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Helicobacter pylori (H. pylori) is the main causative agent responsible for chronic gastritis, peptic ulcer, and gastric cancer in humans. An important virulence factor of H. pylori is urease that converts urea into ammonia, producing a neutral microenvironment, which allows colonization and survival in the stomach lining. Although various therapies have been introduced for the treatment of H. pylori infection, the eradication failure rate stays as high as 5-20% along with frequent recurrence of gastric ulcers even after complete healing. Looking for an alternative mode of treatment using natural products, we investigated the effects of pomegranate peel and licorice extracts that had been fractioned using ethyl acetate and methanol into 4 fractions (F1-F4) on the growth (disc diffusion and minimum inhibitory concentration - MIC) and urease activity of this pathogen. We found that all fractions had antimicrobial activity with the maximum activity observed with the F1 fraction of both pomegranate peel and licorice extracts with growth inhibitory zones of 33 mm and 26 mm, and MICs of 2 and 1 mg/ml, respectively. The F2 and F4 fractions of licorice extract, and F3 of pomegranate peel extract showed MIC values of 4 mg/mL, whereas the F4 fraction of pomegranate peel extract and F3 of licorice extract showed MIC values of 8 mg/ml. The F1 and F2 fractions of pomegranate peel caused 80 and 91% inhibition of urease activity and the F1 fraction of licorice caused total inhibition (100%) of H. pylori urease activity at MIC values. In conclusion, these results indicate that both pomegranate and licorice contain important bioactive compounds against H. pylori and should be examined further to help in the fight against this important pathogen. [ABSTRACT FROM AUTHOR]

Olive mill wastewater (OMW) is a common pollutant in Jordan due to the large number of olive mills and the importance of the olive oil industry in the country. In this study, the effects of OMW and fertilizer on soil microbial populations were examined by counting the number of microbial colonies on each plate after respective treatments with water, OMW, and fertilizer. Colonies were identified based on macroscopic and microscopic examination as well as a range of biochemical tests. After treatment with OMW, a significant increase was exhibited in the Bacillus (p-value of 0.011 in clay) and Yeast (pvalues of 0.001 in clay and 0.037 in sand) populations. In contrast, Staphylococcus, Streptomyces (p-values of 0.034 in clay and 0.016 in sand) and Mold (p-value of 0.013 in sand) exhibited population decreases. Our results showed that OMW significantly affects natural soil microbial populations, which is an important finding as most of the OMW in Jordan is disposed of in a way that exposes it to the soil. This study illustrated that OMW has a potential to be recycled and utilized as an antibacterial agent. Further studies should be conducted using molecular PCR analysis in order to accurately determine the species of each studied microorganism. [ABSTRACT FROM AUTHOR]

One step polymerization of [2-(methacryloyloxy)-ethyl trimethyl ammonium chloride] (METAC) onto the surface of silicon dioxide nanopowder (SDNP) has been carried out to achieve quaternized polymer/nanosilica composite. Various aspects of a quaternized polymer (such as anion selectivity, ion exchange capacity, biocompatibility and antibacterial activity) have been evaluated for the possible applications in analytical and biomedical fields. The composite has been characterized by FTIR, TGA, TEM, and chemical and biochemical analysis. The role of SDNP in polymerizing METAC has been elucidated. The core-shell structure of the composite favors chromate selectivity and desireable bioactivity. [ABSTRACT FROM AUTHOR]

Background: GPs can detect cognitive impairment at a very early stage, allowing early support for people and their caregivers. The early onset of cognitive impairment is between 50 and 60 years. Currently, in France, the Mini Mental State Examination remains the most used screening test, though it has a lower sensitivity and specificity than the Montreal Cognitive Assessment (MoCA) for detecting mild cognitive impairment, taking an average of 15 minutes to complete., Aim: To investigate the feasibility of the MoCA during routine consultations in general practice for the early detection of cognitive impairment and to determine prevalence of cognitive impairment in a primary care setting., Design & Setting: A quantitative, prospective feasibility study was carried out in real-life working condition during routine consultation., Method: GPs performed MoCA on adults aged 50 years and older, without suspected or confirmed cognitive impairment., Results and Conclusion: 61 GPs performed 221 MoCA with a mean duration of 8 minutes and detected mild neurocognitive impairment in 62% of patients. The MoCA is feasible and easy to perform during routine consultations in general practice by trained and experienced physicians., (Copyright © 2024, The Authors.)

Monoterpenoid indole alkaloid (MIA) biosynthesis in Catharanthus roseus is a paragon of the spatiotemporal complexity achievable by plant specialized metabolism. Spanning a range of tissues, four cell types, and five cellular organelles, MIA metabolism is intricately regulated and organized. This high degree of metabolic differentiation requires inter-cellular and organellar transport, which remains understudied. Here, we have characterized a vacuolar importer of secologanin belonging to the multidrug and toxic compound extrusion (MATE) family, named CrMATE1. Phylogenetic analyses of MATEs suggested a role in alkaloid transport for CrMATE1, and in planta silencing in two varieties of C. roseus resulted in a shift in the secoiridoid and MIA profiles. Subcellular localization of CrMATE1 confirmed tonoplast localization. Biochemical characterization was conducted using the Xenopus laevis oocyte expression system to determine substrate range, directionality, and rate. We can confirm that CrMATE1 is a vacuolar importer of secologanin, translocating 1 mM of substrate within 25 min. The transporter displayed strict directionality and specificity for secologanin and did not accept other secoiridoid substrates. The unique substrate-specific activity of CrMATE1 showcases the utility of transporters as gatekeepers of pathway flux, mediating the balance between a defense arsenal and cellular homeostasis., (© 2024. The Author(s).)

Consumption of toxic metal contaminated fish is a significant risk to human health. The Ganga river is one of the vital river systems in India, and it nurtures a rich biodiversity of flora and fauna. In the present study, screening of potential toxic metal elements (Cd, Cr, Mn, Cu, Pb, Ni, Zn, and As) was undertaken in 31 food fishes, especially the small indigenous fishes (SIFs) from the lower stretch of river Ganga by inductively coupled plasma mass spectrometry (ICP-MS). The concentration of toxic metal elements varied among different fish species. Among the toxic metal elements studied, Cr, Zn, and As were found to be dominant in Eleotris fusca; Cd, Ni, and Pb were highest in Securicula gora; Cu was highest in Cabdio morar; and Mn was highest in Coilia dussumieri. The average pollution load index values (APLI) for all the fishes analyzed were less than one except for Eleotris fusca, which indicated no serious toxic metal element pollution load. The estimated daily intake values (EDI) for the toxic metal elements were found to be within the permissible maximum tolerable daily intake (MTDI). Among the fishes studied, only a few species showed hazard index (HI) greater than one, indicating non-carcinogenic health risks. Similarly, the target carcinogenic values (TCR) for most of the toxic metal elements were below the permissible limit (10 -4 ) in the fishes that assures minimal cancer risk. This study provides a comprehensive data on the composition of potential toxic metal elements of 31 food fishes from the lower stretch of the river Ganga, the first of its kind, and suggests the necessity of periodic monitoring of these in the aquatic ecosystem., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The COVID-19 pandemic has necessitated changes in European healthcare systems, with a significant proportion of COVID-19 cases being managed on an outpatient basis in primary healthcare (PHC). To alleviate the burden on healthcare facilities, many European countries developed contact-tracing apps and symptom checkers to identify potential cases. As the pandemic evolved, the European Union introduced the Digital COVID-19 Certificate for travel, which relies on vaccination, recent recovery, or negative test results. However, the integration between these apps and PHC has not been thoroughly explored in Europe., Objective: To describe if governmental COVID-19 apps allowed COVID-19 patients to connect with PHC through their apps in Europe and to examine how the Digital COVID-19 Certificate was obtained., Methodology: Design and setting: Retrospective descriptive study in PHC in 30 European countries. An ad hoc, semi-structured questionnaire was developed to collect country-specific data on primary healthcare activity during the COVID-19 pandemic and the use of information technology tools to support medical care from 15 March 2020 to 31 August 2021. Key informants belong to the WONCA Europe network (World Organization of Family Doctors). The data were collected from relevant and reliable official sources, such as governmental websites and guidelines., Main Outcome Measures: Patient's first contact with health system, governmental COVID-19 app (name and function), Digital COVID-19 Certification, COVID-19 app connection with PHC., Results: Primary care was the first point of care for suspected COVID-19 patients in 28 countries, and 24 countries developed apps to complement classical medical care. The most frequently developed app was for tracing COVID-19 cases (24 countries), followed by the Digital COVID-19 Certificate app (17 countries). Bulgaria, Italy, Serbia, North Macedonia, and Romania had interoperability between PHC and COVID-19 apps, and Poland and Romania's apps considered social needs., Conclusions: COVID-19 apps were widely created during the first pandemic year. Contact tracing was the most frequent function found in the registered apps. Connection with PHC was scarcely developed. In future pandemics, connections between health system levels should be guaranteed to develop and implement effective strategies for managing diseases.

Background: In France, 40% of people aged over 16 (20 million) report having at least one chronic disease requiring long-term treatment. Compliance is estimated to be 50% on average., Aim: To study the practical management of oral treatments at home by people living with one or more chronic diseases., Design & Setting: Thirty general practitioners in France were invited by e-mail to enrol ten consecutive patients with chronic diseases., Method: A quantitative, descriptive, observational, cross-sectional study was carried out using standardised questionnaires to assess the socio-demographic profile of doctors and patients and the management of oral medication at home., Results: Twenty general practitioners collected 180 questionnaires: 69.4% said they did not find taking their medication a problem; 42.8% used a pillbox; 79.4% said they knew 'all' their medications. 61% reported forgetting to take their medication., Conclusion: More than half of patients are non-adherent. Personalised reminders could reduce unintentional medication non-adherence., (Copyright © 2024, The Authors.)

Amino acids are significant biomolecules that govern the major metabolic processes and act as precursors for macromolecules such as proteins that are crucial to life. Fish is an integral component of human nutrition and a dietary source of high-quality animal proteins and amino acids. In this context, the crude protein and amino acid compositions of food fish from different landing stations of the Ganga river have been determined. The Kjeldahl method was utilized to determine the crude protein content and the amino acids were analyzed using high-performance liquid chromatography (HPLC); data on 30 food fish were assessed. The study showed that among the fish studied, Eleotris fusca , Macrobrachium malcomsonii , and Mystus cavasius were rich in most of the amino acids important for human nutrition, such as glycine, glutamic acid, cysteine, threonine, phenylalanine, methionine, lysine, leucine, isoleucine, histidine, and valine. Further, it was observed that the daily consumption of these fish (approximately 50 g) can fulfil the daily requirement of these individual amino acids for an adult human with a body weight of 60 kg. Therefore, the amino acid composition analyzed in the present study could be utilized for recommendation by clinicians according to the requirement for specific amino acids, and fish can be prescribed as a natural supplement against the amino acid requirement.

Flame retardants (FRs) are commonly added to commercial products to achieve flammability resistance. Since most of them are not chemically bonded to the materials, they could be leached to the environment during the production and disposal cycle. These FRs were categorised based on their chemical nature, including brominated, organophosphorus-, mineral- and nitrogen-based. This review summarised the abiotic degradation reactions of these four classes of FRs, with a focus on thermal and photodegradation reactions in environmental and food matrices. Only 24 papers have reported related information on abiotic degradation reactions that could be useful for predicting possible degradation pathways, and most focused on brominated FRs. Most studies also investigated the thermal degradation of FRs under high temperatures (>400 °C), which exceeds the normal cooking temperature at 100-300 °C. For photodegradation, studies have used up to five times the energy typically used in UV radiation during food processing. It is recommended that future studies investigate the fate of these FRs in foods under more realistic processing conditions, to provide a more comprehensive picture of the estimated consumption of FRs and their degradation products from foods, and facilitate a better risk assessment of the use of these novel FRs.

Background: Primary Health Care (PHC) plays a crucial role in managing the COVID-19 pandemic, with only 8% of cases requiring hospitalization. However, PHC COVID-19 data often goes unnoticed on European government dashboards and in media discussions. This project aims to examine official information on PHC patient care during the COVID-19 pandemic in Europe, with specific objectives: (1) Describe PHC's clinical pathways for acute COVID-19 cases, including long-term care facilities, (2) Describe PHC COVID-19 pandemic indicators, (3) Develop COVID-19 PHC activity indicators, (4) Explain PHC's role in vaccination strategies, and (5) Create a PHC contingency plan for future pandemics., Methods: A mixed-method study will employ two online questionnaires to gather retrospective PHC data on COVID-19 management and PHC involvement in vaccination strategies. Validation will occur through focus group discussions with medical and public health (PH) experts. A two-wave Delphi survey will establish a European PHC indicators dashboard for future pandemics. Additionally, a coordinated health system action plan involving PHC, secondary care, and PH will be devised to address future pandemic scenarios., Analysis: Quantitative data will be analysed using STATA v16.0 for descriptive and multivariate analyses. Qualitative data will be collected through peer-reviewed questionnaires and content analysis of focus group discussions. A Delphi survey and multiple focus groups will be employed to achieve consensus on PHC indicators and a common European health system response plan for future pandemics. The Eurodata research group involving researchers from 28 European countries support the development., Discussion: While PHC manages most COVID-19 acute cases, data remains limited in many European countries. This study collects data from numerous countries, offering a comprehensive perspective on PHC's role during the pandemic in Europe. It pioneers the development of a PHC dashboard and health system plan for pandemics in Europe. These results may prove invaluable in future pandemics. However, data may have biases due to key informants' involvement and may not fully represent all European GP practices. PHC has a significant role in the management of the COVID-19 pandemic, as most of the cases are mild or moderate and only 8% needed hospitalization. However, PHC COVID-19 activity data is invisible on governments' daily dashboards in Europe, often overlooked in media and public debates., (© 2024. The Author(s).)

The monitoring of legacy contaminants in sentinel northern marine mammals has revealed some of the highest concentrations globally. However, investigations into the presence of chemicals of emerging Arctic concern (CEACs) and other lesser-known chemicals are rarely conducted, if at all. Here, we used a nontarget/suspect approach to screen for thousands of different chemicals, including many CEACs and plastic-related compounds (PRCs) in blubber/adipose from killer whales (Orcinus orca), narwhals (Monodon monoceros), long-finned pilot whales (Globicephala melas), and polar bears (Ursus maritimus) in East Greenland. 138 compounds were tentatively identified mostly as PRCs, and four were confirmed using authentic standards: di(2-ethylhexyl) phthalate (DEHP), diethyl phthalate (DEP), di(2-propylheptyl) phthalate (DPHP), and one antioxidant (Irganox 1010). Three other PRCs, a nonylphenol isomer, 2,6-di-tert-butylphenol, and dioctyl sebacate, exhibited fragmentation patterns matching those in library databases. While phthalates were only above detection limits in some polar bear and narwhal, Irganox 1010, nonylphenol, and 2,6-di-tert-butylphenol were detected in >50% of all samples. This study represents the first application of a nontarget/suspect screening approach in Arctic cetaceans, leading to the identification of multiple PRCs in their blubber. Further nontarget analyses are warranted to comprehensively characterize the extent of CEAC and PRC contamination within Arctic marine food webs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Honeys of particular botanical origins can be associated with premium market prices, a trait which also makes them susceptible to fraud. Currently available authenticity testing methods for botanical classification of honeys are either time-consuming or only target a few "known" types of markers. Simple and effective methods are therefore needed to monitor and guarantee the authenticity of honey. In this study, a 'dilute-and-shoot' approach using liquid chromatography (LC) coupled to quadrupole time-of-flight-mass spectrometry (QTOF-MS) was applied to the non-targeted fingerprinting of honeys of different floral origin (buckwheat, clover and blueberry). This work investigated for the first time the impact of different instrumental conditions such as the column type, the mobile phase composition, the chromatographic gradient, and the MS fragmentor voltage (in-source collision-induced dissociation) on the botanical classification of honeys as well as the data quality. Results indicated that the data sets obtained for the various LC-QTOF-MS conditions tested were all suitable to discriminate the three honeys of different floral origin regardless of the mathematical model applied (random forest, partial least squares-discriminant analysis, soft independent modelling by class analogy and linear discriminant analysis). The present study investigated different LC-QTOF-MS conditions in a "dilute and shoot" method for honey analysis, in order to establish a relatively fast, simple and reliable analytical method to record the chemical fingerprints of honey. This approach is suitable for marker discovery and will be used for the future development of advanced predictive models for honey botanical origin., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

A sensitive modified QuEChERS extraction method was developed to assess the levels of free and conjugated bisphenols (BPs) in human milk collected between 2018 and 2019 from two regions of South Africa (the Limpopo Province Vhembe district, n = 194; Pretoria, n = 193) and Canada (Montreal, n = 207). Total BPA (free and conjugated) and BPS were the predominant bisphenols detected in samples from Vhembe and Pretoria, whereas total BPS was the predominant bisphenol detected in Montreal samples. The levels of total BPA in samples from Vhembe and Pretoria ranged between < MDL-18.61 and

Background: During the COVID-19 pandemic, the majority of patients received ambulatory treatment, highlighting the importance of primary health care (PHC). However, there is limited knowledge regarding PHC workload in Europe during this period. The utilization of COVID-19 PHC indicators could facilitate the efficient monitoring and coordination of the pandemic response. The objective of this study is to describe PHC indicators for disease surveillance and monitoring of COVID-19's impact in Europe., Methods: Descriptive, cross-sectional study employing data obtained through a semi-structured ad hoc questionnaire, which was collectively agreed upon by all participants. The study encompasses PHC settings in 31 European countries from March 2020 to August 2021. Key-informants from each country answered the questionnaire. Main outcome: the identification of any indicator used to describe PHC COVID-19 activity., Results: Out of the 31 countries surveyed, data on PHC information were obtained from 14. The principal indicators were: total number of cases within PHC (Belarus, Cyprus, Italy, Romania and Spain), number of follow-up cases (Croatia, Cyprus, Finland, Spain and Turkey), GP's COVID-19 tests referrals (Poland), proportion of COVID-19 cases among respiratory illnesses consultations (Norway and France), sick leaves issued by GPs (Romania and Spain) and examination and complementary tests (Cyprus). All COVID-19 cases were attended in PHC in Belarus and Italy., Conclusions: The COVID-19 pandemic exposes a crucial deficiency in preparedness for infectious diseases in European health systems highlighting the inconsistent recording of indicators within PHC organizations. PHC standardized indicators and public data accessibility are urgently needed, conforming the foundation for an effective European-level health services response framework against future pandemics., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association.)

An LC-MS based analytical method was developed and validated for the simultaneous targeted analysis and suspect screening of plastic-related contaminants in e-waste impacted soils. Satisfactory recoveries (97 ± 13 %) were achieved using ultrasound-assisted extraction for 14/15 of the targeted analytes (7 bisphenols and 8 plasticizers) in a range of agricultural and non-agricultural soils. The method was applied to 53 soil samples collected in May 2015 in the region of Agbogbloshie (Ghana) at e-waste facilities (incl. Dump, trade, and burn sites), neighboring non-agricultural (incl. upstream, downstream, and community) and agricultural fields, and at two control agricultural sites away from e-waste recycling facilities. Bisphenol A (BPA) and bis(2-ethylhexyl) phthalate (DEHP) were the two dominant contaminants in e-waste soil (with concentrations up to 48.7 and 184 μg g -1 , respectively), especially at the trade site, where e-waste was sorted and dismantled. The non-targeted workflow was successfully applied to identify additional plastic-related contaminants previously unreported in e-waste impacted soils, including bis(2-propylheptyl) phthalate, diisononyl phthalate, trioctyl trimellitate, 4-dodecylbenzenesulfonic acid, perfluorooctanesulfonic acid, perfluorobutanesulfonic acid, diphenyl phosphate, and triethylene glycol monobutyl ether. The agricultural soils surrounding the e-waste sites were also contaminated by plastic-related chemicals (especially DEHP), highlighting the impact of e-waste activities on the surrounding agricultural system., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Small-scale fishers of Indian Sundarbans depend on open-water fisheries for their livelihoods. They often face health, occupational, and safety issues in their profession due to environmental, socio-economic, and policy changes. The morbidity pattern and related risk factors are important indicators of well-being for any community, hence applicable to small-scale fishers of Sundarbans. The present study was designed to assess patterns of morbidities, associated risk factors including occupational health hazards, and treatment-seeking behavior of small-scale fishers in the Indian Sundarbans., Material and Methods: Household surveys, focused group discussions, and personal interviews were conducted through a predesigned pretested structured questionnaire. Associated risk factors and the nature of seeking treatment were considered during the data collection covering 650 individuals from 132 fishers' families., Results: Morbidities were more frequent in males (39.33%) than in females (28.5%). The fever (31%) was the most dominant reason for morbidities followed by ocular ailments (23%), musculoskeletal disorder (20%), dermatological ailments (17%), and respiratory illness (9%). The highest morbidities (25%) were recorded in the age group of 21-30 years in males while that was 20% in the 11-20 years age group in the case of the females. Physical labor for fishing activities predisposes to health ailments of the studied population., Conclusions: The prevalence of morbidity among the fishermen community was found to be 28.5%. The understanding of the morbidity profile of a population in general and specific age groups of both sexes in specific sheds light on the vulnerability of working groups that will help for effective healthcare planning and resource allocation., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Community Medicine.)

Background: Food adulteration is a global concern, whether it takes place intentionally or incidentally. In Canada, maple syrup is susceptible to being adulterated with cheaper syrups such as corn, beet, cane syrups, and many more due to its high price and economic importance., Results: In this study, the use of attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy was investigated to detect maple syrups adulterated with 15 different sugar syrups at different concentration levels. The spectra were collected in the range of 4000-650 cm -1 in the absorbance unit. These spectra were used to build six libraries and three models. A method that is capable of performing a qualitative library search using a similarity search, which is based on the first derivative correlation search algorithm, was developed. This method was further evaluated and proved to be able to capture adulterated and reject non-adulterated maple syrups, belonging to the color grades golden and amber maple syrups, with an accuracy of 93.9% and 92.3%, respectively. However, for the maple syrup belonging to the dark color grade, this method demonstrated low specificity of 33.3%, and for this reason it was only able to adequately detect adulterated samples from the non-adulterated ones with an accuracy of 81.4%., Conclusion: This simple and rapid method has strong potential for implementation in different stages of the maple syrup supply chain for early adulteration detection, particularly for golden and amber samples. Further evaluation and improvements are required for the dark color grade. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)

Objective: Vulnerability relates to fragile physical, psychological, and socio-environmental circumstances. Pregnant women's social vulnerability can lead to disruptions in their medical follow-ups, prematurity, and increased infant mortality rates, such that their special needs must be considered. Yet, despite different governments' 'perinatality' plans, international literature suggests their care can be improved. Although quantitative studies regularly evaluate these plans, few studies have assessed vulnerable pregnant women's views. This study explores the needs and expectations of vulnerable women regarding their follow-ups during pregnancy and identified strategies to improve their circumstances., Methods: The study was a phenomenological qualitative study involving semi-structured interviews with women who gave birth in the past six months (December 2017 to June 2018) and who fulfilled at least one vulnerability criterion. The women were recruited by French midwives and general practitioners (GPs)., Findings: Concerning these vulnerable pregnant women, three phenomenological categories emerged: 1) they need to be monitored by a single trusted contact; 2) they seek medical and social support adapted to their situations that addresses their needs; and 3) they expect kind and person-centred communication skills from professionals who provide them appropriate information., Conclusion: We identified various international recommendations to screen and care for vulnerable pregnant women, but still these women often experience numerous challenges. Finally, the implementation of recommendations for healthcare professionals based on women's real-life experiences could help optimise the identification of vulnerable pregnant women as well as their follow-up care., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Most COVID-19 patients were treated in primary health care (PHC) in Europe., Objectives: To demonstrate the scope of PHC workflow during the COVID-19 pandemic emphasising similarities and differences of patient's clinical pathways in Europe., Methods: Descriptive, cross-sectional study with data acquired through a semi-structured questionnaire in PHC in 30 European countries, created ad hoc and agreed upon among all researchers who participated in the study. GPs from each country answered the approved questionnaire. Main variable: PHC COVID-19 acute clinical pathway. All variables were collected from each country as of September 2020., Results: COVID-19 clinics in PHC facilities were organised in 8/30. Case detection and testing were performed in PHC in 27/30 countries. RT-PCR and lateral flow tests were performed in PHC in 23/30, free of charge with a medical prescription. Contact tracing was performed mainly by public health authorities. Mandatory isolation ranged from 5 to 14 days. Sick leave certification was given exclusively by GPs in 21/30 countries. Patient hotels or other resources to isolate patients were available in 12/30. Follow-up to monitor the symptoms and/or new complementary tests was made mainly by phone call (27/30). Chest X-ray and phlebotomy were performed in PHC in 18/30 and 23/30 countries, respectively. Oxygen and low-molecular-weight heparin were available in PHC (21/30)., Conclusion: In Europe PHC participated in many steps to diagnose, treat and monitor COVID-19 patients. Differences among countries might be addressed at European level for the management of future pandemics.

Objective: Alcohol-associated liver disease (ALD) is the leading cause of liver-related mortality worldwide. Current strategies to manage ALD focus largely on advanced stage disease, however, metabolic changes such as glucose intolerance are apparent at the earliest stage of alcoholic steatosis and increase the risk of disease progression. Ceramides impair insulin signaling and accumulate in ALD, and metabolic pathways involving ceramide synthase 6 (CerS6) are perturbed in ALD during hepatic steatosis. In this study, we aimed to investigate the role of CerS6 in ALD development and the relevance of CerS6 to human ALD., Methods: C57BL/6 WT and CerS6 KO mice of both sexes were fed either a Lieber-DeCarli control (CON) or 15% ethanol (EtOH) diet for six weeks. In vivo metabolic tests including glucose and insulin tolerance tests (GTT and ITT) and energy expenditure were performed. The mice were euthanized, and serum and liver lipids and liver histology were examined. For in vitro studies, CerS6 was deleted in human hepatocytes, VL17A and cells were incubated with EtOH and/or C 16:0 -ceramides. RNAseq analysis was performed in livers from mice and human patients with different stages of ALD and diseased controls., Results: After six weeks on an EtOH diet, CerS6 KO mice had reduced body weight, food intake, and %fat mass compared to WT mice. Energy expenditure increased in both male and female KO mice, however, was only statistically significant in male mice. In response to EtOH, WT mice developed mild hepatic steatosis, while steatosis was ameliorated in KO mice as determined by H&E and ORO staining. KO mice showed significantly decreased long-chain ceramide species, especially C 16:0 -ceramides, in the serum and liver tissues compared to WT mice. CerS6 deletion decreased serum TG and NEFA only in male not female mice. CerS6 deletion improved glucose tolerance and insulin resistance in EtOH-fed mice of both sexes. RNAseq analysis revealed that 74 genes are significantly upregulated and 66 genes are downregulated by CerS6 deletion in EtOH-fed male mice, with key network pathways including TG biosynthetic process, positive regulation of lipid localization, and fat cell differentiation. Similar to RNAseq results, absence of CerS6 significantly decreased mRNA expression of lipid droplet associated proteins in EtOH-fed mice. In vitro, EtOH stimulation significantly increased PLIN2 protein expression in VL17A cells while CerS6 deletion inhibited EtOH-mediated PLIN2 upregulation. C 16:0 -ceramide treatment significantly increased PLIN2 protein expression compared to CON. Notably, progression of ALD in humans was associated with increased hepatic CerS6 expression., Conclusions: Our findings demonstrate that CerS6 deletion improves glucose homeostasis in alcohol-fed mice and exhibits sex-based differences in the attenuation of EtOH-induced weight gain and hepatic steatosis. Additionally, we unveil that CerS6 plays a major role as a regulator of lipid droplet biogenesis in alcohol-induced intra-hepatic lipid droplet formation, identifying it as a putative target for early ALD management., Competing Interests: Declaration of Competing Interest RC receives research support from Intercept Pharmaceuticals and Merck, Inc., (Copyright © 2023 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Flame retardants (FRs) are often added to commercial products to achieve flammability resistance, but they are not chemically bonded to the materials, so, they can be easily released into the environment during the production and disposal processes. When honeybees travel to collect nectar during the pollination process, they are prone to be contaminated by chemicals in the air. Therefore, honey contamination has been proposed as an indicator of the pollution status in a particular region. To date, the occurrence of flame retardants in urban honey has yet to be explored. In this study, a direct injection method was used, coupled with LC-QTOF-MS, to analyze honey samples. This method was applied to urban (n = 100) and rural (n = 100) honey samples from the Quebec province (Canada), and the levels of flame retardants in urban and rural honey samples were not significantly different. In the targeted approach, two of the target FRs, tris(2-butoxyethyl) phosphate (TBOEP) and triphenyl phosphate (TPHP), were detected and confirmed at an average trace concentration (<1 ng mL -1 ). Additionally, a non-targeted screening workflow with an in-house-built library was developed and validated to screen for flame retardants in honey. Tris (2-chloropropyl) phosphate (TCIPP) was identified in honey using the non-targeted screening workflow and confirmed using a pure analytical standard, but there are other compounds detected in the non-targeted analysis that have yet to be validated. This study was the first to report FR compounds based on a direct injection method, coupled with a non-targeted screening workflow, at a trace level in a honey matrix. It also showed that a non-targeted workflow was effective to detect and identify unknown compounds present in the honey sample; hence, this provided a novel angle for the occurrence of FRs in air, with honey as a bio-indicator., Competing Interests: Declaration of competing interest The authors report no conflict of interest for the following manuscript submitted for your review (Original Article):, (Copyright © 2023. Published by Elsevier Ltd.)