Abstract: Malnutrition is a disease leading to unfavourable changes. It affects 35-55% of hospitalized patients, and in the case of cancer even 40-90% of patients. Screening nutritional status allows for prevention of malnutrition, which will be an element as important as its treatment. Malnutrition in patients after severe injuries significantly increases catabolic changes. Cytokines and hormones such as epinephrine and cortisol are released, which among other things can increase energy expenditure by 50%. The effect of a properly conducted nutritional treatment is the maintenance or improvement of the nutritional status in patients whose nutrition with a natural diet is insufficient, as well as, in some cases, treatment of the underlying disease. Immunonutrition is characteristic for patients with neurological disorders or cancer. It is a regimen based on the supply of selected ingredients that have the ability to affect immunological and anti-inflammatory pathways. such substances are omega - 3 fatty acids, glutamine, arginine, nucleotides, antioxidants and prebiotic fiber.

Abstract: The global climate crisis impacts health in numerous ways, and Public Health Inspectors (PHIs) are also addressing these issues at work. Their responsibilities have evolved in response to this pressing crisis. This study examines the effects of PHIs in classifying and assessing environmental psychosocial, organizational risks and workplace hazards exacerbated by the global climate crisis at the workplace. It highlights PHIs' challenges in adapting to changing environmental conditions and the implications for Public Health. An α mixed-methods approach was utilized, combining Quantitative Reviews, and Secondary Data Analysis in the Development model of occupational risk, and environmental health incidents reported over the past decade, by public health inspectors. PHIs. The methodology is approached from a variety of sources, including PubMed, Medline, EMBASE, CINAHL, Web of Science, ScienceDirect, alongside databases and resources provided by WHO, OSHA. By categorizing environmental risks and workplace hazards PHIs identify and classify these risks, prioritize their efforts, and develop targeted strategies for prevention and mitigation. Findings underscore the necessity for enhanced education, training and resources to effectively address the evolving landscape of environmental health risks, to handle climate-related challenges and continuous education. Public Health services and organizations must enforce regulations for sustainable practices, leading to new workplace dynamics.

Abstract: Toxic metal exposure is a pervasive global health concern, with significant implications for human health. Toxic metals such as lead, mercury, arsenic, and cadmium are widely distributed in the environment due to natural processes and human activities. Industrial emissions, mining, smelting, and agricultural practices contribute to environmental contamination, while consumer products, food, water, and air serve as common exposure pathways for humans. Exposure to toxic metals can occur through inhalation, ingestion, and dermal contact. Inhalation is a significant route for metals like lead and cadmium, primarily through occupational settings and environmental pollution. Ingestion of contaminated food, water, and beverages is a primary route for mercury and arsenic exposure, while dermal contact with contaminated soil, water, or consumer products can also contribute to exposure. Toxic metals exert their adverse effects through various mechanisms, including oxidative stress, disruption of cellular function, and interference with enzymatic processes. These metals can enter cells and tissues, where they bind to biomolecules such as proteins and DNA, leading to cellular damage, inflammation, and apoptosis. The health effects of toxic metal exposure are diverse and can affect multiple organ systems. Neurological effects, including neurodevelopmental deficits in children and cognitive impairment in adults, are well-documented for metals such as lead and mercury. Cardiovascular effects, such as hypertension and increased risk of cardiovascular disease, are associated with cadmium exposure. Renal toxicity, manifested as kidney damage and renal dysfunction, is a common consequence of exposure to metals like cadmium and lead. Additionally, certain toxic metals, including arsenic and cadmium, are classified as carcinogens and have been linked to various cancers, including lung, bladder, and liver cancer. Prevention of toxic metal exposure requires a multi-faceted approach, including regulatory measures, environmental monitoring, and public education. Regulation of industrial emissions, implementation of pollution control measures, and promotion of safer alternatives are essential for reducing environmental contamination. Monitoring programs for environmental and human biomarkers of exposure are critical for assessing exposure levels and identifying at-risk populations. Efforts to mitigate these risks require collaborative action at the local, national, and global levels to implement effective preventive measures and safeguard public health. This comprehensive overview will provide valuable insights into the complex interplay between toxic metal exposure and human health, highlighting the importance of proactive measures to address this global health challenge.

Abstract: Abstract Significance: This survey represents the most comprehensive analysis conducted to date on COVID-19 vaccination attitudes. The findings will contribute to public education, inform CDC policies, and help overcome vaccine hesitancy across diverse demographic groups. Background: This research focuses on comparing attitudes toward mandatory COVID-19 vaccination, pediatric vaccination, pregnancy vaccination, and self-vaccination status across professional groups, including physicians, nurses, allied healthcare providers, and non-healthcare workers. Factors such as race, gender, age, time zone, religious beliefs, parental status, and long COVID disease were also analyzed. A Survey analysis of 48 studies provided additional context, and findings from May 2023 to August 2024 highlighted the progress in vaccination rates. Methods: A cross-sectional survey (n = 24,794) was conducted between May 2021 and July 2023, focusing on mandatory vaccination for adults, children, and pregnant women. The survey results were compared with Review of Surveys of 48 studies. Logistic regression and chi-square tests were used for statistical analysis, with P-values < 0.05 indicating significance. Results: Physicians exhibited the highest support for mandatory vaccination (85%), while non-healthcare workers showed the lowest support (50%) (p < 0.001) [1,2]. Significant differences were observed in attitudes based on race, gender, religious beliefs, and parental status (p < 0.001). The corroborated these findings, revealing consistent disparities across these demographic variables. From May 2023 to August 2024, notable improvements in vaccination rates, especially among non-healthcare workers and racial minorities, were observed [3,4]. Conclusions: While healthcare professionals show higher vaccination rates and support for mandatory policies, non-healthcare workers and minority groups require targeted interventions to overcome vaccine hesitancy. Future efforts should focus on maintaining vaccination momentum, addressing misinformation, and improving access.

Abstract: Detecting interactions is a critical aspect of medical research. When interactions are present, it is essential to calculate confidence intervals for both the main effect and the interaction effect. This requires determining the covariance between the two effects. In a two-stage individual patient data (IPD) meta-analysis, the coefficients, as well as their variances and covariances, can be calculated for each study. These coefficients can then be combined into an overall estimate using either a fixed-effect or random-effect meta-analysis model. The overall variance of the combined coefficient is typically derived using the inverse-variance method.However, to the best of our knowledge, no existing studies have addressed how to calculate the overall covariance between the main effect and the interaction effect in the context of meta-analysis. In this paper, we propose a straightforward and transparent method for calculating this covariance when interactions are considered in a meta-analysis. To facilitate implementation, we have developed an R package, covmeta, which is available at https://github.com/enwuliu/covmeta.

Abstract: The human microbiome, a complex ecosystem of microorganisms residing in and on the body, plays a pivotal role in regulating a wide range of physiological processes, including digestion, immune responses, and metabolic functions. In recent years, the rapidly growing field of microbiome-driven therapeutics has garnered significant attention for its potential to revolutionize healthcare. This review explores the evolving landscape of microbiome-based therapies, with a particular focus on the gut microbiome and its implications for both gut health and precision medicine. We highlight recent advances in understanding how microbial communities influence disease pathogenesis and treatment outcomes, spanning conditions such as inflammatory bowel disease (IBD), metabolic disorders, neurological diseases, and even cancer. This article also discusses emerging therapeutic strategies, including probiotics, prebiotics, fecal microbiota transplantation (FMT), and microbial-based drugs, as well as the challenges associated with their clinical implementation. Additionally, we examined how the integration of microbiome profiling and metagenomic data is advancing the field of precision medicine, paving the way for more personalized and effective treatments. This review serves as a comprehensive resource that synthesizes current knowledge, identifies key gaps in microbiome research, and offers insights into the future direction of microbiome-driven therapeutics, thus providing a valuable framework for clinicians, researchers, and policymakers seeking to harness the potential of the microbiome to advance personalized healthcare solutions.

Abstract: Thallium poisoning, which may be accidental or criminal, presents with a nonspecific clinical picture but is rapidly progressive. Delay in diagnosis may cause the appearance of serious, often irreversible, and sometimes fatal lesions. Prompt treatment with Prussian Blue before toxicological confirmation results in immediate improvement in cases of intoxication, without appreciable side effects, and is therefore recommended as an "ex juvantibus" strategy in cases of suspected thallium poisoning. A successfully treated case of poisoning is presented as an example of this strategy. An analysis of the contaminated well water the patient had unknowingly drunk subsequently showed pollution over 75 times higher than the potable limit, and plasma levels revealed values 267 times higher than the normal range. All the test results were received when the patient undergoing treatment had improved so much that she had been discharged from hospital. To complete the study, we conducted a scoping review to understand the extent and type of evidence in relation to latency in diagnosis of intoxication and health effects. The review of 27 articles covering 101 cases of thallotoxicosis confirmed that early treatment with Prussian Blue offers the best chance of achieving complete recovery.

Abstract: Introduction: Nonalcoholic fatty liver disease (NAFLD) is a clinical pathological syndrome characterized by steatosis and fat accumulation in liver parenchymal cells without a history of excessive alcohol drinking in a patient. Currently, there is no definitive treatment for NAFLD, and its prevalence increases with age, obesity, and after menopause. Among the ways to treat it, we can mention regular sports exercises and the use of natural supplements. Therefore, the aim of this research is to investigate and compare the effect of aerobic-resistance training with royal jelly supplementation on changes in paraoxonase 1, oxidized LDL, liver function and lipid profile in postmenopausal women with non-alcoholic fatty liver disease. Methods: This semi-experimental study on 23 women with non-alcoholic fatty liver disease with average weight (71.34 ± 11.63 kg), age (48.54 ± 3.88 years), body mass index (27.63 ± 4.20 kg/m2) who were randomly Two groups of exercise+supplement (n=12) and exercise+placebo (n=11) were divided; done Both groups performed 8-station resistance exercises (8-12 repetitions in 2-4 sets) for 8 weeks, 3 sessions per week (for 35-40 minutes, from 10-15 RPE) and then From 10-15 minutes of active rest, they performed aerobic exercises with an intensity of 40-85% of the target heart rate, in two-minute intervals with 45 seconds of active rest. Royal jelly supplement (500 mg on training days, before each training session) was consumed. Blood sampling was done before and 48 hours after the last training session. Statistical analysis was performed using variance test with repeated measures (two groups x two stages of pre-test-post-test) in SPSS software with a significance level of p

Abstract: Background: Multiple studies have found an association between ambient air quality, noise pollution, green spaces, and health. The underlying mechanisms of this association remain partly unknown. In this study, we focus on subjective perception as a potential underlying factor. Methods: The data consisted of a linkage between the 2001 census, register mortality data from the 1st of October 2001 to the 31st of December 2016 and objective indicators of the residential living environment (air and noise pollution and green spaces). We used Cox regression to investigate the impact of objective and subjective indicators of the living environment and their potential interaction effect on all-cause mortality in the Brussels Capital Region. Results: A negative subjective perception of the residential living environment is associated with a higher mortality hazard, even when controlling for socio-demographic parameters. Similarly, also objective indicators of air pollutants and green spaces are related to mortality. When studying the interaction effect, the beneficial effect of a neutral subjective perception stands out. Subjectively satisfied individuals living in the worst objective conditions showed the highest mortality hazard. Noise pollution was the only exception, characterised by a lack of an interaction effect. Conclusion: This study showed that besides objective indicators, subjective perception of the residential environment also matters and that both interact in influencing life chances. Subjective indicators not only have a genuine independent impact, they also act as an underlying factor in the relationship between objective residential environment and health.

Abstract: Background: The relationship between hemoglobin and serum iron levels and mortality risk in patients with coronary artery disease (CAD) is not well understood. Methods: We analyzed data from 3,224 patients with CAD using Cox proportional hazards regression models to assess the association of hemoglobin and serum iron levels with cardiovascular and all-cause mortality. Results: Over a median follow-up period of 8.9 years, 636 patients died, including 403 from cardiovascular causes. Higher hemoglobin and serum iron levels were linked to a reduced risk of cardiovascular and all-cause mortality. Patients in the highest quartiles of hemoglobin and serum iron levels had multivariable-adjusted hazard ratios (HRs) of 0.62 (95% CI, 0.46–0.85) and 0.51 (95% CI, 0.37–0.69) for cardiovascular mortality, and 0.64 (95% CI, 0.50–0.83) and 0.67 (95% CI, 0.53–0.85) for all-cause mortality, compared to those in the lowest quartile. A one-standard deviation increase in hemoglobin and serum iron levels corresponded to a 19% and 24% reduction in cardiovascular mortality risk and a 19% reduction in all-cause mortality risk for both factors. Restricted cubic spline analysis revealed L-shaped and U-shaped associations between hemoglobin and serum iron levels and cardiovascular and all-cause mortality, respectively. These associations were consistent across various age groups, sex, and CAD types. Conclusions: Hemoglobin and serum iron levels are significantly associated with lower risks of cardiovascular and all-cause mortality in patients with CAD. Further research is needed to evaluate the effects of iron supplementation in these patients.