Geno Roalakona, Andrew Maru, Timothy N. W. Jackson, Teatulohi Matainaho, Garry Nou, Nakapi Tefuarani, Andrew D. Watt
Snakebite envenoming is a major public health challenge across Papua New Guinea (PNG). Since 2018, the PNG Snakebite Partnership has distributed life-saving Australian antivenoms to health centres across PNG, trained healthcare workers in appropriate snakebite patient management, and collected snakebite patient data to map the impact of snakebite at participating health centres. Here, we report on the snakebite patient data collected through the PNG Snakebite Partnership between 2018 and 2023. This retrospective analysis reviewed the clinical records of patients treated for snakebites at 49 health centres across PNG between 5 th March 2018 and 31 December 2023 collected on behalf of the PNG National Department of Health (NDoH) through the PNG Snakebite Partnership. Data included 1. Patient demographics ( e.g. , age, sex), 2. Circumstances of the bite ( e.g. , location, size, and time), 3. Observed clinical symptoms, 4. Treatments administered ( e.g. , antivenom), and 5. Patient outcomes, where available. A total of 2,573 snakebite patients attended participating health facilities during the 5.75-year study period. Most snakebite patients were male (59.89%) with a median age of 24 (16.00-35.00). Children (≤16 years of age) accounted for a quarter of all snakebite patients (n = 651, 25.30%). September had the highest number of bites recorded (n = 260) though no statistical differences were observed across months or seasons. Of the 2,573 snakebite patients assessed, 1,199 patients (46.60%) were administered antivenom, with just under half of patients receiving taipan antivenom (n = 535, 44.62%), followed by polyvalent antivenom (n = 442, 36.86%), and death adder antivenom (n = 222, 18.51%). Antivenom was shown to be well tolerated with <15% (n = 169) of patients recorded as experiencing adverse reactions, most of which were classified as mild. 32 fatal snakebites were recorded during the study period, equating to a fatality rate of 2.36% (adult rate – 2.42%; child rate – 2.56%). With the increased availability of free and effective antivenoms through the Partnership, consistent and widespread public health interventions can work to reduce the burden of snakebite in challenging and resource-limited environments. These preliminary analyses estimate that between 901–1,100 snakebite patients survived their bites after receiving treatment through the Partnership. These estimates highlight the success of the program; however, it is also important to acknowledge that they are based on incomplete data. For a more accurate accounting of the impact of this program, further efforts that increase the collection of accurate and complete patient data are required to provide a more finely tuned assessment of both the scale of snakebite and the impact of the Partnership across PNG.
Juan Manuel Ríos, Yoshifumi Horie, Mariano Hugo Masiokas, Diego Esteban Cargnelutti
Microplastics (MPs) pollution has emerged as a pervasive contaminant in remote environments; however, its occurrence in high-altitude snow remains poorly constrained. Here, we provide baseline evidence of MP contamination in snow from four mountaineering camps on Mount Aconcagua (6,962 masl), the highest peak in the Americas and in the entire Western and Southern Hemispheres. Microplastics were identified using µFTIR-ATR spectroscopy. The mean MPs concentration was 38 MP L -1 , with site-specific values of 79 ± 37, 27 ± 8.3, 40 ± 16, and 5 ± 1 MP L -1 at the Plaza de Mulas base camp, and at the Canada, Nido de Condores, and Berlin higher elevations camps, respectively. Significantly higher concentrations at the base camp highlight the influence of intense human activity on MP accumulation, even in these remote high-mountain settings. Fibers (<5 mm), predominantly blue, were the dominant shape (90%), and polymer analysis revealed polyester, polyethylene, and epoxy as the main constituents. These findings indicate that snow is an effective matrix for assessing atmospheric deposition of MPs in andine environments. The spatial distribution of MPs suggests that local emissions associated with mountaineering activities represent a key source, although long-range atmospheric transport cannot be excluded. Our study provides the first documented evidence of the pollution of MPs in this world-famous climbing area, underscoring the vulnerability of high-altitude ecosystems to plastic pollution. Given the ecological significance and increasing human pressure in the Aconcagua Provincial Park, these results highlight the urgent need for targeted waste management strategies and regulatory actions to mitigate MP inputs in this fragile mountain environment.
Millions of tons of plastic are produced worldwide each year. Currently, it is almost impossible to avoid plastic and exposure to its effects. There are many chemical compounds that are used in its production. Some of them, classified as plasticizers, are phthalates, which are found in food packaging, toys, and many cosmetics. They give plastics durability, flexibility, and heat resistance. Humanity is exposed to these substances primarily through ingestion, i.e., processed food and its storage, and through inhalation of polluted air. Consequently, phthalates and their metabolites can be detected in the human body. Due to their ubiquity, they pose a global threat to human health. They contribute to overweight and obesity, insulin resistance, diabetes, and disorders of the nervous and endocrine systems. The purpose of this article was to review existing research on the impact of phthalates on diet, the development of obesity, and diabetes.
Sameera Reem Imthiaz, Suryapratap Ray, Gracy Anu Francis, Rahul Vashishth
We review the genotoxic effects of trace metal exposure and evaluate an efficient treatment strategy. Toxic metal(loid)s cause significant risks to animal health and ecosystems because of their toxicity and bioaccumulation potential. We then examine the mechanisms of genotoxicity, which include direct DNA damage, oxidative stress, epigenetic alterations, and interference with DNA repair mechanisms. This review highlights the health implications of toxic metal exposure: symptoms like increased cancer risks, reproductive and developmental toxicity, and chronic health disorders. Various assessment and biomonitoring techniques for toxic metal genotoxicity, including biomarkers like DNA adducts and chromosomal aberrations, and analytical methods such as the comet assay and PCR-based molecular assays, are discussed. We evaluate treatment strategies, including chelation therapy, antioxidant supplementation, and phytoremediation, emphasizing their efficacy and limitations. The importance of regulatory frameworks, public health interventions, and environmental remediation programs in mitigating toxic metal exposure is also discussed. We identify research gaps in understanding the long-term effects of low-dose chronic exposure and interactions between multiple toxic metals. This comprehensive review contributes to the field by synthesizing current knowledge on toxic metal genotoxicity and treatment strategies. We provide valuable insights for researchers, healthcare professionals, and policymakers toward the development of more effective prevention and intervention strategies. We emphasize challenges and future directions and highlight the importance of continued research in this critical area of public health and environmental science.
Accurate risk assessment for fatal diquat poisoning is critical to improving clinical outcomes. Therefore, this study aimed to evaluate the combined value of the multiple organ dysfunction syndrome (MODS) and neutrophil-to-lymphocyte ratio (NLR) in predicting in-hospital all-cause mortality from acute diquat poisoning. This work retrospectively enrolled diquat self-poisoning patients in Guangzhou 12th People’s Hospital between 2017 and 2023. Demographic, exposure, and 24-h laboratory data were extracted. A time-dependent Cox model evaluated MODS as a time-varying predictor. LASSO and logistic regression identified independent predictors and established the prediction equation; restricted cubic splines assessed dose-response. Bootstrap internal validation evaluated discrimination and calibration; however, variable selection was not repeated within each resample, and therefore the optimism-corrected performance metrics should be interpreted with caution. SHAP quantified feature contributions. NLR was significantly elevated in non-survivors compared to survivors (median 31.37 vs. 11.19, P < 0.001). In the time-dependent Cox analysis, MODS remained independently associated with mortality (hazard ratio [HR] = 35.24, 95% CI: 13.57–91.50, P < 0.001). In the exploratory logistic regression, MODS (adjusted odds ratio [aOR] = 34.63, 95% CI: 7.47–245.65, P < 0.001), diquat dose (aOR = 1.34 per 10 mL, 95% CI: 1.22–1.63, P < 0.001), and NLR (aOR = 1.07, 95% CI: 1.02–1.13, P = 0.01) were independently associated with in-hospital all-cause mortality. The combined model achieved an AUC of 0.976 (Bootstrap 95% CI: 0.951–0.998), with an optimism-corrected AUC of 0.970, an apparent calibration intercept of 0, an apparent calibration slope of 1, and a Brier score of 0.0553 (95% CI: 0.0140–0.0775). SHAP values ranked feature importance as diquat dose (0.179) > MODS (0.145) > NLR (0.069). Sensitivity analyses confirmed the robustness of these findings. MODS and NLR were independently associated with in-hospital all-cause mortality in acute diquat poisoning. When applied after the first 24–72 h of admission, the combined model shows promise as a potential exploratory tool for risk stratification; however, external validation in larger multicenter cohorts is required before any consideration of bedside application.
