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Tris(1-chloro-iso-propyl) phosphate (TCIPP) emerged as the predominant organophosphorus flame retardants (OPFRs) in both dust and air environments. This study investigated its respiratory toxicity using mouse inhalation model. Molecular docking and dynamics simulations revealed that TCIPP could binds to glutathione peroxidase 4 (GPX4) with an affinity of -5.3098 kcal/mol, stabilizing the protein conformation. Inhalation TCIPP exposure (34 μg/m3 for 1 h) significantly reduced GPX4 expression and GSH levels in lung tissue. Histopathological examination indicated severe pulmonary injury, including inflammatory cell infiltration, alveolar wall thickening and apoptosis after TCIPP inhalation. Besides, DHE staining revealed that the ROS level increased by 94.7% in the lung after TCIPP exposure. Meanwhile, the results revealed a 50.7% increase in lung iron content (Fe2+), along with elevated ferroptosis markers (p53, Transferrin Receptor 1 (TFR1)) and reduced FTH1 levels following TCIPP inhalation. These effects were counteracted by the ferroptosis inhibitor Fer‑1 (0.8 mg/kg), which also attenuated pathological damage, ROS accumulation, and NLRP3‑mediated pyroptosis. Concurrently, electron microscopy analysis demonstrated mitochondrial cristae membrane disruption and shrinkage, accompanied by dysregulated expression of mitochondrial dynamics regulators (down‑regulated Mfn1/2 and up‑regulated Drp1), all of which were reversed by Fer‑1. Collectively, the results indicate that TCIPP inhalation induces GPX4‑dependent ferroptosis, promoting inflammatory responses and mitochondrial imbalance, ultimately driving respiratory toxicity. Ferroptosis thus represents a potential therapeutic target for organophosphorus flame retardant‑associated lung injury, which may aid in biomarker discovery for related pulmonary diseases.

This meta-analysis was designed to compare airway complication rates between deep vs. awake laryngeal mask airway (LMA) removal in pediatric non-airway surgery, while discussing the impact of anesthetic agents, patient position and age. We systematically searched PubMed, Web of Science, and Cochrane Library to identify studies meeting the inclusion criteria. The primary outcome measured was the incidence of overall airway complications, which included laryngospasm, airway obstruction, desaturation, breath-holding, cough, and excessive secretions. Secondary outcomes included subgroup analyses stratified by patient positioning during LMA removal, inhalational anesthetic agents and age. Pooled analysis of 10 randomized controlled trials (RCTs) (n = 1,713) revealed no significant difference in overall airway complications (relative risk (RR) of 0.93, 95% confidence interval (CI) [0.65-1.32], p = 0.68) or specific outcomes (laryngospasm, desaturation, breath-holding, cough) between deep and awake LMA removal; however, deep removal was associated with a significantly higher airway obstruction risk and a lower incidence of excessive secretions. Subgroup analyses demonstrated that inhalational anesthetic agents type (sevoflurane/isoflurane) did not alter most complications but universally increased airway obstruction risk, whereas positioning during deep removal reduced secretions in both lateral/supine positions yet increased obstruction, with lateral positioning uniquely lowering desaturation risk. Notably, age did not modulate the airway obstruction risk profile: children under 6 years and over 6 years exhibited comparably elevated obstruction risks with deep removal. This meta-analysis suggests awake LMA removal is associated with lower airway obstruction risk than deep removal, which primarily reduces secretions. Given the higher clinical severity of obstruction, clinicians may prioritize its prevention. This finding appears consistent across age groups, though caution is advised for infants (<2 years) due to limited data. Lateral positioning may mitigate desaturation during deep removal. We suggest risk-stratified protocols, with lateral positioning and monitoring advised if deep removal is performed.

Microplastics (MPs) are pervasive environmental contaminants with potential implications for human health. Although inhalation is considered a major route of exposure, most investigations have focused on the lower respiratory tract, leaving the upper airway relatively understudied. Recent studies have detected MPs in nasal lavage fluid, specimens from patients with allergic rhinitis, tissue from patients with chronic rhinosinusitis, and the olfactory bulb of the human brain. Concerns have also been raised that synthetic polymerbased medical devices, including nasal irrigation bottles and continuous positive airway pressure systems, may contribute to upper airway exposure. This review summarizes current evidence on the detection and characterization of MPs in the human nasal cavity and upper airway, discusses environmental and medical device-related exposure pathways, and examines emerging implications for rhinologic diseases. Methodological limitations and priorities for future research are also reviewed.

Fused filament fabrication 3D printers have become popular for at-home use. While these printers enable the convenient creation of 3D objects, their potential inhalation hazards are not widely known among the public. 3D printer feedstocks, known as filaments, consist of a variety of plastics, including acrylonitrile butadiene styrene (ABS), poly-lactic acid (PLA), and polycarbonate (PC), all of which have been linked to the emission of indoor air particles during 3D printing. These particle emissions have also been linked to adverse effects in in-vivo and in-vitro studies. The objective of this study was to characterize particle emissions from seventeen commercially available printing filaments in an enclosed test chamber and explore how particles behaved at different time points during the 3D printing process. Particle number concentrations, particle number emission rates, and size distributions were collected and quantified from a sampling flask using a scanning mobility particle sizer. Particle number concentrations were greatest among ABS filaments, followed by metal-containing PLA, PLA, and PC filaments. Size distributions at different time points showed that particle distributions widened and reached a stable distribution at approximately ten minutes into data collection. On average, particles were also observed to be largest among ABS filaments while emissions from one PLA manufacturer showed consistently larger particle sizes than the other. A relative ranking comparison of average particle number concentrations with results from a recent study [1] that used filaments with the same lot numbers found some similarity, despite different methods for particle capture.

Opioid use disorder complicates the management of burn injuries, particularly in achieving adequate pain control. While prior single-institution studies have evaluated associations between opioid use and burn outcomes, multi-institutional analyses of inpatient complications remain limited. Using the American Burn Association Noncommercial Burn Research Dataset, this study compares inpatient outcomes among patients with prehospital opioid-positive screening versus those with negative screening. Among 32&#x2009;052 patients included, 50.5% screened positive for opioids at the time of presentation. These patients were more likely to be female (p&#x2009;<&#x2009;.0001), more likely to possess scald injuries (p&#x2009;<&#x2009;.0001), and less likely to be experiencing homelessness (p&#x2009;<&#x2009;.0001) or to be diagnosed with inhalation injury (p&#x2009;<&#x2009;.005). Opioid positivity was associated with increased odds of infectious complications, such as cellulitis (OR&#x2009;=&#x2009;2.7, p&#x2009;<&#x2009;.0001) and sepsis (OR&#x2009;=&#x2009;1.41, p&#x2009;<&#x2009;.001). Opioid negativity, conversely, had a higher prevalence of acute respiratory distress syndrome (p&#x2009;<&#x2009;.0001), acute kidney injury (p&#x2009;<&#x2009;.0001), respiratory failure (p&#x2009;<&#x2009;.05), and cardiac arrest (p&#x2009;<&#x2009;.05). The opioid-negative population also necessitated more frequent admission to the critical care unit (p&#x2009;<&#x2009;.05) and demonstrated higher overall mortality (p&#x2009;<&#x2009;.0001). These findings highlight the vulnerability of opioid-negative patients who may have delayed presentation and more severe injuries than originally anticipated. This work underscores the need for heightened vigilance and equitable, early care for these patients to mitigate risk in this group.

Malignant hyperthermia is a rare but potentially fatal complication of general anesthesia caused by inhalational anesthetics and depolarizing skeletal muscle relaxants. The mechanism of the disease involves an uncontrolled increase in skeletal muscle metabolism as a result of abnormal calcium regulation. Early diagnosis, immediate discontinuation of the triggering agent, and rapid administration of dantrolene are crucial for patient survival. We present the case of a 32-year-old man who underwent elective rhinoseptoplasty at a city 1-day surgery clinic where dantrolene was not available. During the procedure, the patient experienced an increase in body temperature, followed by cardiac arrest. The patient was transferred to the emergency department of a tertiary care university hospital, where dantrolene treatment was initiated and the patient was qualified for extracorporeal cardiopulmonary resuscitation. Despite several hours of intensive care, the patient died.

Coastal waters impacted by fecal contamination pose health risks to recreational users through direct water contact; however, risk to users, workers and surrounding communities from potential airborne exposure remain poorly understood. This study quantified two human-associated sewage markers (HF183 and pepper mild mottle virus (PMMoV)) and two enteric viruses (norovirus GII (NoVGII) and human adenovirus (HAdV)) in paired water and air samples collected in San Diego County, USA, from the Tijuana River, a binational river flowing into the US from Mexico that is polluted with untreated and treated wastewater, a community site on the beach (Imperial Beach), and a northern reference site (La Jolla Shores). A total of 23 paired water and air samples were collected during the dry season, with 10 water samples collected during the wet season. All microbial targets were consistently detected at high concentrations in the Tijuana River water, while concentrations in Imperial Beach water were significantly lower. In contrast, airborne concentrations were comparable between the two sites, with PMMoV detected in all air samples. Log-transformed ratios of the concentrations in air and water samples indicate enrichment in the air samples from Imperial Beach compared to the Tijuana River. PMMoV showed the most consistent detection and the strongest relationship with airborne HAdV and NoV levels, suggesting PMMoV as a conservative indicator of aerosolized viruses of human fecal origin in such settings. These findings indicate that coastal surf zones may serve as important interfaces for aerosolization of wastewater-associated microorganisms and suggest that inhalation could represent a previously underrecognized exposure pathway in contaminated coastal environments.

Quality of life (QoL) in type 2 diabetes mellitus (T2DM) is frequently impaired by disease-related complications and symptoms. Aromatherapy has been proposed as a non-pharmacological means of improving QoL. This review evaluates randomized controlled trials (RCTs) of aromatherapy and QoL in adults with T2DM experiencing diabetes-related complications. The review was prospectively registered in PROSPERO (CRD42024625423) and reported according to PRISMA. Web of Science, PubMed, Scopus, CINAHL, Google Scholar and the Cochrane Library were searched between December 2024 and January 2025. Eligibility criteria followed the PICOS framework, and full database-specific search strings are reported. Two reviewers independently performed study selection, data extraction and quality appraisal using the Joanna Briggs Institute (JBI) checklist for RCTs. Owing to heterogeneity, the data were synthesized narratively. Four RCTs comprising 293 randomized participants were included; three enrolled patients with diabetic peripheral neuropathic pain and one patients with insomnia. Aromatherapy was delivered by massage in three trials and by inhalation in one. JBI scores ranged from 9 to 12 of 13 (three high, one moderate quality). Randomization, baseline comparability and analysis were adequate throughout, whereas allocation concealment was unclear in three trials and blinding was incomplete in the massage trials. All four trials reported significant QoL improvement. Aromatherapy may improve QoL in complicated T2DM, but the evidence is limited by few small trials and by susceptibility to performance and detection bias. Adequately powered, registered, placebo-controlled RCTs with concealed allocation and blinded outcome assessment are needed. The online version contains supplementary material available at 10.1007/s40200-026-02033-z.

Single-inhaler triple therapy (SITT) combining an inhaled corticosteroid, long-acting &#x3b2;2-agonist, and long-acting muscarinic antagonist (ICS/LABA/LAMA) represents the current ceiling of inhaled pharmacotherapy for moderate-to-very-severe chronic obstructive pulmonary disease and severe uncontrolled asthma. Five device platforms are currently approved: two extrafine formulations delivering beclomethasone dipropionate/formoterol/glycopyrronium (the Modulite solution pressurised metered-dose inhaler [pMDI] and the NEXThaler breath-actuated dry powder inhaler [DPI]); the co-suspension pMDI Aerosphere platform (budesonide/glycopyrrolate/formoterol); the standard-particle Ellipta DPI (fluticasone furoate/umeclidinium/vilanterol); and the low-resistance, single-dose capsule-based DPI Breezhaler (mometasone furoate/indacaterol/glycopyrronium). Despite a shared pharmacological class, these systems differ in aerosol physics, particle engineering, intrapulmonary deposition patterns, and device-patient interaction. Furthermore, some of them are authorized only for COPD or asthma. This narrative review examines the technology and in vivo deposition evidence for each SITT platform, discusses real-world performance determinants (particle size, flow dependency, technique robustness), and proposes an expert-informed framework for patient-level device selection. Methodological limitations include reliance on in silico Functional Respiratory Imaging data when in vivo scintigraphy is unavailable, and inconsistent dose denominators across studies (emitted vs. metered dose). Cross-platform comparisons are limited by heterogeneous methodologies, and no SITT platform has demonstrated universal superiority. In platform-specific studies, NEXThaler shows relatively high lung deposition (&#x223c;55% of emitted dose) though flow-dependent; Aerosphere is robust to inhalation technique variations; Modulite provides extrafine, peripheral delivery; Ellipta and Breezhaler offer once-daily convenience with moderate deposition. Rational device selection requires structured assessment of patient inspiratory capacity, disease phenotype, coordination, and adherence. Head-to-head scintigraphy and prospective imaging-outcome studies represent major evidence gaps.

Aspiration pneumonia (AP), a serious condition resulting from the inhalation of foreign materials into the lungs, is a significant concern for patients with compromised swallowing mechanisms, especially those with neurological disorders. Sialorrhea (hypersalivation) exacerbates the risk of aspiration, and botulinum neurotoxin type A (BoNT-A) has been identified as a potential treatment to manage sialorrhea. However, the direct impact of BoNT-A on reducing AP risk remains inadequately explored, particularly in adult populations. BoNT-A works by inhibiting the release of acetylcholine at the neuromuscular junction, thereby reducing salivary gland stimulation and saliva production. This review aims to evaluate the current state of research on the use of BoNT-A for managing sialorrhea and its potential to reduce AP risk, with a specific focus on the adult population. A comprehensive review of existing literature was conducted, focusing on the efficacy of BoNT-A in treating sialorrhea in both pediatric and adult populations. Studies were assessed for their findings on the impact of BoNT-A on drooling and related complications, including the risk of AP. Meta-analyses and individual studies were reviewed to summarize the current knowledge and identify research gaps. In pediatric patients, BoNT-A has been shown to effectively reduce sialorrhea, with several studies and meta-analyses demonstrating its efficacy in managing drooling associated with neurological conditions such as cerebral palsy. However, evidence linking BoNT-A directly to reduced AP risk is limited. In adults, while BoNT-A has been beneficial in managing sialorrhea associated with conditions such as Parkinson's disease and brain injuries, studies specifically exploring its impact on AP risk are lacking. Current evidence supports the efficacy of BoNT-A in managing neurological sialorrhea across both adult and pediatric populations. However, a critical gap exists in studies directly investigation whether BoNT-A reduces AP risk in adults with neurological disease.

Occupational arsenic exposure (OEA), mainly through inhalation in workplace settings, is an established carcinogenic hazard associated with lung, skin, and bladder cancers. However, long-term trends and the global cancer burden attributable to OEA remain insufficiently characterized. Data from the Global Burden of Disease Study 2021 were used to analyze the cancer burden attributable to OEA from 1990 to 2021. Indicators included summary exposure values (SEVs), deaths, years lived with disability (YLDs), and disability-adjusted life years (DALYs) at global, regional, and national levels. Estimates were reported with 95% uncertainty intervals (UIs) generated from 1000 Monte Carlo simulations. Age-standardized indicators, Joinpoint regression, inequality analysis, decomposition analysis, and frontier analysis were used to assess spatiotemporal trends, drivers, and disparities. Seven forecasting models were evaluated to predict trends from 2022 to 2036. Between 1990 and 2021, global OEA SEV increased from 0.408% to 0.496% (average annual percentage change [AAPC]&#x2005;=&#x2005;0.288). Cancer deaths rose from 5.5 to 10.5 thousand, YLD from 1.5 to 3.3 thousand, and DALYs from 169.6 to 298.7 thousand. In contrast, age-standardized death rate (AAPC&#x2005;=&#x2005;-0.300) and DALYs rate (AAPC&#x2005;=&#x2005;-0.531) declined. Men bore higher overall burdens, but women experienced faster increases (AAPC 0.428 vs 0.171). High-socio-demographic index (SDI) countries showed continuous improvement, whereas middle- and low-SDI regions-particularly East, South, and Southeast Asia-experienced substantial increases. In East Asia, the AAPCs for age-standardized SEVs, age-standardized death rates, age-standardized YLDs rates, and DALYs rates were 0.953, 1.067, 1.849, and 0.809, respectively. Inequality analysis indicated stable absolute gaps but reduced relative disparities, with burdens still concentrated in low-SDI countries. Decomposition suggested that population growth was the main driver of global burden increases, and frontier analysis highlighted limited improvement potential in low-SDI regions. Forecasting models indicated that the absolute burden of occupational arsenic exposure will continue to rise over the next 15 years. The cancer burden attributable to OEA is still increasing globally, with persistent prevention gaps and socioeconomic disparities. Focused interventions in low- and middle-SDI countries and rapidly industrializing regions are needed, including strengthened occupational exposure regulations, improved workplace arsenic monitoring, engineering controls, personal protective equipment, and regular health surveillance for workers in high-risk industries, to reduce inequalities and mitigate public health threats.

Acute lung injury(ALI) and acute respiratory distress syndrome(ARDS) are severe respiratory diseases characterized by uncontrolled inflammatory responses and disruption of the alveolar-capillary barrier. This type of disease is often triggered by multiple factors such as infection, sepsis, trauma, or inhalation injury, and the pathological process involves multiple sections including inflammatory cascade reactions, oxidative stress imbalance, abnormal activation of immune cells, and increased pulmonary microvascular permeability. Owing to their complex pathogenesis and high mortality, available clinical therapeutic approaches remain limited. Therefore, the development of safe and effective therapeutic agents to attenuate ALI has become a major focus of current research field. As a TCM, Rheum palmatum has a long history of use in clearing heat and toxins, purging the bowels, and regulating systemic inflammatory responses. In recent years, increasing attention has been paid to its therapeutic effect in ALI. RESULTS:: show that R. palmatum and its major bioactive anthraquinones, such as emodin and rhein, exert protective effects through multi-target and multi-pathway mechanisms. These mechanisms mainly include inhibition of inflammatory signaling pathways such as nuclear factor-&#x3ba;B(NF-&#x3ba;B), mitogen-activated protein kinase(MAPK), and NOD-like receptor protein 3(NLRP3) inflammasome, attenuation of oxidative stress response, activation of the nuclear factor erythroid 2-related factor 2(Nrf2)-mediated antioxidant defense system, regulation of programmed death in immune cells including macrophages, improvement of immunometabolic status, modulation of macrophage polarization and the gut microbiota as well as the gut-lung axis, and so on. In addition, R. palmatum has been shown to preserve the integrity of the alveolar-capillary barrier and to suppress excessive neutrophil activation and the overformation of neutrophil extracellular traps(NETs), thereby reducing inflammation amplification effect and the risk of immune microthrombi. This paper summarized the action mechanisms and research progress of R. palmatum in the treatment of ALI, aiming to elucidate the unique advantages of R. palmatum anthraquinones in intervening in the complex pathological processes of ALI through systemic regulatory networks and to provide a solid theoretical basis for the research and development of innovative R. palmatum-based medicines and their clinical combination medication.

Lactose (LA), the primary carrier in dry powder inhalers (DPIs), often exhibits excessive drug adhesion, which impairs aerosolization. In this study, four coating methods solid mixing, vapor deposition, suspension coating, and solution coating were evaluated to modify LA surfaces. Solution coating with leucine (Leu) proved optimal and was defined as Nanometer Layer Coating (NLC). When blended with jet-milled dexamethasone (DEX), NLC-LA increased the fine particle fraction from 20% to 50% and improved flowability, reducing Carr's Index to 24%. Reduced adhesion forces and increased surface smoothness of NLC-LA were confirmed by scanning electron microscopy, synchrotron radiation micro computed tomography and atomic force microscope. Continuous Leu coverage at nanometer-scale thickness was verified using Raman imaging, focused ion beam-scanning electron microscopy, time-of-flight secondary ion mass spectrometry, and synchrotron radiation x-ray microdiffraction. In vivo studies demonstrated that DEX DPI formulated with NLC-LA enhanced bioavailability and allowed a 30-fold dose reduction while maintaining therapeutic efficacy against high-altitude acute lung injury. Collectively, the NLC strategy bridges fundamental surface engineering with translational DPI performance, advancing inhalation science and formulation development.

Construction dust is a major source of air pollution and easily causes intractable respiratory diseases such as pneumoconiosis. Dust suppressants are effective for dust control, yet most existing studies only focus on dust suppression performance, lacking systematic toxicological assessments, especially data on extrapulmonary multi-organ toxicity. In this study, SPF male C57BL/6 mice were used to establish three subchronic inhalation exposure groups: dust alone, dust suppressant alone, and co-exposure of dust and suppressant. Indicators including body weight, organ coefficients, blood routine, serum cytokines, and liver, kidney, and heart pathological lesions were detected to investigate the extrapulmonary multi-organ toxicity of an eco-friendly composite dust suppressant. The suppressant had little effect on mouse body weight. At appropriate concentrations (4-20&#x2009;mg/m3), it inhibited dust-induced inflammatory responses and alleviated liver and kidney injuries. When the concentration reached 100&#x2009;mg/m3, the suppressant interacted with dust to increase DNA oxidative damage markers, indicating potential genotoxic risks. This study fills the gap in extrapulmonary toxicological research of dust suppressants, provides references for toxicology evaluation and experimental basis for determining safe application concentrations on construction sites.

Occupational pesticide exposure is a significant global health concern for agricultural workers, and research aimed at addressing it has long been shaped by the "knowledge deficit" framework, which dominates pesticide safety research and treats workers as rational actors who lack adequate information. This framing fails to account for how risk perceptions are socially organised, culturally reproduced, and structurally embedded within specific occupational contexts. This study applies Abric's Central Core Theory (CCT) of Social Representations to examine how 20 Chilean farmworkers in the Maule Region construct and organise their understanding of occupational pesticide exposure. Using open-ended interviews analysed through Rodr&#xed;guez (2007) qualitative methodology, central and peripheral elements were identified across four representational domains: pesticide identity and risk, routes of exposure, prevention conditions, and health and environmental effects. The analysis suggests a coherent representational system organised around a paradoxical central core: pesticides are simultaneously objectified as "liquids", normalising their use as routine agricultural matter, and recognised as "poison," acknowledging their danger. The functional logic sustaining this paradox is characterised as sensory-practical rationality: risk is perceived, graded, and managed according to sensory detectability rather than toxicological magnitude, producing a stable pattern of conditional risk acceptance. Sensory cues structure how exposure routes are represented (visible oral and inhalation risk versus the invisible dermal hazard), anchor the hierarchy of health effects (from immediately witnessed poisoning to intergenerational malformation and cancer), and constrain the salience of environmental harm to what can be materially apprehended. This representational architecture is not a product of ignorance or cognitive error, but rather a culturally embedded and structurally reproduced form of lay expertise shaped by precarious labour conditions, limited regulatory enforcement, and export-market compliance pressures. The findings carry implications for how occupational health interventions are designed and how risk communication can engage invisible cumulative hazards beyond the limits of sensory-practical knowledge.