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Copyright of Revista de Toxicología is the property of Asociacion Espanola de Toxicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Toxicología is the property of Asociacion Espanola de Toxicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Toxicología is the property of Asociacion Espanola de Toxicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The species Anemonia sulcata, are cnidarians that serve as bioindicators in marine ecosystems, indicating the health of the environment and changes in environmental conditions. Monitoring anemone populations and studying their well-being and distribution provide valuable insights into marine ecosystem conditions. This study aimed to investigate the impact of the COVID pandemic on the metal content (Al, Cd, Cu, Fe, Pb, and Zn), 120 A. sulcata collected during a six-year period (2017-2022). The results showed a constant decreasing trend, but with the lowest concentrations occurring in 2020, matching with the two-month lockdown from March to May. This findings suggest that the reduced anthropogenic pressure on the coast due to the absence of tourism significantly decreased pollution levels. Therefore, the study supports the importance of promoting sustainable tourism worldwide, highlighting that minimizing human impact on coastal areas through responsible tourism practices can effectively reduce pollution in marine ecosystems. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Toxicología is the property of Asociacion Espanola de Toxicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina Interna de Mexico is the property of Colegio de Medicina Interna de Mexico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Toxicología is the property of Asociacion Espanola de Toxicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Toxicología is the property of Asociacion Espanola de Toxicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Toxicología is the property of Asociacion Espanola de Toxicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Toxicología is the property of Asociacion Espanola de Toxicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Dried fruits are one of the most frequently consumed products by the population. Drying fruits prolongs their shelf life and also concentrates more nutrients. However, these products may contain dangerous levels of trace elements that can be harmful to health. The content of trace elements (Al, B, Ba, Cd, Cr, Li, Ni, Pb, Sr, V) in 42 samples of different dried fruits (dates, prunes, sultanas, dried apricot kernels, and dried figs) was determined by inductively coupled plasma spectrometry (ICP-OES). The concentrations of Al found in prunes (12.7 ± 5.13 mg Al/kg) and the concentrations of B found in dried plums (6.26 ± 4.45 mg B/kg) were significantly higher ( p < 0.05). Regarding the risk assessment, the percentages of contribution to the maximum recommended intakes by Li in all the dried fruits studied stand out, reaching 35.3% in the case of dried plums. This study concludes that the recommended daily intake of dried fruit (30 g/day) does not pose a toxicological risk about these trace elements.

High fluoride exposures can lead to adverse effects such as dental and bone fluorosis, as well as endocrine and cognitive developmental problems. Water is the main dietary source of this ion, although significant concentrations have also been detected in other beverages widely consumed by the population such as soft drinks. A total of 200 soft drink samples (60 flavoured, 70 extracts, 60 fruit juice and 10 soft drinks) were analysed by fluoride ion selective potentiometry. A consumption of 330 mL was estimated for exposure assessment and subsequent F-risk assessment by soft drink consumption. The highest average concentration was found in extract soft drinks (2.45 ± 1.15 mg/L), followed by flavoured (1.71 ± 2.29 mg/L) and carbonated soft drinks (1.38 ± 0.40 mg/L), while the lowest was found in fruit juice soft drinks (1.09 ± 0.62 mg/L). The flavours with the highest concentration were tea-melon and tea-passion fruit with 3.66 ± 0.40 and 3.17 ± 0.56 mg/L respectively and the lowest was lemon flavour with 0.69 mg/L. The contribution of these beverages, considering the UL (Upper level) reference values set by EFSA (European Food Safety Authority) are between 3.28-41.78%, depending on age group and sex., (© 2023. The Author(s).)

Rio Grande is a city located on a narrow industrialized and urbanized Brazilian peninsula, characterized by wetlands. Due to population growth, numerous urban backfilled regions were built to expand the territorial area of the city. Currently, more than 60% of the central area of the city comes from the grounding of wetlands. The material used for the expansion of the territory had a history of contamination from metals from the tannery and textile industries (mainly Hg) and urban solid waste. In addition to past sources, the city has an active industrial complex with fertilizer, petrochemical, and grain industries. This study evaluated the risks to human health caused by metals (Hg, Fe, Ni, Cr, Cu, Pb, and Zn) in original soils and backfills, considering the oral, inhalation, and dermal routes of exposure for children and adults using the tool human health risk assessment (HHRA) proposed methodology by USEPA. A total of 63.81% of the original soil samples and 57.14% of the backfill soil samples showed a non-carcinogenic risk (HInc>1) for at least one evaluated metal. Still, approximately 10% of the samples presented carcinogenic risk when the Cr was considered in the hexavalent form. The dermal (Hg, Ni, and Cr) and oral (Fe, Cu, and Zn) exposure routes had the greatest contribution to the total risk. The non-carcinogenic risk for Hg, Cr(VI), and Pb was heterogeneously distributed between the original soils and backfills and associated with the proximity to some pollution sources. Given the complexity of historical occupation in the municipality and the increasing industrialization, both the original areas and the backfills should be included in the risk management strategy to minimize risks., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

For the potential health benefits and nutritional value, polyphenols are one of the secondary metabolites of plants that have received extensive research. It has anti-inflammatory and cytotoxicity-reducing properties in addition to a high antioxidant content. Macromolecular polyphenols and polysaccharides are biologically active natural polymers with antioxidant and anti-inflammatory potential. Arsenic is an ecologically toxic metalloid. Arsenic in drinking water is the most common way people come into contact with this metalloid. While arsenic is known to cause cancer, it is also used to treat acute promyelocytic leukemia (APL). The treatment's effectiveness is hampered by the adverse effects it can cause on the body. Oxidative stress, inflammation, and the inability to regulate cell death cause the most adverse effects. Polyphenols and other macromolecules like polysaccharides act as neuroprotectants by mitigating free radical damage, inhibiting nitric oxide (NO) production, lowering A42 fibril formation, boosting antioxidant levels, and controlling apoptosis and inflammation. To prevent the harmful effects of toxins, polyphenols and pectin lower oxidative stress, boost antioxidant levels, improve mitochondrial function, control apoptosis, and suppress inflammation. Therefore, it prevents damage to the heart, liver, kidneys, and reproductive system. This review aims to identify the effects of the polyphenols in conjugation with polysaccharides as an ameliorative strategy for arsenic-induced toxicity in various organs., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interests., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Cereals and cereal-based foods continue to be basic foods in all diets. Despite being known for their high nutritional value; they can also contain contaminants (hazards) such as toxic metals. This study assesses the Cd, Pb and Hg dietary exposure from cereals and derivatives marketed in Madeira and the Azores and characterizes the risks by evaluating the Cd and Hg intake contributions to the tolerable intakes and by estimating the Margin of Exposure (MOE) in the case of Pb. In Madeira, metals follow the descending order of Cd > Pb > Hg. Cd stands out as having the highest levels (0.307 mg Cd/kg in oats; 0.237 mg/kg in rye). High levels of Pb (0.347 mg/kg) were also detected in rye. Regarding total mercury, rice stands out (0.0013 mg/kg) followed by wheat (0.001 mg/kg). While all cereals and derivatives except maize consumed in Madeira exceed the maximum value of Cd allowed by the EU, 50.0% of the rye and 25.0% of the corn flour samples exceeded the European Pb limit. The daily consumption of 100 g of oats, rye flour and rye represent high contributions to the TWI of Cd (93.2 - 120%). The MOE values of Pb from the consumption of rye (100 g/day) are 1,294 (nephrotoxic effects) and 3,082 (cardiotoxic effects). In the Azores, corn flour (0.72 mg Pb/kg) stands out with 85.7% of the samples exceeding the maximum Pb EU limit and MOE values of 626 (nephrotoxic effects) and 1,490 (cardiotoxic effects). Regular daily consumption of corn flour makes a low (< 10%) contribution to the Cd TDI. In conclusion, the Pb exposure from the consumption of cereals and derivatives could have toxic effects such as nephrotoxicity or cardiotoxicity in adults. The results highlight the need to set up monitoring and surveillance programs for the safety of cereals and their derivatives in Madeira and the Azores in terms of lead and cadmium., (© 2023. The Author(s).)

Infertility has become more common, with an increased exposure to toxic compounds including heavy metals (HM). Follicular fluid (FF) surrounds the developing oocyte in the ovary and can be analysed to assess metal content. The levels of twenty-two metals were measured in the FF of ninety-three females in a reproduction unit, and their influence on assisted reproduction technique (ART), were examined. The metals were determined by optical emission spectrophotometry. Low values of copper, zinc, aluminium, and calcium favour polycystic ovary syndrome. The relationships between the number of oocytes and metals: iron (r s =0.303; p=0.003) and calcium (r s =-0.276; p=0.007) are significant, as well as between the number of mature oocytes with iron (r s =0.319; p=0.002), calcium (r s =-0.307; p=0.003) and sodium (r s =-0.215; p=0.039) and are near to significance in the case of aluminium (r s =-0.198; p=0.057). In the group with a fertilisation rate ≤ 75%, 36% of the women presented calcium >176.62 mg/kg compared to the group with a fertilisation rate ≥ 75% where this percentage was only 10% (p=0.011). An excess of iron and calcium reduces the good quality embryo rate, and an excess of potassium impairs the blastocyst rate. If potassium is above 237.18 mg/kg and calcium is below 147.32 mg/kg, these conditions favour embryo implantation. Pregnancy is influenced by high potassium and low copper levels. Controlling exposure to toxic elements is recommended for all couples with reduced fertility or receiving an ART., (© 2023. The Author(s).)

Protein supplements (PS) are trendy foods, especially those made from whey. In addition to providing protein, these products are a source of metals, providing essential elements (Na, K, Mg, Ca, Mo, Mn, Fe, Co, Cu, and Zn) and other potentially toxic elements (Al, B, Sr, V Ba, and Ni). In this study, 47 whey PS samples were analyzed for mineral elements by ICP-OES, and their dietary exposures were assessed for three consumption scenarios. Elements found in higher concentrations were K (4689.10 mg/kg) and Ca (3811.27 mg/kg). The intake of 30 g PS (average recommended amount/day) provides about 20% of the established reference value (NRI) for Cr (18.30% for men and 25.63% for women) and Mo (26.99%). In a high daily consumption scenario (100 g PS/day) and when the maximum concentrations are considered, Cr, Zn, Fe, Mo, and Mg dietary intakes of these metals exceed the daily recommended intakes and could pose a risk. The daily intake of 30, 60, and 100 g of whey PS for 25 years does not pose a health risk since the hazard index (HI) is less than one in these consumption scenarios, and the essential elements contributing most to HI are Co, followed by Mo and Cr. It is recommended to improve the information to the consumers of these new products. Furthermore, to help in the management and prevention of these potential health risks, it would be advisable to improve the regulation of these dietary supplements and their labeling.

Sports nutrition supplementation is a widespread practice. Whey protein supplements contribute not only to protein intake but also to dietary exposure to minerals. The labelling present provides the percentage of protein and rarely refers to other components, such as potentially toxic elements such as B, Cu, Mo, Zn, and V that present tolerable upper intake levels set by the European Food Safety Authority. The percentage of protein declared on supplement labelling was checked using the Kjeldahl method, and the levels of Ca, Mg, K, Na, Ba, B, Co, Cu, Cr, Sr, Fe, Li, Mn, Mo, Ni, V, Zn, and Al were analyzed by ICP-OES with the aim of characterizing the protein and mineral contents of isolate and concentrate whey protein supplements representative of the European market. The protein content was 70.9% (18-92.3%) and statistically significant differences were observed between the declared and real protein percentages. Among the minerals, K (4689.10 mg/kg) and Ca (3811.27 mg/kg) presented the highest levels, whereas Co (0.07 mg/kg) and V (0.04 mg/kg) showed the lowest levels. It was concluded that the quality and safety of these products needs to be monitored and regulated. A high degree of non-compliance with labelling claims was detected. Furthermore, the contributions to the recommended and tolerable intakes among regular consumers need to be assessed.

Bioaccumulation is the process by which living organisms accumulate substances, such as pesticides, heavy metals, and other pollutants, from their environment. These substances can accumulate in the organism's tissues over time, leading to potential health risks. Bioaccumulation can occur in both aquatic and terrestrial ecosystems, and can have a significant impact on the health of both humans and wildlife. The objective of this study is to find out if the concentrations of metals in the tuna species of the Canary Islands are suitable for human consumption and if they pose a health risk. Fifteen samples of Acanthocybium solandri, Katsuwonus pelamis, Thunnus albacares, Thunnus obesus and Thunnus thynnus present in canaries were analyzed. Ten grams of muscle were taken from each specimen and the metals Al, Cd, Cr, Cu, Fe, Li, Ni, Pb and Zn were determined by Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES). The tuna species that presented more metals with a higher concentration compared to the others was T. thynnus , reaching up to 100 times more than the other studied species in Fe content with 137.8 ± 100.9 mg/Kg, which may be due to the fact that it is the largest species that reaches ages of more than fifteen years. The species Thunnus thynnus should not be suitable for commercialization according to the current legislation on the concentrations of Cd in blue fish, since 75% of the specimens studied exceeded the concentration legislated for Cd. A total of 40% of the studied specimens of this this species exceeded the legislated values for the concentration of Pb in oily fish meat, so this species must be monitored to ensure that it does not pose a risk to human health.

Background and Objective: Surgical creation of arteriovenous fistulas (AVF) and grafts (AVG) continues to be the mainstay access for hemodialysis (HD). Avoidance of dependence on dialysis catheters continues to be a worldwide mission in dialysis access. Importantly, there is no one-size-fits-all approach to hemodialysis access and each patient should undergo access creation that is patient-centered. The aim of this paper is to review the literature, current guidelines, and discuss the common types of upper extremity hemodialysis access and their reported outcomes. We will also share our institutional experience regarding the surgical creation of upper extremity hemodialysis access., Methods: The literature review incorporates twenty-seven relevant articles from 1997 to present and one case report series from 1966. Sources were gathered from electronic databases including PubMed, EMBASE, Medline, and Google Scholar. Only articles written in the English language were considered and study designs varied from current clinical guidelines, systematic and meta-analyses, randomized controlled trials, observational studies, and two main vascular surgery textbooks., Key Content and Findings: This review exclusively focuses on the surgical creation of upper extremity hemodialysis accesses. Creating a graft versus fistula ultimately is decided by the existing anatomy, and is centered around the need of the patient. Preoperatively, the patient should undergo a thorough history and physical exam, with special attention to any previous central venous access, as well as, delineating the vascular anatomy with ultrasound imaging. The major tenets of access creation are choosing the most distal site of the non-dominant upper extremity whenever possible; and ideally creation of an autogenous access is preferred over a prosthetic graft. Described in this review are multiple surgical approaches for upper extremity hemodialysis access creation and associated institutional practices performed by the surgeon author. In the postoperative period, follow up care and surveillance are imperative to preserve a functioning access., Conclusions: The most recent guidelines regarding hemodialysis access still favor arteriovenous fistula as the primary goal for patients with suitable anatomy. Preoperative evaluation including patient education, intraoperative ultrasound assessment, meticulous technique, and careful postoperative management are all paramount for successful access surgery. Dialysis access remains quite challenging, but with diligence the great majority of patients can be dialyzed without catheter dependence., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cdt.amegroups.com/article/view/10.21037/cdt-21-565/coif). The series “Endovascular and Surgical Interventions in the End Stage Renal Disease Population” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare., (2023 Cardiovascular Diagnosis and Therapy. All rights reserved.)

The Canary Islands, located in the Atlantic Ocean, are an archipelago of volcanic origin which, for decades, has been affected by natural fluoride contamination in the water supply of some of its islands, mainly the island of Tenerife. In addition, recent volcanic eruptions in the archipelago and the increased demand for water supply have led to an increase in the fluoride content in other areas which, historically, were not affected. Fluoride content was determined in 274 water supply samples from the most populated islands of the Canary Islands (Tenerife and Gran Canaria) collected during the months of June 2021 to May 2022. The samples were analysed by fluoride ion selective potentiometry. The highest concentrations in Tenerife were found in the municipalities of Sauzal (7.00 mg/L) and Tegueste (5.39 mg/L), both water samples are over the parametric value of 1.5 mg/L set in the supply water legislation. In the Gran Canaria Island, the highest fluoride levels were found in Valsequillo and Mogán with 1.44 mg/L in both locations, but under the parametric fluoride value abovementioned. Consumption of just 1 L of water per day in the El Sauzal area would result in a contribution rate of 77% for adults and children over 15 years of age (Upper Level value of 7 mg/day) and 108% for children 9-14 years of age (UL value of 5 mg/day). The contribution rates increase considerably, reaching or exceeding 100% of the reference value (UL) with increasing consumption of 1 to 2 L of water per day. Therefore, it is considered that there is a health risk of overexposure to fluoride on the island of Tenerife. In the case of the island of Gran Canaria, it has been shown that even the consumption of 2 litres of water per day does not confer contribution rates that pose a health risk.

Energy generated by coal can contaminate the environment by releasing toxic elements, including metals. The human health risk assessment (HHRA) associated with geographic information system (GIS) tools can assist the management of contaminated areas, such as coal mining areas. The objective of the study was to carry out the assessment and spatialization of the risk to human health of potentially hazards elements (PHEs) in the soil for children and adults, from multiple exposure routes (oral, inhalation and dermal) in the Candiota mines, largest coal mining region of Brazil. The non-carcinogenic risks (HQ) of PHEs (Cu, Pb, Zn, Ni, Cr, Fe, Mn, Cd, As and Se) and carcinogenic risks of As were estimated and spatialized. The results revealed a risk for children exposure to Mn, with greatest contribution through dermal route. Mn (HQ derm 72.41-96.09% and HQ inh 40.84-82.52%) and Fe (HQ o 43.90-81.44%) were the metals with greatest contribution to human health risk among studied population. As did not present carinogenic risk to adults. The spatial distribution of non-carcinogenic risk showed that Cr, As, Fe, Pb, Ni, Zn and Cu have higher HInc close to the coal mining areas, while Mn, Se and Cd have the highest HInc values in surrounding municipalities (Pinheiro Machado; Pedras Altas and Hulha Negra). The use of HHRA associated with GIS tools provides important elements for decision-making in the management of contaminated sites, indicating chemical elements, locations, routes of exposure and priority target populations., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

There are a large number of pests which are detrimental to plant production, specifically to banana cultivation, and the use of pesticides is the main method of control of these pests. Therefore, the number of active substances in pesticides has been steadily increasing since before the Second World War. There is growing consumer concern about the health effects of pesticide residues and there is certainly evidence of a link between pesticide exposure and the prevalence of chronic diseases. Therefore, it is of particular interest to study the presence of pesticide residues in bananas and their toxicological, agricultural and legal implications. In this study, the content of pesticide residues in bananas produced in the Canary Islands during a ten-year period from 2008 to 2017 was determined. A total of 733 samples of bananas were analysed during the study period, in which 191 different active substances were investigated, involving 103,641 assessments. The samples analysed were selected in such a way that they are representative of the banana sector in the Canary Islands as a whole, taking into account geographical and climatic factors, cultivation methods and the processing of bananas in packaging, which are the differentiating factors in the use of pesticides. The reference parameter for the residue investigation is the MRL (maximum residue limit).

Instant soups and noodles are one of the most widely consumed commercial food products. These products are made from ingredients of animal (chicken, meat) and/or vegetable origin, in addition to various food additives that prolong the shelf life of the product. It should be noted that instant soups are a dehydrated product, whose water-removal process can increase the accumulation of contaminants, such as toxic metals (Al, Cd, or Pb), that are harmful to the health of consumers. The content of toxic metals (Al, Cd, and Pb) in a total of 130 samples of instant soups of different types (poultry, meat, and vegetables) was determined by ICP-OES (inductively coupled plasma-optical emission spectrometry). The Al content (32.28 ± 19.26), the Cd content (0.027 ± 0.016), and the Pb content (0.12 ± 0.13) in the vegetable soups were worth mentioning. Considering an intake of twenty grams (recommended by the manufacturer), the dietary intake of Al (19.56% of the TWI set at 1 mg/kg bw/week), the intake of Cd (6.59% of the TWI set at 2.5 µg/kg bw/week), and the Pb intake (16.18% of the BMDL set for nephrotoxic effects at 0.63 µg/kg bw/week and 6.84% of the BMDL set for cardiovascular effects at 1.50 µg/kg bw/week) in the population aged 3-10 years, instant soups are not recommended for the population aged 3-10 years, while their consumption does not pose a health risk for adults. However, it is necessary to consider the cooking water used in the preparation of these products, as it may increase exposure to these toxic metals, in addition to the rest of the diet.

Fluoride is present in various foods ingested daily. It has been demonstrated that the intake of high concentrations of fluoride, both in adults and children, can cause pathologies, among which dental fluorosis, osteoporosis and damage to the central nervous system stand out. The objective of this study was to determine the fluoride concentrations in 60 samples of ready-to-drink cold brewed coffee of different brands and types (expresso, cappuccino, macchiato and decaffeinated) by the fluoride ion-selective potentiometric method. A statistical analysis was also performed to discern the existence of differences between these categories. The highest fluoride concentration (1.465 mg/L) was found in espresso coffee followed by Macchiato (1.254 mg/L). Decaffeinated coffee is the one that presented the lowest fluoride concentration with 0.845 mg/L. The risk assessment was conducted considering different consumption scenarios (250, 500 and 750 mL/day). The UL (upper level) established by the EFSA (European Food Safety Authority) at 7 mg/day was used. The consumption of three servings poses no health risk; however, it confers a significant value of fluoride contribution to the diet.

Microplastics (MPs) have been identified as emerging environmental pollutants classified as primary or secondary based on their source. Composition, shape, size, and colour, among other characteristics, are associated with their capacity to access the food chain and their risks. While the environmental impact of MPs has received much attention, the risks for humans derived from their dietary exposure have not been yet assessed. Several institutions and researchers support that the current knowledge does not supply solid data to complete a solid risk characterization of dietary MPs. The aim of this paper is to review the current knowledge about MPs in foods and to discuss the challenges and gaps for a risk analysis. The presence of MPs in food and beverages has been worldwide observed, but most authors considered the current data to be not only insufficient but of questionable quality mainly because of the outstanding lack of consensus about a standardized quantifying method and a unified nomenclature. Drinking water, crustaceans/molluscs, fish, and salt have been identified as relevant dietary sources of MPs for humans by most published studies. The hazard characterization presents several gaps concerning the knowledge of the toxicokinetic, toxicodynamic, and toxicity of MPs in humans that impede the estimation of food safety standards based on risk. This review provides a tentative exposure assessment based on the levels of MPs published for drinking water, crustaceans and molluscs, fish, and salt and using the mean European dietary consumption estimates. The intake of 2 L/day of water, 70.68 g/day of crustaceans/molluscs, 70.68 g/day of fish, and 9.4 g/day of salt would generate a maximum exposure to 33,626, 212.04, 409.94 and 6.40 particles of MPs/day, respectively. The inexistence of reference values to evaluate the MPs dietary intake prevents the dietary MPs risk characterization and therefore the management of this risk. Scientists and Food Safety Authorities face several challenges but also opportunities associated to the occurrence of MPs in foods. More research on the MPs characterization and exposure is needed bearing in mind that any future risk assessment report should involve a total diet perspective.

Objectives/hypothesis: Novel laryngotracheal wound coverage devices are limited by complex anatomy, smooth surfaces, and dynamic pressure changes and airflow during breathing. We hypothesize that a bioinspired mucoadhesive patch mimicking how geckos climb smooth surfaces will permit sutureless wound coverage and also allow drug delivery., Study Design: ex-vivo., Methods: Polycaprolactone (PCL) fibers were electrospun onto a substrate and polyethylene glycol (PEG) - acrylate flocks in varying densities were deposited to create a composite patch. Sample topography was assessed with laser profilometry, material stiffness with biaxial mechanical testing, and mucoadhesive testing determined cohesive material failure on porcine tracheal tissue. Degradation rate was measured over 21 days in vitro along with dexamethasone drug release profiles. Material handleability was evaluated via suture retention and in cadaveric larynges., Results: Increased flocking density was inversely related to cohesive failure in mucoadhesive testing, with a flocking density of PCL-PEG-2XFLK increasing failure strength to 6880 ± 1810 Pa compared to 3028 ± 791 in PCL-PEG-4XFLK density and 1182 ± 262 in PCL-PEG-6XFLK density. The PCL-PEG-2XFLK specimens had a higher failure strength than PCL alone (1404 ± 545 Pa) or PCL-PEG (2732 ± 840). Flocking progressively reduced composite stiffness from 1347 ± 15 to 763 ± 21 N/m. Degradation increased from 12% at 7 days to 16% after 10 days and 20% after 21 days. Cumulative dexamethasone release at 0.4 mg/cm 2 concentration was maintained over 21 days. Optimized PCL-PEG-2XFLK density flocked patches were easy to maneuver endoscopically in laryngeal evaluation., Conclusions: This novel, sutureless, patch is a mucoadhesive platform suitable to laryngeal and tracheal anatomy with drug delivery capability., Level of Evidence: NA Laryngoscope, 131:1958-1966, 2021., (© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).)

Vascularization is critical for engineering mineralized tissues. It has been previously shown that biomaterials containing preformed endothelial networks anastomose to host vasculature following implantation. However, the networks alone may not increase regeneration. In addition, a clinically applicable source of cells for vascularization is needed. In this study, vascular networks were generated from endothelial cells (ECs) derived from human induced pluripotent stem cells (iPSCs). Network formation by iPSC-ECs within fibrin gels was investigated in a mesenchymal stem cells (MSCs) coculture spheroid model. Statistical design of experiments technique was evaluated for its predicting capability during the optimization of experimental parameters. The prevascularized units were combined with hydroxyapatite nanoparticles to develop a vascularized composite hydrogel that was implanted in a rodent critical-sized cranial defect model. Immunohistological staining for human-specific CD31 at week 1 indicated the presence and maintenance of the implanted vessels. At 8 weeks, the prevascularized systems resulted in higher vessel density over MSC-only scaffolds. The implanted vessels appeared to establish flow with host vasculature. While there was a slight increase in bone volume in the prevascularized bone construct compared to MSC-only bone constructs, there was not a profound increase in bone regeneration. These results show that scaffolds with network structures can be generated from ECs derived from iPSC and that the networks survive and inosculate with the host postimplantation in a bone model. Impact statement Vascularization is critical for engineering bone. Prevascularized scaffolds have been shown to improve postimplantation vascularization. Herein, vascularized networks were generated from induced pluripotent cells derived from endothelial cells. These vascularized units were combined with a fibrin/hydroxyapatite scaffold to develop a prevascularized construct for bone regeneration. Implantation of these scaffolds in a small animal cranial defect model resulted in network inosculation and increased vascularization, but exhibited only a limited effect on bone formation. This study provides insight into the challenges of generating vascularized bone.

Extracellular matrix (ECM) products have the potential to improve cellular attachment and promote tissue-specific development by mimicking the native cellular niche. In this study, the therapeutic efficacy of an ECM substratum produced by bone marrow stem cells (BM-MSCs) to promote bone regeneration in vitro and in vivo were evaluated. Fluorescence-activated cell sorting analysis and phenotypic expression were employed to characterize the in vitro BM-MSC response to bone marrow specific ECM (BM-ECM). BM-ECM encouraged cell proliferation and stemness maintenance. The efficacy of BM-ECM as an adjuvant in promoting bone regeneration was evaluated in an orthotopic, segmental critical-sized bone defect in the rat femur over 8 weeks. The groups evaluated were either untreated (negative control); packed with calcium phosphate granules or granules+BM-ECM free protein and stabilized by collagenous membrane. Bone regeneration in vivo was analyzed using microcomputed tomography and histology. in vivo results demonstrated improvements in mineralization, osteogenesis, and tissue infiltration (114 ± 15% increase) in the BM-ECM complex group from 4 to 8 weeks compared to mineral granules only (45 ± 21% increase). Histological observations suggested direct apposition of early bone after 4 weeks and mineral consolidation after 8 weeks implantation for the group supplemented with BM-ECM. Significant osteoid formation and greater functional bone formation (polar moment of inertia was 71 ± 0.2 mm 4 with BM-ECM supplementation compared to 48 ± 0.2 mm 4 in untreated defects) validated in vivo indicated support of osteoconductivity and increased defect site cellularity. In conclusion, these results suggest that BM-ECM free protein is potentially a therapeutic supplement for stemness maintenance and sustaining osteogenesis., (© 2020 Wiley Periodicals LLC.)

Objective: Volcanic eruptions are a natural source of substances potentially dangerous to human health. The island of El Hierro (Canary Islands, Spain) suffered a marine volcanic eruption in 2012, making it necessary to monitor the levels of certain elements that can alter the quality of groundwater supply. The objective of this work was to determine the content of metals and trace elements in the groundwater supply of the Isla del Hierro and to check if they met the quality parameters established in Spanish legislation., Methods: The content of metals and trace elements (aluminum, lead, cadmium, calcium, potassium, sodium, magnesium, boron, barium, cobalt, chromium, copper, iron, lithium, manganese, molybdenum, nickel, strontium, vanadium, zinc, fluorine) in a total of 60 samples of groundwater supply and agriculture from six different sampling points on the island. The determination was carried out by inductively coupled plasma optical emission spectrophotometry (ICP-OES) and by fluoride ion selective potentiometry. The data were statistically analyzed applying the Kolmogorov-Smirnov test, Levene's statistic, Kruskal-Wallis, Mann-Whitney U, ANOVA and Tukey's test. Significant differences were those that met p<0.05., Results: The highest mean concentration of lead was recorded in the Tigaday samples (0.003±0.0005 mg/L), finding statistically significant differences (p<0.05) in the lead levels between the sampling points. The elements analyzed were below the parametric values set in Royal Decree 140/2003., Conclusions: The results obtained reflect that, in all the samples analyzed, the quality parameters established in the Spanish legislation (RD 140/2003) are met, being, therefore, waters suitable for human consumption., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background: Many bariatric surgeons test the anastomosis and staple lines with some sort of provocative test. This can take the form of an air leak test with a nasogastric tube with methylene blue dye or with an endoscopy. The State Department of Health Statistics in Texas tracks outcomes using the Texas Public Use Data File (PUDF)., Methods: We queried the Texas Inpatient and Outpatient PUDFs for 2013 to 2017 to examine the number of bariatric surgeries with endoscopy performed at the same time. We used the International Classification of Diseases Clinical Modification Version 9 (ICD-9-CM) and ICD-10 procedure codes and Current Procedural Terminology for Sleeve Gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) and endoscopy, and the ICD-9-CM and ICD-10 diagnosis codes for morbid obesity., Results: There were 74,075 SG reported in the Texas Inpatient and Outpatient PUDF for the years 2013-2017. Of the SG performed, 5,521 (7.4%) had an intraoperative endoscopy. For the 19,192 LRYGB reported, 1640 (8.6%) underwent LRYGB + endoscopy. This was broken down by SG only vs SG + endoscopy and LRYGB only vs LRYGB + endoscopy. Overall, SG + endoscopy had a significantly shorter length of stay (LOS) vs LRYGB + endoscopy at 1.74 d vs 2.34 d ( P < .001) and a significantly less cost of $71,685 vs $91,093 ( P < .001)., Conclusions: A small percentage of SG and LRYGB patients underwent endoscopy for provocative testing over the study period. Provocative testing with endoscopy costs more for SG and LRYGB and was associated with a shorter LOS., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest directly relevant to the content of this article., (© 2020 by JSLS, Journal of the Society of Laparoscopic & Robotic Surgeons.)

Background: Gastric bypasses were the most common bariatric surgery for many years, and long-term complications after gastric bypass are known to be relatively common. Symptomatic hiatal hernia (HH) with pouch migration is a less-known complication. However, when these are symptomatic, they require surgical repair., Objective: We present a case series of late-term HH after gastric bypass and discuss the common presentation and treatment., Setting: University program in the United States., Methods: A retrospective chart review was performed of patients presenting with late-term HH after gastric bypass performed by a single surgeon during 2002 through 2018. The review captured presentation and symptoms, age, body mass index, time from index surgery, radiologic studies, and the reoperative details. If available, the original operative note was reviewed along with any preoperative imaging studies. A review of the literature was also performed., Results: Seven patients were included in the case series. The average time from the index surgery was 11.9 years (range 9-16) and the average age of the patient at time of presentation was 60.1. The average body mass index at the time of the HH repair was 34 kg/m 2 . The most common presenting symptom was gastroesophageal reflux. Both computed tomography and upper gastrointestinal series were used for diagnosis with a common finding of HH and pouch migration into the mediastinum. HH repair with bioabsorbable mesh was performed in all patients, with an average operative time of 105 minutes., Conclusion: HH can present late after gastric bypass become symptomatic. When symptomatic, it needs to be addressed surgically and can usually be done through a minimally invasive approach., (Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Objectives: In-office or operative injection laryngoplasty requires needle stability for accurate material placement. To date, no reports compare injection forces based on needle gauge, bends, length, or material type or temperature. We hypothesize these factors alter injection forces and could impact clinical use., Methods: Swine larynges were placed in a compression testing machine. Syringes were affixed to a stabilizing crossbeam. Straight needles (25G 1.5-inch; 27G 1.25-inch; or 9.8-inch malleable shaft 16G per oral with 24G tapered needle tip) were inserted into the swine vocal folds to simulate realistic tissue resistance pressure. Compressive loading was conducted at 40 mm/minute until steady-state force was achieved. Tests were completed with calcium hydroxylapatite (CaHa), carboxymethylcellulose, and hyaluronic acid at various temperatures and CaHa with various bends in the needles (n = 3 per group, comparisons performed by two-way analysis of variance (ANOVA), Tukey's post-hoc)., Results: Needle size, shape, and temperature altered injection force. Steady-state force was highest with the per-oral needle at a mean of 44.55N compared to 26.44N and 29.77N in the 25G and 27G percutaneous needles, respectively (P < 0.001). Stiffness rate (initial increasing force vs. distance to initiate injection) ranged from 19.75N/mm (per oral) to 22.06N/mm (25G) to 24.56N/mm (27G), (P = 0.875). Adding multiple bends to the per-oral needle increased stiffness rate to 24.99N/mm (P = 0.035), whereas the 25G needle stiffness rate remained unchanged (P = 0.941), with the stiffness rate decreasing in the 27G needle with increasing bends (P = 0.033). Increased temperature decreased injection forces across all materials., Conclusion: Needle caliber, length, and bends impact steady-state forces and stiffness rates during vocal fold injection., Level of Evidence: NA Laryngoscope, 129:1060-1066, 2019., (Published 2018. This article is a U.S. Government work and is in the public domain in the USA.)