Concerns exist regarding the potential carcinogenic effect of N-nitrosodimethylamine (NDMA) as a contaminant of the antihypertensive medication, valsartan. This study evaluated the association of NDMA-contaminated valsartan with cancer incidence. Nationwide longitudinal observational cohort of 3,231,212 participants from the National Health Insurance Service of South Korea consisted and was followed up more than 7 years. We performed 1:1:1 pairwise propensity score matching (PSM) of NDMA-uncontaminated, NDMA-contaminated, and initially-suspended-but-finally confirmed as NDMA-uncontaminated valsartan user-groups. The primary outcome was any primary cancer incidence. The secondary outcome was the incidences of 12 organ-specific cancers. The risks of all-cause and cardiovascular deaths were estimated before and after the withdrawal of valsartan. Among participants (59.5 ± 13.1 yr; male, 53.5%), valsartan new users had adjusted hazard ratios and 95% confidence intervals of 1.069 (1.054-1.085) and 1.172 (1.128-1.216) for any cancer in the NDMA-exposed period (versus NDMA-unexposed) before and after PSM, respectively. Regardless of PSM, prostate cancer risk increased significantly. All-cause and cardiovascular mortality did not differ significantly with NDMA exposure before and after emergent banning. Use of valsartan products contaminated with NDMA was associated with a modestly increased risk of overall cancer compared with uncontaminated products, a finding that requires confirmation in further studies.
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Accumulation of insoluble extracellular amyloid-β (Aβ) plaques and intraneuronal fibrillary hyperphosphorylated tau fibrils in the brain are widely believed to contribute to the progressive neurodegeneration and neuronal loss characteristic of the Alzheimer's disease and the associated dementia. Anti-amyloid immunotherapies that reduce cerebral Aβ burden in affected individuals have been approved based on biological outcomes from clinical trials. However, the extent to which Aβ clearance translates into improved meaningful clinical, cognitive, and functional benefit versus risk and cost is unclear based on available data. Here, the critical barriers that limit the impact of anti-amyloid immunotherapies, including aducanumab, lecanemab, and donanemab, are discussed. Treatment slows cognitive decline by ∼20-30% in certain patient subsets, but absolute improvements in cognitive and functional outcomes remain modest. Independent analyses of how treatment impacts health span suggests statistically significant trial results may not translate into significant real-world benefit. Response is most significant in cases of early-stage disease where levels of copathology tau are low. Edema and brain hemorrhage occur frequently, particularly in carriers of APOE-e4 alleles, an established genetic risk factor for Alzheimer's disease, raising safety concerns which led to some regulators banning treatment in this patient group. Strict clinical trial eligibility criteria, high treatment costs relative to patient benefit, intensive during-treatment monitoring, and the absence of population-level screening programs further limit treatment accessibility and generalizability. Emerging evidence of accelerated brain atrophy and immunotherapy tolerance further complicates benefit-risk consultation. Sustaining drug- discovery pipelines by exploring combination therapies, tau-targeted approaches, drug repositioning, and novel small molecules through will be essential to provide comprehensive treatment options and personalized treatment plans for affected patients.
Cosmetics are defined by the U.S. Food and Drug Administration (FDA) as "articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body…for cleansing, beautifying, promoting attractiveness, or altering the appearance". However, the safety of cosmetic ingredients is the responsibility of the manufacturer and exposure to some of these chemicals can result in unintentional harmful effects in humans. Thus, some states are banning specific chemicals, at the state legislation level, from being used in cosmetics, which includes known endocrine disruptors such as dibutyl phthalate, diethylhexyl phthalate, and per- and polyfluoroalkyl substances (PFAS). In this study, we aim to determine the toxicity pathways significantly affected by the cosmetic ingredients (both banned and non-banned), compared to the non-cosmetics compounds in the Tox21 10K library. The Tox21 10K compound library (which includes 113 banned, 927 non-banned cosmetic ingredients and 8,185 non-cosmetic compounds) was previously screened against a panel of ~ 90 cell-based and biochemical assays. The hit rates (i.e., the percentage of compounds active in an assay) of the cosmetic and non-cosmetic compounds, as well as banned and non-banned compounds, in each Tox21 assay were compared using a Fisher's exact test, and a p-value < 0.05 was considered statistically significant. We found that the evaluated cosmetic compounds were significantly more active in 11 antagonist mode assays and 23 agonist mode assays compared to the non-cosmetic compounds. The banned compounds were significantly more active in 7 antagonist mode and 6 agonist mode assays compared to the non-banned compounds. The targets of the antagonist assays included enzymes such as CYP2C19 and aromatase (CYP19A1), and the agonist assays included the Keap1/Nrf2 antioxidant response element pathway. In the present study, we compared the bioactivity profiles of cosmetic ingredients and non-cosmetic compounds (not used in cosmetics), as well as the banned and non-banned cosmetic ingredients, across the Tox21 assays. The analyses revealed distinct molecular pathways for these chemicals which furthers our mechanistic understanding of cosmetics ingredient toxicity and may help direct the selection of cosmetic ingredients in the future with potentially less bioactivity. Not applicable.
Hexahydrocannabinol (HHC) is a semi-synthetic cannabinoid that recently emerged as a legal alternative to Δ9-tetrahydrocannabinol. Due to emerging concerns regarding its neuropsychiatric safety profile, including psychosis, it was banned in July 2025. We report two cases of HHC-induced psychosis in adolescents requiring inpatient psychiatric admission, both with no prior psychiatric history. Both individuals required about six weeks of inpatient treatment, with their symptoms resolving following abstinence from HHC and antipsychotic medications. These cases support recent regulatory measures banning HHC and highlight the need for ongoing clinician awareness of this agent and its associated risk of psychosis.
Syringe services programs (SSPs) decrease HIV and overdose incidence among people who use drugs (PWUD). In May 2024, Pueblo, Colorado, banned syringe distribution, citing public complaints about syringe litter. The ban was overturned in June 2024. The two SSPs in Pueblo halted syringe distribution during the three-week ban but continued other services. The effect of short-term syringe bans on harm reduction services is unknown. We analyzed program data from one SSP in Pueblo, Colorado, and syringe litter pickup data from the Pueblo Department of Parks and Recreation from January to September 2024. We used Interrupted Time Series analysis to evaluate the association between the syringe distribution ban and four weekly outcomes: SSP visits, naloxone kits distributed, syringes distributed, and syringe litter collected. The ban was associated, on average, with 31 fewer visits (95% CI: -48, -15), 23 fewer naloxone kits distributed (95% CI: -34, -12), and 2406 fewer syringes distributed (95% CI: -3308, -1504) every week. There was an immediate decrease of 120 syringe litter units collected (95% CI: -285, 46) weekly. After the ban was overturned, there was an immediate increase and increasing trend in visits, naloxone kits, and syringes distributed, and no changes in syringe litter. Naloxone distribution did not return to expected levels in the 16 weeks following the ban being overturned. Banning syringe distribution in Pueblo, Colorado was associated with sustained decreases in SSP usage and naloxone distribution. Eliminating funding for certain SSP activities could inadvertently decrease access to naloxone.
Electronic (E)-scooters have become increasingly common in Ireland. This study provides the first Irish orthopaedic-focused analysis of paediatric E-scooter-related injuries over a six-year period. It assesses the impact of the legislation change in 2024 banning E-scooter use in those under 16 years of age. We conducted a retrospective analysis of e-scooter-related orthopaedic trauma presenting to our emergency department (ED). Ninety-eight paediatric patients were identified between January 2020 and August 2025. This period included fourteen months prior to and subsequent to the legislation change. Four primary outcomes were analysed: Injury Severity Score (ISS) > 16, surgical intervention, injuries per patient, and fractures per patient. Medical records and patient imaging were reviewed. There were 98 paediatric patients who presented to our ED with e-scooter-related orthopaedic trauma. The average age was 12 years old with a 3:1 male-to-female ratio. There was a notable rise in cases presenting in 2025. Post-legislation comparisons showed: an increase in major trauma, a 27% increase in injuries per patient, a stable fracture rate and a decline in surgical intervention. Post-legislation injury trends remain concerning. Despite legislation, injury rates rose, with widespread non-compliance. Upper limb injuries and traumatic brain injuries were common. Multidisciplinary care was often required. A national paediatric trauma database is needed to guide prevention and policy. Systemic reforms and targeted interventions are essential to mitigate this growing public health issue.
Domestic dogs are widely distributed and exert profound effects on ecosystems, through competition, disease transmission, and killing of native species. Nevertheless, little is known about how the presence of domestic dogs interacts with habitat structure and food availability in determining habitat use of native carnivores. We investigated how the habitat use and activity of an ecologically sensitive mesopredator, the clouded tiger-cat (Leopardus pardinoides), is affected by habitat structure, prey availability, anthropogenic pressures, and dog (Canis lupus familiaris) activity in an isolated protected area of the Colombian Andes. We collected data on the occurrence and activity of both species from 23 single-camera traps placed in the cloud forest of the Alto del Nudo Soil Conservation District between July 2022 and September 2023. We used negative binomial generalized linear models to assess the habitat use of clouded tiger-cats and dogs in relation to habitat structure (topography, vegetation productivity, and connectivity), prey availability (for clouded tiger-cats), and human pressure (human modification and road proximity). We used kernel density functions and diel niche models to assess temporal relationships of clouded tiger-cats with dogs and small mammals. Clouded tiger-cat habitat use increased with topographic slope, but decreased with human modification. Dog detections did not affect clouded tiger-cat habitat use, being detected in 100% of the sampling stations with clouded tiger-cat presence (ratio of 4:1 dog-clouded tiger-cat detections). There was a low temporal overlap between both species, with dogs being mainly diurnal and clouded tiger-cats nocturnal. Human modification and widespread invasion of dogs can negatively affect clouded tiger-cats in this degraded protected area, but they reduce these pressures using well-preserved forest at steep slopes in the night. We advise taking actions to reduce the spatial contact between clouded tiger-cats and dogs through banning the unsupervised incursion of dogs into the protected area while implementing neutering and adoption campaigns.
Childhood obesity has surged dramatically in the United States over the past three decades, with over 30% of children now classified as overweight or obese. This rising trend presents a major public health and economic challenge, with obesity-related costs rising from just over 1% of United States gross domestic product in 2005 to 3.3% in 2019 and projected to reach 4.6% by 2060 if left unaddressed. While conventional narratives often attribute obesity to poor individual choices, this policy brief highlights the broader social determinants that shape childhood obesity across different levels of influence. Using a Socio-ecological Model Framework, the brief explores individual, interpersonal, community, and policy-level contributors, including genetic factors, psychosocial stress, family and cultural influences, school and neighborhood food environments, targeted marketing by food corporations, and regulatory gaps. The brief concludes by recommending four upstream policy interventions. These include banning the sale of unhealthy foods within school premises and promoting healthy school food environments through regulation and education, implementing fiscal measures by taxing unhealthy foods and subsidizing healthier alternatives, integrating physical activity into children's daily routines through school based and urban planning policies and Strengthening evidence systems and context-specific research. These strategies provide transferrable policy lessons for addressing childhood obesity in other settings including in low-and middle-income countries experiencing similar nutrition transitions. However, their implementation should be adapted to local health system capacities, food environments and policy contexts.
Flavored tobacco sales restriction policies, including menthol cigarette restriction policies and flavored e-cigarette restriction policies, reduce access to tobacco products that are easier to initiate and harder to quit. Flavored products are targeted to minority populations, including African American and Black and LGBT+ communities. This work aims to understand if these minoritized communities report differences in support for flavor policies, which address products that are marketed to their communities. A 2025 non-probability sample of N = 1542 U.S. adults were asked how much they support banning menthol cigarettes and flavored e-cigarettes. Participants provided demographic information including sexual orientation, gender identity, sex at birth, and race/ethnicity. Logistic regression analyses were used to investigate race/ethnicity and LGBT+ identity as predictors of flavored tobacco policy support. No significant relationship was found between racial/ethnic identity and support for a menthol ban. LGBT+ identity predicted lower odds of support for a flavored e-cigarette restriction policy (aOR: 0.62, 95% CI: 0.41, 0.93). There is no evidence of differential support for a menthol cigarette ban according to race/ethnicity and there is lower support of a flavored e-cigarette ban among LGBT+ adults. Further research is needed to inform messaging strategies to mobilize support among these populations.
Tobacco consumption gets normalized with its positive portrayal through tobacco advertisement, promotions and sponsorship (TAPS) of tobacco products, to initiate or catalyze consumption. While the Cigarettes and Other Tobacco Products Act, 2003 (COTPA) bans TAPS in India, it is prevalent through social media, cable television, sponsorship of cricket matches, music or award shows, school or college events, etc., and through brand stretching to nontobacco avenues like consumer goods, hotel chains, etc., COTPA shows internal inconsistencies in its short title, preambular aim, and provisions, which carve out an exception for advertising at points of sale. Ban's implementation is also limited due to the expensive action-taking mechanism and limited fines. These lacunae are further exacerbated by the inconsistencies of COTPA with other laws governing trademarks, cable television, food safety, consumer protection, etc. that allow for the advertisement of cobranded products of tobacco companies. To address TAPS comprehensively in India, these inconsistencies need to be redressed, arguably through legislative amendments in COTPA and allied laws, better implementation mechanisms, simplifying seizure of evidence for presentation in courts, and prioritizing public health over commercial interests of tobacco companies in the judicial pronouncements.
Nepal's government banned social media in early September 2025 as it was exposing nepotism and the excessive and luxurious lifestyles of families of influential political leaders. The ban enraged Nepali youth particularly those aged 14-29 known as Generation Z (Gen Z) who accordingly gathered to protest peacefully and lawfully as allowed by Article 17, Nepal Constitution 2015. However, the police opened fire on them using live ammunition causing 77 deaths. We present a case of a 22-year-old man who had been protesting and died from gunshot injuries inflicted by the police during these demonstrations against a social media ban. The wound trajectory was inconsistent with Nepal's legal requirement to aim below the knee. Indeed, the upward posterior-to-anterior trajectory of this lethal injury suggests the victim was retreating, rather than posing a threat to his attacker and points towards human rights violation during the protest in Nepal.
The use of sports supplements among adolescents is rising globally, driven by fitness trends and social media influence, yet knowledge gaps persist. This study aimed to assess supplement usage patterns, knowledge, attitudes, information sources, and the impact of a social media educational intervention among Serbian secondary school students. A single-group pre-post educational intervention study was conducted in secondary school students (aged 14-18) in Vojvodina, Serbia. A 21-question anonymous questionnaire was distributed to 1000 students along with parental informed consent forms. Pre-intervention survey assessed sociodemographics, physical activity and social media habits, supplement use information sources, and awareness of risks and banned substances. Based on the initial findings, an educational campaign delivered 56 short videos (≈70 s each) on Instagram and TikTok covering most frequently used supplements (e.g., creatine, proteins, caffeine, energy drinks). After, the intervention survey was repeated. The data were analyzed using the McNemar-Bowker test of symmetry. In this study, 65% of Serbian secondary school adolescents reported being physically active, engaging predominantly in gym workouts and team sports. The majority of participants initiate dietary supplement use independently, without consulting healthcare professionals or adults. The most commonly used supplements were vitamins and minerals, while energy drinks ranked notably high. Social media intervention had a limited impact due to its short duration; however, certain changes were detected. Serbian adolescents frequently use sports supplements without adequate professional guidance. Long-term TikTok/Instagram interventions could be used in the future in order to influence behaviors and improve knowledge about sport supplement use.
Prediction of the molecular consequences of missense variants in genetic diseases places a challenge, often resulting in ambiguous classifications by different algorithms. Thus, such variants of unclear significance (VUS) require a thorough molecular characterization to judge if they are pathogenic or not. Pathogenic variants in the AGA gene encoding for aspartylglucosaminidase (AGA) result in aspartylglucosaminuria (AGU), a lysosomal storage disorder. For a correct diagnosis, it is important to understand the effect of VUS found in AGU patients on the structure and function of the AGA enzyme. In this study, several AGA missense variants found in AGU patients were characterized by biochemical and bioinformatics methods. The pathogenicity of most of these variants was verified, but some of them exhibited only a minor pathogenic effect on AGA function. Especially the Leu126Val variant showed a high residual AGA activity, and a homozygous patient with this variant has a mild AGU phenotype with atypical symptoms. In the era of personalized medicine, our data stress the importance of molecular characterization of unclear genetic variants for the choice of best treatment options.
Invasive plant species pose significant ecological and economic challenges, threatening biodiversity and altering soil properties, while conventional control methods are often costly and resource-intensive. This review examines the potential of composting invasive plant biomass as a viable and sustainable alternative that aligns with circular economy principles. Invasive plant biomass can contain up to 2%-3% nitrogen, 1%-2% phosphorus, and 2%-5% potassium, making it a nutrient-rich organic soil amendment that can reduce reliance on chemical fertilizers by up to 30% in terms of cost, enhance soil health, and improve crop growth. Despite these benefits, many challenges remain, including the persistence of allelopathic chemicals, viable seeds, and regulatory complexities. This review also identifies critical research gaps, scalability of composting technologies, and socio-economic implications while also addressing the regulatory frameworks needed to enable its safe and practical application. Additionally, it explores opportunities for green job creation and policy innovation. In conclusion, overcoming these gaps is essential to unlocking the full potential of invasive plant composting as a viable and sustainable waste management strategy. This review highlights the dual potential of invasive plant species as a sustainable resource for compost production while addressing environmental challenges and economic opportunities. Invasive plant species pose significant ecological threats by disrupting native ecosystems and biodiversity. However, their management remains a persistent challenge. Our review critically evaluates the potential of converting these species into compost, promoting circular bioeconomy practices while mitigating environmental risks. We explore key aspects such as the biochemical properties of invasive plants, composting processes, their impact on soil health and microbial communities, and economic feasibility. Furthermore, we discuss the regulatory and policy frameworks that can support the integration of invasive plant‐derived compost into sustainable agriculture.
To quantify geographic accessibility to abortion services for servicewomen in the continental United States after the Dobbs v. Jackson Women's Health Organization decision. We extracted ZIP code of residence for 203,139 servicewomen (18-49 years of age) from the Military Health System Data Repository in December 2024. We performed point density analyses and spatiotemporal network modeling of servicewomen's locations and distance to 389 geocoded abortion clinics using ArcGIS Pro. We calculated travel times to abortion clinics by state-level legal restrictions (most restrictive, restrictive, and somewhat/protective based on the Guttmacher Institute state abortion restriction categories) and geographic region. We estimated mean driving times and the proportion of servicewomen within 30-, 60-, and 90-minute travel-time thresholds. Mean driving time to the nearest clinic for the 193,029 successfully geocoded servicewomen was 164.1 minutes. More than half (55.5%) required more than 90 minutes of travel time, and 8.5% lived within 30 minutes. Mean driving time was significantly higher in the most restrictive states (381.7 minutes) compared with restrictive states (118.9 minutes, difference of means 262.8, 95% CI, 260.1-265.5) and to somewhat/protective states (68.7 minutes, difference of means 313.1, 95% CI, 310.7-315.4). Of 47,672 servicewomen stationed in most restrictive states, 99.7% required travel times exceeding 90 minutes compared with 60.1% (n=41,811) in restrictive states (odds ratio [OR 0.51], 95% CI, 0.50-0.53) and 23.5% (n=17,846) in somewhat/protective states (OR 0.27, 95% CI, 0.26-0.28). Servicewomen in Western Interior and South regions averaged almost 3 and more than 7 hours of travel time for care, respectively. Travel time exceeded 90 minutes for over 99% in the South and for the majority in the Western Interior (90.1%), East Coast (62.7%), and Midwest (54.7%). Over half of reproductive-aged servicewomen in the continental United States face significant travel burdens to access abortion services. One-quarter reside in banned states with nearly universal geographic constraints. Current legal and policy environments create substantial structural differences that may affect servicewomen's reproductive health.
Although many organophosphate pesticides are now banned in European countries, they continue to be used in various parts of the world and can still be detected as pollutants of surface waters. Organophosphates are well characterized for their acute neurotoxic effects, while the long-term effects of sub-lethal concentrations, closer to the levels that can be found in the environment, remain poorly understood. In this study, we examined the intergenerational epigenetic effects of diazinon exposure in the freshwater keystone species Daphnia magna. Using chronic exposure to an environmentally relevant concentration (30 ng/L), combined with genome-wide DNA methylation profiling at nucleotide resolution, we found that diazinon induces distinct and context-dependent changes in DNA methylation, without significantly affecting global methylation levels. Methylation patterns varied across generations and exposure windows, with the strongest effects observed following indirect embryonic exposure. Despite such exposure-specific epigenetic signature, we identified a core set of twelve genes whose methylation levels were consistently altered in exposed parents (F0) and their direct offspring (F1). These genes are involved in key biological processes, including reproduction, regulation of gene expression and development, in line with previously reported phenotypic effects of diazinon. Further supporting the impact of diazinon on developmental programs, we found a significant reduction in body size in both F0 and F1. Together, our results show that low-dose diazinon exposure reshapes the epigenetic landscape of D. magna in a developmental stage-dependent manner and suggest that DNA methylation changes may contribute to the response associated with diazinon exposure accross multiple generations.
Invasive intracoronary imaging represents the gold standard for identifying vulnerable coronary plaques, but it is not suitable for widespread clinical use. Coronary computed tomography angiography (CTA) may offer a noninvasive alternative. This study aims to integrate coronary CTA-derived plaque morphology, pericoronary inflammation, and plaque burden into a unified morphology-inflammation-burden (MIB) score and to evaluate its association with plaque vulnerability and clinical outcomes. Patients undergoing coronary CTA followed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS) were followed for a median of 31 months. High-risk plaque, pericoronary adipose tissue attenuation, and total plaque burden (TPB) were quantified and compared with invasive imaging. A vulnerable lesion was defined as ≥2 vulnerability features on OCT. A total of 438 patients (median age 67 years) and 1,038 plaques were included; 45.4% presented with non-ST-segment elevation acute coronary syndrome. High-risk plaque, elevated pericoronary adipose tissue attenuation, and high TPB were independently associated with OCT-defined vulnerability (P < 0.05 for all). TPB correlated with IVUS percent atheroma volume (Pearson's r = 0.69; P < 0.001). The MIB score demonstrated a stepwise increase in vulnerability, exceeding a predicted risk of 90% in the highest category. Vulnerable patients, defined by the presence of ≥1 untreated lesion with a high MIB score, had a significantly higher rate of cardiac death, acute coronary syndrome, or revascularization (15.3% vs 4.4%; P < 0.001). A coronary CTA-derived MIB score correlates with plaque vulnerability by intracoronary imaging and identifies patients at increased risk for adverse events. These findings support the value of coronary CTA for noninvasive risk stratification in clinical practice. (Massachusetts General Hospital and Tsuchiura Kyodo General Hospital Coronary Imaging Collaboration; NCT04523194).
We report a fatal case of a 40-year-old man who developed rhino-orbito-cerebral mucormycosis complicated by central retinal artery occlusion, cavernous sinus thrombosis, and internal carotid artery occlusion. Mechanical thrombectomy was performed for the internal carotid artery occlusion, with subsequent Sanger sequencing of the fungal components within the retrieved thrombus to identify Rhizopus arrhizus. To the best of our knowledge, this is the first report establishing the species-level identification of R. arrhizus in mucormycosis-associated large-vessel occlusion. These findings provide direct histopathological evidence of angioinvasive mucormycosis attributable to R. arrhizus.