Insecticide exposure and associated acute health effects in farmers in a rice growing district of India.

This study investigated insecticide usage and associated acute health hazards in rice farming in Odisha, India. A retrospective cross-sectional study design was used to collect data from 139 participants, in the post-monsoon period, 2023. The participants were overwhelmingly male, mostly aged 30 and over, with basic literacy and a range of educational attainment, three-quarters ceasing education by 10th grade and a significant number never attending school. Most farmers/farmworkers used low or moderately toxic insecticides in low doses, typically 3 times/year. However, uptake of appropriate PPE was poor when mixing and applying insecticides. Almost two-thirds (63.4%) of participants reported discomfort/illness after insecticide exposure. Over 90% reported up to 3 symptoms, most experiencing skin irritation. The reported health symptoms were significantly higher among those who ate and drank during insecticide application, compared to those who did not. The number of symptoms reported was also significantly higher in participants who had seen or heard of community insecticide poisoning cases in the previous 12 months, compared with those who had not. Further research is needed on barriers to using effective PPE and on information and training on risks and controls of insecticide exposure that are appropriate for rice farmers in Odisha, India.

A scoping review to evaluate occupational controls and their effectiveness when handling engineered nanomaterials in workplaces.

Research has shown that controlling worker exposure to engineered nanomaterials (ENMs) helps to reduce the exposure risk to employees in workplaces. This study aimed to identify the available evidence on the effectiveness of various control methods used in the workplace to reduce worker exposure to ENMs. The search was conducted in databases-Medline, OVID, Scopus, Science Direct, Web of Science, and Cochrane and the gray literature published from January 2010 to December 2022. The search keywords included ENM controls and their efficiency in workplace environments. Of the 152 studies retrieved, 22 were included in the review. The control measures in the review included (1) substitution controls; (2) engineering measures (i.e., isolation, direct source extraction, and wetting technologies); (3) personal protective equipment; and (4) administrative and work practices. The study results indicate that the above-mentioned control measures were effective in reducing ENM exposures. This information can be used to help employers choose the most effective controls for their workplaces.

Global Regulatory Frameworks for the Use of Artificial Intelligence (AI) in the Healthcare Services Sector.

The healthcare sector is faced with challenges due to a shrinking healthcare workforce and a rise in chronic diseases that are worsening with demographic and epidemiological shifts. Digital health interventions that include artificial intelligence (AI) are being identified as some of the potential solutions to these challenges. The ultimate aim of these AI systems is to improve the patient's health outcomes and satisfaction, the overall population's health, and the well-being of healthcare professionals. The applications of AI in healthcare services are vast and are expected to assist, automate, and augment several healthcare services. Like any other emerging innovation, AI in healthcare also comes with its own risks and requires regulatory controls. A review of the literature was undertaken to study the existing regulatory landscape for AI in the healthcare services sector in developed nations. In the global regulatory landscape, most of the regulations for AI revolve around Software as a Medical Device (SaMD) and are regulated under digital health products. However, it is necessary to note that the current regulations may not suffice as AI-based technologies are capable of working autonomously, adapting their algorithms, and improving their performance over time based on the new real-world data that they have encountered. Hence, a global regulatory convergence for AI in healthcare, similar to the voluntary AI code of conduct that is being developed by the US-EU Trade and Technology Council, would be beneficial to all nations, be it developing or developed.

Successes and Opportunities during the Pandemic: Reflections and Revelations from a Vaccine Development Perspective.

The Centre of Regulatory Excellence (CoRE) launched an annual lecture series in 2021 in Singapore to honor the memory of the late Professor Sir Alasdair Breckenridge, CoRE's founding Chair, and foster dialogue on global biomedical and regulatory perspectives, challenges, and advances. The 2022 Sir Alasdair Breckenridge Lecture "Success and Opportunities in the Pandemic" was delivered by Dr Penny M Heaton, former CEO of the Bill & Melinda Gates Foundation Research Institute and current Global Therapeutics Lead for Vaccines at Johnson & Johnson. Dr Heaton highlighted key lessons on the importance of trust, collaboration, and transparency in the context of health care and vaccine production.

Is using nanosilver mattresses/pillows safe? A review of potential health implications of silver nanoparticles on human health.

Human exposure to engineered nanoparticles has become inevitable in today's extensive commercial use and large-scale production of engineered nanoparticles. Even though several studies have characterised the exposure to nanomaterials during wakeful state (related to occupational exposures and exposures from commercially available particles), very few studies on human exposure during sleep exist. As the study of exposure to all possible nanomaterials during sleep is extensive, this study focuses on exposure to specifically silver nanoparticles which are present in beddings and mattresses. The reasoning behind the use of silver nanoparticles in bedding and related materials, possible routes of entry to various population groups in several sleep positions, exposure characterisation and toxicity potential of such silver nanoparticles are reviewed in this study. The toxicity potential of silver nanoparticles in vivo tests with relation to mammals and in vitro tests on human cells has been tabulated to understand the risks associated during oral, dermal and inhalation exposure to silver nanoparticles. The exposure to humans with regard to dermal absorption and oral intake has been summarised. Although potential inhalation exposure to silver nanoparticles is increasing, only a few studies address the possible toxic effect of inhaled silver particles. Determination of exposure to silver nanoparticles in beddings is a topic that has been less researched, and this review aims to provide background information for future research and help establish a comprehensive risk assessment during sleep in the times of increasing usage of nanoparticles in our daily activities. Despite the current limitations of our understanding, risk assessments must utilise the available data and apply extrapolation procedures in the face of uncertainty, in order to address the needs of regulatory programs. This would enable safe use of the antimicrobial properties of silver nanoparticles without negatively impacting human health. Until then, it would be better to adopt a conservative approach on the usage of silver nanoparticles in daily used commercial items.

Effect modification by transferrin C2 polymorphism on lead exposure, hemoglobin levels, and IQ.

BACKGROUND: Iron deficiency and lead exposure remain significant public health issues in many parts of the world and are both independently associated with neurocognitive deficits. Polymorphisms in iron transport pathways have been shown to modify the absorption and toxicity of lead. OBJECTIVE: We hypothesized that the transferrin (TF) C2 polymorphism modifies the effects of lead and hemoglobin on intelligence. METHODS: Children aged 3-7 years (N=708) were enrolled from 12 primary schools in Chennai, India. The Binet-Kamath Scale of Intelligence were administered to ascertain intelligence quotient (IQ). Venous blood was analyzed for lead and hemoglobin levels. Genotyping for the TF C2 polymorphism (rs1049296) was carried out using a MassARRAY iPLEXTM platform. Stratified analyses and interaction models, using generalized estimating equations, were examined to explore interactions between lead, hemoglobin, and TF C2 categories. RESULTS: A one-unit increase in log blood lead and 1g/dl higher hemoglobin was associated with -77 (95% CI: -136, -18) and 17 (95% CI 14, 21) IQ points, respectively, among children carrying the C2 variant. In comparison, among children who had the homozygous wildtype allele, the same increment of lead and hemoglobin were associated with -21(95% CI: -65, 24) and 28 (95% CI: 15, 40) IQ points, respectively. There was a significant interaction between lead (p=0.04) and hemoglobin (p=0.07) with the C2 variant. CONCLUSION: Children who carry the TF C2 variant may be more susceptible to the neurotoxic effects of lead exposure and less protected by higher levels of hemoglobin.

Lead exposure and visual-motor abilities in children from Chennai, India.

Lead exposure poses a major environmental hazard in India, but little information is available on the impact of lead exposure on visuo-motor development in Indian children. We hypothesize that higher blood lead levels are associated with poorer visual-motor, visual-spatial and fine motor functioning among children. We conducted a cross-sectional study of 814 school children, aged 3-7 years. Lead in whole blood was measured using the LeadCare Analyzer. The Wide Range of Visual Motor Abilities Test (WRAVMA) was administered to each child by trained examiners. The mean blood lead level was 11.4±5.3 µg/dL. In multivariate analyses adjusting for mother's education level, father's education level, average monthly income, hemoglobin and sex, WRAVMA scores were inversely related to blood lead level. An increase of 10 µg/dL was associated with a decrease of 2.6 points (95% CI: -4.5 to -0.7, P=0.006) in the Visual Motor Composite score and a decrease of 2.9 points (95% CI: -5.1 to -0.7, P=0.011) in the Drawing subtest. Exploration of the shape of the dose-effect relationships using spline functions indicated some non-linearities, with the steepest declines in visual-motor skills occurring at higher blood lead levels. Among urban Indian children, higher blood lead levels are associated with decreased visual-motor abilities, particularly visual-motor integration.

Early sexual maturity in local boars of Northeastern India: age-related changes in testicular growth, epididymal sperm characteristics and peripheral testosterone levels.

The present study reports the age related changes in the peripheral testosterone levels, testicular and epididymal growth and development and cauda epididymal spermiogram in local pigs of Northeastern India, which attain sexual maturity around 3 months of age. Local boars (n = 20) were castrated at monthly intervals from 2 to 6 months of age (4 boars per month) to study the testicular growth and development and the epididymal spermiogram. Blood samples, collected from local boars (n = 6) at monthly intervals from 2 to 6 months of age, were analyzed for testosterone levels by radioimmunoassay. Compared to Hampshire boars, significantly (P < 0.05) high testosterone levels were observed in the local boars as early as 2 months of age. The mean (± SEM) level of testosterone in the local boars at 2, 3 and 4 months of age was 11.89 ± 1.52, 20.45 ± 1.33 and 20.38 ± 2.0 ngml(-1), respectively. Though there was consistently significant (P < 0.05) difference in the body weight between Hampshire and local pigs, the same was not observed in case of testicular weight except at 3 and 6 months of age. In line with the above observation, the testis:body weight ratio (gram testis per kg body weight) was significantly (P < 0.05) higher in the local boars compared to the Hampshire boars at any time of observation, which ranged from 0.8 to 1.0 in case of Hampshire and from 2.3 to 3.0 in local boars. The sperm concentration in the cauda epididymal fluid of local boars at 2, 3 and 6 months of age was 2255 ± 186.6, 3685 ± 103.8 and 4325 ± 146.2 million/ml, respectively and the sperm motility, viability and total abnormality was 73.3, 75.2 and 6.2%, respectively at 3 months of age. Taken together, the testosterone level, testicular growth and development and epididymal spermiogram indicate the trait of early sexual maturity in the local pigs as compared to Hampshire.

Use of natural antimicrobials to increase antibiotic susceptibility of drug resistant bacteria.

Plant-derived antibacterial compounds may be of value as a novel means for controlling antibiotic resistant zoonotic pathogens which contaminate food animals and their products. Individual activity of natural antimicrobials (eugenol, thymol, carvacrol, cinnamaldehyde, allyl isothiocyanate (AIT)) and activity when paired with an antibiotic was studied using broth microdilution and checkerboard methods. In the latter assays, fractional inhibitory concentration (FIC) values were calculated to characterize interactions between the inhibitors. Bacteria tested were chosen because of their resistance to at least one antibiotic which had a known genetic basis. Substantial susceptibility of these bacteria toward the natural antimicrobials and a considerable reduction in the minimum inhibitory concentrations (MIC's) of the antibiotics were noted when paired combinations of antimicrobial and antibiotic were used. In the interaction study, thymol and carvacrol were found to be highly effective in reducing the resistance of Salmonella Typhimurium SGI 1 (tet A) to ampicillin, tetracycline, penicillin, bacitracin, erythromycin and novobiocin (FIC<0.4) and resistance of Streptococcus pyogenes ermB to erythromycin (FIC<0.5). With Escherichia coli N00 666, thymol and cinnamaldehyde were found to have a similar effect (FIC<0.4) in reducing the MIC's of ampicillin, tetracycline, penicillin, erythromycin and novobiocin. Carvacrol, thymol (FIC<0.3) and cinnamaldehyde (FIC<0.4) were effective against Staphylococcus aureus blaZ and in reducing the MIC's of ampicillin, penicillin and bacitracin. Allyl isothiocyanate (AIT) was effective in reducing the MIC of erythromycin (FIC<0.3) when tested against S. pyogenes. Fewer combinations were found to be synergistic when the decrease in viable population (log DP) was calculated. Together, fractional inhibitory concentrations < or = 0.5 and log DP<-1 indicated synergistic action between four natural antimicrobials and as many as three antibiotics to which these bacteria were normally resistant.

Lead exposure and behavior among young children in Chennai, India.

BACKGROUND: Lead exposure has long been associated with deficits in IQ among children. However, few studies have assessed the impact of lead on specific domains of behavior and cognition. OBJECTIVE: We evaluated the associations between lead and different domains of neurobehavior and their relative sensitivity to lead. METHODS: We determined blood lead levels using a LeadCare instrument in 756 children 3-7 years of age attending pre- and elementary schools in Chennai, India. Anxiety, social problems, inattention, hyperactivity, and attention deficit hyperactivity disorder (ADHD), as well as executive function were assessed in children by their schoolteachers using Conners' Teacher Rating Scales-39, Conners' ADHD/Diagnostic and Statistical Manual for Mental Disorders, 4th Edition Scales (CADS), and the Behavior Rating Inventory of Executive Function questionnaires, with higher scores denoting worse behavior. Analyses were carried out using multivariate generalized estimating equations with comparisons of outcome Z-scores to assess the relative strengths of the associations between log-blood lead and the different domains of behavior. RESULTS: Mean blood lead level was 11.4 +/- 5.3 microg/dL. Blood lead was associated with higher anxiety (beta = 0.27, p = 0.01), social problems (beta = 0.20, p = 0.02), and higher scores in the ADHD index (beta = 0.17; p = 0.05). The effect estimate was highest for global executive function (beta = 0.42; p< 0.001). CONCLUSIONS: Higher blood lead levels in this population of young children is associated with increased risk of neurobehavioral deficits and ADHD, with executive function and attention being particularly vulnerable domains to the effects of lead.