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Hypocalcaemia remains a prevalent laboratory finding in pregnancy, capable of inducing adverse maternofoetal outcomes. This study compares the prevalence of hypocalcaemia in apparently healthy pregnant women from the ionised, and total calcaemia viewpoints and further identifies factors associated with total crude and ionised hypocalcaemia in pregnancy. A hospital-based cross-sectional study was conducted between November 2020 and September 2021, targeting apparently healthy pregnant women received in late pregnancy in four maternities in the Nkongsamba Health District, Cameroon. Blood samples were collected and analysed for serum ionised calcium concentrations and pH (by ion-selective electrode potentiometry), and for total calcium and albumin concentration (by atomic absorption spectrophotometry). Sociodemographic, obstetric and nutritional data were collected using an interviewer-administered questionnaire. The average age of the 1074 participants included in the study was 28.20±6.08 years. The prevalence of total crude and total albumin-corrected hypocalcaemia in this study was 61.64 [58.69-64.50]% and 56.70 [53.72-59.64]%, respectively (p-value = 0.000). The prevalence of ionised hypocalcaemia was very low (2.89 [2.04-4.07]%) compared with the prevalence of total hypocalcaemia (p-value = 0.000). Monthly income below 100.000FCFA (179 USD) (AOR = 0.73, p-value = 0.024), taking more than 2 meals daily (AOR = 0.68, p-value = 0.006) and taking desserts (AOR = 0.73, p-value = 0.046) reduced the odds of total crude hypocalcaemia, while having banana/plantain and tubers as the content of their most consumed meal significantly increased the odds of total crude hypocalcaemia (AOR = 1.37, p-value = 0.012). Single women (AOR = 2.54, p-value = 0.021), with a higher education (AOR = 3.27, p-value = 0.017), who initiated antenatal care before 4 months (AOR = 2.47, p-value = 0.029), had their odds of ionised hypocalcaemia significantly increased. On the other hand, women below 30 years (AOR = 0.44, p-value = 0.039), with occupations other than housewife (AOR = 0.34, p-value = 0.027), and women who took desserts between meals (AOR = 0.45, p-value = 0.034) had their odds of ionised hypocalcaemia significantly reduced. Taking calcium supplements simultaneously with other supplements also significantly reduced the odds of total hypocalcaemia in pregnancy (OR = 0.69, p-value = 0.027). Ionised hypocalcaemia in pregnancy is a rare finding. Only 2.89% of all apparently healthy pregnant women have ionised hypocalcaemia in late pregnancy, while 56.70% have total hypocalcaemia. Factors like the daily number of meals, taking of desserts, the content of the most consumed meal and monthly revenue significantly affect the prevalence of total hypocalcaemia in pregnancy. On the other hand, factors like age above 30 years, having a higher education, being single, having initiated antenatal care before 4 months of pregnancy, being a housewife and not taking desserts between meals have a significantly positive association with ionised hypocalcaemia.

Background Aitchisonia rosea ( A. rosea ), traditionally used for oxidative stress-related conditions, lacks comprehensive scientific validation of its antioxidant mechanisms and cellular protective effects. This study aimed to meticulously investigate the phytochemical composition, in vitro antioxidant capacity, and protective efficacy of A. rosea extracts and essential oil against oxidative damage in biomolecular and cellular models. Results Analysis of the essential oil by gas chromatography-mass spectrometry (GC-MS) identified key bioactive components, including sesquiterpenes (e.g., germacrene, beta-caryophyllene) and oxygenated monoterpenes (e.g., carvacrol, linalool). Various solvent extracts, particularly methanol, ethyl acetate, and n -butanol fractions, along with the essential oil, demonstrated potent antioxidant activities across multiple assays including radical scavenging (DPPH), reducing power (FRAP), and Trolox equivalent antioxidant capacity (TEAC), indicating significant free radical neutralisation capabilities. Crucially, these samples provided substantial protection against hydrogen peroxide (H 2 O 2 )-induced genotoxicity, evidenced by reduced DNA damage in comet assays and enhanced preservation of plasmid DNA integrity in gel-based assays. Furthermore, the extracts and essential oil significantly inhibited oxidative haemolysis in red blood cells (RBCs), demonstrating effective membrane stabilisation. Throughout all biological assessments, low cytotoxicity profiles were observed, as demonstrated by the haemolytic assay, affirming the safety of the tested materials. Conclusions The findings substantiate the remarkable antioxidant and cytoprotective potential of A. rosea , primarily attributed to its rich array of polyphenolic, flavonoid, and terpenoid compounds. The demonstrated ability to safeguard both DNA and erythrocyte membranes from oxidative insults establishes A. rosea as a scientifically validated candidate for further pharmaceutical and industrial development, particularly for applications targeting oxidative stress-mediated diseases.

Municipal solid waste incineration generates by-products like nitrogen oxides, sulfur dioxide, and hydrogen chloride, contributing to environmental issues such as acid rain, ozone depletion, and photochemical smog. While industrial sites use desulfurization and denitrification to reduce emissions, no studies have modeled the formation mechanisms and influencing factors of these pollutants from a pollution reduction perspective. This study first analyzes the municipal solid waste incineration process to identify the main factors affecting the concentration of pollutants related to desulfurization and denitrification. A coupled numerical simulation model for the whole life cycle desulfurization and denitrification process in real municipal solid waste incineration power plants is then constructed using a method that couples two software tools. Next, based on a double orthogonal experimental design, virtual simulation data are generated using the numerical simulation model. Finally, an improved interval type-II fuzzy broad learning algorithm is applied to construct a mechanism model for the whole process of desulfurization and denitrification-related pollutant concentration, using the obtained virtual simulated data. Using a Beijing incineration plant as a case study, the whole life cycle model is successfully established. The research provides data for optimizing pollutant reduction, examines influencing factors, and lays the groundwork for future intelligent control.

Oral diseases associated with systematic diseases as metabolic and vasculitic have been included in this paper. This will enhance our understanding of the salivary function in promoting healthy oral condition. The study investigates the effects of type I and type II diabetes mellitus in well-controlled diabetic patients, in addition to Behçet disease (BD) on saliva flow rate (SFR), pH, the decay, missing, and filled tooth (DMFT) index, glucose, and major earth-alkaline ions (Ca2+ and Mg2+) compared to healthy males and age-matched controls. Saliva samples were collected from 1403 male human subjects, distributed on 7 levels including 3 control groups, and analyzed. The symptoms and clinical observations were enrolled. A preprandial salivary glucose has illustrated statistically strong significant and positive correlations with HbA1c and blood glucose levels. TIDM saliva showed lower pH, SFR, and Ca2+ but higher Mg2+, caries risk, and poor metabolic control. These led to dysfunction of secretory capacity of salivary glands. TIIDM proved higher SFR, DMFT, and glucose than TIDM patients. DM oral calcium has decreased by age while magnesium sharply slopes at seniority. BD oral fluid is associated with lower glucose and minerals but noticeably with both higher pH and DMFT.

Despite the evidence that calcium supplementation in pregnancy improves maternofoetal outcomes, many women still do not take calcium supplements during pregnancy in Cameroon. This study identifies factors that influence calcium supplementation during pregnancy in a low resource setting. We conducted a cross-sectional hospital-based study (from November 2020 to September 2021) targeting 1074 healthy women in late pregnancy at the maternities of four major health facilities in the Nkongsamba Health District, Cameroon. Data were collected using an interview-administered semi-structured questionnaire and analysed using Epi Info version 7.2.4.0, and the statistical threshold for significance set at p-value = 0.05. The mean age of the participants was 28.20±6.08 years, with a range of 15-47 years. The proportion of women who reported taking any calcium supplements in pregnancy was 72.62 [69.85-75.22]%. Only 12% of calcium-supplemented women took calcium supplements throughout pregnancy, while a majority (50%) took calcium supplements just for 4-5 months. Women believe that taking calcium supplements is more for foetal growth and development (37.12%) and prevention of cramps (38.86%), than for the prevention of hypertensive diseases in pregnancy (2.84%). About all pregnant women (97.65%) took iron and folic acid supplements during pregnancy, and 99.24% took these supplements at least once every two days. Upon control for multiple confounders, the onset of antenatal care before 4 months of pregnancy (AOR = 2.64 [1.84-3.78], p-value = 0.000), having had more than 3 antenatal care visits (AOR = 6.01 [3.84-9.34], p-value = 0.000) and support/reminder from a partner on the necessity to take supplements in pregnancy (AOR = 2.00 [1.34-2.99], p-value = 0.001) were significantly associated with higher odds of taking any calcium supplements in pregnancy. Calcium supplementation practices in pregnancy remain poor in this population and far from WHO recommendations. Early initiation of antenatal care, a high number of antenatal visits and reminders or support from the partner on supplement intake significantly increase the odds of taking any calcium supplements in pregnancy. In line with WHO recommendations, women of childbearing age should be sensitised to initiate antenatal care earlier and attain as many visits as possible. Male involvement in prenatal care might also boost the likelihood of these women taking calcium supplements.

Disorders of total calcium (tCa) in pregnancy have been associated with adverse maternofoetal outcomes. However, studies evaluating this from the viewpoint of ionised calcaemia are practically inexistent. This study estimates the prevalence of some adverse maternal and foetal outcomes and the potential effect of ionised calcium (iCa), tCa, albumin and calcium supplementation on some maternofoetal outcomes. A cross-sectional study was conducted among 1074 pregnant women in late pregnancy from four health facilities in the Nkongsamba Health District. Data were collected by interview, analysis of maternal blood samples and measurement of maternal and foetal parameters. Total calcaemia and albuminaemia were measured by atomic absorption spectrophotometry, while iCa and pH were measured using ion-selective potentiometry. Associations were measured using the odds ratio in simple and multiple logistic regression. The prevalence of low birth weight, macrosomia, and hypertension in pregnancy was 6.27 [4.97-7.89]%, 4.78 [3.65-7.89]%, 10.24 [8.57-12.20]%, respectively. Following multiple logistic regression, women with iCa levels ≤ 1.31mmol/L had significantly increased odds of hypertension in pregnancy (AOR = 2.47 [1.63-3.74], p-value = 0.000), having babies with low birth weight (AOR = 2.02[1.33-3.61], p-value = 0.002), low birth length (AOR = 2.00 [1.34-2.99], p-value = 0.001), low brachial circumference (AOR = 1.41[1.10-1.81], p-value = 0.007), first minute Apgar score < 7 (AOR = 3.08[1.70-5.59], p-value = 0.000) and fifth minute Apgar score < 7 (AOR = 2.86[1.32-6.16], p-value = 0.007). Ionised calcaemia had no significant association with maternal body mass index immediately after birth and the head circumference of the baby. Total calcaemia was found to have no significant association with any of the selected outcomes, while women with total albuminaemia ≤ 30mg/L had significantly higher odds of having babies with low birth weight (AOR = 3.40[1.96-5.91], p-value = 0.000), and Apgar scores < 7 at the first (AOR = 2.07[1.16-3.70], p-value = 0.013). Calcium supplementation showed no significant association with any of the selected outcomes except for the first (OR = 0.42[0.24-0.72], p-value = 0.002) and fifth minute Apgar score (OR = 0.25[0.12-0.50], p-value = 0.000). The prevalence of low birth weight, macrosomia, and hypertension in pregnancy was 6.27 [4.97-7.89]%, 4.78 [3.65-7.89]%, 10.24 [8.57-12.20]%, respectively. Maternal iCa levels ≤ 1.31mmol/L significantly increase the odds of having babies with low birth weight, low birth length, low brachial circumference at birth, low Apgar scores at the first and fifth minutes and maternal hypertension in pregnancy. Low maternal albuminaemia is significantly associated with low birth weight, and Apgar score < 7 at the first minute. None f the selected maternofoetal outcomes directly depend on total calcaemia, given that none of the associations was statistically significant. Even though iCa levels remain relatively normal in normal pregnancies, it remains the strongest predictor of foetal outcomes. Calcium supplementation significantly improves the Apgar scores at the first and fifth minute. Routine pregnancy follow-up should include evaluating maternal calcaemic states, particularly the ionised fraction, to detect the low-normal concentrations likely to impact maternal and foetal outcomes. Normal iCa levels for pregnant women need revisiting.

Background Despite its prevalence, Familial Mediterranean Fever (FMF) remains poorly understood, with limited therapeutic options available to manage its debilitating symptoms. The discovery of a potential link between FMF and dietary components has sparked new hope for personalized nutritional interventions, yet the complex interplay between genetic and environmental factors underlying disease pathogenesis remains unclear. Objectives This study aimed to investigate the complex relationships between dietary components, nutrient profiles, and FMF symptoms, with a focus on developing personalized nutrition strategies for FMF management. Methods This cross-sectional study recruited 100 FMF patients and 50 healthy controls, matched for age, sex, and ethnicity. Participants completed a comprehensive food frequency questionnaire, and blood samples were analyzed for biomarkers of inflammation and nutrient profiles. Advanced statistical methods were employed to identify patterns and correlations between dietary components, nutrient profiles, and FMF symptoms. Results The study revealed significant correlations between FMF symptom severity and specific dietary components, including pro-inflammatory omega-6 fatty acids, advanced glycation end-products, and lectins, as well as anti-inflammatory omega-3 fatty acids, antioxidants, and fiber. Factor analysis identified four distinct dietary patterns, which collectively explained 92.86% of the variance in FMF symptom severity. The adoption of an anti-inflammatory diet was associated with improved symptom management and quality of life. Conclusions This study provides novel insights into the complex relationships between dietary components, nutrient profiles, and FMF symptoms, highlighting the potential for personalized nutrition strategies to revolutionize FMF management. The identification of specific dietary components associated with FMF symptom severity has significant implications for the development of targeted dietary recommendations that address individual patients’ unique requirements. Further research is necessary to fully elucidate the mechanisms underlying these relationships and to develop effective personalized nutrition strategies for FMF management. WHO clinical trial registry TCTR20241022008 (Familial Mediterranean Fever - Dietary Habits and Symptom Management, Date of Registration: 17 November, 2024) ( https://www.thaiclinicaltrials.org/show/TCTR20241022008 ). Graphical abstract

Multiple electrolyte disorders, including sodium, potassium and calcium disorders, have been associated with hypertension in pregnancy. Most of these studies failed to evaluate the combined effect of low and high sodium, potassium, calcium and chloride ion concentrations on hypertension in pregnancy. This study evaluates the combined effect of these ion categories (low, normal, high) on hypertension in pregnancy. Biochemical ion assays and blood pressure measurements were carried out on 1074 apparently healthy pregnant women in late third trimester. Serum potassium, sodium, chloride, and ionised calcium were measured by ion-selective electrode potentiometry, while total plasma calcium was measured by absorption spectrophotometry. Hypertension in pregnancy was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. The prevalence of hyponatraemia, hypokalaemia, hypochloraemia, ionised hypocalcaemia and total hypocalcaemia in late pregnancy was 1.30 [0.78–2.18]%, 3.55 [2.60–4.84]%, 1.96 [1.28–2.97]%, 1.49 [0.92–2.21]% and 43.58 [40.64–46.56]%, respectively. Hypernatraemia, hyperkalaemia, hyperchloraemia, ionised hypercalcaemia and total hypercalcaemia were found in 1.49 [0.92–2.41]%, 2.34 [1.59–3.43]%, 4.38 [3.31–5.77]%, 39.94 [37.06–42.90]%, 2.79 [1.96–3.96]% of the participants, respectively. The prevalence of hypertension in pregnancy was 7.17 [5.77–8.87]%. When ion categories were considered in multiple logistic regression, only ionised and total calcium had significant associations with hypertension in pregnancy. Women with ionised hypercalcaemia had lower odds of hypertension in pregnancy (AOR = 0.50 [0.29–0.87], p-value = 0.015), and women with total hypocalcaemia had higher odds of hypertension in pregnancy (AOR = 1.99 [1.21–3.29], p-value = 0.007), compared to women with ionised and total normocalcaemia, respectively. Increasing kalaemia was associated significantly with higher odds of hypertension in pregnancy; however, kalaemia below and above the normal concentrations had no significant association with hypertension. Nonetheless, participants with kalaemia ≤ 3.98 mmol/L, had lower odds of hypertension in pregnancy compared with those with higher kalaemia (OR = 0.40 [0.24–0.66], p-value = 0.0003). Calcium disorders remain the most frequent electrolyte disorders in pregnancy. When normal cut-offs are considered for calcium and other ions, only ionised and total calcium influence the occurrence of hypertension in pregnancy. Kalaemia seems to affect hypertension in pregnancy but primarily within its normal concentrations. Serum electrolyte follow-up is indispensable for a proper pregnancy follow-up.

The intersection of nutrition and digital innovation is rapidly reshaping approaches to dietary assessment, behavior change, and public health promotion. This study integrates findings from a comprehensive narrative literature review, expert opinion synthesis, a case study of digital nutrition interventions in Syria, and a quantitative cross-sectional needs assessment involving 900 residents of Damascus Governorate. The quantitative survey is reconceptualized as a foundational stage identifying the prevailing nutrition challenges and behavioral patterns among Damascus residents. The subsequent narrative review and Syrian case study build on these baseline insights, critically evaluating how current digital interventions align with, or fall short of, addressing these empirically defined local needs. The qualitative component identifies emerging trends in personalized nutrition platforms, mobile food tracking applications, and tele-nutrition counseling, highlighting their diverse functionalities and potential benefits in both developed and humanitarian settings. The Syrian case study illustrates how context-specific digital initiatives—such as e-Nutrition platforms and mobile apps—can yield documented positive impacts on nutrition knowledge and dietary habits, even amidst crisis conditions. The quantitative needs assessment reveals significant health concerns, including an estimated high prevalence, based on self-reported data, of physical inactivity (58% not meeting WHO recommendations), suboptimal dietary intake, and overweight/obesity (55%). These estimates, derived from a convenience sample with likely education and digital engagement biases, highlight notable disparities by sex, age, and education. Multivariate regression analysis confirms key sociodemographic predictors of these behaviors. Specifically, females were significantly associated with low physical activity and overweight/obesity (AORs 1.80 and 1.45, respectively), while males were associated with low fruit/vegetable intake (AOR 1.60). Collectively, the findings underscore the promise of digital technologies in advancing nutrition equity and health outcomes, while also emphasizing the need for culturally adapted, targeted, and evidence-informed interventions that specifically address the identified local disparities. Addressing barriers such as digital literacy, infrastructure limitations, and privacy concerns is essential for equitable implementation. The study calls for targeted policies and future research to formally validate local digital tools and enhance their scalability in resource-constrained and conflict-affected settings. Graphical Abstract

Hypocalcaemia in pregnancy remains a major health issue, particularly in the developing world where daily calcium intakes are suboptimal. This electrolyte imbalance can lead to severe maternofoetal and childhood consequences. Calcium supplementation, amongst others, contributes significantly to meeting calcium demands in pregnancy. With ionised calcaemia as the gold standard for diagnosis, total calcaemia and albumin-corrected calcaemia in other pathological states have been found to overestimate the burden of hypocalcaemia. The main objectives of this study are to describe the blood calcium level (total, albumin corrected, and ionised calcaemia) and associated maternofoetal outcomes while identifying determinants of calcium supplementation and ionised hypocalcaemia. This study will also evaluate the sensitivity and specificity of albumin corrected calcaemia as a diagnostic tool for hypocalcaemia (ionised calcaemia as the gold standard) among pregnant women in the Nkongsamba Regional Hospital, Cameroon. Our study will target a total of 1067 term pregnant women who shall be included consecutively into the study as they arrive the maternity of the Nkongsamba Regional Hospital for their last antenatal care visit. Data shall be collected using a semi-structured interview-administered questionnaire and blood samples collected for total plasma calcium, albumin and serum ionized calcium assays. Additional data will be collected at birth (maternal and foetal variables; foetal outcomes evaluated as secondary outcomes). Total calcaemia and albuminemia shall be measured by atomic absorption spectrophotometry, while ionised calcaemia will be measured by ion-selective electrode potentiometry(using MSLEA15-H electrolyte analyzer) per standard BIOLABO and MSLEA15 protocols, respectively. Data will be analysed using the statistical softwares epi-Info version 7.2.2.16 and STATA version 16. This study will present a more precise estimate of the burden of hypocalcaemia in late pregnancy as well as identify and analyse the different factors associated with calcium supplementation and ionised hypocalcaemia among term pregnant women in a developing world setting. Maternofoetal outcomes associated with hypocalcaemia will be determined as well as the sensitivity and specificity of total and albumin-corrected calcaemia in diagnosing hypocalcaemia. Our findings will contribute significantly to designing or strengthening interventions to control this electrolyte imbalance.