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Background: Water and food security in Israel and the Palestinian Authority are deeply interconnected due to the region's arid climate and water scarcity, shared water resources, and interrelated agricultural sectors. Therefore, jointly addressing water reuse is vital to supporting sustainable agricultural production and ensuring food safety. Objectives: This paper examines the food safety implications of the cross-border trade of fresh fruits and vegetables between the Palestinian Authority and Israel, with an emphasis on the influence of, water technologies, agricultural practices, and environmental health. Methods: This paper provides a comprehensive review of existing data to assess water irrigation quality, food safety, and water reuse regulations in the Palestinian Authority and Israel. Results: Significant discrepancies in food safety, food quality, and exposure to contaminants from fresh produce result from different water reuse regulations, practices, and socioeconomic conditions. Given the volume of trade, consumer mobility, and environmental sustainability, coupled with geopolitical limitations between the Palestinian Authority and Israel, there is an urgent need for a unified regulatory strategy for wastewater reuse ensuring food safety and security. We propose a single, coordinated approach to overseeing wastewater reuse to enhance public health and address contaminants of emerging concern that are not currently regulated. Navigating the political and legislative complexities in a proactive stance requires both Israeli and Palestinian decision-makers to address the matter conscientiously. Existing data and the precautionary principle are sufficient to propose an interim prohibition on treated wastewater irrigation for leafy vegetables to mitigate pollution risks and act as a catalyst for improving irrigation water quality. Conclusions: Our proposed strategy for a unified water reuse regulation emphasizes the necessary steps for its implementation and addresses potential obstacles. This strategy underscores the importance of responsible wastewater management in advancing common goals of environmental sustainability, food safety, and human health. Short Synopsis: We propose a coordinated Israeli-Palestinian approach to wastewater reuse to ensure food safety based on shared environmental and health concerns, economic considerations, and the precautionary principle. Plain language title : A Call for Joint Israeli-Palestinian Guidelines for Water Recycling to Improve Food Security and Safety Plain language summary : The Palestinian Authority and Israel share a common ecosystem and closely interrelated water supply, agriculture, and food markets. Differences in economic conditions, water use, and farming methods in each society affect the safety and quality of traded food. Because of varying regulations on how wastewater is reused for irrigation, there are noticeable differences in the food safety, exposing both populations to harmful contaminants. To address this concern, there is a pressing need to unify the regulation of wastewater reuse. We suggest that both Israeli and Palestinian authorities should work together on a coordinated plan to oversee wastewater reuse, which would improve public and environmental health and address contaminants that are not currently regulated. In the interim, an immediate temporary ban on using treated wastewater for irrigating leafy vegetables could reduce pollution risks, and encourage improvements in the quality of water used for irrigation. The responsible management of wastewater is a common Palestinian and Israeli interest for sustaining water and food security, to protect both the environment and the health of all people in the region. [ABSTRACT FROM AUTHOR]

Epidemiologic studies have demonstrated an association of elevated plasma homocysteine levels with greater bone resorption and fracture risk. Vitamins B12 , B6 , and folic acid are cofactors in homocysteine metabolism, and supplementation with B vitamins is effective in lowering homocysteine levels in humans. However, randomized trials of supplemental B vitamins for reduction of fracture risk have been limited. Therefore, we performed an ancillary study to the Women's Antioxidant and Folic Acid Cardiovascular Study (WAFACS), a large randomized trial of women with preexisting cardiovascular disease or three or more coronary risk factors, to test whether a daily B vitamin intervention including folic acid (2.5 mg/day), vitamin B6 (50 mg/day), and vitamin B12 (1 mg/day) reduces nonspine fracture risk over 7.3 years of treatment and follow-up. Among 4810 women, we confirmed 349 nonspine fracture cases by centralized review of medical records. In a substudy of 300 women (150 in treatment group and 150 controls) with paired plasma samples at randomization and follow-up (7.3 years later), we measured two bone turnover markers, including C-terminal cross-linking telopeptide of type I collagen (CTX) and intact type I procollagen N-propeptide (P1NP). In Cox proportional hazards models based on intention-to-treat, we found no significant effects of B vitamin supplementation on nonspine fracture risk (relative hazard = 1.08; 95% confidence interval, 0.88 to 1.34). In a nested case-cohort analysis, there were no significant effects of B vitamins on fracture risk among women with elevated plasma homocysteine levels, or low levels of vitamins B12 or B6 , or folate at baseline. Furthermore, treatment with B vitamins had no effect on change in markers of bone turnover. We found no evidence that daily supplementation with B vitamins reduces fracture risk or rates of bone metabolism in middle-aged and older women at high risk of cardiovascular disease. © 2017 American Society for Bone and Mineral Research.

BackgroundDisease models are useful for prospective studies of pathology, identification of molecular and cellular mechanisms, pre-clinical testing of interventions, and validation of clinical biomarkers. Here, we review animal models relevant to vascular cognitive impairment (VCI). A synopsis of each model was initially presented by expert practitioners. Synopses were refined by the authors, and subsequently by the scientific committee of a recent conference (International Conference on Vascular Dementia 2015). Only peer-reviewed sources were cited.MethodsWe included models that mimic VCI-related brain lesions (white matter hypoperfusion injury, focal ischaemia, cerebral amyloid angiopathy) or reproduce VCI risk factors (old age, hypertension, hyperhomocysteinemia, high-salt/high-fat diet) or reproduce genetic causes of VCI (CADASIL-causing Notch3 mutations).ConclusionsWe concluded that (1) translational models may reflect a VCI-relevant pathological process, while not fully replicating a human disease spectrum; (2) rodent models of VCI are limited by paucity of white matter; and (3) further translational models, and improved cognitive testing instruments, are required.

Background: In the 1940s to 1950s, high-dose folic acid supplements (>5 mg/d) were used clinically to reverse the megaloblastic anemia of vitamin B12 deficiency caused by pernicious anemia. However, this treatment strategy masked the underlying B12 deficiency and possibly exacerbated its neuropathological progression. The issue of masking and exacerbating B12 deficiency has recently been rekindled with the institution of folic acid fortification and the wide-spread use of folic acid supplements. Objectives: The objectives of this review are to describe clinical and epidemiological evidence that excess folic acid exacerbates B12 deficiency, to summarize a hypothesis to explain this phenomenon, and to provide guidance for clinicians. Results: Cognitive function test scores are lower and blood homocysteine and methylmalonic acid concentrations are higher in people with low B12 and elevated folate than in those with low B12 and nonelevated folate. High-dose folic acid supplementation in patients with pernicious anemia or epilepsy cause significant reductions in serum B12. It is hypothesized that high-dose folic acid supplements cause depletion of serum holotranscobalamin and thus exacerbate B12 deficiency. Conclusion: The evidence for excess folic acid exacerbating B12 deficiency is primarily correlative or from uncontrolled clinical observations, and the hypothesis to explain the phenomenon has not yet been tested. Nonetheless, the evidence is sufficiently compelling to warrant increased vigilance for identifying B12 deficiency in at risk individuals, including older adults and others with low B12 intake or conditions that are associated with B12 malabsorption, who also ingest excessive folic acid or are prescribed folic acid in high doses. Plain language title: Excess Folic Acid and Vitamin B12 Deficiency: Clinical Implications? Plain language summary: It has been known for many decades that high doses of the B vitamin supplement, folic acid, can alleviate the anemia of vitamin B12 deficiency, at least temporarily. However, by alleviating the anemia, such folic acid supplements were said to "mask" the underlying vitamin B12 deficiency, thus allowing neurological damage to continue or possibly be exacerbated. Consequently, treating vitamin B12 deficiency with high dose folic acid was discontinued in the 1970s. The issue of whether folic acid supplements can exacerbate vitamin B12 deficiency reemerged in the 1990s with folic acid fortification of cereals and grains in the United States and Canada (and now in over 80 countries around the world) to prevent spina bifida and other birth defects. This narrative review summarizes the results of studies that have assessed the relationships between folic acid and folate and vitamin B12 status in patients and in populations. A recent hypothesis on how folic acid might exacerbate vitamin B12 deficiency is summarized, and recommendations to clinicians are made for increased vigilance in assessing vitamin B12 status in certain groups at risk of vitamin B12 deficiency, including older adults, people with gastrointestinal issues and other factors that cause vitamin B12 malabsorption, people with unexplained neurological problems, and people who follow vegan or vegetarian diets which are naturally low in vitamin B12. [ABSTRACT FROM AUTHOR]

Folic acid (FA) supplements and food fortification are used to prevent neural tube defects and to lower plasma homocysteine. Through exposure to food fortification and vitamin supplement use, large populations in the United States and elsewhere have an unprecedented high FA intake. We evaluated dietary and supplemental intakes of folate and FA in relation to an index of immune function, natural killer cell (NK) cytotoxicity, among 105 healthy, postmenopausal women. Among women with a diet low in folate ( 400/[micro]g/d had reduced NK cytotoxicity compared with those consuming a low-folate diet and no supplements (P = 0.02). Prompted by this observation, we assessed the presence of unmetabolized FA in plasma as a biochemical marker of excess FA. Unmetabolized folic acid was detected in 78% of plasma samples from fasting participants. We found an inverse relation between the presence of unmetabolized FA in plasma and NK cytotoxicity. NK cytotoxicity was ~23% lower among women with detectable folic acid (P = 0.04). This inverse relation was stronger among women [greater than or equal to 60 y old and more pronounced with increasing unmetabolized FA concentrations (P-trend = 0.002). Because of the increased intake of FA in many countries, our findings highlight the need for further studies on the effect of long-term high FA intake on immune function and health. KEY WORDS: * carcinogenesis * folic acid * immune function * natural killer cells