Paraquat (PQ) is one of the most commonly used herbicides, but it has polluted the environment and threatened human health through extensive and improper usage. Here, a new naked-eye PQ immunochromatographic strip was developed to recognize PQ in domestic water and real human samples within 10 min based on a novel custom-designed anti-PQ antibody. The PQ test strip could recognize PQ at a concentration as low as 10 ng/ml, reaching the high-efficiency time-of-flight mass spectrometry detection level and identifying trace amounts of PQ in samples treated with a diquat (DQ) and PQ mixture. Notably, both the performance evaluation and clinical trial of the proposed PQ strips were validated in multiple hospitals and public health agencies. Taken together, our study firstly provide the clinical PQ-targeted colloidal gold immunochromatographic test strip designed both for environment water and human sample detection with multiple advantages, which are ready for environmental monitoring and clinical practice.

Exposure to traffic-related air pollution (TRAP) may enhance the risk of cardiovascular disease. However, the short-term effects of TRAP components on the cardiovascular system are not well understood. We conducted a randomized, double-blinded, crossover intervention study in which 39 healthy university students spent 2 h next to a busy road. Participants wore a powered air-purifying respirator (PAPR) or an N95 mask. PAPRs were equipped with a filter for particulate matter (PM), a PM and volatile organic compounds (VOCs) filter or a sham filter. Participants were blinded to PAPR filter type and underwent randomized exposures four times, once for each intervention mode. Blood pressure (BP), heart rate (HR) and heart rate variability (HRV) were measured before, during and for 6 h after the roadside exposure. Linear mixed-effect models were used to evaluate the effects of the interventions relative to baseline controlling for other covariates. All HRV measures increased during and following exposure for all intervention modes. Some HRV measures (SDNN and rMSSD during exposure and SDNN after exposure) were marginally affected by PM filtration. Wearing the N95 mask affected VLF power and rMSSD responses to traffic exposure differently than the PAPR interventions. Both systolic and diastolic BP increased slightly during exposure, but then were generally lower than baseline after exposure for the sham and filter interventions. HR, which fell during exposure and mostly remained lower than baseline after exposure, was lower yet with all filter interventions compared to the sham mode following exposure. Therefore, short-term exposure to traffic acutely affects HRV, BP and HR, but N95 mask and PAPR interventions generally show little efficacy in reducing these effects. Removing the PM component of TRAP has some limited effects on HRV responses to exposure but exaggerates the traffic-related decrease in HR. HRV findings from N95 mask interventions need to be interpreted cautiously.

Despite an increasing understanding of the issue of marine pollution, humanity continues on a largely unsustainable trajectory. This study aimed to identify and classify the range of scientific studies and interventions to address coastal and marine pollution. We reviewed 2417 scientific papers published between 2000 and 2018, 741 of which we analysed in depth. To classify pollution interventions, we applied the systems-oriented concept of leverage points, which focuses on places to intervene in complex systems to bring about systemic change. We found that pollution is largely studied as a technical problem and fewer studies engage with pollution as a systemic social-ecological issue. While recognising the importance of technical solutions, we highlight the need to focus on under-researched areas pertaining to the deeper drivers of pollution (e.g. institutions, values) which are needed to fundamentally alter system trajectories.

Sustainable clinical trials involve conducting trials in a socially conscious and environmentally responsible manner. This involves considering the effects of clinical trials on the environment and the populations engaged in the studies. The pharmaceutical sector, particularly clinical research, is a large contributor to greenhouse gas emissions. The need for a legal framework considering the environmental impact of hundreds of global clinical trials cannot be overstated. Clinical trials’ carbon footprint is a complex subject that calls for cooperation from various parties, including researchers, trial sponsors, healthcare providers, and regulatory organizations. The waste generated during clinical trials, including packaging materials, laboratory supplies, and hazardous waste from the disposal of clinical samples, can adversely affect public health and the environment. Therefore, addressing this issue is essential to ensure that clinical trials are conducted in an environmentally and socially responsible manner. The purpose of this study is to discuss potential strategies to cut down on carbon emissions, discuss the challenges in setting up clinical trials in an environmentally sustainable way, and highlight the importance of a precautionary approach during the various phases of conducting clinical trials. Although there is limited research on greenhouse gas emissions generated by clinical trials, it is evident that more work needs to be done in this field.

Health care-associated infections are reported among the top causes of hospital deaths worldwide. Their prevention is a first priority for patient safety in acute care hospitals. Education and training is recommended as a core component for effective infection prevention and control programs. This study aimed to assess the effect of an infection control training course on the knowledge and practices of medical interns in a large academic hospital in Egypt. The study included 268 medical interns who were getting their practical training at Tanta University Hospitals, Egypt during the study period. Knowledge and practices regarding infection control measures were assessed using a predesigned questionnaire sheet and an observational checklist before and after intervention by infection control training course based on Egyptian national guide for infection control. The data have been analyzed through the application of descriptive frequency, percentages, mean of scores, and the inferential analysis that includes paired t test and Monte Carlo test. The level of statistical significance was adopted at p≤0.05. There was a statistically significant (p < 0.0001) increase in total knowledge score (65.4±13.9 versus 80.2 ±13.2) and total practices score (65±11.3 versus 108±7.9) of infection control measures among studied participants before intervention compared with after intervention. A significant strong positive correlation was detected (r= 0.8, p= 0.0001) between total knowledge and practice scores after intervention by training course. There is a strong positive correlation between knowledge and practices so intervention by infection control training course using teaching multimedia and role play significantly improves the knowledge and practice levels of the studied medical interns.

Long-term exposure to air pollutants and residential greenness related to advanced fibrosis have been sparsely studied in low- and middle-income countries. A total of 29883 participants were selected from a cross-sectional survey of the Henan Rural Cohort. Concentrations of air pollutants (particulate matter with an aerodynamic diameter ≤ 1.0 μm (PM₁), ≤ 2.5 μm (PM₂.₅), ≤ 10 μm (PM₁₀) and nitrogen dioxide (NO₂)) for participants were predicted by using a spatiotemporal model. Residential greenness of each participant was indicated by Enhanced Vegetation Index (EVI) and Normalized Difference Vegetation Index (NDVI). Independent and joint associations of air pollutants and residential greenness indices with prevalent advanced fibrosis reflected by fibrosis-4 score (FIB4), aspartate-to-platelet-ratio index (APRI) and ALT/AST ratio were analyzed by generalized linear mixed models and their interactive effect on prevalent advanced fibrosis were visualized by using the interplot method. Long-term exposure to PM₁, PM₂.₅, PM₁₀ and NO₂ were positively related to FIB4 or APRI as well as prevalent intermediate-high advanced fibrosis; EVI was negatively related to FIB4 or APRI as well as prevalent intermediate-high advanced fibrosis. Negative associations of residential greenness indices (EVI or NDVI) with prevalent advanced fibrosis were decreased as increased air pollutants (PM₁, PM₂.₅, PM₁₀ or NO₂) (P < 0.05 for all). This study indicated that residential greenness may partially attenuate negative effect of long-term exposure to air pollutants related to increased prevalent intermediate-high advanced fibrosis, implying that residential greenness may be an effective strategy to reduce the burden of prevalent hepatic fibrosis and its related disease in association with exposure high levels of air pollutants. The Henan Rural Cohort study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699, http://www.chictr.org.cn/showproj.aspx?proj=11375)

Dengue fever (DF) is one of the world’s most important vector-borne illnesses. In 2017, Egypt experienced a dengue outbreak. This study aimed to assess the knowledge and attitudes of nursing students regarding DF and the effectiveness of an education intervention to improve students’ knowledge and attitude. An intervention study was conducted among 4th year nursing students of Tanta Faculty of Nursing using a self-administered predesigned validated questionnaire before and after introducing an educational session. The main DF information sources were formal teaching, social networks, television, and physicians. Less than half of the students (45.5%) had “good” knowledge grade after the intervention compared with only 7.2% in the pre-test. The students’ knowledge and attitude improved after the application of the intervention session. The positive impact of the educational intervention on knowledge and attitude regarding DF and its prevention among the target group revealed the importance of the inclusion of teaching materials about DF into the students’ curricula.

The widespread use of sodium nitrite (NaNO₂) as food preservative, rampant use of nitrogenous fertilizers for agricultural practices, and improper disposal of nitrogenous wastes have drastically increased human exposure to high nitrite levels causing various health disorders and death. In the present study, the protective effect of carnosine and N-acetylcysteine (NAC) against NaNO₂-induced intestinal toxicity in rats was investigated. Animals were given a single acute oral dose of NaNO₂ at 60 mg/kg body weight with or without prior administration of either carnosine at 100 mg/kg body weight/day for 7 days or NAC at 100 mg/kg body weight/day for 5 days. Rats were killed after 24 h, and intestinal preparations were used for the evaluation of biochemical alterations and histological abrasions. Administration of NaNO₂ alone decreased the activities of intestinal brush border membrane and metabolic enzymes and significantly weakened the anti-oxidant defense system. DNA damage was also evident as observed by increased DNA-protein crosslinking and fragmentation. However, prior administration of carnosine or NAC significantly ameliorated NaNO₂-induced damage in intestinal cells. Histological studies support these biochemical results, showing intestinal damage in NaNO₂-treated animals and reduced tissue injury in the combination groups. The intrinsic anti-oxidant properties of carnosine and NAC must have contributed to the observed mitigation of nitrite-induced metabolic alterations and oxidative damage. Based on further validation from clinical trials, carnosine and NAC can potentially be used as chemo-preventive agents against NaNO₂ toxicity.