Exposure Factors Research Articles

The Use of Artificial Intelligence to Analyze the Exposome in the Development of Chronic Diseases: A Review of the Current Literature

The “Exposome” is a concept that indicates the set of exposures to which a human is subjected during their lifetime. These factors influence the health state of individuals and can drive the development of Noncommunicable Diseases (NCDs). Artificial Intelligence (AI) allows one to analyze large amounts of data in a short time. As such, several authors have used AI to study the relationship between exposome and chronic diseases. Under such premises, this study reviews the use of AI in analyzing the exposome to understand its role in the development of chronic diseases, focusing on how AI can identify patterns in exposure-related data and support prevention strategies. To achieve this, we carried out a search on multiple databases, including PubMed, ScienceDirect, and SCOPUS, from 1 January 2019 to 31 May 2023, using the MeSH terms (exposome) and (‘Artificial Intelligence’ OR ‘Machine Learning’ OR ‘Deep Learning’) to identify relevant studies on this topic. After completing the identification, screening, and eligibility assessment, a total of 18 studies were included in this literature review. According to the search, most authors used supervised or unsupervised machine learning models to study multiple exposure factors’ role in the risk of developing cardiovascular, metabolic, and chronic respiratory diseases. In some more recent studies, authors also used deep learning. Furthermore, the exposome analysis is useful to study the risk of developing neuropsychiatric disorders or evaluating pregnancy outcomes and child growth. Understanding the role of the exposome is pivotal to overcome the classic concept of a single exposure/disease. The application of AI allows one to analyze multiple environmental risks and their combined effects on health conditions. In the future, AI could be helpful in the prevention of chronic diseases, providing new diagnostic, therapeutic, and follow-up strategies.

Sustainable Urban Development: A Comprehensive Model for Assessing Health Risks from Compounded Pollution in Xi’an

Global climate change and rapid urbanization have brought unprecedented environmental challenges, especially in rapidly expanding cities like Xi’an, posing potential challenges to sustainable development if not accompanied by adequate greenery, thoughtful layouts, and pollution control measures. The increasing frequency and intensity of urban air pollution (e.g., PM2.5, PM10, O3) and extreme climate events (e.g., heatwaves) have heightened health risks for residents. Existing studies mostly focus on single pollution or climate factors, neglecting the compounded effects of these factors. To fill this research gap, this study presents a health risk assessment model, specifically by analyzing the compounded effects of heatwaves and air pollution. By integrating hazard, exposure, and vulnerability factors using the entropy weight–TOPSIS method, the results reveal significant spatial differences in health risks across various regions of Xi’an. The findings provide valuable guidance for urban planners and policymakers to better address environmental hazards, reduce health risks, and promote sustainable urban development.

Emergence of Streptococcus suis infection from Goa, India

Abstract Streptococcus suis is an emerging zoonotic bacterium that causes severe invasive disease in humans. In India, only two human case reports have been recorded till now. In the present report, we described the clinical case report along with an epidemiological investigation of the first S. suis case from Goa, India. The clinical presentation and detailed history regarding the potential exposure factors for the infection were recorded and to trace the source of the infection, the meat markets and the backyard piggeries in the vicinity of the patient’s residence were investigated. Case definitions were formulated and enhanced surveillance was initiated in the State to identify any additional cases. The case-patient was a co-morbid 63-year-old female, who was provisionally diagnosed with meningitis and septicaemia and S . suis infection was detected using automated microbial identification systems. The epidemiological investigation revealed that the patient was involved in handling raw pork one day prior to the symptom onset. Based on the active case finding, no additional case of S. suis was detected in the area. The present case was a sporadic case of S. suis in Goa, India and case-patient may have been exposed to the bacteria by handling raw pork while cooking. One Health impact statement Our investigation described the 3rd case of Streptococcous suis from India. This is significant because despite the abundance of the source of infection across the country i.e. high prevalence in the pig population, there are unusually low number of human cases, which can be attributed to very low clinical index of suspicion and lack of diagnostic tests in humans, as evidenced in the present case. A multi-disciplinary One Health approach has been applied for the present case investigation as the Human Health, Animal Health and Food Safety aspects were investigated in collaboration with the State Health & Animal Husbandry departments along with the academia. The findings of the present investigation will aid in enhancing the clinical index of suspicion among clinicians and awareness among high-risk groups like veterinarians for S. suis infection in humans and animals. The multi-disciplinary One Health approach aided us in tracing the source of the infection, which would help in generating evidence for designing preventive interventions.

OPTIMIZATION OF RADIATION PROTECTION IN PATIENTS THROUGH IMPLEMENTATION OF LOCAL DIAGNOSTIC REFERENCE LEVEL (DRL) IN PANORAMIC DENTAL EXAMINATION IN RADIOLOGY INSTALLATION OF PROF. DR. MARGONO SOEKARJO HOSPITAL

One of the principles of radiation protection is optimization. Optimization is done to make the dose received as low as reasonably achievable (ALARA) by considering economic and social factors. Implementation of radiation protection optimization can be done with dose management through the Local Diagnostic Reference Level (DRL). In recent years, the Nuclear Energy Regulatory Agency (BAPETEN) has set the Indonesian DRL value for several X-ray modalities, including dental panoramic. This study was motivated by panoramic patient dose audit data using the auto mode exposure factor, which operators often use. The method for determining the manual mode exposure factor is carried out by comparing the image quality of the current variations of 6.3 mA, 8 mA, 10 mA, 13 mA, and 16 mA with a fixed voltage of 66 kV and a time of 14.1 seconds. The local DRL value was obtained by comparing the dental panoramic auto mode measurements with manual mode using certain exposure factors according to the recommendations in the initial study using a head phantom. This study used 100 patient data with adult human criteria aged over 15. The results obtained from the initial study and questionnaires in manual mode were the values that had the highest CNR and SNR at a current variation of 10 mA. The exposure factor was then used to collect patient data. The local DRL value obtained for auto mode was 83.35 mGy cm2; in manual mode, it was 57.7 mGy cm2. Manual mode exposure factors in dental panoramic examinations affected the implementation of local DRL values with a decrease of 30.77% from auto mode. The use of manual mode in dental panoramic examinations significantly reduces the radiation dose received by patients, so the use of manual mode is one of the steps to optimize radiation protection. Keywords: Diagnostic Reference Level (DRL), optimization of radiation protection in patients, dental panoramic.

EFFECTIVE DOSE ANALYSIS IN ABDOMEN AP EXAMINATION PATIENTS WITH CALDOSE_X VERSION 5.0

This study evaluates radiation dose exposure during diagnostic radiology procedures using X-rays and their potential risks, including cancer, to optimize radiation safety through the CALDose_X software that calculates the absorbed organ dose, effective dose, and cancer risk, according to the lowest possible achievable (ALARA) principle. This study used a quantitative experimental design to evaluate the impact of filter thickness variations on Entrance Surface Air Kerma (ESAK) and effective dose by analyzing data from 54 patients undergoing AP Abdominal X-ray examinations. The results showed that the effective dose to the abdominal organs varied with exposure factors and Focus to Detector Distance (FDD), where the colon wall had the highest sensitivity with doses ranging from 0.030 mSv to 0.126 mSv, followed by the stomach and pancreas. Increasing kV, mAs, and FDD increased the effective dose, emphasizing the importance of careful dose management. This study concluded that exposure factors and FDD affect the effective dose received by the abdominal organs, with recommendations to monitor patient doses, revise national diagnostic reference levels, and establish standard protocols with health authorities. Keywords: CALDose_X, X-ray Exposure Factor, patient dose, ESAK, Effective Dose, Abdomen AP.

DETERMINATION OF LOCAL DIAGNOSTIC REFERENCE LEVEL (DRL) ON CONVENTIONAL RADIOTHERAPY SIMULATOR WITH BRAIN METASTASIS CASES AT DR. ADHYATMA, MPH HOSPITAL

Conventional simulators in 2-dimensional (2D) radiotherapy procedures can be done with fluoroscopy and single exposure features. The most significant percentage of 2D patients in the radiotherapy installation of Dr. Adhyatma MPH Hospital, are patients with brain metastasis cases, with a percentage of 65% of all 2D patients. Therefore, this study focuses on brain metastasis cases. The feature used in the Radiotherapy Installation of Dr. Adhyatma MPH Hospital is the single exposure feature, which is identical to conventional diagnostic radiology examinations. Radiation in diagnostic radiology requires a local Diagnostic Reference Level (DRL) on a conventional radiotherapy simulator as a guideline for optimizing radiation protection for medical exposure. This study aims to determine the local DRL value of a conventional radiotherapy simulator in cases of brain metastasis and compare it with the national DRL in lateral head examinations. The local DRL value obtained is then used as a guideline in improving services to increase the quality of service to patients. The data collection method is carried out in 2 (two) ways, namely calculating the local DRL value from the ESAK value and interviews related to the quality of the resulting image. The exposure factors used in this study followed the same routine exposure factors with a tube voltage of 72 kV and a tube current of 25 mAs. The local DRL value obtained was 0.586 mGy, with a percentage difference of 51% lower than the national DRL. With this value, the quality of the resulting image is classified as optimal and easy to assess. Thus, the exposure factors in the conventional radiotherapy simulation process in cases of brain metastasis can be used as a guideline for clinical practice at RSUD dr. Adhyatma, MPH. Keywords: conventional radiotherapy simulator, 2-dimensional radiotherapy, local DRL, diagnostic patients, radiation dose.

ESTIMATION OF DOSE ESTIMATION USING THE SPECIFIC DOSE SIZE METHOD OF RADIOGRAPH IMAGE REPEAT ANALYSIS AS A FORM OF RADIATION SAFETY IN THE RADIOLOGY INSTALLATION OF KLATEN ISLAMIC HOSPITAL

Repeat analyses are radiographs that are not clinically acceptable and are requested to be retaken. The primary purpose of the repeat analyses program is to take corrective action, record the repeated radiographic images, and determine the cause of the repetition so that it can be minimized or even eliminated. Klaten Islamic Hospital needs to keep its radiology services optimal and safe for patients as a referral hospital. One indicator of the quality of service is the low repetition rate of radiographic images. This study aims to determine the percentage of factors causing the repetition of radiographic images and suggested solutions to minimize repeat radiographic images in the Radiology Department. Survey research with a quantitative approach to repeating radiographic images at the Radiology Department. The study was conducted in February-May 2024 using observation, survey, and documentation. The percentage of repetition of radiographic images at the Radiology Installation of Klaten Islamic Hospital in the first month was 2.72%, in the second month was 3.04%, in the third month was 4.05%, and in the fourth month was 3.43%. Factors causing the repetition of radiographic images include miscollimation (clipped), artifacts, exposure factors, tools, and patient movement. Suggested solutions to minimize the factors causing the repetition of radiographic images in the Radiology Installation of Klaten Islamic Hospital are good communication between radiographers and patients, double checking before exposure, clear instructions to patients, ensuring there are no objects that can become artifacts, using appropriate exposure parameters, calibrating and testing suitability regularly, reporting if there is equipment damage, and using immobilization techniques. Keywords: Repeat Analyses, Digital Radiography, radiation safety for patient.

OPTIMIZATION OF EXPOSURE FACTORS WITH VARIATION OF FILTER THICKNESS ON DOSE VALUES AND RADIOGRAPHIC IMAGE QUALITY IN PELVIS EXAMINATION

This study examines the impact of varying X-ray tube voltage (kV) and filter thickness on patient radiation dose and image quality in radiographic procedures. It aims to optimize exposure factors to minimize patient dose while maintaining diagnostic image quality, contributing to safer and more efficient radiological practices. This quantitative experimental study investigates the impact of varying filter thickness and tube voltage on patient radiation dose. Using X-ray equipment, dosimeters, and phantoms, measurements of Incident Air Kerma (INAK) and Entrance Surface Air Kerma (ESAK) and effective dose are taken, followed by image quality assessments to optimize exposure factors while maintaining diagnostic efficacy. The study demonstrated that increasing filter thickness decreases both INAK and ESAK values, with the most significant dose reduction occurring at 2 mm thickness. Optimal image quality and effective dose reduction were observed with the 1 mm filter at 80 kV, reducing the dose by 14.3% to 20% while maintaining good spatial resolution and contrast. The study concludes that using a 1 mm aluminum filter with 80 kV significantly reduces the effective dose while maintaining image quality. It is recommended that hospitals adopt additional filters, conduct further research with different materials, and optimize exposure factors. Training for radiology technicians on these practices is essential to enhance patient safety and image quality. Keywords: X-ray Equipment, Entrance Surface Air Kerma, Effective Dose, Image Quality.

The relationship between pulmonary ventilation function and bone marrow hematopoietic function: A mendelian randomization analysis

Background: In recent years, the comorbidity between respiratory and hematopoietic system diseases has emerged as a new challenge. However, the potential genetic link between the ventilatory function of the respiratory system and the hematopoietic function of the bone marrow remains unclear. In this study, we conducted a comprehensive investigation into the possible genetic connection between lung ventilatory function and bone marrow hematopoietic function. Methods: We selected two exposure factors, Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC), which represent pulmonary ventilation function, and two outcome indicators, Immature Fraction of Reticulocytes (IFR) and Reticulocyte Count (RC), which represent bone marrow hematopoiesis function, from published genome-wide association studies. Based on the three core assumptions of Mendelian randomization analysis, we extracted Single Nucleotide Polymorphism (SNPs) associated with FEV1 and FVC as instrumental variables for the exposure factors. We then conducted two-sample Mendelian randomization analyses using inverse variance weighted (IVW), weighted median, and MR-Egger regression methods. Lastly, we assessed the reliability of the testing results through MR-Egger, Cochran’s Q test, and the leave-one-out test. Through these steps, we aimed to explore the causal relationship between pulmonary ventilation function and the outcome of bone marrow hematopoiesis function and evaluated the reliability of the testing results using methods such as MR-Egger, Cochran’s Q test, and the leave-one-out test. Results: The IVW method revealed that a decrease in FEV1 is associated with an increase in IFR (β = −0.072, 95% CI: −0.131 to −0.014, p = 0.01), and the results from MR-Egger regression showed a similar association (β = −0.169, 95% CI: −0.342 to −0.004, p = 0.05). Furthermore, a decrease in FEV1 is associated with an increase in RC (β = −0.143, 95% CI: −0.198 to −0.087, p =4.00E-07), and MR-Egger regression yielded consistent results (β = −0.216, 95% CI: −0.381 to −0.541, p=1.07E-02). Similarly, a decrease in FVC is associated with an increase in IFR (β = −0.073, 95% CI: −0.116 to −0.031, p = 6.17E-04), and MR-Egger regression showed a similar trend (β = −0.046, 95% CI: −0.160 to −0.067, p=0.42). Additionally, a decrease in FVC is associated with an increase in RC (β = −0.173, 95% CI: −0.221 to −0.125, p = 2.33E-12), and MR-Egger regression yielded consistent results (β = −0.142, 95% CI: −0.272 to −0.012, p = 3.32E-02). The reliability tests indicated heterogeneity in the above MR analyses but no evidence of horizontal pleiotropy. Therefore, a fixed-effect model IVW was used to explore the causal relationships, which were found to be robust and reliable with no outliers or significant bias in this study. Conclusion: This study indicates that there is a negative causal relationship between pulmonary ventilation function and bone marrow hematopoietic function. A decrease in pulmonary ventilation function stimulates bone marrow hematopoiesis. However, further research is needed to elucidate this mechanism.

Block-level spatial integration of population density, social vulnerability, and heavy precipitation reveals intensified urban flooding risk

Under the context of global warming and rapid urbanization, cities worldwide confront the pressing problem of urban waterlogging, hindering progress towards Sustainable Development Goals. Effective planning and mitigation of urban flooding require a comprehensive understanding of the spatial and temporal patterns of rainfall and risk heterogeneity. However, evaluating urban water-logging risk is challenged by the need for city-scale hydrological simulation and generally lacks comprehensive metrics integrating fine-scale datasets. To address these gaps, we developed a simulation method for urban flood hazards by integrating hydrological models and Random Forest algorithms. We then took Shenzhen, a megacity in China, as a case study, and investigated the spatial patterns of urban flooding risk and its determinants at the block level based on the risk assessment framework represented by Hazards-Exposure-Vulnerability (H-E-V) dimensions. We found that socio-economic indicators exhibited spatial clustering, while hazard-related indicators displayed more dispersed patterns. High-risk areas exhibited a highly heterogeneous spatial pattern, predominantly influenced by vulnerability and exposure factors, as well as the spatial mismatch among the three dimensions. Our results emphasize the importance of integrating spatial heterogeneity of exposure and vulnerability into climate adaptation resource allocation, addressing both current and future demands for effective climate mitigation.

Risk Factors and Injury Prevention in the Throwing Athlete

Arm injuries are the most common throwing injury, with growing concern as the most severe injuries, such as UCL reconstruction continue to rise. Furthermore, throwing injuries are frequently recurrent suggesting once injured, players are at increased risk for another arm injury. The increase in injury rates and severity has been attributed to increases in pitching volume and year around participation, and specialized training. Thus, initial efforts to prevent arm injuries by USA Baseball and Little League have focused on the extrinsic factor of pitching exposure in the form of pitch counts, yet arm injury rates have stayed constant. Therefore, injury prevention strategies should include extrinsic factors, and address modifiable, intrinsic factors that are associated with arm injury. Collectively addressing factors such as shoulder range of motion and strength deficits, trunk and lower extremity function, and implantation of training programs yields a comprehensive approach to reduce arm injury rates. We will use a directed acyclic graph (DAG) to organize how the internal factors (i.e. fatigue, injury history, ROM and strength) interact with the external factors (i.e. training load and pitching exposure) and how together they are thought contribute to potential injury and inform arm injury reduction strategies. This will provide a roadmap to build adaptable arm injury reduction strategies to improve the modifiable physical factors in context of the external factors that change over time and between throwing athletes. Level of EvidenceLevel V, Expert Opinion

Changes in the prevalence of hepatitis B and C viral infections in Sindh province, Pakistan: Findings from two sero-surveys in 2007 and 2019.

Pakistan harbours a large burden of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. We utilised repeat sero-surveys to assess progress achieved towards hepatitis elimination in Pakistan. Multilevel logistic regression evaluated the change in HBV infection (HBV surface antigen (HBsAg)-positive) prevalence and HCV exposure (HCV antibody (HCV-Ab)-positive) prevalence between two sero-surveys from 2007 and 2019 for Sindh province and associated risk factors. Adjusted odds ratios (aORs) were estimated and population-attributable fractions (PAF) for modifiable risk factors for HCV exposure. The 2007 and 2019 surveys included 8855 and 6672 individuals. HBsAg prevalence decreased from 2.6% (95% confidence intervals (95% CI): 2.2-2.9) in 2007 to 1.1% (95% CI: 0.8-1.3) in 2019, while HCV-Ab prevalence increased from 5.1% (95% CI: 4.6%-5.5%) to 6.2% (95% CI: 5.6%-6.8%). The age and gender-adjusted HBsAg prevalence decreased by 80% (aOR = 0.2, 95% CI: 0.1-0.4) among children and 60% (aOR = 0.4, 95% CI: 0.3-0.6) among adults over 2007-2019, while HCV-Ab prevalence decreased by 60% (aOR = 0.4, 95%CI:0.2-0.7) in children and increased by 40% (aOR = 1.4, 95% CI: 1.2-1.7) in adults. HCV-Ab prevalence was lower in adults with secondary (aOR = 0.6, 95% CI: 0.5-0.8) and higher (aOR = 0.5, 95%CI:0.3-0.8) education compared to illiterates and higher among adults reporting blood transfusion (aOR = 1.7, 95% CI: 1.2-2.4), family history of hepatitis (aOR = 2.5, 95% CI: 1.9-3.3), past year medical injection (aOR = 2.1, 95% CI: 1.6-2.7), being tattooed (aOR = 1.4, 95% CI: 1.0-1.9) and shaved by traditional barber (aOR = 1.2, 95% CI: 1.0-1.5). Modifiable risk factors accounted for 45% of HCV exposure, with medical injection(s) accounting for 38% (95%CI,25.7-48.4%). Overall HCV has increased over 2007-2019 in Sindh province, while HBV prevalence has decreased. Medical injections should be an important focus of prevention activities.

Multicenter study of factors associated with nonsurvival in hospitalized periparturient goats.

Periparturient reproductive complications appear to be common in hospitalized goats. More information is needed about periparturient reproductive complications and survival in goats with these conditions. Identify exposure factors associated with nonsurvival in periparturient does hospitalized ≤1 day or ≥2 days. A total of 198 periparturient does presented to 9 university veterinary hospitals from October 2021 to June 2022. Multicenter, matched case-control study. Conditional logistic regression was used to identify exposure factors associated with nonsurvival in periparturient does hospitalized ≤1 day or ≥2 days. Overall doe survival was 79% (156/198). Survival in the 1st day of hospitalization was 71% (52/73) and survival in does hospitalized ≥2 days was 83% (104/125). Among goats hospitalized ≤1 day, labor duration before admission (odds ratio [OR] = 4.8; P = .04), uterine tears (OR = 48.2; P < .001), and vaginal/perineal trauma diagnosed during hospitalization (OR = 6.2; P = .03) were associated with nonsurvival. Among goats hospitalized ≥2 days, factors associated with nonsurvival included labor duration before admission (OR = 6.2; P = .004), pregnancy toxemia (OR = 6.07; P = .04), and Cesarean section (OR = 11.35; P = .02). Longer labor duration before admission is an important predictor of nonsurvival in hospitalized does. Clients should be educated that early detection and veterinary care are critical for improving outcome in periparturient does.

Assessment of variations in upper and lower gonial angle in children with mouth breathing habit

Background: Mouth breathing is one of the most common deleterious oral habits in children. The habitual position of muscles inside and outside the mouth will affect dental development. Mouth breathing influences skeletal growth and thereby affects the cephalometric parameters. The present study aimed to assess if there is any variation in upper and lower gonial angles in children with mouth breathing habit. Methods: The 33 patients in the age group of 8 to 12 years reporting to the Department of Pediatric and Preventive Dentistry with chief complaint of mouth breathing was selected for the study based on inclusion and exclusion criteria. Lateral cephalograms of these children were taken with a digital panoramic system under standard exposure factors, as recommended by the manufacturer. Upper and lower gonial angles were determined on the lateral cephalograms. The values obtained were tabulated and subjected to statistical evaluation. Results: The mean upper and lower gonial angles were seen to increase from the normal in children with mouth breathing habit. However, independent sample t test showed no statistically significant difference in upper and lower gonial angles with a p value of 0.598 in upper gonial angle and 0.714 in lower gonial angle. Contusions: Early detection of the changes in the upper and lower gonial angles can help a pediatric dentist in effectively framing a treatment plan in children with mouth breathing habit, to prevent further deterioration in the dental and skeletal structures and be able to correct the already occurred unfavourable changes in them.

Long-term effects of arsenic on glucose-insulin homeostasis: A gene-environment interaction study

Abstract Background Arsenic exposure and genetic factors are associated with an increased risk of type 2 diabetes, yet study of environment-gene interaction on glucose-insulin homeostasis remains scarce. We aimed to investigate the associations and interactions of urinary total arsenic (UTAs) and genetic susceptibility with glucose-insulin homeostasis through a longitudinal epidemiological study. Methods A total of 6136 observations (3063 participants) from the baseline, 3-year follow-up, and 6-year follow-up of the Wuhan-Zhuhai cohort were included in this study. In each study period, we repeatedly measured UTAs, fasting plasma glucose (FPG), fasting plasma insulin (FPI), and homeostasis model-assessed insulin resistance (HOMA-IR) and β-cell function (HOMA-β). Polygenic risk scores (PRSs) specific for all traits were constructed by corresponding genome-wide association summary statistics. Linear mixed models were used to assess associations and interactions of UTAs and PRSs with four indicators of glucose-insulin homeostasis. Results After adjustment for all covariates, the βs (95% CIs) for the annual growth rates of FPG, FPI, and HOMA-IR were 0.020 (0.008, 0.032), 0.007 (0.002, 0.013), and 0.011 (0.004, 0.017), respectively, associated with each ln-unit increase in UTAs. Compared to subjects with the first-quartile PRS and low UTAs, participants with the fourth-quartile PRS and high UTAs had a 0.029 (0.012, 0.047) or 0.032 (0.012, 0.051) ln-unit increase in the annual growth rate of FPI or HOMA-IR, respectively. UTAs and PRS had significant interactions on the longitudinal progressive increases of FPI and HOMA-IR (P interaction &amp;lt; 0.05). Conclusions Arsenic exposure and genetic variants are significantly synergistic risk factors for dysregulation and progressive deterioration of glucose-insulin homeostasis. Our findings emphasize the importance of reducing arsenic exposure to maintain normal glucose-insulin metabolism, especially for those at higher genetic risk. Key messages • Arsenic exposure was associated with annual increased rates of FPG, FPI, and HOMA-IR. • Arsenic exposure and trait-specific PRSs are synergistic risk factors for glucose-insulin homeostasis impairment.

Healthy air for healthy minds

Abstract Background The adverse health effects from exposure to air pollution is increasingly known. A recent report shows that at least 95% of the world’s population breathe air containing dangerous levels of pollutants. According to estimates from the World Health Organization (WHO), ambient air pollution is related to 4.2 million deaths every year. Less is known about the association between indoor air (especially particulate matter 2.5 and volatile organic compounds (VOC) pollution and mental health conditions. Many sources of indoor air pollution exist, such as pressed wood products, pesticides, secondhand smoke, stoves, heaters, overcrowding and fireplaces. Aims We aim to synthesize knowledge on the effects of particulate matter 2.5 in indoor air and mental health conditions. Methods We systematically reviewed the association of indoor air pollution with mental health conditions using the databases Pubmed and EMBASE. Results Exposure to indoor air pollutants is associated with increased anxiety and depression and less cognitive performance. These results are robust; however, the impact of PM2.5 is larger for less-educated and female respondents. Females cook with solid fuels and biomass more often. Physical exposure and gender factors overlap in the exposure to indoor air pollutants. Discussion Poor indoor air quality should be part of a comprehensive assessment of factors influencing mental health and cognition. Neuroinflammation might explain the effects of poor air on mental health and cognition. Further research is needed to combine research on the social determinants of mental health and the effects of indoor air. Studies in different settings such as home, work, and hospitals are needed to better understand the specific exposures of indoor air pollution and mental health conditions in different population groups.

Social Media Shaping Youth’s Perception of Moroccan Female Political Leaders

This paper addresses the role of social media consumption amongst youth and its implications in shaping their perceptions of Moroccan female political leaders. Based on examining previous scholarly works, this research investigates a large body of literature including how social media platforms impacts youth’s engagement in political and civic activities. The role of social media in shaping perceptions about female political leaders is also discussed from a theoretical standpoint. Aiming to identify, the influence of a number of identified form the literature, this paper adopted a quantitative strategy utilizing a survey that was addressed to (N=309) participant targeted on both social media platforms and within university campus. Based on the descriptives, the correlation analysis and regression analysis of the data gathered, this study identified that the level of education, social media exposure, online interactions, political awareness, and cultural factors significantly influence youth’s perceptions of female political leaders. These findings highlight the factors influencing young adults’ perceptions about the Moroccan political landscape and the importance of media education and literacy to enhance critical thinking skills amongst Moroccan youth.

Occupational class difference in COVID-19 symptoms in France: contribution of work-related exposures

Abstract Background The association between socio-occupational class and SARS-CoV-2 infection remains inconclusive and may depend on the setting and the pandemic stage. Our study aims to quantify self-reported COVID-19 symptoms by occupational class (OC) in spring 2020 in France and explain observed differences using work-related risk factors. Methods We analyzed data from the EpiCoV population-based cohort, comprising 46,849 active workers aged 18-64 in metropolitan France. COVID-19 symptoms were sudden loss of taste/smell, fever with cough, fever with shortness of breath, or fever with chest oppression. Separating regions highly affected by COVID-19 from other regions, we related OC with reporting of COVID-19 symptoms and assessed the mediation effect of work-related SARS-CoV-2 exposures (contact with the public, using public transportation, self-perceived exposure) using the Karlson-Holm-Breen mediation analysis method. Results During the study period, 7.1% of the workers reported COVID-19 symptoms. In both regions, work-related SARS-CoV-2 exposures were related to higher reporting of symptoms, and those exposures were more prevalent in the lowest than in the highest OCs. However, the association of OC with reporting symptoms was not the same in the two regions. In less affected regions, the lowest OC reported COVID-19 symptoms less often than the highest OC, whereas in highly affected regions, symptoms were more frequent in middle OCs, and this was partly explained by work-related SARS-CoV-2 exposures. Conclusions Different socio-occupational patterns of symptoms were observed in the two groups of regions. The situation in the less affected regions, with more reporting in the highest relative to the lowest classes, may be attributable to exposure factors playing a role opposite to that of work-related exposures. Further studies on OC disparities in COVID-19 severity are needed based on hospitalization and mortality. Key messages • During the early pandemic, in regions less affected by COVID-19, the upper occupational class reported more COVID-19 symptoms, whereas the middle class did so in highly affected regions. • Work-related exposure to SARS-CoV-2 mediates the association between occupational class and reporting COVID-19 symptoms to some extent, even when the occupational gradient is reversed.

Mendelian Randomization Analysis of Non-small Cell Lung Cancer and Five Exposure Factors Based on Pathway Enrichment Analysis

Mendelian Randomization Analysis of Non-small Cell Lung Cancer and Five Exposure Factors Based on Pathway Enrichment Analysis

Causal associations of MICB, CTSA, and MMP9 proteins with oral cancer: Mendelian randomization study

Oral cancer (ORCA) is the most prevalent histological subtype of oral malignancies in which immune modulation is relevant. The goal of this work was to employ Mendelian randomization (MR) to investigate the causal connection between the immune-related proteins MICB, CTSA, MMP9, and ORCA. The Open GWAS database of the Integrative Epidemiology Unit (IEU) was accessed to collect GWAS data for ORCA (ieu-b-4961), MICB (prot-a-1898), CTSA (prot-a-717) and MMP9 (prot-a-1921). From 372,373 samples, the ORCA dataset comprises 7,723,107 single nucleotide polymorphisms (SNPs). MICB, CTSA, and MMP9 all have 10,534,735 SNPs and 3,301 sample sizes. Then, the primary SVMR implementation approaches were weighted mode, simple mode, inverse variance weighted (IVW), weighted median, and MR-Egger. IVW was the most effective technique. A sensitivity study was also carried out to assess the correctness of SVMR data, with special focus devoted to heterogeneity, horizontal pleiotropy, and Leave-One-Out (LOO). MVMR was eventually implemented as well. A Mendelian randomization analysis of the three exposure factors in the dataset (ieu-b-94, ebi-a-GCST012237) was also performed to validate the study results. According to the SVMR results, there was a noteworthy causal interaction between ORCA and MICB (P = 0.0014), MMP9 (P = 0.0343), and CTSA (P = 0.0003). Furthermore, odds ratios (ORs) values revealed that MMP9 (OR = 1.0005) was an ORCA risk factor, whereas MICB (OR = 0.9994) and CTSA (OR = 0.9993) were security factors. The robustness of the SVMR findings was confirmed by the p-values of the heterogeneity and horizontal pleiotropy, both of which were greater than 0.05. The MVMR result did not affect any of the safety or hazard features of these three exposure factors. However, the P value for MMP9 was greater than 0.05, implying that MICB and CTSA may have a greater influence on ORCA than MMP9. The validation outcomes in both datasets harmonized with the findings from previous research, thereby solidifying the reliability of results. Our investigation provided a crucial resource for further research on the subject by demonstrating a causal relationship between ORCA and MICB, CTSA, and MMP9.