Science has long examined how the built environment impacts health and wellbeing, yet most research has relied on observational and longitudinal studies. Much less attention has been paid to field experiments as a method to understand how environmental conditions may impact health. Although formal field experiments are common in public health, environmental psychology and related fields, they remain rare in urban planning and design despite their potential to inform how urban transformations may improve health and wellbeing. This scoping review examines how field experiments have been used to assess the health and wellbeing impacts of the built environment. Following an extensive keyword search, we identified studies published between 2015 and 2025 that employed a field experimental design in an urban or peri-urban context and directly assessed health-related outcomes associated with built environment characteristics or interventions. A total of 26 studies met the inclusion criteria and were analysed according to their topical focus, methodological design, assessed health outcomes, and reported challenges and limitations. Most studies focused on the health and wellbeing impacts of exposure to urban green features, accounting for over two thirds of reviewed studies. Mental health and wellbeing outcomes were assessed more frequently than physical health outcomes, often through a combination of self-reported and objective physiological measures. Only a limited number of studies involved direct interventions or transformations of the built environment, while most compared existing environmental conditions. The limited number of field experiments addressing issues beyond urban green features suggests there is considerable opportunity to expand the use of field experiments to assess the health impacts of other types of built environment interventions, particularly in the context of the growing popularity of tactical urbanism and temporary urban transformations.
To evaluate the recent literature on differential exposure to and health risks from wildfire smoke across subpopulations, whether wildfire-derived PM2.5 affects health differently from non-wildfire-derived PM2.5, and how wildfire smoke composition affects health. We found inconsistent evidence of differential exposure to and health risks from wildfire PM2.5 by population subgroups. This could be due to variation in wildfire PM2.5 infiltration into buildings and ability to take individual protective actions, both of which have been noted to be related to socio-economic status in the recent scientific literature. Respiratory health endpoints have been the most consistent and commonly evaluated health outcome in studies of wildfire smoke; additional research is needed to resolve conflicting findings for non-respiratory health outcomes (e.g., cardiovascular disease). Although some recent studies have documented larger health risks from wildfire-derived as compared to non-wildfire-derived PM2.5, we document how further research could evaluate whether these findings are confounded by type of fuel burned, due to methodological concerns, or are true. We also conclude that more research is necessary to elucidate potential differences in health risks of constituents of wildfire smoke other than PM2.5 or from burning of different fuels. Wildfire smoke is projected to continue to increase. We encourage future research to move away from further documentation of respiratory health impacts of wildfire smoke, which has been very well established, into studies of other health endpoints that have been less well studied to date, more exploration into health effects from wildfire smoke constituents other than PM2.5 and from different types of fires (i.e., wildland urban interface (WUI) fires versus wildland fires), and additional exploration of remaining uncertainties with a goal of further supporting public health protection from wildfire smoke.
Current data analysis and coordination methods do not effectively support nurses and midwives in risk reduction, as retrospective reporting does not allow real-time insights and precludes proactive, preventive care. Analysis of administrative data within Australia's health care sector to predict risk may help address this shortcoming. Predictive analytics can transform these data into meaningful insights, identifying harm risk profiles that benefit the performance of Australian and international clinical programs. Importantly, these tools may support nurses and midwives in preventing adverse events and predicting high-risk situations. Researchers, in collaboration with local health network staff, will develop a proof-of-concept predictive risk algorithm. The "predictive harm response management algorithmic tool to reduce adverse events in healthcare settings" program (project DHCRC-0156) will provide real-time insights via an interactive dashboard, enabling nurses, midwives, and health administration to assess risks and optimize resources in health care settings. This protocol details the algorithm development activities for subproject 1a, predictive risk model development, which aims to develop and pilot-test a predictive harm algorithm across 2 South Australian local health networks. This study aims to identify the clinical harm outcome of interest and relevant data sources per site and build a suitable data solution to model predictors of harm risk and identify actionable clinical, workforce, and environmental factors that affect the harm outcome of interest. This study design includes three phases: (1) model generation, (2) model evaluation, and (3) prototype development. Data linkage by SA-NT DataLink can only proceed following approval from each of the following: the South Australia Department for Health and Wellbeing Human Research Ethics Committee, the University of South Australia Human Research Ethics Committee, and hospital governance committees. The clinical dataset will be split into a training set, a validation set, and a test set. Exploratory data analysis will be undertaken to ascertain features and classify outcomes from the raw dataset. Derived features will be computed, feature correlations will be estimated, and initial feature selection will be performed. Iterative model development will occur over 3 stages, and a dashboard to display these results will be developed. The study commenced on July 19, 2021, and will conclude on December 31, 2025. Finalized results are expected in December 2025. This research will conclude with the development of the algorithm for transferability to health care environments. Research activities will be detailed in publicly available reports and manuscripts prepared for peer-reviewed journals that will be drafted in accordance with existing and appropriate checklists. DERR1-10.2196/75474.
Nipah virus (NiV) is a highly pathogenic zoonotic henipavirus associated with severe neurological and respiratory disease and a high case fatality rate. Although outbreaks have remained geographically limited, recurrent events in South and Southeast Asia highlight the persistent risk posed by NiV and the potential global consequences of delayed detection and response. In non-endemic regions such as Europe, preparedness presents distinct challenges due to the rarity of cases, stringent biosafety requirements, and reliance on specialised diagnostic and clinical capacities that may degrade without routine use. This narrative review synthesises evidence from peer-reviewed literature and international public health agency reports on NiV biology, epidemiology, diagnostics, treatment, and preparedness, with a particular focus on operational implications for Europe within a One Health framework. We examine determinants of zoonotic spillover and limited human-to-human transmission, outline constraints across the diagnostic pathway including specimen handling and biosafety requirements and summarise current approaches to clinical management and investigational medical countermeasures. Attention is given to how these factors inform risk assessment, diagnostic readiness, and clinical recognition in non-endemic health systems. Preparedness for NiV should be conceptualised as a continuous process of biomonitoring and response rather than an episodic emergency activity. Integrated surveillance across human, animal, and environmental domains is essential for early identification of spillover signals and proportionate public health action. For Europe, sustained preparedness depends on maintaining functional capacity across laboratory networks, clinical services, and public health systems, supported by cross-border coordination and the systematic integration of One Health intelligence.
Global food systems face increasing strain from population growth, climate change, and unsustainable agricultural practices. Food sustainability aims to provide safe, nutritious, and sufficient food for all while safeguarding environmental, social, and economic stability. The aim of this study was to examine food sustainability as a growing public health challenge and to analyse potential pathways for change through application of Beattie's health promotion model. Narrative analytical review. A qualitative narrative review of international policy reports, peer reviewed literature, and public health frameworks was undertaken. Evidence relating to food systems, sustainability, and health promotion was critically analysed using Beattie's model to explore legislative, behavioural, and community-based interventions. Evidence indicates that current global food systems contribute to environmental degradation, food insecurity, and rising diet related disease burden. Policy fragmentation, unsustainable consumption patterns, and social inequalities represent key barriers. Application of Beattie's model highlights how combined top down policy measures and bottom up community actions can support sustainable transformation. Achieving food sustainability requires collaborative action across policy, individual, and community levels. Using Beattie's model within public health frameworks can guide more effective interventions to reduce waste, improve nutrition, and support sustainable development.
Louisiana has one of the largest concentrations of petrochemical industry in the USA. Many studies have assessed patterns of industrial pollution and health in Louisiana; we aim to systematically review this evidence. We systematically searched PubMed, Web of Science, Embase, APA PsycInfo, and GreenFILE for peer-reviewed papers published 1999-2024 that reported geographical variation in health or industrial pollution, and/or tested for an association between the two in Louisiana. We used Covidence to support standardized review and extraction. We identified 2485 non-duplicate papers in our search; 53 met the inclusion criteria. Most reported quantitative findings. All studies of industrial pollution described air pollution (some also described other pollution). Studies described various health outcomes, including cancer, respiratory health, mortality, and COVID-19. Overall, people who lived closer to industrial activity had higher pollution exposure and worse health. Black and lower-income residents were exposed to more industrial activity than white and higher-income residents. Twenty-one studies assessed statistical associations between industrial pollution and health; many found an association. Twenty-one studies were quantitative and adjusted for confounding, 29 studies did not adjust for confounding (including qualitative studies), and three studies did not adjust for confounding and had authors with industry ties. Evidence suggests that there is a higher burden of air pollution and worse health outcomes in industrialized areas of Louisiana. While there was some evidence of significant associations between industrial pollution and health outcomes, research with larger sample sizes and improved pollution exposure measurements could be informative.
In Africa, the disease burden of diarrheal and respiratory diseases is amplified by limited surveillance capacity, diagnostic limitations, and socioeconomic inequalities. In rapidly urbanizing settings such as Kigali (Rwanda), integrating wastewater-based epidemiology (WBE) into existing surveillance systems offers a promising strategy for generating real-time epidemiological intelligence, identifying community-level hotspots, and addressing gaps in traditional reporting systems. Gastrointestinal and respiratory infections remain major causes of morbidity and mortality globally, particularly in low- and middle-income countries (LMICs), where traditional clinical surveillance systems frequently underreport the true disease burden. This systematic review synthesizes current evidence on the detection of gastrointestinal and respiratory pathogens in wastewater and evaluates the utility of WBE for early warning and public health action. A narrative review approach was used to identify peer-reviewed literature, global health reports, and surveillance studies focusing on the wastewater detection of gastrointestinal and respiratory pathogens. Databases including PubMed, Scopus, and Google Scholar were searched for studies published between 2000 and 2026. The search yielded 1247 records, of which 312 duplicates were removed. After title/abstract screening, 228 full-text articles were retrieved and assessed for eligibility. After a detailed evaluation, 108 studies were excluded for the following reasons: absence of pathogen-specific wastewater data (n = 46), a focus on environmental monitoring without public health relevance (n = 25), insufficient methodological description (n = 21), or other eligibility limitations such as a lack of primary data (n = 16). WBE provides a non-invasive, cost-effective approach for monitoring symptomatic and asymptomatic infections. Challenges involve variability in sampling, environmental factors affecting viral decay, and differences in laboratory workflows. WBE is a powerful complement to traditional infectious disease surveillance, offering early warning capabilities, population-level coverage, and real-time insights into pathogen circulation. Integrating WBE into surveillance programs, especially in LMICs such as Rwanda, can significantly strengthen epidemic preparedness, guide resource allocation, and improve outbreak response. Sustained investment in laboratory capacity, standardized protocols, and multisector collaboration is essential to fully leverage WBE for public health protection.
Nontuberculous mycobacteria (NTM) are an ecologically diverse group of environmental mycobacteria that are increasingly recognized as an important cause of human and animal disease. While most infections arise from environmental exposure, evidence from outbreak reports and genomic epidemiology suggests animal- associated and device-associated transmission pathways that intersect with human occupational and clinical risk. This review synthesizes current knowledge on zoonotic and animal-associated NTM, including recent taxonomy updates driven by genomic approaches, major reservoirs (including aquaculture, livestock, wildlife, and engineered water systems), as well as clinical and veterinary manifestations, and operational laboratory approaches for detection and characterization. We present a tiered diagnostic framework, ranging from microscopy and culture to targeted polymerase chain reaction (PCR), whole-genome sequencing, and emerging metagenomic and artificial intelligence (AI)-based pipelines, and we discuss biosafety considerations, reporting standards, and One Health surveillance priorities. Key research gaps include distinguishing true animal-to-human transmission from shared-source exposure, harmonizing One Health metadata and antimicrobial resistance (AMR) surveillance, and validating climate-sensitive predictive models. We propose practical, resource-adaptive recommendations for surveillance, laboratory workflows, and outbreak response. A coordinated global investment in integrated One Health genomic surveillance, harmonized metadata standards, and capacity building is urgently required to detect, attribute, and mitigate zoonotic NTM threats.
The toxicity of many pesticides to humans and their contribution to various health problems continue to increase rapidly. This study highlights the inherent effects of highly hazardous pesticides (HHPs) used in smallholder agricultural systems. Primary data were collected through interviews, while secondary data came from scientific databases and search engines, including Scopus, PubMed, Web of Science, and Google Scholar. A total of 810 respondents participated in the study. The characterization of health and environmental impacts was based on the active ingredients mostly used, especially those that have been discontinued, withdrawn, or banned in other regions due to their harmfulness. The toxicological profile focused on effects such as neurotoxicity, reproductive toxicity, developmental toxicity, immunotoxicity, genotoxicity, carcinogenicity, and endocrine disruption. Results show that over 150 active ingredients are used in pesticides, some of which are classified as highly hazardous pesticides (HHPs). Key pesticides like lambda-cyhalothrin, glyphosate, 2,4-dimethylamine, mancozeb, chlorpyrifos, profenofos, cypermethrin, carbendazim, paraquat, atrazine, and carbofuran dominate smallholder farming. The widespread use of HHPs in Tanzania, under current conditions, constitutes a significant public health and environmental crisis, suggesting that knowledge does not always translate into safe practices. The combination of inherently hazardous pesticides, inadequate regulatory oversight, and unsafe handling practices creates a perfect storm of exposure. Strengthening laws and regulations around pesticide registration, post-market monitoring, and enforcement is urgently needed to protect human health and the environment.
Given reports that the Coronavirus Disease 2019 can survive on environmental surfaces for a period, public attention to surface disinfection has increased. However, only a few studies have investigated the current status of standard infection control practices for environmental surfaces. Therefore, we aimed to investigate the implementation status of standard infection control methods for dental environmental surfaces among South Korean dental hygienists and to analyze the factors influencing these practices. A survey was conducted to investigate surface infection control methods in dental office environments. A questionnaire, consisting of general characteristics and infection control methods stratified by environmental surfaces, was distributed to dental hygienists. Overall, 190 dental hygienists responded to the survey; responses from eight participants with incomplete data were excluded, and the remaining 182 responses were analyzed using SPSS software. The surfaces with the highest implementation rate of standard infection control methods were the bracket Table (23.1%), followed by the light-curing unit head. In contrast, drawer handles (0.5%) had the lowest implementation rates. The odds of implementing standard infection control methods were higher for dental hygienists treating 40 or more patients daily compared with those treating 19 or fewer patients. In addition, the odds of implementing standard infection control methods were higher when an infection control personnel was present than when absent. Based on a thorough understanding of dental institutions and accumulated evidence, our findings highlight the need to improve standard infection control methods for efficient implementation, and offer strategies to increase their implementation.
Trifluoroacetic acid (TFA) is an ultrashort-chain perfluoroalkyl substance (PFAS) characterized by environmental persistence, water solubility, and a growing global presence, resulting primarily from the degradation of fluorinated compounds. Evidence suggests that plant-based foods may represent an underestimated exposure route, with wine emerging as a significant dietary source due to accumulation in soils, irrigation water, and plant uptake. This review provides an updated summary of the evidence on the environmental sources and temporal evolution of TFA in wine, its analytical detection, its contribution to dietary exposure, potential implications for human health, and current regulatory attention. A structured but non-systematic literature search was conducted using PubMed and Scopus, supplemented by European reports and monitoring data, and in accordance with SANRA guidelines. Evidence shows that TFA concentrations in wine derive from widespread environmental sources and have increased over time, from negligible levels before the 1970s to a marked increase in recent decades. Reported concentrations range from tens to several hundred µg/L, despite analytical challenges. Exposure estimates indicate that wine may contribute significantly to total dietary TFA intake in regular consumers. Although toxicological data suggest low acute toxicity, uncertainties remain regarding long-term exposure, and regulatory limits for TFA in foods and beverages are lacking.
Psittacosis caused by Chlamydia psittaci has re-emerged in China as sporadic cases and localized outbreaks. However, current knowledge remains fragmented across the clinical, veterinary, epidemiological, and public health fields. This scoping review mapped studies on psittacosis in China, identified major knowledge gaps, and defined priorities for research, clinical management, and prevention and control. Following the Arksey and O'Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), China National Knowledge Infrastructure (CNKI), Wanfang, PubMed, Web of Science, and Embase were searched for studies published between 1 January 1985 and 31 December 2025 and synthesized eligible studies with descriptive statistics and thematic analysis. A total of 424 studies were included. Research interest showed recent sharp increases and was concentrated in Eastern and Central China. Case reports and series dominated the literature, whereas analytic epidemiology, standardized surveillance, and high-resolution molecular studies remained limited. Reported cases were most often documented in middle-aged and older adults with avian exposure, including pet birds and poultry, and the reported occurrence showed a winter-spring pattern. Pneumonia was the predominant clinical presentation, and severe cases could progress to acute respiratory distress syndrome and multi-organ dysfunction. Metagenomic next-generation sequencing (mNGS) was the most frequently reported diagnostic method in recent studies, while PCR and serology remained important complementary tools. Overall, the literature is growing rapidly, but remains uneven in geographic coverage, study design, and integration across human, animal, and environmental sectors. These findings support broader One Health surveillance, stronger analytic and molecular epidemiology, and more standardized approaches to diagnosis, source investigation, and prevention in China.
The Comrades Marathon is the world's oldest and largest ultra-marathon, held annually between Durban and Pietermaritzburg, South Africa, since 1921. As a nationally televised event with substantial participation, it provides a unique natural laboratory for studying the physiological demands of prolonged, high-intensity endurance running. This narrative review synthesizes current evidence on physiological responses, performance trends, and health implications associated with participation in the Comrades Marathon. A systematic search of EBSCO, PubMed, SciELO, and Web of Science identified studies published up to December 2025. Of 116 records retrieved, 42 publications (field studies and case reports) met eligibility criteria and focused specifically on the Comrades Marathon. Women represented 4.2% of finishers, with female participation beginning in 1975. Growth in finishers during the 1970s was driven primarily by men aged 30-59 years. Men were consistently faster than women across all age groups, although the sex performance gap narrowed over time and overall performance improved. Peak performance occurred at ∼29.9 years in men and ∼36.0 years in women. Medical encounters occurred at rates up to 20 per 1000 starters. The most affected organ systems were fluid/electrolyte (8.8%; 8.3-9.4), central nervous system (4.0%; 3.7-4.5), and gastrointestinal (2.9%; 2.6-3.2). Dehydration (7.5%; 7.0-8.1) and exercise-associated muscle cramping (3.2%; 2.9-3.6) were the most common diagnoses. Exercise-associated hyponatremia was uncommon (<2%), whereas hypernatremia was substantially more prevalent. Early race editions reported isolated deaths, likely due to ischemic heart disease. Cardiac biomarker elevations and echocardiographic changes observed post-race were transient. The race induced muscle inflammation without major knee MRI abnormalities. In the 1970s, cases of acute kidney injury and renal failure occasionally required dialysis. Faster, well-trained runners showed higher rates of post-race upper respiratory tract infection than slower, less-trained runners. Participation in the Comrades Marathon is associated with well-characterized post-race physiological disturbances. Notably, the event demonstrates an unusually high prevalence of acute kidney injury and hypernatremia compared with other ultra-endurance races, underscoring the substantial renal and fluid-electrolyte stress imposed by prolonged, high-intensity running in challenging environmental conditions. These insights can inform individualized hydration strategies, targeted race preparation, and optimized medical support for ultra-endurance athletes. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251252644, identifier CRD420251252644.
Neurology and psychiatry have operated as separate disciplines for over a century, yet this division reflects historical and institutional developments rather than the underlying biology of the brain. Contemporary neuroscience shows that brain and mental health disorders share genetic susceptibilities, inflammatory and metabolic pathways, environmental and social risk factors, and clinical features that cross diagnostic boundaries. Cognitive, emotional, sensory, and motor symptoms regularly appear across both neurological and psychiatric populations, and conditions such as seizures, psychosis, mood disorders, cognitive disorders, and sleep disorders are common to both. A brain health framework addresses this reality by treating the brain as a single biological organ whose function emerges from the interplay between genome and exposome - including stress, trauma, social context, existential meaning, pollution, and physical health - and which underlies perception, behaviour, cognition, emotion, resilience, and vulnerability. Translating this perspective into practice requires coordinated action across domains. Clinically, collaborative models such as joint neurology-psychiatry consultations and shared outpatient pathways can be implemented within existing resources to improve diagnostic clarity and continuity of care. In training, a more harmonised curriculum with shared foundations in neurobiology, joint seminars, and cross-rotations would equip clinicians with a common language while preserving specialist depth, and support the emerging fields of preventive neurology and preventive psychiatry. In research, organising studies around shared mechanisms and symptom dimensions, and launching joint funding calls, would enhance translational relevance and reduce duplication. To realise this vision, sustained leadership from European professional bodies is essential to establish collaboration as a shared professional standard.
We explore and summarize the evidence linking cooking to health with consideration of the broader implications for nutrition security. We begin with an overview of social transformations in everyday meal preparation over the past century and how these transformations and cooking at home are associated behaviors. With increased availability of prepared and processed foods in the food environment, making meals at home has emerged as a pro-health behavior with the potential to promote nutrition. Food agency is a means of defining and assessing meal preparation practices, which include cooking but also other practical and cognitive actions. We discuss the theory and measurement of food agency and provide a framework for action to better understand and address possible associations between food agency, cooking skills and behavior, and nutrition security. Available evidence suggests higher level cooking skills, greater frequency of cooking at home, and higher cooking confidence are associated with greater fruit and vegetable intake and higher diet quality. However, numerous barriers to making meals from whole ingredients at home exist including food environments and sociocultural pressures that prioritize convenience. Much of the current research on food and cooking remains focused on consumption. However, more work is needed to articulate the pathways through which food agency and cooking could support dietary quality and nutrition security.
Our commentary critically examines whether the widely accepted projection of a global myopia epidemic, most prominently proposed by Holden et al. (2016), adequately reflects the European context. These projections assume that most regions outside Africa and Oceania will follow an East Asian-type trajectory, implying that Western populations with prolonged formal education are on a similar path. By reviewing recent European epidemiological evidence, including meta-analyses, we highlight that myopia prevalence in European young adults remains approximately 20-30%, substantially lower than the 70-90% levels reported in East Asia. We further examine how differences in educational systems, lifestyle patterns, and environmental exposures, particularly time spent outdoors, may contribute to this divergence. Importantly, this commentary evaluates the extent to which methodological factors influence reported prevalence, particularly in pediatric populations where most epidemiological data are generated. Variation in age structure, sampling strategies, and especially the use of non-cycloplegic refraction can inflate prevalence estimates and contribute to the perception of increasing trends. When analyses are restricted to comparable age groups and cycloplegic data, evidence for a substantial temporal increase in Europe becomes less consistent. Through this analysis, we question whether current global projections may overestimate future risk in Europe by extrapolating from fundamentally different populations. Finally, we propose that monitoring strategies combining pragmatic school-based screening with standardized cycloplegic assessment may provide a more accurate and context-specific understanding of trends. Overall, this commentary suggests that a myopia epidemic is not inevitable and that Europe represents a critical test case for understanding how environmental, educational, and cultural factors shape myopia development.
503B outsourcing facilities were established under the Drug Quality and Security Act of 2013 to address safety concerns in pharmaceutical compounding by enabling large-scale sterile drug production under US Food and Drug Administration (FDA) oversight. Despite regulatory intent, concerns persist regarding inspection rates and compliance with current good manufacturing practices (CGMP). This study aims to investigate FDA oversight, through analysis of inspection activity, of 503B outsourcing facilities registered during the period between 2020 and early 2025. This mixed-methods study analyzed FDA registration and inspection data from public databases for 48 503B outsourcing facilities registered from January 1, 2020 through April 30, 2025. Quantitative measures included inspection frequency, number of significant findings, and time to inspection. Qualitative thematic analysis was conducted on Form 483 and warning letters to identify recurring deficiencies. Of 48 newly registered 503B facilities, only 11 (22.9%) had been inspected, with an average 2.2-year delay from registration to inspection. All inspected facilities had at least 2 significant objectionable findings (mean = 6.2, SD = 3.2). Thematic analysis of 68 findings revealed 5 major domains of deficiency: quality control, personnel training, documentation, process validation, and product labeling. Frequent issues included inadequate sterility testing, poor environmental controls, unvalidated production processes, and deficient recordkeeping. The study reveals critical gaps in FDA oversight of 503B outsourcing facilities, characterized by delayed and infrequent inspections and widespread regulatory noncompliance. These deficiencies pose significant risks to patient safety, particularly in the production of sterile drugs. Immediate regulatory reforms, including adequate FDA funding to support increased inspection frequency, mandatory corrective actions, enhanced staff training, and greater transparency, are necessary to safeguard public health and ensure the integrity of compounded medications.
Since the first reports of organoids cultured from primary human small intestine and colonic epithelium in 2011, these systems have held considerable potential to accelerate our understanding of gastrointestinal (GI) biology and disease. Improvements in tissue isolation and culture conditions for primary tissue organoids, as well as the parallel development of protocols for generating organoids from pluripotent cells, have made organoid research increasingly accessible over the last 15 years. As organoids emerge as bona fide model systems, there is a growing need to understand and evaluate the accuracy and limitations of their ability to represent different aspects of GI biology, both within and across laboratories and experimental contexts. In this Guiding Principles commentary, we outline the current state of the field and challenges for benchmarking human small intestinal and colonic organoids against native GI tract biology. We outline a conceptual framework for approaching organoid benchmarking at multiple scales, review current approaches and efforts in assaying similarities between organoids and their source tissues, and discuss the "next frontiers" for validating organoids as reproducible and high-fidelity models of the human GI tract.
This article provides an overview of the principles of stroke prevention, including the distinctions among primordial, primary, secondary, and tertiary prevention. The relationship between stroke prevention and preservation of brain health is considered, and recent guidelines for primary stroke prevention are emphasized. The current standard for the reduction in risk of stroke focuses on public-facing educational tools and clinical risk prediction algorithms that incorporate demographic, lifestyle, and health factors. Newly developed and validated prediction algorithms include social determinants of health, remove racial biases, and include cardiometabolic and kidney disease. Secondary stroke prevention increasingly accounts for presumed causal mechanisms of stroke while managing risk factors. Long-term monitoring for atrial fibrillation, remote patient monitoring of blood pressure, and increased use of glucagon peptide-like protein-1 receptor agonists are recent developments that may reduce disparities in risk. Vascular risk factor control before and after stroke may help mitigate cognitive decline and dementia by preserving brain health. Social and environmental determinants, or drivers, of health are increasingly recognized contributors to stroke risk, and they may be amenable to policy and population solutions. Primary stroke prevention usually falls to the primary care physician, but neurologists may be involved as well, particularly for patients who present for other reasons or who are incidentally discovered to have cerebral infarcts in the course of evaluation for other conditions. Efforts to prevent stroke will also improve brain health more broadly, including reducing risk of cognitive decline, dementia, and late-life depression.
Astaxanthin (AXT) is a valuable xanthophyll carotenoid extensively utilized across the nutraceutical, pharmaceutical, cosmetic, and aquaculture industries. While this high-demand compound is produced both synthetically and biologically, natural AXT derived from the microalga Haematococcus lacustris (formerly called Haematococcus pluvialis) offers superior bioavailability and safety profiles, dominating the high-value market segment. However, the current industrial reality is hampered by low yields under standard cultivation, significantly restricting commercial viability. This comprehensive review systematically summarizes the latest advancements (2020-2025) in achieving cost-effective and sustainable hyper-production of natural AXT from H. pluvialis. We critically evaluate both established methodologies (e.g., two-phase cultivation, stress induction) and emerging strategies, including CRISPR-Cas9 editing, electrogenetics, and the application of nano-based stressors. Recent studies highlight significant yield enhancements, with reports of 20-35% increases via gene knock-ins and mild electric stimulation, achieving concentrations up to 200 mg L⁻¹. Crucially, this work provides an integrative comparison of advanced genetic engineering tools, nano-based induction protocols, and hybrid cultivation systems, distinguishing it from previous reviews focused predominantly on environmental factor optimization. The analysis offers actionable, evidence-based insights for accelerating the transition from lab-scale innovation to scalable industrial bioprocesses, thereby reducing production costs and enhancing the overall sustainability of natural AXT supply.