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Arsenic is a natural element found in the earth's crust and is extensively present in various environmental components. Anthropogenic activities and a few natural events have generated contaminants that have led to massive environmental pollution, one form of which is arsenic contamination. Arsenic enters the human food chain via contaminated crops, water, seafood, and dairy products. In Pakistan, the increasing concentration of arsenic in the water is causing major health problems. Due to the serious health risks posed by arsenic, it is crucial to design and implement strategies for reducing and preventing the bioaccumulation of arsenic and its entry into the human food chain. There is a need for an institutional framework for arsenic mitigation, accountability, and systemic checks and balances. Targeted short- and long-term policies are required for effective and sustainable management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Quadri et al.)

Androgen deprivation therapy (ADT) is the mainstay regimen in patients with androgen-dependent prostate cancer (PCa). However, the selection of androgen-independent cancer cells leads to castrate resistant prostate cancer (CRPC). The aggressive phenotype of CRPC cells underscores the need to elucidate mechanisms and therapeutic strategies to suppress CRPC outgrowth. Despite ADT, the activation of androgen receptor (AR) transcription factor continues via crosstalk with parallel signaling pathways. Understanding of how these signaling cascades are initiated and amplified post-ADT is lacking. Hormone deprivation can increase oxidative stress and the resultant reactive oxygen species (ROS) may activate both AR and non-AR signaling. Moreover, ROS-induced inflammatory cytokines may further amplify these redox signaling pathways to augment AR function. However, clinical trials using ROS quenching small molecule antioxidants have not suppressed CRPC progression, suggesting that more potent and persistent suppression of redox signaling in CRPC cells will be needed. The transcription factor Nrf2 increases the expression of numerous antioxidant enzymes and downregulates the function of inflammatory transcription factors, e.g., nuclear factor kappa B. We documented that Nrf2 overexpression can suppress AR-mediated transcription in CRPC cell lines. Furthermore, two Nrf2 activating agents, sulforaphane (a phytochemical) and bardoxolone-methyl (a drug in clinical trial) suppress AR levels and sensitize CRPC cells to anti-androgens. These observations implicate the benefits of potent Nrf2-activators to suppress the lethal signaling cascades that lead to CRPC outgrowth. This review article will address the redox signaling networks that augment AR signaling during PCa progression to CRPC, and the possible utility of Nrf2-activating agents as an adjunct to ADT., Competing Interests: All authors declared that there are no conflicts of interest., (© The Author(s) 2021.)

Context: Stress, anxiety, and depression affect medical student populations at rates disproportionate to those of general student populations. Emotional intelligence (EI) has been suggested as a protective factor in association with psychological distress., Objective: To explore the relationships between EI and stress, anxiety, and depression among a sample of US osteopathic medical students., Methods: From February to March 2020, a convenience sample of medical students enrolled at an osteopathic medical school in the southeastern region of the United States were invited to complete a voluntary and anonymous 54-item online questionnaire that included sociodemographic items as well as validated and reliable scales assessing perceived stress, anxiety, depression, and EI. Univariate statistics were calculated to describe the participant characteristics and the study variables of interest. Pearson's product-moment correlations were used to examine relationships between EI and study variables. Three multiple regression models were fitted to examine the relationship between EI and stress, anxiety, and depression, adjusting for sociodemographic factors exhibiting significant bivariate relationships with outcome variables. Dichotomous variables were created that were indicative of positive screens for potential depressive disorder or anxiety disorder. Independent-sample t-tests were used to determine the presence of a statistically significant difference in EI scores between positive screeners for depression and anxiety and their respective counterparts; an alpha level of 0.05 was set a priori to indicate statistical significance., Results: In all, 268 medical students participated in this study, for a response rate of approximately 27%. Importantly, EI exhibited significant negative correlations with stress, anxiety, and depression (r=-0.384, p<0.001; r=-0.308, p<0.001; r=-0.286, p<0.001), respectively). Thus, high levels of stress, anxiety, and depression were observed in the sample. Significant relationships remained following covariate adjustment. Established cutoffs for anxiety and depression were used to classify positive and negative screens for these morbidities. Using these classifications, individuals screening positive for potential anxiety and depression exhibited significantly lower levels of EI than their counterparts showing subclinical symptoms (t=5.14, p<0.001 and t=3.58, p<0.001, respectively)., Conclusion: Our findings support the notion that higher levels of EI may potentially lead to increased well-being, limit psychological distress, improve patient care, and facilitate an ability to thrive in the medical field. We encourage continued study on the efficacy of EI training through intervention, measurement of EI in both academic and clinical settings as an indicator of those at risk for programmatic dropout or psychological distress, and consideration of EI training as an adjunct to the educational program curriculum.

Skin cancers are the most common malignancies diagnosed worldwide. In Gulf Cooperation Council (GCC) countries, skin cancer remains a significant health burden. Multiple studies have attempted to elucidate patient knowledge and attitudes regarding skin cancer risks and behavioral interventions to reduce risks. A systematic literature search of relevant articles was conducted in PubMed, ScienceDirect, and the Saudi Digital Library databases. A narrative analysis of relevant study results was conducted. A total of 12 studies were reviewed across GCC. These studies revealed common themes among GCC populations. Many study participants were aware that excess sun exposure represents a threat to health and increases cancer risk. Several studies reported sun exposure, with a mean of 19.13 h per week. More studies reported patients engaging in lower or no sunscreen use rather than regular sunscreen use. There are discrepancies in the understanding of sun exposure risk and risk mitigation practices among the study populations. Skin cancer poses a significant burden to patients in GCC countries and improved patient education will enhance population health.

Psychiatric disorders are prevalent in dermatology patients. Psychodermatology is the body of knowledge at the intersection of psychiatry and dermatology practice. The purpose of this literature review was to assess the knowledge, attitudes, and practices of health care professionals regarding psychodermatology. A search of relevant articles was conducted in PubMed, CINAHL, ERIC, and PsychInfo databases using a comprehensive set of search terms. Studies were included if (1) study participants were health care professionals, (2) studies contained data that could be extracted, and (3) studies were published in peer-reviewed journals. A review of study findings was conducted. A total of nine studies were included in the review. Studies were conducted in several countries. Findings from the review confirmed that providers frequently reported psychocutaneous disorders in their practice. There were, however, gaps and variations in providers' knowledge base and level of comfort treating these patients. Further, providers acknowledged a lack of training in the practice of psychodermatology. The findings from this review suggest that health care professionals from multiple areas of the world may lack a full understanding, level of comfort, and proper training in psychodermatology. Improving the knowledge base and increasing level of comfort in treating psychodermatological disorders can improve the practice of psychodermatology amongst providers. Further, addressing knowledge and comfort level among providers through training and continuing education may improve outcomes for patients with psychocutaneous disorders.