negative binomial models generally exhibited better model fit than Poisson models, suggesting that over-dispersion in the data is the primary factor driving model fit compared to nonlinearity of predictors and excess zeros. All models predicted the peak periods well but were unable to fit and predict the magnitude of peaks, especially when there were high numbers of cases. Adding new variables including historical RRV cases and mosquito abundance may improve model performance. The standard negative binomial generalised linear model is stable, simple, and effective in prediction, and is thus considered the best choice among all models. [ABSTRACT FROM AUTHOR]

Complex traits are influenced by genetic risk factors, lifestyle, and environmental variables, so-called exposures. Some exposures, e.g., smoking or lipid levels, have common genetic modifiers identified in genome-wide association studies. Because measurements are often unfeasible, exposure polygenic risk scores (ExPRSs) offer an alternative to study the influence of exposures on various phenotypes. Here, we collected publicly available summary statistics for 28 exposures and applied four common PRS methods to generate ExPRSs in two large biobanks: the Michigan Genomics Initiative and the UK Biobank. We established ExPRSs for 27 exposures and demonstrated their applicability in phenome-wide association studies and as predictors for common chronic conditions. Especially the addition of multiple ExPRSs showed, for several chronic conditions, an improvement compared to prediction models that only included traditional, disease-focused PRSs. To facilitate follow-up studies, we share all ExPRS constructs and generated results via an online repository called ExPRSweb. A wide range of health-related, lifestyle, and environmental variables impact disease risks; however, they are often unmeasured. By generating and analyzing polygenic scores that captured these factor's heritable component, we highlight their roles across medical phenotypes of two large biobanks and showcase the scores' ability to improve disease prediction models. [ABSTRACT FROM AUTHOR]

Background: Congenital malformations and adverse fetal outcomes secondary to teratogenic exposures are major public health concerns. We review all inquiries made to the Florida MotherToBaby service center as well as the novel Exposure Clinic, which offers direct patient counseling. Methods: We completed a retrospective review of all inquiries made to the MotherToBaby Florida service and the Exposure Clinic consults between its inception January 2019 through December 2021. All de‐identified data was collected at the time of the inquiry and stored in the OTIS database. Aggregate data was then extracted and descriptive statistics were performed. A p value of less than.05 indicated statistical significance. Results: In 2019, there were 163 total inquiries, 265 in 2020, and 1,279 in 2021. These 1,707 inquiries covered 2,809 unique exposures. In the Exposure Clinic, 49 patients were seen in 2019, 140 in 2020, and 263 in 2021. The clinic's geographical reach increased over time with patients from 22 different counties being seen in 2021. Of all individual exposures, 45% were evaluated in 452 unique encounters in the Exposure Clinic and 55% were evaluated in 1255 unique encounters via traditional modes of contact. The average number of exposures discussed at each clinic appointment 2.8 versus 1.2 in inquiries via traditional methods. The majority of all exposures were regarding prescription medications, specifically psychiatric medications, followed by immunizations. The exposure with the single most inquiries was the COVID‐19 vaccine. Conclusions: This novel clinic structure allows for complex counseling and clinical recommendations regarding exposures during pregnancy. [ABSTRACT FROM AUTHOR]

A man in his mid-20s presented to the occupational health service following an ocular projection with a concentrated solution of lymphocytic choriomeningitis virus (LCMV clone-13). Subsequently, a regular clinical and biological follow-up was initiated. 7 days after exposure, the patient developed influenza-like symptoms. During the acute phase, specific RT-PCR testing of blood plasma was negative for LCMV. Symptomatic treatment was administered, and the symptoms resolved after a few days. The patient remained asymptomatic in the following weeks. Serological follow-up detected a seroconversion 6 weeks after exposure, indicating a recent infection. The occupational health service's protocol, comprising clinical monitoring and serological surveillance, facilitated the detection of seroconversion. This case underscores ocular mucosal exposure as a route of occupational LCMV transmission, which is often not considered. It served as an opportunity to review and enhance prevention measures and laboratory protocols within the biosafety level P2 facility., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Polybrominated diphenyl ethers (PBDEs) are a group of flame retardants used in plastics, textiles, polyurethane foam, and other materials. They contain two halogenated aromatic rings bonded by an ester bond and are classified according to the number and position of bromine atoms. Due to their widespread use, PBDEs have been detected in soil, air, water, dust, and animal tissues. Besides, PBDEs have been found in various tissues, including liver, kidney, adipose, brain, breast milk and plasma. The continued accumulation of PBDEs has raised concerns about their potential toxicity, including hepatotoxicity, kidney toxicity, gut toxicity, thyroid toxicity, embryotoxicity, reproductive toxicity, neurotoxicity, and immunotoxicity. Previous studies have suggested that there may be various mechanisms contributing to PBDEs toxicity. The present study aimed to outline PBDEs’ toxic effects and mechanisms on different organ systems. Given PBDEs’ bioaccumulation and adverse impacts on human health and other living organisms, we summarize PBDEs’ effects and potential toxicity mechanisms and tend to broaden the horizons to facilitate the design of new prevention strategies for PBDEs-induced toxicity.

Objectives: It is crucial to elucidate the causal relevance of nutritional exposures (such as dietary patterns, food intake, macronutrients intake, circulating micronutrients), or biomarkers in non-communicable diseases (NCDs) in order to find effective strategies for NCD prevention. Classical observational studies have found evidence of associations between nutritional exposures and NCD development, but such studies are prone to confounding and other biases. This has direct relevance for translation research, as using unreliable evidence can lead to the failure of trials of nutritional interventions. Facilitated by the availability of large-scale genetic data, Mendelian randomization studies are increasingly used to ascertain the causal relevance of nutritional exposures and biomarkers for many NCDs. Methods: A narrative overview was conducted in order to demonstrate and describe the utility of Mendelian randomization studies, for individuals with little prior knowledge engaged in nutritional epidemiological research. Results: We provide an overview, rationale and basic description of the methods, as well as strengths and limitations of Mendelian randomization studies. We give selected examples from the contemporary nutritional literature where Mendelian randomization has provided useful evidence on the potential causal relevance of nutritional exposures. Conclusions: The selected exemplars demonstrate the importance of well-conducted Mendelian randomization studies as a robust tool to prioritize nutritional exposures for further investigation. [ABSTRACT FROM AUTHOR]