The increasing popularity of roll-your-own (RYO) tobacco has raised toxicological concerns regarding heavy metal exposure. This study quantified fourteen metals (Fe, Zn, Mn, Cr, Cu, Ni, Cd, Mo, Co, Sb, Pb, As, Hg, and V) in RYO tobacco samples collected from ten provinces in Türkiye using inductively coupled plasma optical emission spectrometry (ICP-OES). Fe exhibited the highest mean concentration (18.11mg.kg-1), followed by Zn (10.53mg.kg-1) and Mn (5.020mg.kg-1), whereas As (0.041mg.kg-1), Hg (0.015mg.kg-1) and V (0.001mg.kg-1) occurred at the lowest concentrations. Statistically significant correlations were observed, including Fe-Hg (r = 0.97, p < 0.001) and Zn-As (r = -0.77, p < 0.01), indicating shared geochemical influences and contrasting uptake patterns. Health risk assessment following USEPA guidelines indicated that all Hazard Quotients (HQ < 1) and Hazard Index (HI = 4.8 × 10-3) remained below the non-carcinogenic threshold, and Carcinogenic Risk values ranged from 2.50 × 10-7 to 2.00 × 10-10 and remained below 10-6. The results characterize metal exposure levels in RYO tobacco and indicate potential toxic elements as elements requiring continued monitoring due to their toxicological relevance.

This study investigates the distribution, contamination status, possible sources, and health risks of heavy metals in urban road dust from Vadodara, a rapidly developing industrial city in western India. Vadodara was selected due to its increasing traffic density, mixed land-use pattern, and growing industrial activities, which may contribute to metal accumulation in roadside environments. Road dust samples were analyzed for chromium (Cr), manganese (Mn), nickel (Ni), lead (Pb), zinc (Zn), cadmium (Cd), cobalt (Co), and copper (Cu) using microwave-assisted digestion followed by atomic absorption spectrophotometry. The mean concentrations of metals followed the order: Cr (32.87mg/kg) > Mn (28.64mg/kg) > Zn (7.78mg/kg) > Ni (4.90mg/kg) > Cu (3.85mg/kg) > Pb (3.30mg/kg) > Co (2.68mg/kg) > Cd (0.40mg/kg). Overall, metal levels were lower than those reported for highly industrialized cities, indicating moderate contamination in the study area. Contamination indices (CF, Igeo, and PLI) suggested generally low pollution, although Cd showed localized enrichment at specific high-traffic sites. Ecological risk assessment indicated low to moderate risk, mainly due to Cd. Human health risk assessment showed that ingestion is the main exposure pathway. Non-carcinogenic risk values (HI < 1) indicated no significant risk for both adults and children. However, carcinogenic risk values for children ranged from 1.59 × 10-4 to 5.63 × 10-4 at some locations, approaching or slightly exceeding recommended limits, mainly due to chromium and nickel. Source analysis indicated that traffic-related activities and resuspension of soil particles are the major contributors to metal accumulation. The findings highlight that, although overall contamination levels in Vadodara are not severe, localized hotspots and potential risks for children require attention. These results provide useful baseline data for urban environmental management and can support future monitoring and pollution control strategies in similar developing cities.

The composite indicator (TyG-CVAI), constructed by combining the triglyceride-glucose index and the Chinese visceral adiposity index, can quantify the combined pathogenic effects of insulin resistance and visceral obesity. However, an in-depth exploration of the long-term longitudinal evolution trajectories, cumulative exposure burden of TyG-CVAI, and its nonlinear association with the risk of cardiovascular disease (CVD) subtypes is still lacking. This study aims to prospectively evaluate the dynamic evolution pattern of TyG-CVAI and its predictive value for incident CVD, stroke, and heart disease. Based on the Kailuan prospective cohort, this study included 32,841 participants without CVD prior to the 2012 baseline. Using data from four repeated measurements between 2006 and 2012, the longitudinal evolution trajectories of TyG-CVAI were identified through the K-means clustering algorithm, and its cumulative exposure burden (cumTyG-CVAI) was calculated. Multivariable Cox proportional hazards regression models were utilized to evaluate its association with incident CVD and its subtypes after 2012, and its dose-response relationship and predictive accuracy were assessed using restricted cubic splines (RCS) and receiver operating characteristic (ROC) curves. During a median follow-up of 6.9 years, a total of 3,212 incident CVD events were recorded. Longitudinal analysis identified three distinct evolutionary trajectories: low, moderate, and high. After fully adjusting for confounding factors, compared with the low trajectory group, the high trajectory group faced the highest risk of incident total CVD (HR 1.837, 95% CI 1.588-2.126), stroke (HR 1.919, 95% CI 1.672-2.203), and heart disease (HR 2.260, 95% CI 1.827-2.796). For each standard deviation (SD) increase in cumulative TyG-CVAI, the risks of the aforementioned outcomes significantly increased by 29.2%-34.1%, respectively. RCS analysis showed that TyG-CVAI was positively and linearly correlated with the risk of stroke, while exhibiting a significant nonlinear threshold effect with the risks of total CVD (cumulative inflection point: 4683.98) and heart disease (cumulative inflection point: 4828.73). ROC analysis confirmed that the cumulative TyG-CVAI (AUC: 0.624-0.655) provided incremental improvements in predictive performance compared with single baseline measurements and traditional single or composite metabolic indices (all P < 0.05). The dynamic elevation of TyG-CVAI and its long-term cumulative burden are independent predictors of incident CVD, stroke, and heart disease. Compared to single baseline assessments and traditional static indicators, cumulative TyG-CVAI demonstrates improved risk stratification value for cardiovascular risk, highlighting the clinical utility of integrating longitudinal metabolic monitoring into routine cardiovascular screening. Furthermore, this index shows a nonlinear threshold effect with heart disease and a linear correlation with stroke, highlighting the clinical value of integrating longitudinal metabolic monitoring into routine cardiovascular stratification to achieve precise prevention.

This study investigated the occurrence, spatial-seasonal distribution, and potential human health risks of organochlorine pesticide (OCP) residues in fish collected from eight locations along the Osun River, southwestern Nigeria. Seventeen OCP congeners, including γ-BHC, DDT and its metabolites (DDE and DDD), dieldrin, and heptachlor epoxide, were analyzed using gas chromatography equipped with an electron capture detector (GC-ECD). Descriptive and inferential statistics were employed, whereas human health risks were assessed using carcinogenic and noncarcinogenic indices. Total OCP concentrations in fish ranged from 0.219 to 2.555 mg/kg, with γ-BHC recording the highest concentration (0.994 mg/kg), exceeding the FAO/WHO permissible limit of 0.2 mg/kg. Hazard Index values exceeded the recommended safety threshold (HI > 1) at Oke Gada (1.315), Tesan (1.273), and Odo Oba (1.133), indicating possible health risks to fish consumers. Principal component analysis identified patterns among OCP congeners that may be consistent with historical pesticide application, environmental transformation processes, sediment-associated contamination, and other potential environmental inputs. Carcinogenic risk values exceeded the acceptable USEPA limit (1 × 10-4) at seven of the eight sampling sites, with the highest value observed at Tesan (1.27 × 10-3). Among the detected compounds, γ-BHC and heptachlor epoxide contributed most significantly to both carcinogenic and noncarcinogenic risks. The findings indicate that OCP contamination was present in fish from the Osun River during the study period and highlight the importance of continued environmental monitoring, effective pesticide management, and sustainable pest control practices to reduce potential exposure risks.

Total concentrations of cadmium (Cd), lead (Pb), and arsenic (As) in commercial rice varieties from Kashan, Iran, were measured via ICP-OES, with bioaccessibility assessed using an in vitro gastrointestinal digestion model. Results indicated that Cd levels (0.051-0.068mg/kg) exceeded the FAO/WHO limit but were close to the Iranian standard. Pb concentrations (0.258-0.62mg/kg) surpassed both national and international limits, while As levels (0.018-0.028mg/kg) remained below permissible thresholds. Bioaccessibility ranged from 29% to 55% for Cd, 38%-43% for Pb, and 42%-61% for As, indicating that only a fraction of the metals is released during digestion. Health risk assessment showed Hazard Quotients (HQ) for individual metals below 1, suggesting no significant non-carcinogenic risk. Lifetime Cancer Risk (LCR) values for Cd and As were within acceptable limits (10⁻⁶ to 10⁻⁴). It is concluded that although total concentrations of Cd and Pb exceed regulatory standards, their low bioaccessibility significantly reduces potential health risks under typical consumption patterns.

This study provides a comprehensive sensitivity analysis of risk measures to copula misspecification in CGMY jump-diffusion models, revealing substantial vulnerabilities in Value-at-Risk (VaR) and Expected Shortfall (ES) calculations. Using Monte Carlo simulation with 10,000 paths per scenario across multiple volatility regimes, jump intensities, and confidence levels, the study demonstrates that mean relative errors exceed 200% for VaR and 146% for ES when averaging across all six copula families including the severely misspecified Gumbel copula. Crucially, well-specified elliptical copulas exhibit bootstrap mean errors of only 1.5–2.3% for VaR and 2.0–2.3% for ES, while the Gumbel copula alone drives errors to 280.6% for VaR and 238.4% for ES in bootstrap-estimated means (corresponding to 1,190% and 839% in the worst individual scenarios), indicating that the aggregate averages are dominated by a single family’s structural failure rather than a pervasive property of the modelling framework. Two-way ANOVA confirms that both copula family (F = 3,614 for VaR; F = 5,192 for ES) and confidence level (F = 66 for VaR; F = 44 for ES) exert highly significant effects (all p &lt; 2×10⁻¹⁰), while Tukey HSD post-hoc tests demonstrate that the Gumbel copula is the sole source of statistically distinguishable pairwise differences all five non-Gumbel copulas are statistically indistinguishable from one another at the 95% family-wise level. Contrary to expectation, low-volatility regimes exhibit the highest sensitivity to copula misspecification, while severe-jump regimes exhibit the lowest.

Fast estimations of direct oral anticoagulant (DOAC) plasma concentrations are useful in ruling out clinically significant concentrations before urgent surgical interventions. DOAC-specific anti-factor Xa (anti-Xa) assays are time consuming and not available 24/7 in most hospitals. Anti-Xa assays calibrated with low-molecular weight heparins (LMWHs) are widely available 24/7 and could give concentration estimations for anti-Xa DOACs (DXaIs). This study aimed to determine whether LMWH-calibrated anti-Xa assays could establish thresholds corresponding to DXaI concentrations associated with non-increased bleedingrisk. Omniplasma was spiked with rivaroxaban, apixaban, or edoxaban in a 5-604 ng/mL range. One pooled patient sample was included per DXaI. Samples were analysed in 18 hospital laboratories, using 5 different analyser-reagent combinations (Stago Liquid anti-Xa on STA-R Max2/3, HemosIL Liquid anti-Xa on ACL-TOP350/550, Innovance Heparin on CS2500/CN3000, Biophen Heparin LRT on CS2500/CS5100, Roche anti-Xa on Cobas t511 analysers). Samples were analysed using local LMWH anti-Xa assay protocols using local reagent lots. Delta optical density and "LMWH" anti-Xa-activity were reported. DXaI concentrations were confirmed using liquid chromatography with tandem mass spectrometry detection. Large differences in DXaI sensitivity between reagent groups were observed, which prevent formulation of universal threshold values for non-increased risk of bleeding. However, reagent-specific threshold values can be established with the exception of the Hyphen reagent group, due to high interlaboratory variability. Within analyser-reagent groups, a good correlation between spiked DXaI concentrations and "LMWH" activity assay readout is observed, permitting conversion between the two units up to 75 ng/mL for all DXaIs. Widely available rapid low-to-moderate DXaI concentration estimation can be achieved using LMWH-calibrated anti-Xa assays. Potential applications include ruling out clinically relevant DXaI concentrations before surgery and screening for the presence of a factor Xa inhibitor, but not specific DXaI monitoring.

Objective: To explore the value of the ratio of CD177 level to CD10 level (hereinafter referred to as CD177/CD10 ratio) in neutrophils in predicting infection risk in burn patients, and to establish its normal reference range. Methods: This study was a cross-sectional study. From February 2023 to November 2025, 61 burn patients who met the inclusion criteria were admitted to Affiliated Suzhou Hospital of Nanjing Medical University, including 52 males and 9 females, aged 41.0 (32.0, 55.0) years. Among them, 59 patients underwent inflammatory marker monitoring during the acute stress period on post injury day 1, and 48 patients underwent inflammatory marker monitoring during the high-risk period for infection (hereinafter referred to as high-risk period monitoring) from post injury day 3 to 14. During the same period, 204 healthy volunteers who underwent physical examinations in the physical examination center of the same unit with normal examination results were recruited, including 110 males and 94 females, aged 47.5 (31.0, 67.0) years. Flow cytometry was used to monitor the levels of CD177 and CD10 in the neutrophils from patients on post injury day 1, 3, 5, 7, 10, and 14, as well as from healthy volunteers. According to whether infection occurred, the patients who underwent high-risk period monitoring were divided into infection group (n=31) and non-infection group (n=17). General information such as total burn area at admission, as well as inflammatory markers such as the white blood cell count, neutrophil count, neutrophil, C-reactive protein level, procalcitonin level, CD177 level, CD10 level, and CD177/CD10 ratio, and sequential organ failure assessment (SOFA) scores were compared between the two groups of patients to screen for risk factors affecting the occurrence of infection in patients undergoing high-risk period monitoring. For patients in infection group, the most recent detection data before the confirmed infection was taken for analysis, and for patients in non-infection group, the highest values detected from post injury day 3 to 14 were taken for analysis (the same data selection below). The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the aforementioned inflammatory markers and SOFA score for the infection risk in patients undergoing high-risk period monitoring. The correlation between CD177 level and CD10 level in patients undergoing high-risk period monitoring was analyzed. The CD177 level, CD10 level, and CD177/CD10 ratio were compared among healthy volunteers, patients during the acute stress period and high-risk period for infection. Based on the data of healthy volunteers, the normal reference range for the CD177/CD10 ratio was established using the non-parametric percentile method. Results: There were statistically significant differences between patients in infection group and non-infection group in terms of total burn area, C-reactive protein level, SOFA score, CD177 level, CD10 level, and CD177/CD10 ratio (with Z values of -2.08, -2.58, 0.04, -2.72, -2.86, and -3.20, respectively, P<0.05). The results of univariate logistic regression analysis showed that both total burn area and the lg (CD177/CD10 ratio) were risk factors for infection in patients undergoing high-risk period monitoring (with ORs of 1.03 and 6.91, respectively, 95%CIs of 1.00 to 1.06 and 1.84 to 25.91, respectively, P<0.05). The results of multivariate logistic regression analysis showed that the lg (CD177/CD10 ratio) was an independent risk factor for infection in patients undergoing high-risk period monitoring (OR=5.73, with a 95%CI of 1.11 to 29.60, P<0.05). ROC curve analysis showed that the CD177/CD10 ratio had the largest area under the curve for predicting the infection risk in patients undergoing high-risk period monitoring, which was 0.78 (with a 95%CI of 0.65 to 0.91). Its optimal cut-off value was 3.84, with the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value at the optimal cut-off value being 58.06%, 94.12%, 76.09%, 94.74%, and 55.17%, respectively. In patients undergoing high-risk period monitoring, the CD177 level was significantly negatively correlated with the CD10 level (r=-0.60, P<0.05). Compared with those of healthy volunteers and patients in the acute stress period, the CD10 level of patients in the high-risk period for infection was significantly decreased (with P values both <0.05), while the CD177 level and the CD177/CD10 ratio were significantly increased (P<0.05). The established normal reference range for the CD177/CD10 ratio was 0-0.64. Conclusions: The CD177/CD10 ratio in neutrophils has a certain predictive value for the infection risk in burn patients, and its predictive value is higher than that of white blood cell count, neutrophil count, neutrophil, C-reactive protein level, procalcitonin level, and SOFA score. The established normal reference range for the CD177/CD10 ratio is 0-0.64.

Brain arteriovenous malformations (AVMs) are the leading cause of spontaneous intracranial hemorrhage in children. The recently developed VALE scoring system has demonstrated predictive value for hemorrhage risk in adult AVM patients; however, its applicability to pediatric populations remains unknown. We performed a retrospective analysis of a prospectively maintained vascular database at University Hospital Frankfurt. Pediatric patients (≤ 18years) diagnosed with a single brain AVM between 2005 and 2023 were included. VALE scores were calculated according to the original model using ventricular system involvement, associated venous aneurysms, deep location, and exclusively deep venous drainage. Logistic regression analyses were performed to evaluate associations with hemorrhagic presentation. Discriminatory performance was assessed using receiver operating characteristic (ROC) analysis. A total of 52 pediatric AVM patients were included, of whom 31 (60%) presented with hemorrhage. Associated venous aneurysms were observed in 29% of ruptured AVMs compared with 5% of unruptured lesions and represented the only VALE component that remained significant in multivariable analysis. The complete VALE score demonstrated limited discriminatory performance, yielding an area under the ROC curve (AUC) of 0.608 (95% CI 0.454-0.762). Classification into VALE-defined risk categories showed similarly limited predictive ability (AUC 0.545, 95% CI 0.390-0.700), with no significant increase in hemorrhage risk across risk groups. This study represents the first external validation of the VALE scoring system in a pediatric AVM cohort. In our population, the VALE score demonstrated limited discriminatory performance and could not be conclusively validated. While associated venous aneurysms remained associated with hemorrhagic presentation, larger multicenter studies are required to further evaluate the applicability of the VALE score in pediatric patients and to determine whether pediatric-specific hemorrhage risk prediction models may be beneficial.

This study aimed to determine the concentrations of heavy metals and assess the health risk associated with their exposure through the consumption of Edible Leafy Vegetables (ELVs) distributed in Rafsanjan, the southeast area of Iran. In this study, samples of commonly consumed ELVs, including Coriander, Parsley, Persian Leek, Radish, Basil, and Lettuce, were collected over four seasons in 2024. Inductively coupled plasma mass spectrometry (ICP-MS) was used to quantify the concentration of heavy metals lead (Pb), mercury (Hg), arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni), copper (Cu), aluminum (Al), iron (Fe), manganese (Mn), and zinc (Zn). The concentration of toxic heavy metals was observed for As in Leek during the summer (16.33 ± 1.21mg/kg), Cr in Lettuce during the winter (13.21 ± 1.16mg/kg), and Pb in Radish during the summer (6.10 ± 1.33mg/kg). The overall order of toxic heavy metal concentrations in the samples was As ˃ Cr ˃ Pb ˃ Ni ˃ Cd, and the most contaminated ELVs were ranked Leek ˃ Lettuce ˃ Radish ˃ Parsley ˃ Basil ˃ Coriander. The highest hazard quotient (HQ) value was recorded for As in Leek (4.8733 in children, 4.6993 in adults), AS Lettuce (1.3689 in children, 1.2571 in adults), and Cr in Lettuce (1.6139 in children, 1.4821 in adults). The highest hazard index (HI) values were observed for Leek, followed by Lettuce and Basil. In addition, the highest carcinogenic risk (CR) values were associated with Cr in Lettuce, As in Leek, and Cr in Basil, respectively. Therefore, continuous monitoring of heavy metals, particularly As and Cr in ELVs, is recommended to identify and mitigate contamination sources.

Diabetic patients often experience prolonged hyperglycemia, which leads to sustained harm and malfunction of various body organs. The blood urea nitrogen (BUN) to serum albumin ratio (BAR) and systemic inflammation response index (SIRI) have been proven to be reliable indicators. We aimed to investigate the association of BAR, SIRI and their combination with the risk of diabetic macrovascular diseases. A total of 2,911 participants from Nanfang Hospital diagnosed with type 2 diabetes mellitus (T2DM) were included. Restricted cubic spline (RCS) and logistic regression modelling were used to assess the relation between different values of BAR, SIRI and combined BAR-SIRI and the risk of diabetic macrovascular complications. Receiver operating curve (ROC) analysis was used to compare the predictive value of BAR, SIRI, and their combination for macrovascular outcomes. High value of BAR, SIRI and their combination were associated with increased risk of macrovascular complications (BAR: odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.18-1.78; SIRI: OR(95% CI) = 1.25(1.03,1.52); BAR-SIRI: OR(95%CI) = 1.51(1.21,1.88); all p < 0.05). ROC curve analysis demonstrated that combined BAR-SIRI has the best predictive value for risk of macrovascular outcomes (area under the ROC curve [AUC]: BAR-SIRI: 0.678 > SIRI: 0.674 > BAR: 0.673). BAR, SIRI and their combination exhibit a notable positive correlation with the risk of diabetic macrovascular disease and may be independent predictors of macrovascular complications. ClinicalTrials.gov, TRN: NCT06651983, Registration date: 19 May 2025.

ABSTRACT This study investigated the distribution, sources, and ecological risk of PAHs along the New Damietta and Elrekabia drainage canals in northern Egypt. The isomer ratios indicated that the most abundant sources along the study area were from pyrogenic sources possibly due to anthropogenic activities along the drainage canals as fossil fuel combustion and traffic activities. The risk quotient (RQ) of wastewater to both New Damietta and Elrekabia drainage canals indicated that all detected PAHs exceeded the guideline thresholds, resulting in extremely high ecological risk levels, with Elrekabia drain exhibiting consistently higher risk values than New Damietta drain. Statistically, the difference in source type contribute to variability in PAHs as the industrial activities tend to release heavy PAHs, while agricultural and domestic sources release light and or mixed contaminants. The dendrogram analyses reflect overlapping or similar mixed pollution inputs among the two drains. In both areas, the most contributors to carcinogenic effects in wastewater were benzo[a]pyrene in addition to benzo[b]fluoranthene in sediment extract. The last PAHs individual was also the most mutagenic contributor. The obtained RQ values were several orders of magnitude higher than unity, indicating extremely high ecological risk rather than conventional high-risk classification.

To address the environmental evolution and management needs of emerging contaminants in the Yellow River Basin (Henan Section), China, nine typical functional cross-sections, covering industrial outfalls, sewage treatment plant (STP) effluents, human activity-dense areas, and baseline tributaries, were selected to systematically investigate the occurrence, potential sources, and multi-dimensional risks of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) in surface water. The results indicated a 100% detection rate of the target pollutants across all sites, with PFOA (0.45-7.46 ng/L) being the absolute dominant analogue. The spatial distribution exhibited an evident industrial point-source-driven pattern, where the pollution loads at the Jili District industrial outfall (S7) and STP effluent (S5) were significantly higher than those in non-point sources and natural baseline waters. Source apportionment suggested that direct wastewater discharge and secondary release from regional industrial clusters were likely key contributors to PFAS spatial heterogeneity. Multi-dimensional risk assessments revealed that the current ecological risk quotients (RQ < 0.01) for aquatic organisms and the human health risk values (HR < 0.1) via drinking water ingestion for various age groups were well within safe and controllable ranges. However, PFOS contributed significantly more to the ecological risk than PFOA, and children exhibited slightly higher health exposure vulnerability than adults. Although the overall risk is minimal, PFOA concentrations at high-load cross-sections have exceeded the latest stringent maximum contaminant level (4.0 ng/L) mandated by the US EPA in 2024. This study suggests an urgent need to establish a dynamic, life-cycle monitoring network for PFASs in the basin and to prioritize targeted deep-reduction strategies for high-risk industrial point sources.

Persistent endothelial dysfunction and coagulation abnormalities are increasingly recognized as central components of post-COVID syndrome. However, substantial interindividual variability in long-term coagulation biomarkers suggests the presence of genetically determined susceptibility factors capable of modulating post-infectious thromboinflammatory responses.To determine whether common prothrombotic genetic variants modify long-term D-dimer and INR levels after COVID-19 and to assess their value for precision risk stratification.A controlled observational cohort study included 504 adults aged 18-50 years examined more than two years after PCR-confirmed COVID-19 and 270 control individuals without clinically significant SARS-CoV-2 infection. Genotyping of F2 c.20210G > A, F5 c.1691G > A (Factor V Leiden), and MTHFR c.C677T was performed using real-time PCR. D-dimer and international normalized ratio (INR) were measured monthly for 12 months and averaged. Log-transformed D-dimer was analyzed using multivariable linear regression with interaction terms.All three variants were independent predictors of D-dimer. In adjusted models, F2 GA (+ 31%), F5 GA (+ 37%), MTHFR CT (+ 34%), and MTHFR TT (+ 67%) were associated with higher D-dimer levels (all p < 0.001). Significant amplification of genetic effects was observed in post-COVID individuals (Group × Genotype interaction p < 0.01). INR showed no genotype association.COVID-19 acts as a long-term modifier of inherited thrombophilia phenotypes. Incorporating genetic profiling into post-COVID evaluation may enable precision identification of individuals at risk for persistent hypercoagulability.

Monte Carlo-simulation risk assessment of oral exposure to bisphenols and phthalates via consumption of carbonated drinks from Iranian market.

Assessment of the impact of coal mining activities on surface water quality: A case study of Mokolo River in the Waterberg region, South Africa.

Taking the paddy fields in a high geological background area of Guizhou Province as the research object， the total and available contents of eight heavy metals （Hg， Cd， As， Pb， Cr， Ni， Cu， and Zn） in the soil and rice grains， as well as the physicochemical properties （pH， EC）， were analyzed. Multiple evaluation methods were employed， including the single factor pollution index， Nemerow comprehensive pollution index， integrated soil and agricultural product quality index （IICQ）， and human health risk models. Species sensitivity distribution （SSD） curves and multiple linear regression were utilized to determine safe thresholds for heavy metals in the soil-rice system. The results revealed significant exceedances of Hg （48%）， Cd （30%）， and As （53%） in the soil relative to the Chinese Soil Environmental Quality Standard （GB 15618-2018）， while rice grains exhibited elevated Hg （86.29%）， As （50.25%）， Cd （6.09%）， Pb （5.08%）， and Cr （9.14%） levels exceeding the National Food Safety Standard （GB 2762-2017）. The Nemerow index identified Hg， Cd， and As as primary soil pollutants， with Hg posing the most severe grain contamination. IICQ evaluation indicated predominantly severe soil pollution but only mild-to-moderate grain contamination. Health risk assessment identified oral ingestion as the primary exposure pathway contributing to both non-carcinogenic and carcinogenic risks. Through the fitting of SSD and multiple linear regression models， the safety thresholds of Hg， As， Pb， and Cr in the soil of the study area were all lower than the current national screening values for soil pollution risks in agricultural land， while the safety threshold of soil Cd was higher than the screening value. The research results can provide a reference for the prevention and control of heavy metal pollution risks in paddy fields in high background areas.

Despite advances in intensive care, sepsis and septic shock still have high morbidity and mortality. Microcirculatory disturbance is a key issue in sepsis, leading to hypoperfusion, hypoxia, and organ failure. The skin is a sensitive indicator of microcirculatory changes and often shows early systemic changes. Recently, bedside skin perfusion indicators such as the Mottling score (MS), Capillary Refill Time (CRT), and Peripheral Perfusion Index (PPI) have become common in practice. However, their value in predicting outcomes lacks strong evidence. A systematic search was conducted across databases, including PubMed, Web of Science, Cochrane Library, EBSCO, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP, with a search period spanning from the inception of the databases to January 2026. Cohort studies or case-control studies investigating the correlation between skin perfusion parameters and the prognosis of sepsis patients (primary outcomes: 28-day mortality, 14-day mortality, and in-hospital mortality) were included. Two researchers independently performed literature screening, data extraction, and assessment of the Newcastle-Ottawa Scale (NOS) bias risk. A meta-analysis was performed using RevMan 5.4.1 software. This study included a total of 22 articles, encompassing 2,727 study subjects. The meta-analysis results demonstrated that: (1) Mottling Score (MS), was significantly associated with 28-day mortality (Odds Ratio OR=2.27, 95% Confidence Interval CI: 1.79, 2.87, P<0.001) and 14-day mortality (OR=1.96, 95% CI: 1.32, 2.91, P<0.001); (2) Prolonged Capillary Refill Time (CRT) duration was significantly associated with 28-day mortality (OR=3.29, 95% CI: 2.08, 5.21, P<0.001) and in-hospital mortality (OR=2.46, 95% CI: 1.18, 5.12, P<0.001); (3) Reduced Peripheral Perfusion Index (PPI) was significantly associated with 28-day mortality (OR=5.05, 95% CI: 3.65, 6.98, P<0.001) and in-hospital mortality (OR=4.56, 95% CI: 3.32, 6.26, P<0.001). Sensitivity analysis confirmed robust results with no significant publication bias. The MS, CRT, and PPI, as bedside and non-invasive skin perfusion parameters, demonstrate significant predictive value for mortality risk in sepsis patients. Integrating these indicators facilitates early clinical identification of high-risk patients, guiding risk stratification and resuscitation therapy. Future large-sample prospective studies are required to further standardize their assessment protocols and intervention thresholds.

ObjectiveTo investigate the predictive value of serum prealbumin and ferritin combined with the Positive and Negative Syndrome Scale score for concurrent nutritional risk in hospitalized patients with schizophrenia.MethodsThis retrospective study enrolled 90 hospitalized patients with schizophrenia from the Department of Psychiatry in a psychiatric hospital between May 2023 and March 2024. Nutritional risk was screened and categorized using the Malnutrition Universal Screening Tool. Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale. General demographic data and serum biochemical indicators were collected. Univariate analysis and binary logistic regression analysis were used to identify independent associated factors for nutritional risk. The predictive efficacy of the combination of prealbumin, ferritin, and Positive and Negative Syndrome Scale total score for nutritional risk was evaluated using receiver operating characteristic curve analysis.ResultsAmong the 90 patients, 66 (73.3%) had no nutritional risk (Malnutrition Universal Screening Tool = 0), and 24 (26.7%) had nutritional risk (Malnutrition Universal Screening Tool ≥ 1). Binary logistic regression analysis identified the Positive and Negative Syndrome Scale total score (odds ratio = 1.156, 95% confidence interval: 1.046–1.278), prealbumin (odds ratio = 0.902, 95% confidence interval: 0.866–0.958), and ferritin (odds ratio = 0.890, 95% confidence interval: 0.802–0.981) as independent associated factors for nutritional risk in patients with schizophrenia (p < 0.05). Receiver operating characteristic curve analysis showed that the combined model of prealbumin, ferritin, and Positive and Negative Syndrome Scale total score had an area under the curve of 0.831 (95% confidence interval: 0.730–0.931) for predicting nutritional risk. At the optimal cutoff value of ≥0.311, the sensitivity was 0.750 and the specificity was 0.803.ConclusionHospitalized patients with schizophrenia have a high prevalence of nutritional risk. The combination of serum prealbumin, ferritin, and Positive and Negative Syndrome Scale total score demonstrates good predictive value for concurrent nutritional risk and shows promise as an effective indicator for the early identification of nutritional risk in this patient population in clinical settings.

Objective To characterise proteomic changes associated with depression risk across different follow-up periods and develop predictive models integrating protein and clinical features. Methods Olink proteomic data from the UK Biobank were analysed using logistic regression and Cox proportional hazards models to identify depression-associated proteins. Time-specific analyses were performed within 1-, 5-, and 10-year follow-up windows. Depression was defined using ICD-10 codes. GO and KEGG enrichment analyses were conducted, and predictive proteins were selected using sequential forward selection prior to XGBoost modelling. Results Among 52,121 participants, 2,442 developed depression. Distinct plasma protein signatures were identified across followup windows. Within 1 year, BRK1, MME, LRPAP1, and LRP1 were significantly associated with depression. Within 5 years, MMP12, SPP1, and SPON2 were among 287 unique associated proteins, while TGM2, OMG, and UBAC1 were representative markers among 509 proteins identified within 10 years. LEP was consistently selected across all time windows and in the overall population. The combined protein–clinical XGBoost model achieved the best performance within the 1-year follow-up window (AUC = 0.808, 95% CI: 0.696–0.911), outperforming protein-only and clinical-only models. Conclusion Circulating plasma proteins have predictive value for depression risk, with LEP emerging as a robust biomarker across multiple time horizons.