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Background This study aimed to evaluate the effectiveness of endocervical curettage (ECC) in detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) in HPV-positive postmenopausal women with a type 3 transformation zone (TZ3) and to identify additional predictive factors. Methods A retrospective observational study was conducted including 137 HPV-positive postmenopausal women who underwent colposcopy, ECC, and subsequent LEEP. Variables analyzed included age group, HPV genotype (16/18 vs. non-16/18), transformation zone type, cytology results, and ECC findings. Univariate and multivariable logistic regression analyses were performed to identify predictors of CIN2 + confirmed by LEEP histology. Results CIN2 + prevalence was 27.7% (38/137); ≥CIN3 occurred in 26/137 (19.0%). In multivariable analysis, high-grade cytology (adjusted OR [aOR] 4.65; 95% CI 1.92–11.30; p  < 0.001), TZ3 (aOR 3.05; 1.05–8.85; p  = 0.040) and hrHPV non-16/18 (aOR 2.52; 1.08–5.90; p  = 0.032) were independently associated with CIN2+, while age ≥ 51 years was not (aOR 1.28; 0.57–2.85; p  = 0.55). Absolute risks of CIN2 + were 36.8% with non-16/18 vs. 16.4% with HPV16/18. ECC (cut-off CIN2+) yielded sensitivity 73.7%, specificity 77.8%, PPV 56.0% and NPV 88.5%. Conclusion In postmenopausal women with persistent hrHPV, high-grade cytology and TZ3 are the main drivers of CIN2+ risk. ECC is most useful as a rule-out test (high NPV), whereas expedited diagnostic-therapeutic LEEP may be considered when ASC-H/HSIL coexists with TZ3 in women without fertility desire. The association between non-16/18 genotypes and CIN2+ observed here warrants confirmation in larger multicentre cohorts.

Invasive alien species (IAS) are a problem, especially in drought-prone environments such as the Mediterranean Basin where the exacerbation of the already severe conditions could constrain the native species acclimatation degree, creating new opportunities for IAS. Climate change may drive IAS expansions, even if different IAS can vary in their acclimatation response. Thus, it is important to obtain a broader insight of how the different IAS face abiotic stress. This research aimed to compare the effect of the imposed water stress on physiological and morphological leaf traits of Ailanthus altissima (AA), Robinia pseudoacacia (RP), and Phytolacca americana (PA), which are widely spread IAS in the Mediterranean Basin. Our results showed a species-dependent effect of the water stress at a physiological and morphological level, as well as an interaction between species and stress duration. Despite a common strategy characterized by low stomatal control of the photosynthesis, AA, PA, and RP differ in their sensitivity to water stress. In particular, even if AA was characterized by a more water-spending strategy, it was more resistant to water stress than PA and RP. In this view, the key factor was its plasticity to increase leaf mass per area (LMA) in response to water stress.

It is often discussed whether the biogeography of free-living protists is better explained by the ‘everything is everywhere’(EiE) hypothesis, which postulates that only ecology drives their distribution, or by the alternative hypothesis of ‘moderate endemicity’ in which geographic barriers can limit their dispersal. To formally test this, it would be necessary not only to find organisms restricted to a geographical area but also to check for their presence in any other place with a similar ecology. We propose the use of environmental niche models to generate and test null EiE distributions. Here we have analysed the distribution of 18S rDNA variants (ribotypes) of the myxomycete Badhamia melanospora (belonging to the protozoan phylum Amoebozoa) using 125 specimens from 91 localities. Two geographically structured groups of ribotypes congruent with slight morphological differences in the spores can be distinguished. One group comprises all populations from Argentina and Chile, and the other is formed by populations from North America together with human-introduced populations from other parts of the world. Environmental climatic niche models constructed separately for the two groups have significant differences, but show several overlapping areas. However, only specimens from one group were found in an intensively surveyed area in South America where both niche models overlap. It can be concluded that everything is not everywhere for B. melanospora. This taxon constitutes a complex formed by at least two cryptic species that probably diverged allopatrically in North and South America.

To evaluate the safety and efficacy as a tool of smoking cessation of electronic cigarettes (e-cigarettes), directly comparing users of e-cigarettes only, smokers of tobacco cigarettes only, and smokers of both. Prospective cohort study. Final results are expected in 2019, but given the urgency of data to support policies on electronic smoking, we report the results of the 12-month follow-up. Direct contact and structured questionnaires by phone or via internet. Adults (30-75 years) were included if they were smokers of ≥1 tobacco cigarette/day (tobacco smokers), users of any type of e-cigarettes, inhaling ≥50 puffs weekly (e-smokers), or smokers of both tobacco and e-cigarettes (dual smokers). Carbon monoxide levels were tested in a sample of those declaring tobacco smoking abstinence. Sustained smoking abstinence from tobacco smoking at 12 months, reduction in the number of tobacco cigarettes smoked daily. We used linear and logistic regression, with region as cluster unit. Follow-up data were available for 236 e-smokers, 491 tobacco smokers, and 232 dual smokers (overall response rate 70.8%). All e-smokers were tobacco ex-smokers. At 12 months, 61.9% of the e-smokers were still abstinent from tobacco smoking; 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence. Adjusting for potential confounders, tobacco smoking abstinence or cessation remained significantly more likely among e-smokers (adjusted OR 5.19; 95% CI: 3.35-8.02), whereas adding e-cigarettes to tobacco smoking did not enhance the likelihood of quitting tobacco and did not reduce tobacco cigarette consumption. E-smokers showed a minimal but significantly higher increase in self-rated health than other smokers. Non significant differences were found in self-reported serious adverse events (eleven overall). Adding e-cigarettes to tobacco smoking did not facilitate smoking cessation or reduction. If e-cigarette safety will be confirmed, however, the use of e-cigarettes alone may facilitate quitters remaining so. NCT01785537.

Background Some cancers such as sarcomas (bone and soft tissue sarcomas) and adenoid cystic carcinomas are considered as radioresistant to low linear energy transfer radiation (including photons and protons) and may therefore beneficiate from a carbon ion therapy. Despite encouraging results obtained in phase I/II trials compared to historical data with photons, the spread of carbon ions has been limited mainly because of the absence of randomized medical data. The French health authorities stressed the importance of having randomized data for carbon ion therapy. Methods The ETOILE study is a multicenter prospective randomized phase III trial comparing carbon ion therapy to either advanced photon or proton radiotherapy for inoperable or macroscopically incompletely resected (R2) radioresistant cancers including sarcomas and adenoid cystic carcinomas. In the experimental arm, carbon ion therapy will be performed at the National Center for Oncological Hadrontherapy (CNAO) in Pavia, Italy. In the control arm, photon or proton radiotherapy will be carried out in referent centers in France. The primary endpoint is progression-free survival (PFS). Secondary endpoints are overall survival and local control, toxicity profile, and quality of life. In addition, a prospective health-economic study and a radiobiological analysis will be conducted. To demonstrate an absolute improvement in the 5-year PFS rate of 20% in favor of carbon ion therapy, 250 patients have to be included in the study. Discussion So far, no clinical study of phase III has demonstrated the superiority of carbon ion therapy compared to conventional radiotherapy, including proton therapy, for the treatment of radioresistant tumors. Trial registration ClinicalTrials.gov identifier: NCT02838602 . Date of registration: July 20, 2016. The posted information will be updated as needed to reflect protocol amendments and study progress.

Background Air pollution remains one of the most significant environmental health threats in urban areas. Ground-level O 3 , a secondary pollutant formed through photochemical reactions of nitrogen oxides (NOx) and volatile organic compounds (VOCs) under sunlight, can lead to serious respiratory and cardiovascular effects. This study aimed to quantify the short-term mortality and economic burden attributable to O 3 exposure in Qom, central Iran, during the summer of 2019, providing local evidence to support air quality management policies. Methods Hourly O 3 concentration data were collected from the Qom Environmental Protection Agency for April to August 2019. After data cleaning and interpolation, the daily maximum 8-h average O 3 concentration was calculated. Health impact and related economic burden were estimated using the U.S. EPA’s BenMAP-CE model (version 1.5.8.11). Relative risk (RR) and baseline incidence (BI) values for cardiovascular and respiratory mortality were obtained from previous epidemiological studies. The Value of Statistical Life (VSL) was adjusted for Iran’s gross domestic product (GDP) to estimate the economic cost. Descriptive statistics and concentration–response functions were applied to determine avoidable deaths and associated losses. Results The mean 8-h maximum O 3 concentration during the study period was 0.16 ppm, exceeding the EPA guideline (0.07 ppm) by 2.18 times. Short-term exposure at this level was linked to an estimated 239 premature deaths, including 190 from cardiovascular and 49 from respiratory diseases. The highest impact was observed in adults aged 30–39 years. The total economic loss attributed to these deaths was approximately 43.6 million USD, indicating a substantial burden on public health and the economy. Conclusions This study highlights the urgent need for effective air quality management in Qom. Reducing emissions of O 3 precursors such as NOx and VOCs, especially during warm months, could yield considerable public health and economic benefits. Localized assessments using tools like BenMAP-CE can inform evidence-based policymaking and contribute to sustainable urban development.

Objectives: Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disease with still unknown etiology. We aimed at investigating the association between environmental and occupational factors with ALS risk. Methods: We performed a population-based case-control study in four Italian provinces (Catania, Modena, Novara, and Reggio Emilia) by administration of tailored questionnaires to ALS cases (n = 95) and randomly selected population referents (n = 135). We estimated ALS risk by calculating the odds ratio (OR) with its 95% confidence interval (CI) using an unconditional logistic regression model. Results: We found a positive association with disease risk for history of occupation in the agricultural sector (OR = 2.09, 95% CI 0.79–7.54), especially for longer than 10 years (OR = 2.72, 95% 1.02–7.20). Overall occupational exposure to solvents also suggested a positive association, especially for thinners (OR = 2.27, 95% CI 1.14–4.54) and paint removers (OR = 2.01, 95% CI 0.90–4.48). Both occupational and environmental exposure to electromagnetic fields show a slightly increased risk with OR = 1.69 (95% CI 0.70–4.09) and 2.41 (95% CI 1.13–5.12), respectively. Occupational but not environmental exposure to pesticides (OR = 1.22, 95% CI 0.63–2.37), particularly fungicides, and exposure to metals (OR = 4.20, 95% CI 1.88–9.38), particularly lead, mercury, and selenium, showed an imprecise but positive association. Finally, there was an indication of increased risk for living in proximity to water bodies. Conclusions: Despite the caution that needs to be used due to some study limitations, such as the low number of exposed subjects and the possibility of recall bias, these results suggest the potential role of some environmental and occupational factors in ALS etiology.

Background: Microplastics (MPs) and Nanoplastics (NPs) are plastic fragments that spread in the environment and accumulate in the human body, so they have been becoming a worldwide environmental concern because of their potential human health effects. The aim of this systematic review was to investigate the prospective impact of MPs and NPs on the inflammatory process. Methods: Electronic article search was performed on PubMed, Scopus and Web of Science international databases from 1 Jan 2012 to 31 Dec 2021. Screenings of titles, abstracts and full texts were performed according to the Preferred Reporting Item for Systematic Review and Meta-analyses (PRISMA). The methodological quality of the studies was checked by the Toxicological data Reliability Assessment Tool. Results: Electronic article search identified 125 records, from which 6 in vitro, 11 in vivo and 2 both in vivo and in vitro studies were included. Both in vivo and in vitro studies have showed an increase ofdifferent inflammatory outcomes (Interleukines, Tumor necrosis factor, Chemokines, Interferones, Transcription factors, Growth factors, Oxydoreductase, Proteins and others), thus it seems to confirm the association withthe exposure to microplastics of different types, sizes, exposure times and exposed species. Conclusions: This systematic review seems to support the relationship between the exposure to MPs and the inflammatory processboth in vivo and in vitro. Greater caution is needed about the role of NPs because ofa very small number of studies. Additional high-quality studies are warranted to confirm these results, especially the research should be focused on NPs being lacking literature.

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.

Polystyrene Microplastics (PS-MPs) affect testicular activity, as evidenced by increased oxidative stress, apoptosis, and autophagy activation, impairing steroidogenesis and spermatogenesis. The present study investigates, for the first time in vivo, the potential protective effect of D-aspartate (D-Asp) against PS-MPs-induced damage on the testicular function of adult rats. D-Asp, well-known stimulator of testosterone biosynthesis and spermatogenesis progression, possesses pharmacological properties, including antioxidant and anti-apoptotic ones. The results showed that PS-MP’s adverse effects on testicular activity were reversed by D-Asp treatment. Mechanistically, D-Asp inhibited testicular oxidative stress by modulating the protein levels of CAT, SOD1, SOD2, and 4-HNE; affecting TBARS levels; and reducing apoptosis, as suggested by CYT C analysis and a TUNEL assay. Furthermore, D-Asp administration mitigated PS-MPs-induced autophagy activation by modulating the expression of LC3BI, LC3BII, and p62 proteins. Finally, the amino acid counteracts PS-MPs damage on steroidogenesis and spermatogenesis by restoring normal levels of steroidogenic (StAR, 3β-HSD, and 17β-HSD) and spermatogenic (PCNA and SYCP3) markers. This study encourages further research to understand the potential value of the amino acid in improving human testicular health and male fertility.