Health Risk For Population Research Articles

10.E. Scientific session: Confronting the hidden risks: unveiling the disease burden of chemicals in Europe

Abstract With increasing industrialization and globalization, Europe faces a complex landscape of chemical hazards, ranging from persistent organic pollutants like PFAS to foodborne chemicals and beyond. Understanding the extent of these exposures and their associated population health risks is crucial for environmental and health policy making across Europe. The burden of disease methodology, particularly through metrics such as Disability-Adjusted Life Years (DALYs), combined with economic costs, plays a crucial role in assessing and addressing the impacts of chemicals on population health. DALYs provide a comprehensive measure that quantifies both the years of life lost due to premature death and the years lived with disability, offering a holistic understanding of the disease burden caused by chemical exposures. Additionally, incorporating economic costs into the analysis enables the evaluation of the financial burden imposed by chemical-related illnesses on healthcare systems, productivity, and societal well-being. By leveraging the burden of disease methodology, stakeholders can make evidence-based decisions to protect health of populations and allocate resources effectively, ultimately promoting healthier environments and communities. Several global and European initiatives provide platforms for evidence generation, knowledge-sharing, and action to address the disease burden of chemicals. At the global level, the Foodborne Disease Burden Epidemiology Reference Group of the World Health Organization (WHO/FERG) has estimated the global burden of foodborne diseases, including those caused by chemical contaminants in foods. At European level, the health impact of PFAS and other chemicals of high concern is being spearheaded by the European Environment Agency’s European Topic Centre on Human Health and the Environment, and the European Partnership on the Assessment of Risks from Chemicals (PARC). Furthermore, the Organisation for Economic Cooperation and Development has established a project of an unprecedented scale to measure the economic value of the effects of chemicals on human health. Complementary to these international initiatives, various countries have started to unravel the burden of chemicals based on local data and contextual insights. In this workshop, we will present the state-of-the-art of the disease burden of chemicals, by bringing together insights from key international and national burden of disease initiatives, emphasizing the imperative of addressing the cost of policy inaction in safeguarding public health. We will also show how burden of disease estimates for chemicals can help to monitor the trends towards relevant environment and health goals such as those described in the EU’s zero pollution ambition. Through collaborative discussions and knowledge-sharing, we aspire to identify actionable strategies for policymakers, researchers, and stakeholders to effectively address these challenges and promote a healthier future for all. Key messages • Understanding the vital importance of chemical risks for European health, the utilization of DALY and economic costs reveals their true burden, guiding evidence-based policies. • Global, regional and national initiatives are examining the impacts of chemicals worldwide, contributing to evidence gathering and policy shaping.

The potential of including the microbiome as biomarker in population-based health studies: methods and benefits.

The key role of our microbiome in influencing our health status, and its relationship with our environment and lifestyle or health behaviors, have been shown in the last decades. Therefore, the human microbiome has the potential to act as a biomarker or indicator of health or exposure to health risks in the general population, if information on the microbiome can be collected in population-based health surveys or cohorts. It could then be associated with epidemiological participant data such as demographic, clinical or exposure profiles. However, to our knowledge, microbiome sampling has not yet been included as biological evidence of health or exposure to health risks in large population-based studies representative of the general population. In this mini-review, we first highlight some practical considerations for microbiome sampling and analysis that need to be considered in the context of a population study. We then present some examples of topics where the microbiome could be included as biological evidence in population-based health studies for the benefit of public health, and how this could be developed in the future. In doing so, we aim to highlight the benefits of having microbiome data available at the level of the general population, combined with epidemiological data from health surveys, and hence how microbiological data could be used in the future to assess human health. We also stress the challenges that remain to be overcome to allow the use of this microbiome data in order to improve proactive public health policies.

Trace antibiotic exposure affects murine gut microbiota and metabolism

Gut microbiota is important for host metabolism regulation. Antibiotic exposure disturbs this regulation by affecting the microbiome. Trace levels of antibiotics in water have been widely reported and the impact on gut microbiota remains understudied. We provide evidence of trace antibiotic exposure affecting the host's gut microbiota using a mouse model exposed to trace amounts of azithromycin (AZI) or ciprofloxacin (CIP) in drinking water. AZI exposure in males changed the distribution of gram-positive (Firmicutes and Bacteroidetes) and gram-negative (Proteobacteria, Fusobacteria, and Verrucomicrobia) bacteria at an early age. Both AZI and CIP resulted in abnormal microbiota maturation. Additionally, the production of short-chain fatty acids (SCFAs), including acetate, butyrate, and propionate, in females is affected. Serum hormone and metabolome levels shifted after trace antibiotic exposure. AZI and CIP exposure broadly disrupted original host-microbe interaction relationships between the gut microbiota and SCFAs or serum metabolites. In this study, we demonstrated that trace antibiotic exposure was associated with extensive gut microbiota and metabolism perturbation in mice and that the potential health risks in susceptible populations should be considered.

The Impact of Fat Contents and Different Cooking Processes on the Potential Health Concerns of Polycyclic Aromatic Hydrocarbons in Chicken Doner Kebabs

This study investigated the effects of different fat contents and cooking techniques on the presence of PAHs in chicken doner kebabs, as well as the dietary exposure and potential health risks for the Turkish population. The methodology for the detection and quantification of 16 PAH compounds in chicken doner samples using high-performance liquid chromatography (HPLC-UV) was validated. The limit of detection (LOD), quantification (LOQ), recovery, and relative standard deviation (RSD) were found to be 0.44%–1.14%, 1.45%–3.56%, 63.12%–101.50%, and 0.14%–3.16%, respectively. Our findings revealed that, among the analyzed compounds, BaA was the most dominant PAH compound, and that the charcoal cooking technique resulted in the highest accumulation of both BaP and PAH4 concentrations in chicken doner kebabs. Additionally, a significant increase in PAH levels was observed in relation to higher fat content. Moreover, it was found that the estimated daily intake (EDI) of BaP and PAH4 was higher in charcoal-grilled, well-done, high-fat chicken doner samples. As a result, the fact that the Margin of Exposure (MOE) values calculated for chicken doner samples across the Turkish population are above 10,000 indicates a low level of concern.

Impact of City-Wide Diesel Generator Use on Air Quality in Quito, Ecuador, during a Nationwide Electricity Crisis

As climate change intensifies and 2023 sets the record for the hottest year, the Amazonian region faces severe drought, leading to a hydroelectricity crisis. This study examines the effects of using environmentally harmful backup power solutions, which are all too common in developing countries—specifically, diesel-powered generators—on urban air quality in Quito, Ecuador, during the hydroelectric crisis of 2023/2024. The impact of the blackouts on air pollution is assessed by comparing it to a reference period before the crisis and to an earlier year with similar weather conditions. The findings indicate that extended blackouts (up to 8 h per day) considerably increased concentrations of SO2 (180%), CO (43%), NO2 (39%), and PM2.5 (20%) compared to ‘normal’ conditions. Conversely, O3 pollution levels decreased (−6%). Our findings suggest potential respiratory and cardiovascular health risks for the urban population, highlighting the urgent need for improved energy infrastructure and cleaner backup power solutions in the developing world. Addressing these challenges is critical for ensuring a healthier and more sustainable urban future amidst climate change projections.

Quantification of uncertainty in short-term tropospheric column density risks for a wide range of carbon monoxide

The short-term risks associated with atmospheric trace gases, particularly carbon monoxide (CO), are critical for ecological security and human health. Traditional statistical methods, which still dominate the assessment of these risks, limit the potential for enhanced accuracy and reliability. This study evaluates the performance of traditional models (ARIMA), machine learning models (LightGBM, ConvLSTM2D), and optimized machine learning solutions (Bayes residual optimization ConvLSTM2D LightGBM, Bayes_CL) in predicting Sentinel 5P columnar CO levels. This study findings demonstrate that machine learning models and their optimized versions significantly outperform traditional ARIMA models in cross-validation (CV), visualization, and overall prediction performance. Notably, machine learning model based on Bayes and residual optimization (Bayes_CL) achieved the highest CV score (Bayes_CL R2 = 0.8, LightGBM R2 = 0.79, ConvLSTM2D R2 = 0.75, ARIMA R2 = 0.61), along with superior visualization and other metrics. Using Bayes_CL, we effectively quantified a 2.4% increase in columnar CO levels in mainland China in the second half of 2023, following the complete lifting of COVID-19 lockdowns. This study confirms that machine learning models can effectively replace traditional methods for short-term risk assessment of Sentinel 5P columnar CO. This transition holds significant implications for policy formulation, greenhouse effect assessment, and population health risk evaluation, especially in uncertain situations where human activities are severely disrupted, thereby affecting environmental safety.

Refined prediction of SO2 concentration around Chinese coking enterprises and exposure risk assessment of different populations based on buffer Latin hypercube

Coking enterprises in China are recognized as significant sources of SO2 emissions, making them a key industry with high levels of SO2 intensity. Assessing the health risks for different populations around these coking enterprises nationwide is challenging due to the lack of clarity regarding SO2 concentrations at varying distances from these facilities. To address this issue, we developed a buffer Latin hypercube XGBoost particle swarm optimization (BLH-XGB-PSO) algorithm that combines efficient global search capabilities and accurate prediction performance. This algorithm enables effective traversal of monitoring points located at varying distances and directions around the enterprise while automatically seeking optimal model parameters. Using this model, we accurately predicted the concentration of SO2 every 0.5 km within a 10 km radius around China's coking enterprises in 2017, achieving a high prediction accuracy with an R2 value of 0.97. The prediction results indicate that the highest concentration of SO2 in the vicinity of Chinese coking enterprises is observed in the central region of Shanxi province (65.88 μg/m3). The average annual concentration of SO2 around all production enterprises amounts to 27.9 μg/m3. Furthermore, we conducted an assessment on the impact of coking enterprises on different age groups, genders, and regions regarding the number of affected individuals, health exposure risks, and control effectiveness. Our findings reveal that in 2017, around 5.5 thousand newborns (14.5% male, 85.5% female) had a hazard quotient (HQ) exceeding threshold value which poses potential human health risks. The implementation of the control policy successfully prevented 64,375 thousand people from being affected by higher concentrations of SO2. Greater attention should be devoted to the health risks faced by newborns residing in proximity to coking enterprises, with a particular emphasis on female infants.

Epidemiological profile for type 2 diabetic patients in Babylon City: Across sectional study

Background: Diabetes Mellitus (DM) is a multifaceted and enduring metabolic disorder that has become a prominent global health concern. The global impact of this issue is significant, affecting a large population and presenting substantial health risks, thereby placing a considerable strain on healthcare systems. Type 2 diabetes is a significant public health problem responsible for several macro and microvascular complications. This study aimed to describe the epidemiological profile of type 2 diabetic patients how attending to the specialized center for endocrinology and diabetes in Babylon City. Methodology: A sectional study was conducted between 25th of September 2023 to the 18th of April 2024 to determine the epidemiological characteristics of patients with type 2 diabetes who was attending to the Specialized Center for Endocrinology and Diabetes in Marjan Teaching Hospital, it's a referral center for diabetes and other endocrinology diseases and received diabetes patients of different ages and both sexes from the different health facilities as Public Hospitals, PHC, and Private Clinics. Result: - The study included 751 patients; 58.7% were females, and 41.3% were male. 30.8% were in the age group (60-69) years with an average age of 54.2±14.0 for all involved age (18-90) years. The majority, 47.1%, had diabetes duration of less than 10 years. On admission, 87.6 % of patients suffer from a chronic disease other than diabetes, 30.1 % were overweight, and 48.4 % were obese, with the non-significant difference between percentages using the person chi-square test (2-test) at 0.05 level (P= 0.970). On the other hand, 98.8 % of patients had at least one complication on admission: 81.9% had peripheral neuritis, 85 % had eye fatigue, 84.2 % had severe hypoglycemia, 41.3% had high blood pressure, 35.2% had a diabetic foot and lowest percentage 10.1% had brain strokes. Conclusion: - The patients with type 2 diabetes mellitus have an extremely high risk of disease complications.

Assessing Listeria monocytogenes Growth in Artificially Inoculated Sea-Farmed Product—Raw Sea Bass (Dicentrarchus labrax) Fillet, Produced in Greece

Listeria monocytogenes (Lm) is responsible for listeriosis, a serious foodborne disease, with high hospitalization and mortality rates worldwide. The main cause of listeriosis in humans is the consumption of ready-to-eat (RTE) foods; Commission Regulation (EC) No 2073/2005 establishes microbiological criteria for Lm in RTE foods. Raw fish products are widely consumed, e.g., in sushi and various seafood recipes (e.g., carpaccio, sashimi, maki, nigiri, tartare, etc.), but are not subjected to RTE food safety criteria. The aim of our study was to assess the growth potential of Lm in raw sea bass fillets obtained from a leading aquaculture company in Greece. In order to assess the growth of Lm in raw sea bass fillets, we applied the “challenge test”, a scientific experiment designed to assess the growth of Lm within a specific food product under controlled conditions. According to our results, and taking into consideration the health risk for the listeriosis-vulnerable population, raw fish products utilized in the preparation of RTE foods, including sushi and an array of seafood dishes, should be incorporated in the Category of Safety Criteria of Regulation (EC) No 2073/2005 “Ready-to-eat food able to support the growth of Listeria monocytogenes”.

Analysis of the main indicators of rural health and strategic tasks of countering population health risks in the Republic of North Ossetia-Alania.

Analysis of the main indicators of rural health and strategic tasks of countering population health risks in the Republic of North Ossetia-Alania.

Health risk assessment taking into account N-nitrosamines’ concentrations in food products

N-nitrosamines formed in meat products, especially during heat treatment, are potentially hazardous to human health. Smoked sausages are a product with a high content of N-nitrosamines, including those not regulated in Russia, which can cause health risks for population. The aim of this study was to perform health risk assessment considering ratios of N-nitrosamine concentrations in food products. The data on N-nitrosamines’ concentrations were analyzed using MS Excel and Statistica 10.0 programs. The relationship between these concentrations was evaluated using Spearman correlation coefficient. Parameterization of dependencies was carried out by regression analysis with evaluation of model significance by Fisher's criterion. Differences at the level of p ≤ 0.05 were considered statistically significant. Risk assessment was performed in accordance with the Guideline R.2.1.10.3968-23. Correlation analysis between N-nitrosamines in smoked sausages revealed a significant correlation between concentrations of NDMA and NEMA (rs = 0.77) and NDMA and NPyRA (rs = 0.81) at p < 0.05. The level of total carcinogenic risk (∑CR) derived from data based on calculated concentrations of NEMA and NPyRA was determined to be unacceptable for the adult population. It should be noted that the contribution to ∑CR value (11.0 %) is related to NEMA and NPyRA that are not regulated in Russia. Our study results support the findings of earlier EFSA publications indicating that not only NDMA and NDEA, but also other N-nitrosamines may form a health risk upon simultaneous exposure. Correlation and regression analyses allowed us to assess the concentrations of NEMA and NPyRA in sausages. Use of both these concentrations and actual NDMA and NDEA concentrations established unacceptable carcinogenic risk for certain consumer groups in case N-nitrosamines concentrations were above regulated level. The contribution of NEMA and NPyRA in ∑CR value was 11.0 %.

Оценка риска здоровью с учетом содержания N-нитрозоаминов в пищевых продуктах

N-nitrosamines formed in meat products, especially during heat treatment, are potentially hazardous to human health. Smoked sausages are a product with a high content of N-nitrosamines, including those not regulated in Russia, which can cause health risks for population. The aim of this study was to perform health risk assessment considering ratios of N-nitrosamine concentrations in food products. The data on N-nitrosamines’ concentrations were analyzed using MS Excel and Statistica 10.0 programs. The relationship between these concentrations was evaluated using Spearman correlation coefficient. Parameterization of dependencies was carried out by regression analysis with evaluation of model significance by Fisher's criterion. Differences at the level of p ≤ 0.05 were considered statistically significant. Risk assessment was performed in accordance with the Guideline R.2.1.10.3968-23. Correlation analysis between N-nitrosamines in smoked sausages revealed a significant correlation between concentrations of NDMA and NEMA (rs = 0.77) and NDMA and NPyRA (rs = 0.81) at p < 0.05. The level of total carcinogenic risk (∑CR) derived from data based on calculated concentrations of NEMA and NPyRA was determined to be unacceptable for the adult population. It should be noted that the contribution to ∑CR value (11.0 %) is related to NEMA and NPyRA that are not regulated in Russia. Our study results support the findings of earlier EFSA publications indicating that not only NDMA and NDEA, but also other N-nitrosamines may form a health risk upon simultaneous exposure. Correlation and regression analyses allowed us to assess the concentrations of NEMA and NPyRA in sausages. Use of both these concentrations and actual NDMA and NDEA concentrations established unacceptable carcinogenic risk for certain consumer groups in case N-nitrosamines concentrations were above regulated level. The contribution of NEMA and NPyRA in ∑CR value was 11.0 %.

Hazard and Health Risk Assessment of Heavy Metals in Non-Alcoholic Beverage Consumed in Abia State, Nigeria

The quality of non-alcoholic beverages consumed in Aba, Abia State, southeastern Nigeria and health risk assessment of heavy metals required periodic evaluation so as to avert potential health hazard. Hence, the objective of this paper as to evaluate the hazard and health risk assessment of heavy metals in non-alcoholic beverages consumed in Abia State, Nigeria using health risk assessment models. Heavy metals concentrations were determined using atomic absorption spectrophotometer (Agilent 280FS AA). The average heavy metal concentrations of non-alcoholic drink samples ranged from 0.040 - 1.132 mg/l in ascending order of Zn < Cd < Co < Cu < Pb <Cr < Mn < Fe respectively. The average concentrations of Mn, Cr, Cd, Fe and Pb exceeded the standard maximum permissible limits for drinking water quality. The values of estimated daily intake for Cd, Fe, Pb, Cr, Mn and Zn were within acceptable provisional tolerable daily intake and safe limits. The hazard quotient (HQ) values for Mn, Cr, Cd, Zn and Fe were within safe limit (< 1.0), except for Co and Pb that had HQ values greater than one in over 37.5 % of the total samples, indicating associated potential chronic health risks. Hazard index of 72.5% of all the non-alcoholic drink samples were above the safe limit (>1.0), signifying potential chronic health risk as a result of combine effects of these heavy metals. The incremental life cancer for Cr, Cd and Pb ranged from 2.59E-05 - 1.79E-03, 1.35E-04 – 2.81E-04 and 3.92E-06 - 3.24E-05 respectively. The incremental life cancer values of Pb were within the recommended safe limit of not greater than 1.0 × 10-4 and has the least likelihood of any potential cancer risks. However, Cd, and Cr had cancer risk values higher than the save limits, indicating potential life cancer health risks in both children and adult population.

Изменения климата и лесные пожары как факторы риска здоровью (аналитический обзор)

Climate change in Russia contributes to an increase in the number of forest fires, especially in Siberia and the Far East, leading to the rise in the forest fire danger index. Increased air pollution, which is typical for a number of cities in these regions, is the reason for changes in population health due to the influx of significant volumes of smoke gases from forest fires into populated areas. Smoke from forest fires, consists of aerosols and gases and contains more than 40 pollutants. During fires, frequency of calls for emergency medical care for children tends to increase due to exacerbation of upper respiratory tract diseases, including laryngitis, pharyngitis and acute respiratory infections, as well as attacks of bronchial asthma, and longer exacerbation periods of this disease. Such respiratory dysfunctions appear a few days after fires, which should be taken into account when organizing health monitoring in such situations. Among adult population, an increase in the number of deaths from cardiovascular and respiratory diseases has been proven during forest fires, and there tends to be an increase in the number of requests for medical care for COPD, bronchial asthma, myocardial infarction, coronary heart disease and other diseases. Fires in forest highlands in the Khabarovsk Krai result in deteriorating health of patients with neurological diseases. The generalization of the results obtained by domestic and foreign studies on this issue confirms the need to improve the air pollution monitoring system during forest fires with the determination of PM for timely preventive measures by health systems, Rospotrebnadzor, FMBA and other agencies. It also seems necessary to develop modeling of pollutant spread in ambient air in settlements exposed to them, with assessments of population health risks and development of preventive measures. Given the relevance of these studies, it is advisable to hold seminars with BRICS countries within the framework of international cooperation.

Total mercury and methylmercury levels in Brazilian Amazon fish: A scope review with meta-analysis and local population health risk assessment

IntroductionThe Brazilian Amazon has one of the richest biomes and the largest source of freshwater on the planet. However, anthropogenic activities have also turned this region into one of the highest points of human exposure to mercury ever recorded. Therefore, the aim of the present work was to perform a scope review with meta-analysis in order to evaluate the total mercury (THg) and methylmercury (MeHg) levels in Brazilian Amazon fish, as well as to carry out a local population health risk assessment. MethodsA literature search was systematically performed in research databases and gray literature, remaining 14 studies from 2017 to 2022 for final analysis. The studies were submitted to raw mean and subgroup meta-analysis, followed by a risk characterization and the calculation of a maximum safe consumption of fish for the Amazonian population. ResultsThe selected studies covered 4 Amazonian states, as well as included the analysis of >30 fish species of different trophic levels and sampling in >15 cities. The overall total mercury mean obtained for Brazilian Amazon fish was 0.29 ug g⁻¹. Significant difference was observed between THg levels according to fish trophic level (p < 0.05), which reinforces the MeHg biomagnification. When THg levels from all fish samples were pooled, it was not observed a significant difference among the Amazonian states and the fish sampling season. However, significant variations between microregions and species-specific variations over the seasons should not be discarded. All estimated daily methylmercury intake exceeded the reference dose of 0.1 ug kg BW⁻¹ day⁻¹, resulting in a hazard quotient (HQ) greater than 1 and indicating a risk of chronic exposure by the local population. The maximum safe consumption of fish calculated based on the overall total mercury mean was set as 31, 147 and 173 g week⁻¹ for children, adult women and adult men, respectively, which is much lower than the reality of consumption by the riverside communities (2870 g week⁻¹). ConclusionThere is an urgent need to reduce Hg exposure levels in the region as well as to recommend other protective nutritional strategies to the local population such as defining the fish species with lower mercury contamination levels and their safe weekly consumption.

Climate change and forest fires as health risk factors (Analytical review)

Climate change in Russia contributes to an increase in the number of forest fires, especially in Siberia and the Far East, leading to the rise in the forest fire danger index. Increased air pollution, which is typical for a number of cities in these regions, is the reason for changes in population health due to the influx of significant volumes of smoke gases from forest fires into populated areas. Smoke from forest fires, consists of aerosols and gases and contains more than 40 pollutants. During fires, frequency of calls for emergency medical care for children tends to increase due to exacerbation of upper respiratory tract diseases, including laryngitis, pharyngitis and acute respiratory infections, as well as attacks of bronchial asthma, and longer exacerbation periods of this disease. Such respiratory dysfunctions appear a few days after fires, which should be taken into account when organizing health monitoring in such situations. Among adult population, an increase in the number of deaths from cardiovascular and respiratory diseases has been proven during forest fires, and there tends to be an increase in the number of requests for medical care for COPD, bronchial asthma, myocardial infarction, coronary heart disease and other diseases. Fires in forest highlands in the Khabarovsk Krai result in deteriorating health of patients with neurological diseases. The generalization of the results obtained by domestic and foreign studies on this issue confirms the need to improve the air pollution monitoring system during forest fires with the determination of PM for timely preventive measures by health systems, Rospotrebnadzor, FMBA and other agencies. It also seems necessary to develop modeling of pollutant spread in ambient air in settlements exposed to them, with assessments of population health risks and development of preventive measures. Given the relevance of these studies, it is advisable to hold seminars with BRICS countries within the framework of international cooperation.

Assessment and bioaccumulation of heavy metal contaminants in Golden Mahseer (Tor putitora Hamilton, 1822)

Unpolluted freshwater is a crucial component for maintaining the health of humans. This study aimed to investigate the bioaccumulation and potential health hazards of heavy metal contaminants (Fe, Cd, Cr, Cu, Pb) in water, sediments, and tissues of the golden mahseer fish (Tor putitora) from Zhob River to assess their suitability for human consumption. Samples (soil, water, and fish) were collected from the Zhob River, and Flame Atomic Absorption Spectrometry (FAAS) was employed to measure the concentration of these metals found in soil, water, and various fish body tissues (muscles, skin, gills, and liver). The overall results revealed that water quality parameters, i.e., temperature and pH were found within tolerable ranges, while electrical conductivity and turbidity exceeded the permissible limits of FAO/WHO for fish. Furthermore, this study also identified elevated concentrations of Pb in water and soil, as well as Fe and Cd in soil beyond the standards set by the World Health Organization (WHO) and the United States Environmental Protection Agency (USEPA). In contrast, the concentrations of other targeted metals examined in fish body tissues were found below the permissible limits set by the Food and Agriculture Organization (FAO) and the World Health Organization (WHO), indicating the suitability of this fish species for human consumption. The estimated daily intake (EDI) of these targeted metals in various fish body tissues was found to be within the recommended dietary allowance (RDA), suggesting no associated health risks for the local population. Furthermore, both the Target Hazard Quotient (THQ) and Total Target Hazard Quotient (TTHQ) values measured in this study were less than one, indicating the absence of potential non-carcinogenic health risks related to the consumption of this riverine mahseer fish, but combined metal intake may pose potential health risks. Carcinogenic risk assessment for some metals like Cd, Cr, and Pb revealed no cancer risk for consumers. Moreover, our present research observed comparatively high bioaccumulation (BAF) of each targeted metal in the fish liver from both Zhob River water and soil as compared to other body tissues. Multivariate analysis, including the correlation matrix, revealed strong and significant correlations (P < 0.05) among heavy metal pairs (Fe/Cr, Fe/Pb, Cr/Fe, Cr/Pb, Pb/Fe, Pb/Cr). Hierarchical cluster analysis and Principal Component Analysis (PCA) were utilized to trace the origins of these metals, attributing their presence to nearby rock weathering, mining, as well as municipal and agricultural activities. These factors were recognized as potential sources of heavy metal bioaccumulation in riverine fish. Thus, our current study concluded that the Zhob River was contaminated with these heavy metals and emphasized the need to prevent domestic and industrial sewage inflow. The monitoring of these metals in the food chain was also underscored as crucial for reducing all kinds of associated health risks. This study provides the first report on heavy metal distribution in highly abundant and edible mahseer fishes of the Zhob River.

Towards assessing reliability of next‐generation Internet of Things dashboard for anxiety risk classification

AbstractThe ubiquitous Internet of Things (IoT) and sensing technologies provide an interesting opportunity of remote health monitoring and disease risk categorisation of populations. An end‐to‐end architecture is proposed to facilitate real‐time digital dashboards to visualise general anxiety risks of patients, especially during a pandemic, such as COVID‐19. To collect physiological data related to anxiety (heart rate, blood pressure, and saturation of peripheral oxygen [SPO2]) and communicate them to a centralised dashboard, dubbed ‘X‐DASH’, a hardware prototype of the proposed architecture was developed using Node‐MCU and diverse sensors. The dashboard presents a smart categorisation of users' data, assessing their anxiety risks, to provide medical professionals and state authorities a clear visualisation of health risks in populations belonging to different regions. We categorised the risk levels as Normal, Mild, Moderate, Elevated, Severe, and Extreme, based on the collected physiological data and pre‐defined threshold values. The developed hardware prototype in this work was used to collect data from about 500 patients present at cardiac clinic of a leading general hospital in Karachi (Pakistan) and the anxiety risk levels were assigned based on pre‐defined threshold values. To validate the reliability of the X‐DASH, the personal physician of each patient was consulted and was requested to identify each of their anxiety risk levels. It was found that the risk levels suggested by X‐DASH, (based on data of heart rate, blood pressure, and SPO2 were more than 90% accurate when compared with diagnoses of physicians. Subsequently, packet loss, delay and network overhead for the platform was compared when using MQTT, CoAP and Modbus. Although MQTT has shown higher delays, but it is still recommended due to having a higher reliability.

Emergence and Comparative Genome Analysis of Salmonella Ohio Strains from Brown Rats, Poultry, and Swine in Hungary.

Rats are particularly important from an epidemiological point of view, because they are regarded as reservoirs for diverse zoonotic pathogens including enteric bacteria. This study is the first to report the emergence of Salmonella serovar Ohio in brown rats (Rattus norvegicus) and food-producing animals in Hungary. We first reveal the genomic diversity of the strains and their phylogenomic relationships in the context of the international collection of S. Ohio genomes. This pathogen was detected in 4.3% (4/92) of rats, captured from multiple sites in Hungary. A whole-genome-based genotype comparison of S. Ohio, Infantis, Enteritidis, and Typhimurium strains showed that 76.4% (117/153) of the virulence and antimicrobial resistance genes were conserved among these serovars, and none of the genes were specific to S. Ohio. All S. Ohio strains lacked virulence and resistance plasmids. The cgMLST phylogenomic comparison highlighted a close genetic relationship between rat and poultry strains of S. Ohio from Hungary. These strains clustered together with the international S. Ohio genomes from aquatic environments. Overall, this study contributes to our understanding of the epidemiology of Salmonella spp. in brown rats and highlights the importance of monitoring to minimize the public health risk of rodent populations. However, further research is needed to understand the route of infection and evolution of this serovar.

Artificial Intelligence and Health Inequities in Dietary Interventions on Atherosclerosis: A Narrative Review.

Poor diet is the top modifiable mortality risk factor globally, accounting for 11 million deaths annually with half being from diet-linked atherosclerotic cardiovascular disease (ASCVD). Yet, most of the world cannot afford a healthy diet-as the hidden costs of the inadequate global food system total over USD 13 trillion annually-let alone the much more clinically, financially, and ecologically costly and resource-intensive medical interventions required to address the disease progression and acute complications of ASCVD. Yet, AI is increasingly understood as a force multiplying revolutionary technology which may catalyze multi-sector efforts in medicine and public health to better address these significant health challenges. This novel narrative review seeks to provide the first known overview of the state-of-the-art in clinical interventions and public health policies in healthy diets for ASCVD, accelerated by health equity-focused AI. It is written from the first-hand practitioner perspective to provide greater relevance and applicability for health professionals and data scientists. The review summarizes the emerging trends and leading use cases in population health risk stratification and precision public health, AI democratizing clinical diagnosis, digital twins in precision nutrition, and AI-enabled culinary medicine as medical education and treatment. This review may, therefore, help inform and advance the evidence-based foundation for more clinically effective, financially efficient, and societally equitable dietary and nutrition interventions for ASCVD.