Long-term Health Risks Research Articles

Implementation of Effective Smoking Cessation Strategies for People Living with HIV: A Pilot Implementation Study.

IntroductionUse of tobacco products carries significant long-term health risks, and rates of smoking in persons living with HIV are as high as two to three times that of the general population. This study aimed to increase assessment of readiness to quit smoking and provide cessation counseling to patients receiving HIV care through an infectious disease clinic.MethodsThis study was a pilot implementation in a single-center teaching hospital. In total, 603 active patients with HIV were followed in clinic at the time of the study start; of these, 79 were active tobacco smokers (13%) and eligible for the intervention. Providers were educated on recommendations for tobacco smoking cessation counseling, intervention strategies, and options for treatment. Patients who smoked tobacco were assessed for readiness to quit. Cessation counseling and tobacco cessation mediations or nicotine replacement were provided at the discretion of the patient and physician based on visit discussions. Primary outcome measures were increase in assessment of readiness to quit and in providing cessation counseling. Secondary measures included tabulation of the number of patients provided with a tobacco smoking cessation treatment and those with a successful quit episode.ResultsThere was a moderate increase in patients assessed for readiness to quit and who received tobacco smoking cessation counseling and treatment medications during the pilot. In total, 11 patients (8.7%) reported quitting smoking for at least two weeks.ConclusionsAdditional work on streamlined mechanisms to identify tobacco use and provide efficient and effective tobacco smoking cessation counseling are needed in this high-risk population.

Assessment of Verbesina alternifolia and Mentha piperita oil extracts on Clinostomum phalacrocoracis metacercariae from Tilapia zillii

BackgroundClinostomiasis (yellow grub disease) is a disease of freshwater fish caused by the encysted metacercariae (EMC) of Clinostomum spp. showing retarded growth, unusual host behavior, and even death in fishes. Thus, the purpose of this study was to conduct an assessment of two selected plant extract: V. alternifolia and M. piperita oil extracts on tegument surface of C. phalacrocoracis metacercariae (MC) from T.zillii as utilisation of biodegradable, eco-friendly plant extracts in environmental remediation to avoid utilization of chemotherapy to control of parasitic diseases leading to potential long-term health risks on the environment and humans.ResultsThe results of evaluation efficacy of plant oil extracts, namely V. alternifolia and M. piperita on C. phalacrocoracis MC infecting T. zillii, were dependent on dose and exposure time. The lethal concentrations caused by V. alternifolia extract were determined LC50 at (400 ppm/24 h), and contrarily, the worms from gp2 exposed to M. piperita extract at LC50 (1000 ppm/48 h) and did not cause complete mortality among the exposed worms. Statistically, mortality of C. phalacrocoracis caused by V. alternifolia was found to be a stronger effect significantly higher than that caused by M. piperita. The fine integument structures observed suffered stronger effect that appeared as severe damage and desquamation of worm’s teguments after exposure of V. alternifolia. In contrast, the M. piperita treatment exhibited edematous, swollen teguments, and blebs. Therefore, C. phalacrocoracis was an adequate model for evaluation of in vitro anthelmintic effects, contributing to the endeavors to identify suitable plant extracts, V. alternifolia and M. piperita.ConclusionsThis study highlights on assessment of selected two plant extracts; V. alternifolia and M. piperita revealed a stronger effect of V. alternifolia than M. piperita on tegumental surface of C. phalacrocoracis worms and, also, recommended the successful utilization of V. alternifolia on investigated worms as anthelmintic efficacy.

Brain Inflammation and Intracellular α-Synuclein Aggregates in Macaques after SARS-CoV-2 Infection.

SARS-CoV-2 causes acute respiratory disease, but many patients also experience neurological complications. Neuropathological changes with pronounced neuroinflammation have been described in individuals after lethal COVID-19, as well as in the CSF of hospitalized patients with neurological complications. To assess whether neuropathological changes can occur after a SARS-CoV-2 infection, leading to mild-to-moderate disease, we investigated the brains of four rhesus and four cynomolgus macaques after pulmonary disease and without overt clinical symptoms. Postmortem analysis demonstrated the infiltration of T-cells and activated microglia in the parenchyma of all infected animals, even in the absence of viral antigen or RNA. Moreover, intracellular α-synuclein aggregates were found in the brains of both macaque species. The heterogeneity of these manifestations in the brains indicates the virus’ neuropathological potential and should be considered a warning for long-term health risks, following SARS-CoV-2 infection.

The physiological role of lactose in native and hydrolyzed milk: a review

Lactose is a disaccharide composed of glucose and galactose fragments. It is the most predominant carbohydrate found in milk. The physiological significance of lactose is primarily determined by its energetic properties. Consuming lactose helps maintain the balance of the gut microflora. In addition, lactose stimulates the absorption of calcium in children and helps to increase bone strength. However, not all people absorb lactose equally. In the body, lactose is hydrolyzed by the enzyme β-galactosidase (lactase). Lactase deficiency in the gastrointestinal tract causes lactose intolerance and is defined as a clinical syndrome characterized by abdominal pain, nausea, flatulence, and diarrhea that may occur after drinking milk. Two thirds of the world's population have problems digesting lactose. People with lactose intolerance often avoid dairy products. However, dairy products are an essential part of a healthy, balanced diet and are a rich source of nutrients. Limiting the consumption of dairy products can lead to deficiencies in important nutrients and contribute to the development of long-term health risks such as decreased bone density, hypertension and diabetes. Nutritional support, in this case, is one of the most effective methods of disease prevention. The need for people with lactose intolerance is shown to optimize nutritional status by including lactose-free and low-lactose dairy products in the diet. It is shown that the world market for lactose-free dairy products is the fastest growing segment in the dairy.

Assessment of worker chemical exposures in California vape shops

E-cigarettes are battery-operated devices that heat a liquid mixture to make an aerosol that is inhaled, or vaped, by the user. Vape shops are retail environments designed to fulfill customer demand for diverse e-liquid flavors and hardware options, which create unique worker exposure concerns. To characterize exposures to vape shop workers, especially to flavoring chemicals associated with known respiratory toxicity, this study recruited vape shops from the San Francisco Bay Area. In six shops, we measured air concentrations for volatile organic compounds, formaldehyde, flavoring chemicals, and nicotine in personal and/or area samples; analyzed components of e-liquids vaped during field visits; and assessed metals on surface wipe samples. Interviews and observations were conducted over the course of a workday in the same six shops and interviews were performed in an additional six where sampling was not conducted. Detections of the alpha-diketone butter flavoring chemicals diacetyl and/or 2,3-pentanedione were common: in the headspace of purchased e-liquids (18 of 26 samples), in personal air samples (5 of 16), and in area air samples (2 of 6 shops). Two exceedances of recommended exposure limits for 2,3-pentanedione (a short-term exposure limit and an 8-hr time-weighted average) were measured in personal air samples. Other compounds detected in the area and personal air samples included substitutes for diacetyl and 2,3-pentanedione (acetoin and 2,3-hexanedione) and compounds that may be contaminants or impurities. Furthermore, a large variety (82) of other flavoring chemicals were detected in area air samples. None of the 12 shops interviewed had a health and safety program. Six shops reported no use of any personal protective equipment (PPE) (e.g., gloves, chemical resistant aprons, eye protection) and the others stated occasional use; however, no PPE use was observed during any field investigation day. Recommendations were provided to shops that included making improvements to ventilation, hygiene, use of personal protective equipment, and, if possible, avoidance of products containing the alpha-diketone flavoring chemicals. Future research is needed to evaluate the long-term health risks among workers in the vape shop retail industry and for e-cigarette use generally. Specific areas include further characterizing e-liquid constituents and emissions, evaluating ingredient health risks, evaluating the contributions of different routes of exposure (dermal, inhalation, and ingestion), and determining effective exposure mitigation measures.

Sex Differences between Medical Students in the Assessment of the Fear of COVID-19.

Background: Differing expressions of the fear of COVID-19 between men and women can potentially increase both immediate and long-term physical health risks. We predicted that women students would express greater fear of COVID-19. Methods: We used an Internet-delivered Fear of COVID-19 Scale (FCV-19S) to assess fear among men (n = 100) and women (n = 272) from a larger population of academic medical center members (n = 1761). Sex differences in emotional and physical symptoms were assessed as subcategories within fear scores. Results: Women reported greater fear of COVID-19 than men (p < 0.001). Women reported greater emotional fear (p < 0.001) on specific scale items (thinking of COVID-19, watching news stories about COVID-19, and losing sleep due to fear of contracting COVID-19). Discussion/Conclusions: These results provide a better understanding of how fear of COVID-19 can differ based on sex and how that fear may be expressed differently through emotional and physical symptoms. This information will inform academic health centers of COVID-19 prevention and management policies that may include a gender-specific focus.

Potentially toxic elements pose significant and long-term human health risks in river basin districts with abandoned gold mines.

Gold (Au) mining area is known to be one of the major sources of toxic elements; however, the potential risks of toxic elements from abandoned Au mines to the surrounding river basin districts and human exposure pathways to toxic elements need to be clarified. In this study, the distribution and mobilities of nine toxic elements (As, Cd, Cu, Pb, Sb, Zn, Cr, Ni and V) in Kesennuma City, Tohoku Region in Japan, a typical Au-mining district with several river basins, were studied through a geochemical survey (including element total concentrations and water-/acid-leaching concentrations determinations, as well as GB calculations), and environmental assessment on these elements in soil, river sediment, and river water samples from the study area. The contamination evaluation by index of geo-accumulation (Igeo) and enrichment factor (EF) suggested that As, Cu, Ni and Sb enrichments were greatly observed in the vicinity of the abandoned Au mines; moreover, calculated GB upper values for Cu in the river sediment surpass that of Tohoku Region. It has been found in this study that each element has particular mobility, which eventually influences its exposure pathway to humans. For instance, As in soil and sediment poses adverse non-carcinogenic risks and unacceptable carcinogenic risks to especially children mainly through groundwater ingestion. To minimize the potential risks associated with exposure to toxic elements in Au-mining districts, effective risk management measures should be implemented around river system by Au-mining companies even after their long-time closures, based on the consideration of each element's mobility.

Effects of Cu and Zn contamination on chicken manure-based bioponics: Nitrogen recovery, bioaccumulation, microbial community, and health risk assessment

In bioponics, although chicken manure is an efficient substrate for vegetable production and nitrogen recovery, it is often contaminated with high Cu and Zn levels, which could potentially cause bioaccumulation in plants and pose health risks. The objectives of this study were to assess nitrogen recovery in lettuce- and pak choi-based bioponics with Cu (50–150 mg/kg) and Zn (200–600 mg/kg) supplementation, as well as their bioaccumulation in plants, root microbial community, and health risk assessment. The supplementation of Cu and Zn did not affect nitrogen concentrations and plant growth (p > 0.05) but reduced nitrogen use efficiency. Pak choi showed higher Cu and Zn bioconcentration factors than lettuce. Bacterial genera Ruminiclostridium and WD2101_soil_group in lettuce roots and Mesorhizobium in pak choi roots from Cu and Zn supplemented conditions were significantly higher (p < 0.05) than controls, suggesting microbial biomarkers in plant roots from Cu and Zn exposure bioponics depended on plant type. Health risk assessment herein revealed that consumption of bioponic vegetables with Cu and Zn contamination does not pose long-term health risks (hazard index <1) to children or adults, according to the US EPA. This study suggested that vegetable produced from chicken manure-based bioponics has low health risk in terms of Cu and Zn bioaccumulation and could be applied in commercial-scale system for nutrient recovery from organic waste to vegetable production; however, health risk from other heavy metals and xenobiotic compounds must be addressed.

Anti-Müllerian hormone as a marker of ovarian reserve and premature ovarian insufficiency in children and women with cancer: a systematic review.

BACKGROUNDFemale patients undergoing anticancer treatment are at elevated risk of adverse ovarian outcomes including infertility and premature ovarian insufficiency (POI), which is associated with short- and long-term health risks. Anti-Müllerian hormone (AMH) is a key biomarker of ovarian reserve, but its role prior to and after cancer treatment is less well understood.OBJECTIVE AND RATIONALETo conduct a systematic review evaluating AMH as a biomarker of ovarian reserve and POI before and after anticancer treatment, which has become a pressing clinical issue in reproductive medicine. There are a large number of observational studies, but differences in patient groups, cancer diagnoses and study design make this a confusing field that will benefit from a thorough and robust review.SEARCH METHODSA systematic literature search for AMH in women with cancer was conducted in PubMed, Embase and Cochrane Central Register of Controlled Trials up to 1 April 2021. Bias review was conducted using the Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) protocol along with qualitative assessment of quality. Exploratory subgroups were established based on age, cancer type and length of follow-up.OUTCOMESNinety-two publications (N = 9183 patients) were included in this analysis after quality and bias review. Reduced/undetectable AMH was consistently identified in 69/75 studies (92%) following chemotherapy or radiotherapy, with reductions ranging from 42% to concentrations below the limit of detection, and many reporting mean or median declines of ≥90%. Where longitudinal data were analysed (42 studies), a majority (33/42 (79%)) of studies reported at least partial recovery of AMH at follow-up, however, effect estimates were highly variable, reflecting that AMH levels were strongly impacted by anticancer treatment (i.e. the chemotherapy regimen used and the number of treatment cycles need), with recovery and its degree determined by treatment regimen, age and pre-treatment AMH level. In 16/31 (52%) publications, oligo/amenorrhoea was associated with lower post-treatment AMH consistent with impending POI, although menstruation and/or pregnancy were reported in patients with low or undetectable AMH. Long-term (>5 years) follow-up of paediatric patients following cancer treatment also found significantly lower AMH compared with control groups in 14/20 (70%) of studies, with very variable effect sizes from complete loss of AMH to full recovery depending on treatment exposure, as in adult patients.WIDER IMPLICATIONSAMH can be used to identify the damaging effect of cancer treatments on ovarian function. This can be applied to individual women, including pre-pubertal and adolescent girls, as well as comparing different treatment regimens, ages and pre-treatment AMH levels in populations of women. While there was evidence for its value in the diagnosis of POI after cancer treatment, further studies across a range of diagnoses/treatment regimens and patient ages are required to clarify this, and to quantify its predictive value. A major limitation for the use of AMH clinically is the very limited data relating post-treatment AMH levels to fertility, duration of reproductive lifespan or time to POI; analysis of these clinically relevant outcomes will be important in further research.

Sleep improvements on days with later school starts persist after 1 year in a flexible start\xa0system

Early school times fundamentally clash with the late sleep of teenagers. This mismatch results in chronic sleep deprivation posing acute and long-term health risks and impairing students' learning. Despite immediate short-term benefits for sleep, the long-term effects of later starts remain unresolved. In a pre-post design over 1 year, we studied a unique flexible school start system, in which 10–12th grade students chose daily between an 8:00 or 8:50AM-start. Missed study time (8:00–8:50) was compensated for during gap periods or after classes. Based on 2 waves (6–9 weeks of sleep diary each), we found that students maintained their ~ 1-h-sleep gain on later days, longitudinally (n = 28) and cross-sectionally (n = 79). This gain was independent of chronotype and frequency of later starts but attenuated for boys after 1 year. Students showed persistently better sleep quality and reduced alarm-driven waking and reported psychological benefits (n = 93) like improved motivation, concentration, and study quality on later days. Nonetheless, students chose later starts only infrequently (median 2 days/week), precluding detectable sleep extensions in the flexible system overall. Reasons for not choosing late starts were the need to make up lost study time, preference for extra study time and transport issues. Whether flexible systems constitute an appealing alternative to fixed delays given possible circadian and psychological advantages warrants further investigation.

Pathways of parental influence on adolescent diet and obesity: a psychological stress–focused perspective

Youth obesity has become increasingly prevalent, with 34.5% of US adolescents 12-19 years old estimated to have overweight or obesity. Disordered eating and weight concern peak in adolescence, and overeating to cope with negative emotions can affect long-term health and obesity risk. Parents significantly influence adolescent diet quality, and parental stress may influence parenting behaviors that increase the risk for stress-motivated eating and obesity in adolescents. Chronic or repeated exposure to parental stress may lead to stress-related neurophysiological changes that promote consumption of palatable foods and obesogenic eating habits in adolescents. Understanding how parental stress influences adolescents' eating behavior may reveal novel access points for reducing adolescent obesity. Here, we aim to provide a new stress-focused framework for developing intervention strategies targeted at obesity prevention in adolescents.

Eco-toxic risk assessment and source distribution of trace metals in surface sediments of the coastal and in four rivers estuary of Sarawak

BackgroundTrace metals pollution in the coastal and estuarine sediment could harm water quality and aquatic organisms, leading to potential long-term health risks on the environment and humans. Thus, the purpose of this study was to conduct an assessment of selected trace metals in surface sediments of the coastal and in four rivers estuary in the Sarawak State of Malaysia to investigate their distribution, environmental risk, and potential source distribution.ResultsAverage concentrations of trace metals in sediment increased in the following order: Cd ˂ As ˂ Co ˂ Cu ˂ Ni ˂ Cr ˂ Zn ˂ Mn ˂ Mg ˂ Fe. The enrichment, contamination, and geo-accumulation index results showed that surface sediments were polluted with Zn and Mg. In contrast, the other metals (i.e., As, Fe, Mn, Ni, Cr, Cu, Co, and Cd) indicated background concentration to minor contamination. Generally, the pollution load index values showed that almost all the sampling sites were unpolluted with the selected trace metals. Sediment quality guidelines (SQGs) and risk indexes were employed to assess the ecotoxicological risk of trace metal contamination in the sediments. The results proved that studied trace metals are not likely to have a deleterious impact on bottom-dwelling organisms. Still, a further accumulation of trace metals such as Zn, Ni, and Cr with time may adversely affect bottom-dwelling organisms. The risk index results showed a low ecological risk to the study sites. The correlation analysis and principal component analysis indicated that nine studied trace metals have strong interrelationships, suggesting common pollution sources or similar geochemical characteristics.ConclusionsThe study highlights the need to make tremendous efforts to monitor and control trace metal pollution in the coastal and estuarine areas.

Maternal diabetes and fetal cardiac output.

The intrauterine environment is a key determinant for long-term health outcomes. Adverse fetal environments, such as maternal diabetes, obesity and placental insufficiency are strongly associated with long-term health risks in children. Little is known about differences in fetal cardiac output hemodynamics of diabetic mothers (DM) vs. non-diabetic mothers (NDM). Our study aims to investigate the left-sided, right-sided, and combined cardiac output (CCO) in fetuses of DM vs. NDM. Retrospective data were collected in fetuses of DM (N = 532) and NDM (103) at mean gestational age 24 weeks. Examination included 2D echo and pulse wave Doppler. Wilcoxon rank sum tests and Chi-square tests were used to test for distribution difference of maternal and fetal continuous and categorical measures respectively between DM and NDM. Intraclass correlation coefficients were calculated to assess intra-observer reliability of fetal cardiac measurements. DM mothers had higher mean weight (89.7±22.2 kg) than NDM (76.8±19.8 kg), p < 0.0001 and higher mean BMI (33.4±7.5) than NDM (28.3±5.8), p < 0.0001. C-section delivery occurred in 66% of DM vs. 35% of NDM fetuses. Fetuses of DM mothers had significantly larger semilunar valve diameter, higher left ventricular (LV) output, higher combined cardiac output and lower right ventricle /left ventricle ratio compared to NDM. The greater CCO (adjusted for fetal weight), left sided cardiac output in the fetuses of DM, compared to NDM, represent differences in cardiac adaptation to the diabetic environment.

Mitigating the Long-term Health Risks of Adverse Pregnancy Outcomes

This Viewpoint discusses the increased long-term risks for cardiovascular disease among individuals who have had adverse pregnancy outcomes and describes mitigation strategies for physicians to use over the life span of these patients.

Commentary on “The protective effects of wellbeing and flourishing on long-term mental health risk”

Commentary on “The protective effects of wellbeing and flourishing on long-term mental health risk”

Age-Adjusted Prevalence and Characteristics of Women with Polycystic Ovarian Syndrome in Korea: A Nationwide Population-Based Study (2010-2019).

Polycystic ovarian syndrome (PCOS) is a common endocrine disorder in women of reproductive age and is associated with an increased risk of obesity, compensatory hyperinsulinemia, dyslipidemia, metabolic syndrome, and endometrial cancer. This study analyzed 544619 women using the Korean Informative Classification of Disease, version 10, codes E28.0–E28.9 in the population-based National Health Information Databases from 2010 to 2019. The age-adjusted incidence and prevalence rates of PCOS over 10 years among Korean women were 2.8% and 4.3%, respectively; and they increased in the late teens, peaked in the 20s, and began to decrease at the age of 30. We also found that the body mass index, levels of fasting blood glucose, and high-density lipoprotein values in the recent two years (2018–2019) were higher in women with PCOS compared to the general population. This is the first study to investigate the prevalence of PCOS in a nationwide population of reproductive-aged Korean women. Further research is needed to examine the short- and long-term health risks and psychological problems associated with PCOS.

Changes of rivers and lakes water quality in Lake Ebinur Basin, Xinjiang(2005-2020)

艾比湖流域是西北地区重要的生态屏障，维持着该地区乃至整个新疆北部的生态平衡.艾比湖流域水环境的好坏关系着当地经济和流域的可持续发展.然而，针对艾比湖流域长期水质变化、营养状况和健康风险的研究较少，故基于艾比湖流域2005—2020年12个断面长时间序列的监测数据，利用加拿大水质指数（Canadian water quality index，CWQI）评价河湖水质状况，采用综合营养状态指数（comprehensive trophic level index，TLI （∑））评价艾比湖水体富营养化状态，使用Risk评价水环境健康风险（water environment healthy risk，WEHR），并结合逐步多元线性回归（SMLR），分析了水质参数与CWQI、TLI（∑）与WEHR之间的关系.结果表明：（1）精河CWQI下游大于上游，而博尔塔拉河相反，且精河与博尔塔拉河均存在点源污染，精河CWQI的变化范围46.29~98.71，博尔塔拉河CWQI的变化范围25.36~99.71，艾比湖CWQI的变化范围42.29~55.95，变异系数介于0.01~0.23之间；（2）2005—2020年艾比湖水体TLI （∑）大多数介于轻度富营养和中度富营养状态之间；氮磷比表明，研究区为磷限制状态，主要受农业面源污染、放牧、生活废水等人为活动的影响；（3）精河WEHR上游大于下游，而博尔塔拉河相反.水环境健康风险主要受化学致癌物影响，砷（As）的影响最大，其次为六价铬（Cr⁶⁺）.各断面点总风险超过美国环境保护署（United States Environmental Protection Agency，USEPA）规定的最大可接受风险水平；（4）逐步多元线性回归分析表明，影响水质的参数有高锰酸盐指数（COD_Mn）、氨氮、总磷（TP）、总氮（TN）、大肠菌群（E.coli）、透明度和挥发酚（volatile phenol，VP），影响水体富营养化参数为COD_Mn、TP、TN，影响WEHR的参数为氟化物（F^-）、铜（Cu）、砷（As）、镉（Cd）、六价铬（Cr⁶⁺）、铅（Pb）、氰化物（Cyanide）和挥发酚（VP）.本文的研究结果可为区域水环境可持续发展和水资源的合理配置提供有力的科学依据.;Lake Ebinur Basin is an important ecological barrier in Northwest China, maintaining the ecological balance of the region and even the whole northern Xinjiang Province. The water environment of Lake Ebinur Basin is closely related to the local economy and the sustainable development of the basin. However, there are few studies on long-term water quality change, nutritional status and health risk. Therefore, this paper is based on the long time-series monitoring data of 12 sections in Lake Ebinur Basin from 2005 to 2020. The water quality of rivers and lakes was evaluated by the Canadian water quality index (CWQI), the eutrophication status of Lake Ebinur was evaluated by the comprehensive trophic level index (TLI(∑)), and the water environment health risk (WEHR) was evaluated. Combined with stepwise multiple linear regression (SMLR), the relationships between water quality parameters and CWQI, TLI(∑) and WEHR were analyzed. The results show that:(1) The CWQI of Jing River in the lower reaches is larger than that in the upper reaches, while that in Bortala River is opposite, and there is point source pollution both in Jing River and Bortala River. The CWQI of Jing River ranges 46.29-98.71, Bortala River 25.36-99.71, Lake Ebinur 42.29-55.95, respectively, and the coefficient of variation ranges from 0.01 to 0.23; (2) The TLI(∑) of Lake Ebinur from 2005 to 2020 is between mild and moderate eutrophication; the ratio of nitrogen to phosphorus shows that the study area is phosphorus limited; (3) The WEHR in the upper reaches of Jing River is larger than that in the lower reaches, while that in Bortala River is opposite. The health risk of the water environment is mainly affected by chemical carcinogens, As is the most important, followed by Cr⁶⁺. The total risk of each section exceeds the maximum acceptable risk level specified by the United States Environmental Protection Agency (USEPA); (4) Stepwise multiple linear regression analysis showed that COD_Mn, NH₃-N, TP, TN, E. coli, SD (secchi depth) and VP (volatile phenol) affected water quality, COD_Mn, TP and TN affected water eutrophication, and F^-, Cu, As, Cd, Cr⁶⁺, Pb, cyanide and VP affected WEHR. The results of this study can provide a strong scientific basis for the sustainable development of the regional water environment and the rational allocation of water resources.

Patients' Perceptions of Long-Term Health Risks: Survey of Patients in a Multidisciplinary Postpartum Hypertension Clinic

“The 4th trimester” is a critical priority, especially for high-risk patients. Gaps in patients’ understanding of their disease may affect their participation in postpartum (PP) care. We aimed to assess patients’ perceived health knowledge at baseline immediately PP and at 6 weeks after participation in a multidisciplinary MFM-cardiology PP hypertension clinic (MY HEART).

Role of Single Nucleotide Variants in FSHR, GNRHR, ESR2 and LHCGR Genes in Adolescents with Polycystic Ovary Syndrome.

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women, affecting up to 16.6% of reproductive-age women. PCOS symptoms in adolescents comprise oligomenorrhoea/amenorrhoea and biochemical and/or clinical hyperandrogenism. Long-term health risks of PCOS patients include infertility, metabolic syndrome, type 2 diabetes and cardiovascular disease. Genetic factors have been proven to play a role in development of the syndrome and its symptoms. Objective: To investigate single nucleotide variants (SNVs) in the GNRHR, ESR2, LHCGR and FSHR genes in adolescent patients with PCOS and their association with PCOS symptoms. Methods: We conducted a cross-sectional study comprising of 152 adolescents: 63 patients with PCOS, 22 patients at risk of developing PCOS and 67 healthy controls. Participants were recruited from out-patients attending a gynaecologist at the Children’s Clinical University Hospital, Riga, Latvia, between January 2017 and December 2020. Genomic DNA was extracted from whole blood, and SNVs in the GNRHR, ESR2, LHCGR and FSHR genes were genotyped. The distributions of SNV genotypes were compared among the three groups and genotype-phenotype associations within the PCOS group were evaluated. Results: No statistically significant differences were found in the distributions of genotypes for GNRHR (rs104893837), ESR2 (rs4986938), LHCGR (rs2293275) and FSHR (rs6166, rs6165, rs2349415) among PCOS patients, risk patients and healthy controls. Within the PCOS group, ESR2 rs4986938 minor allele homozygous patients had a significantly higher level of total testosterone than major allele homozygous patients and heterozygous patients. A significantly higher total testosterone level was also observed in PCOS patients carrying the LHCGR rs2293275 minor allele compared with major allele homozygous patients. Conclusions: The SNVs ESR2 rs4986938 and LHCGR rs2293275 play a role in the phenotypic characteristics of PCOS. To fully uncover their influence on the development of PCOS and its symptoms, further studies of larger cohorts and a follow up of this study sample through to adulthood are required. Furthermore, studies of adolescent PCOS patients conducted prior to the latest European Society of Human Reproduction and Embryology (ESHRE) criteria (2018) should be re-evaluated as the study groups might include risk patients according to these updated criteria, thereby potentially significantly impacting the published results.

The protective effects of wellbeing and flourishing on long-term mental health risk

ObjectivePersonal wellbeing reflects individuals’ experiences of positive mental health and those with high wellbeing can be described as flourishing. Increasingly, wellbeing and flourishing are informing public health policy and clinical practice. However, the long-term benefit of wellbeing and flourishing on negative mental health outcomes over the life course is not widely explored. MethodData were from the Personality and Total Health Through Life study, based in Canberra, Australia. Participants were recruited to three age cohorts (Early Adulthood n ​= ​991; Middle Adulthood n ​= ​1,510; Later Adulthood n ​= ​1,432). Wellbeing was operationalised by positive and negative affect, life satisfaction, morale, resilience and social support. Flourishing status was defined by those reporting the highest levels of wellbeing. Mental Health was operationalised by depression and anxiety symptoms, and any depressive disorder. A sub-set of early (n ​= ​439) and middle adulthood (n ​= ​1,275) participants completed the Composite International Diagnostic Interview (CIDI). ResultsAssociations between individual wellbeing indicators with mental health were mostly attenuated or of small magnitude in multivariate analyses, except for negative affect and low mastery which consistently reported substantial 4-year risk for all age cohorts. In contrast flourishing status reported consistently strong protection against poor mental health outcomes. ConclusionIndividual wellbeing indicators are not as strongly related to mental health outcomes as a higher-order latent wellbeing factor reflecting flourishing. However, multiple measures of wellbeing are needed to capture the gamut of wellbeing experiences and are related to improved mental health outcomes over the long-term and are generally consistent across adulthood.