Health Implications Research Articles

Weighted ensemble deep learning approach for classification of gastrointestinal diseases in colonoscopy images Aided by explainable AI

Gastrointestinal diseases are significant health issues worldwide, requiring early diagnosis due to their serious health implications. Therefore, detecting these diseases using artificial intelligence-based medical decision support systems through colonoscopy images plays a critical role in early diagnosis. In this study, a deep learning-based method is proposed for the classification of gastrointestinal diseases and colon anatomical landmarks using colonoscopy images. For this purpose, five different Convolutional Neural Network (CNN) models, namely Xception, ResNet-101, NASNet-Large, EfficientNet, and NASNet-Mobile, were trained. An ensemble model was created using class-based recall values derived from the validation performances of the top three models (Xception, ResNet-101, NASNet-Large). A user-friendly Graphical User Interface (GUI) was developed, allowing users to perform classification tasks and use Gradient-weighted Class Activation Mapping (Grad-CAM), an explainable AI tool, to visualize the regions from which the model derives information. Grad-CAM visualizations contribute to a better understanding of the model’s decision-making processes and play an important role in the application of explainable AI. In the study, eight labels, including anatomical markers such as z-line, pylorus, and cecum, as well as pathological findings like esophagitis, polyps, and ulcerative colitis, were classified using the KVASIR V2 dataset. The proposed ensemble model achieved a 94.125% accuracy on the KVASIR V2 dataset, demonstrating competitive performance compared to similar studies in the literature. Additionally, the precision and F1 score values ​​of this model are equal to 94.168% and 94.125%, respectively. These results suggest that the proposed method provides an effective solution for the diagnosis of GI diseases and can be beneficial for medical education.

Rhizobacterial volatile organic compounds: Implications for agricultural ecosystems' nutrient cycling and soil health

Rhizobacterial volatile organic compounds: Implications for agricultural ecosystems' nutrient cycling and soil health

Identification of a PET hydrolytic enzyme from the human gut microbiome unveils potential plastic biodegradation in human digestive tract.

Widespread use of polyethylene terephthalate (PET) plastics and their recycling challenges have led to substantial accumulation of PET wastes in global environments, with inevitable consequences for their entry into the food chains. Recent studies have increasingly documented the ingestion of microplastics by humans through food and beverages. However, the fate of these microplastics within the gastrointestinal tract, particularly the role of the human gut microbiota, remains inadequately understood. To address this knowledge gap, we employed a bioinformatics workflow integrated with functional verification to investigate the PET digestion/degradation capabilities of intestinal microorganisms. This approach identified a novel PET hydrolase-HGMP01 from the human gut metagenome, which exhibits the capacity to hydrolyze PET nanoparticles. Moreover, comprehensive exploration for HGMP01 homologues in the human gut metagenome and metatranscriptome unveil their distribution in diverse intestinal microorganisms. This study provides biochemical evidence for an unforeseen role of human gut microbiome in plastic digestion, thus holding substantial implications for human health.

What’s in a word? Defining “gene therapy medicines”

Gene therapy medicinal products (GTMPs) have emerged as a transformative class of medicines. Defining what a certain class of medicines encompasses, and what it does not, is key, with ample implications and consequential regulatory requirements. In April 2023, the European Commission proposed new pharmaceutical legislation safeguarding the public health within the European Union with a new, broader definition of GTMP, including genome editing medicines and nucleic acids of either source, regulating, replacing, or adding a genetic sequence that mediates its effect by transcription or translation. This definition is all-encompassing for any "genetic" intervention and is agnostic to mechanism of action, duration of action, location of action, and associated risk. Here, we take this as a paradigm to discuss how terminology and definitions are more than just words and can have meaningful regulatory, scientific, and public health implications.

Tick-Borne Pathogens in Mongolian Ticks: The High Prevalence of Rickettsia raoultii and Its Public Health Implications.

In Mongolia, a substantial segment of the population is engaged in pastoralism, leading to frequent interactions with livestock and heightened exposure to tick-infested environments. Consequently, ticks and the endemic tick-borne pathogens (TBPs) they harbor present significant health threats. In May 2021, we conducted a study to evaluate the prevalence of 9 TBPs in ticks collected from four regions in Mongolia: Uvurkhangai, Tuv, Bayan-Ulgii, and Khentii. The pathogens surveyed included Anaplasma, Rickettsia, Bartonella, Borrelia, Ehrlichia, Babesia, Toxoplasma, Theileria, and lumpy skin disease virus. Molecular analysis of 1,142 ticks revealed that, although the majority of TBPs were not detected, 89.1% of the ticks were positive for Rickettsia. Genetic characterization using the 16S rRNA and gltA genes identified the pathogen identified the pathogen Rickettsia raoultii. Species identification indicated a predominance of Dermacentor nuttalli (70.0%) and Dermacentor silvarum (30.0%). These findings highlight the extensive prevalence of R. raoultii in Mongolia and underscore the urgent need for heightened awareness and preventive measures due to the high level of interaction between livestock and humans. The genetic similarity of R. raoultii sequences to those found in neighboring countries suggests potential cross-border transmission, underscoring the importance of conducting similar research in surrounding regions. This study advances our understanding of the epidemiology of tick-borne diseases in Mongolia and can inform public health strategies aimed at mitigating the risks associated with these infections.

Modification of the association between cold spells and cardiovascular disease by changes in natural gas prices: A nationwide time-series study

BackgroundAlthough the association between low ambient temperature and cardiovascular disease (CVD) is well-established, the effect of winter energy prices on this association remains unknown. AimThis ecological study aimed to investigate whether changes in natural gas prices (NGP), which account for a significant portion of winter energy prices in Korea, affect the association of cold spells with hospital admissions and mortality due to CVD. MethodsData from the National Health Insurance Service and Statistics Korea were used to determine the daily number of hospital admissions and mortality rates associated with CVD. From January 2012 to February 2017, the NGP continually increased by 24.1%. From January 2012 to December 2014 the NGP continually decreased by 32.6% owing to the Korea Gas Corporation’s management decisions, independent of external socioeconomic factors. We investigated the differences in the associations between cold spells and CVD-related outcomes in price-increasing and price-decreasing periods using a Poisson regression with a distributed lag nonlinear model. Cold spells were assessed on two consecutive days at the 5th percentile of the temperature for each region. ResultsThe meteorological factors and air pollution levels were similar between the two periods. The association between cold spells and hospital admissions due to CVD was stronger during the price-increasing period than during the price-decreasing period [ratio of cumulative relative risk (RRR) = 1.71, 95% confidence interval (CI): 1.31–2.22]. The difference in the association with mortality due to CVD between the two periods was not significant, although the point estimate remained >1 (RRR = 1.11, 95% CI: 0.90–1.38). ConclusionsChanges in energy prices may modify the cold spell-related CVD risk, possibly by inducing behavioral changes to manage energy expenditure. Policymakers should take into account the potential public health implications of changes in energy prices, alongside their economic effects.

Assessment of Health Disparities and Sexual Orientation Response Choices Used in Two US National Population-Based Health Surveys, 2020‒2021.

Objectives. To (1) compare responses to 2 survey questions designed to measure sexual orientation and (2) understand how variation in responses is associated with mental health. Methods. Data were from the National Longitudinal Study of Adolescent to Adult Health (Add Health) Sexual Orientation/Gender Identity, Socioeconomic Status, and Health Across the Life Course (SOGI-SES) study (2020-2021) in the United States. We used the adjusted Wald test to compare proportions of respondents who were (1) categorized as heterosexual or straight and sexual minorities using the sexual orientation questions designed for the Add Health study and the National Health Interview Survey (NHIS) and (2) diagnosed with depression or anxiety or panic disorder. Results. The Add Health question detected more than twice as many sexual minority respondents as the NHIS question. Those who responded as sexual minorities to the Add Health question but as heterosexual or straight to the NHIS question, primarily "mostly heterosexuals," had mental health outcomes that were more like those who were consistently classified as sexual minorities versus those consistently classified as heterosexual or straight. Conclusions. Current measures of sexual orientation in national-level surveys may underestimate the sexual minority population and sexual orientation‒related health disparities. Public Health Implications. Results illustrate the need for further research to expand measurement of sexual orientation on population-based health surveys. (Am J Public Health. 2024;114(12):1375-1383. https://doi.org/10.2105/AJPH.2024.307839).

The human dimensions of harmful algal blooms: An evolving research agenda

Harmful algal blooms (HABs) are a global phenomenon occurring in a range of aquatic environments, with the potential to have diverse environmental, social and economic impacts. There is growing interest in the human dimensions of HABs particularly as a result of the increased occurrence of HABs linked to anthropogenic activities. However, to date this has focused more on the economic and health implications of HABs events rather than broader human dimensions. This paper presents a series of research priorities that could strengthen social science research on HABs, highlighting topics related to public awareness and attitudes, community science, governance and co-development of solutions, links to the blue economy agenda, impacts on marine culture and heritage, and impacts on health and wellbeing. Finally, the paper presents a series of recommendations developing a transdisciplinary research agenda in order for the ongoing challenges of HABs to be addressed.

Sociodemographic inequalities in residential nighttime light pollution in urban Bulgaria: An environmental justice analysis

IntroductionOutdoor nighttime light (NTL) is a potential anthropogenic stressor in urban settings. While ecological studies have identified outdoor NTL exposure disparities, uncertainties remain about disparities in individual exposure levels, particularly in Europe. AimTo assess whether some populations are disproportionately affected by outdoor NTL at their residences in urban Bulgaria. MethodsWe analyzed 2023 data from a representative cross-sectional survey of 4,270 adults from the five largest Bulgarian cities. Respondents’ annual exposures to outdoor artificial nighttime luminance were measured using satellite imagery and assigned at their places of residence. We calculated the Gini coefficient as a descriptive NTL inequality measure. Associations between respondents’ NTL exposure levels and sociodemographic characteristics were assessed by estimating quantile mixed regression models. Stratified regressions were fitted by gender and for each city. ResultsWe found moderate distributive NTL inequalities, as indicated by a 0.214 Gini coefficient. Regression analyses found associations between greater NTL exposure and higher educational attainment. Respondents with incomes perceived as moderate experienced less NTL exposure at the 0.5 and 0.8 quantiles, while unemployed respondents experienced lower exposure at the 0.2 and 0.5 quantiles. We observed null associations for the elderly and non-Bulgarian ethnicities. Regardless of the quantile, greater population density was associated with higher NTL levels. Stratification by sex did not yield substantial differences in the associations. We observed notable city-specific heterogeneities in the associations, with differences in the magnitudes and directions of the associations and the NTL quantiles. ConclusionsNTL exposures appeared to embody an environmental injustice dimension in Bulgaria. Our findings suggest that some sociodemographic populations experience higher exposure levels to NTL; however, those are not necessarily the underprivileged or marginalized. Identifying populations with high exposure levels is critical to influencing lighting policies to ease related health implications.

Metals leached from aluminium foil into Clarias gariepinus muscles roasted at high temperatures: Potential contamination and controlling factors

Aluminium (Al) foil can leach metals into fish during roasting, potentially creating health implications, which informed this study. The roasted (using Al foil) and unroasted fish (control) samples (n = 48) were analysed for metals (Al, Co, Pb, Ni, Cr, Cd, and As) using ICP-AES. The following ranges were recorded for Al (5.51 - 6.35 mg/kg), Co (0.25 - 0.35 mg/kg), Pb (0.48 - 0.65 mg/kg), Ni (2.37 - 4.70 mg/kg), Cr (0.25 - 0.43 mg/kg), Cd (0.05 - 0.07 mg/kg), As (0.32 - 0.45 mg/kg). According to redundancy analysis, foil area had the most influence on metal leaching. The percentage weight loss of the foil after fish roasting indicates leaching of its metal contents into the fish. The EDI and THQ of As, and HI of metals indicate potential risk over time, as a result, roasting of fish with foil should be discontinued.

Dietary exposure to high-intensity sweeteners by the Brazilian self-declared diabetic population and general Brazilian population

Due to an increasing use of high-intensity sweeteners in foods and potential health implications of high levels exposure, the intake of high-intensity sweeteners present in the diet of the Brazilian population and the self-declared diabetic population, based on national consumption data from the 2017-2018 Family Budget Survey (POF), was estimated. The occurrence of the high-intensity sweeteners was established by labeling foods obtained in physical stores and online, in two scenarios: average and maximum concentration. Food consumption data were derived for the self-declared diabetic Brazilian population and the Brazilian population for average consumers and consumers only, stratified by: sex, age, habitation, and regions from Brazil. For consumers only of the general Brazilian population, the intake of sodium cyclamate, steviol glycosides, and sucralose exceeded the Acceptable Daily Intake (ADI), mainly in adolescents (131.3%, 117.2, 123.0% of respective ADI). The estimated intake for the diabetic population was below ADI in all scenarios calculated. The most exposed diabetic population to sodium cyclamate and sucralose were female (69.6% and 59.4% of respective ADI) and the elderly (79.2% and 70.1% of respective ADI). The Brazilian population, mainly high consumers, was more exposed to high-intensity sweeteners than the self-declared diabetic population.

Machine learning in personalized cancer treatment: Implications for global public health

Cancer remains a leading cause of mortality worldwide, posing a significant challenge to global public health. Traditional approaches to cancer treatment often adopt a "one-size-fits-all" strategy, which may not be effective for every patient due to the complex and heterogeneous nature of the disease. Personalized cancer treatment aims to tailor therapeutic interventions to the individual characteristics of each patient, enhancing the efficacy and reducing adverse effects. In recent years, machine learning (ML) has emerged as a powerful tool in personalized cancer care, offering the potential to revolutionize diagnosis, prognosis, and treatment by leveraging vast amounts of biomedical data. This review explores the current landscape of machine learning applications in personalized cancer treatment, including its role in imaging, genomics, and drug discovery. We provide an overview of key machine learning techniques, highlight successful case studies from both developed and developing nations, and examine the challenges and limitations associated with the integration of these technologies into clinical practice. Furthermore, we discuss the implications of machine learning-driven personalized cancer care for global public health, emphasizing its potential to address disparities in access to healthcare and improve outcomes in resource-limited settings. Finally, we offer insights into future research directions and policy considerations that could accelerate the adoption of machine learning in global cancer treatment, fostering a more equitable and effective healthcare ecosystem.'

Prevalence of syphilis infection among migrant workers in Qatar: a nationwide cross-sectional survey

ObjectivesScant data are available on syphilis infection within migrant populations worldwide and in the population of the Middle East and North Africa region. This study investigated the prevalence of both...

Comparative metagenomics of microbial communities and resistome in southern farming systems: implications for antimicrobial stewardship and public health

Agricultural practices significantly influence microbial diversity and the distribution of virulence and antimicrobial resistance (AMR) genes, with implications for ecosystem health and food safety. This study used metagenomic sequencing to analyze 60 samples (30 per state) including water, soil, and manure (10 each) from Alabama (a mix of cattle and poultry sources) and Tennessee (primarily from cattle). The results highlighted a rich microbial diversity, predominantly comprising Bacteria (67%) and Viruses (33%), with a total of over 1,950 microbial species identified. The dominant bacterial phyla were Proteobacteria, Cyanobacteria, Actinobacteria, Firmicutes, and Bacteroidetes, with the viral communities primarily represented by Phixviricota and Uroviricota. Distinct state-specific microbial profiles were evident, with Alabama demonstrating a higher prevalence of viral populations and unique bacterial phyla compared to Tennessee. The influence of environmental and agricultural practices was reflected in the microbial compositions: soil samples were notably rich in Actinobacteria, water samples were dominated by Proteobacteria and Cyanobacteria, and manure samples from Alabama showed a predominance of Actinobacteria. Further analyses, including diversity assessment and enterotype clustering, revealed complex microbial structures. Tennessee showed higher microbial diversity and phylogenetic complexity across most sample types compared to Alabama, with poultry-related samples displaying distinct diversity trends. Principal Coordinate Analysis (PCoA) highlighted notable state-specific variations, particularly in manure samples. Differential abundance analysis demonstrated elevated levels of Deinococcus and Ligilactobacillus in Alabama, indicating regional effects on microbial distributions. The virulome analysis revealed a significant presence of virulence genes in samples from Alabama. The community resistome was extensive, encompassing 109 AMR genes across 18 antibiotic classes, with manure samples displaying considerable diversity. Ecological analysis of the interactions between AMR gene subtypes and microbial taxa revealed a sophisticated network, often facilitated by bacteriophages. These findings underscore the critical role of agricultural practices in shaping microbial diversity and resistance patterns, highlighting the need for targeted AMR mitigation strategies in agricultural ecosystems to protect both public health and environmental integrity.

Exploring patient perspectives on shared decision making about bariatric surgery in two healthcare systems.

To assess patient perspectives on the level of shared decision making (SDM) experienced related to bariatric surgery. Severe obesity is common and has serious health implications. Yet, few eligible patients pursue bariatric surgery. Shared decision making could be a useful approach for considering treatment options. Patients were surveyed at Kaiser Permanente and UPMC clinics providing bariatric surgical services. Cross-sectional samples represent three time points: (a) Cohort 1 (C1): following referral; (b) Cohort 2 (C2): after initial bariatric practice appointment; (c) Cohort 3 (C3): following pre-operative visit. Patients completed the electronic survey instruments: CollaboRATE, SDM-Q-9, and National Quality Forum (NQF) SDM process measures. The sample included 167 participants, half from each site. Cohort distribution was 35% C1, 33% C2, and 32% C3. Mean age was 43.8years (SD 13.5), BMI was 48kg/m2 (SD 8.63), 81% were female and 73% were white. Overall, 62% reported CollaboRATE top scores, with a dose-response (C1: 54%, C2: 60%, C3: 72%). Mean (SD) SDM-Q-9 score (possible range: 0-100) was: 79.6 (22.5); with C1: 66.9 (26.5), C2: 83.4 (18.0), and C3: 88.4 (15.9). The average NQF score (possible range: 0-4) was 3.11 (1.14), with C1: 2.71 (1.27), C2: 3.31 (1.09), and C3: 3.28 (0.97). Patients seeking bariatric care reported moderate or high levels of SDM. In general, SDM metrics were highest just before surgery.

Comparative cardiovascular adaptations in aquatic vs. terrestrial vertebrates: Implications for human cardiovascular health

Comparative cardiovascular adaptations in aquatic vs. terrestrial vertebrates: Implications for human cardiovascular health

The Role of Sarcopenic Obesity in Hyperlipidemia and Its Impact on Metabolic Health

Sarcopenic obesity, a condition characterized by the simultaneous presence of reduced muscle mass and increased adiposity, has emerged as a critical health concern in the context of metabolic disorders. This review examines the complex interplay between sarcopenic obesity and hyperlipidemia, focusing on the implications for metabolic health. The coexistence of diminished muscle mass and excess fat alters lipid metabolism, leading to elevated circulating lipid levels and exacerbating cardiovascular risks. Mechanisms contributing to this dysregulation include insulin resistance, chronic low-grade inflammation, and altered adipokine secretion, all of which are exacerbated in sarcopenic obesity. Moreover, the condition predisposes individuals to metabolic syndrome, type 2 diabetes, and cardiovascular diseases, highlighting the need for targeted therapeutic strategies. This article discusses the underlying pathophysiology, the role of lifestyle factors, and potential interventions aimed at mitigating the impact of sarcopenic obesity on hyperlipidemia and overall metabolic health. Keywords: Sarcopenic obesity, hyperlipidemia, metabolic health, insulin resistance, inflammation, adipokines, cardiovascular disease, metabolic syndrome

Detection and Characterization of Visceral Anisakid Nematodes in Blue Whiting from Portuguese Waters

This study employs molecular detection techniques, including conventional PCR and Sanger sequencing, to investigate the prevalence, species composition and public health implications of Anisakid nematodes in blue whiting (Micromesistius poutassou) caught off the Portuguese coast. With Portugal’s high fish consumption rates and increasing preference for raw or undercooked seafood, the risk of parasitic infections, particularly anisakidosis, is rising. Fifty blue whiting fish were examined, showing a 100% infection rate with Anisakid larvae. Molecular analysis identified 68.1% of the larvae as Anisakis simplex, 18.1% as Anisakis pegreffii, and 13.8% as Hysterothylacium aduncum, marking the first report of H. aduncum in blue whiting in Portugal. Phylogenetic analysis based on the internal transcribed spacer (ITS) 1, 5.8S ribosomal RNA and ITS-2 confirmed the species classification. Notably, 42.9% of the fish were infected with multiple Anisakid species, increasing the risk of allergenic sensitization. Statistical analysis showed no significant correlation between fish width and parasitic load, and a weak negative correlation was found between fish length and parasitic load. The study contributes to food safety by integrating molecular tools that enable rapid and accurate species identification, offering new insights into the detection of biological contaminants in seafood. These findings are significant considering the rising trend in raw seafood consumption, underscoring the urgent need for enhanced detection strategies and broader parasite monitoring programs to mitigate public health risks. The high prevalence of parasitized fish highlights the necessity for the implementation of safe cooking practices to reduce the risk of anisakidosis. Further research into the allergenic potential of Hysterothylacium spp. and the ecological factors influencing this nematode distribution is recommended.

Ultra-Processed Food and Prostate Cancer Risk: A Systemic Review and Meta-Analysis

Background/Objectives: Prostate cancer is the second leading cause of cancer death among American men, following lung cancer. While diet and exercise have been extensively studied in relation to prostate cancer prevention, the evidence remains inconclusive. Methods: A comprehensive literature search was performed to identify observational studies investigating the association between ultra-processed food (UPF) consumption and prostate cancer risk and mortality, determined by the NOVA classification system. In addition, we conducted subgroup analyses to assess the association based on study design, age, and data collection methods. Results: Six studies were identified, including four cohort studies and two case–control studies. No significant association was found between high UPF consumption and increased risk of prostate cancer [RR = 1.02, 95% confidence interval (CI) = 0.96–1.08, n = 5]. However, there was a slight increase in mortality (RR = 1.15, 95% CI = 0.99–1.35, n = 2). A subgroup analysis by the dietary assessment method revealed an RR of 1.01 (95% CI = 0.93–1.09) for studies using the food frequency questionnaire (FFQ) and 1.04 (95% CI = 0.93–1.16) for studies using 24-h recalls. There was no significant heterogeneity among the studies (I2 = 0, p = 0.82). Conclusions: This meta-analysis suggests no significant association between high UPF consumption and prostate cancer risk. Given the known associations with other chronic diseases, the potential public health implications of reducing UPF consumption remain important. Further research with the use of more robust food assignment systems and more precise dietary assessments is needed to clarify the role of UPF in prostate cancer development.

Molecular regulators of chemotaxis in human hematopoietic stem cells.

Hematopoietic stem cells (HSCs), essential for lifelong blood cell regeneration, are clinically utilized to treat various hematological disorders. These cells originate in the aorta-gonad-mesonephros region, expand in the fetal liver, and mature in the bone marrow. Chemotaxis, involving gradient sensing, polarization, and migration, directs HSCs and is crucial for their homing and mobilization. The molecular regulation of HSC chemotaxis involves chemokines, chemokine receptors, signaling pathways, and cytoskeletal proteins. Recent advances in understanding these regulatory mechanisms have deepened insights into HSC development and hematopoiesis, offering new avenues for therapeutic innovations. Strategies including glucocorticoid receptor activation, modulation of histone acetylation, stimulation of nitric oxide signaling, and interference with m6A RNA modification have shown potential in enhancing CXCR4 expression, thereby improving the chemotactic response and homing capabilities of human HSCs. This review synthesizes current knowledge on the molecular regulation of human HSC chemotaxis and its implications for health and disease.