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Investigation of Ochratoxin A Levels in Commercially Available Turkish Coffee and Risk Assessment. 市售土耳其咖啡中赭曲霉毒素A含量调查及风险评估。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-02-06 DOI: 10.3390/toxins18020084
Hayrettin Özer

This study evaluated the occurrence of ochratoxin A (OTA) in Turkish coffee and its potential health implications under current consumption patterns by analyzing 65 ground and roasted Turkish coffee samples collected across Türkiye. OTA contamination was detected in 53 samples (82%). Based on the mean OTA concentration, the Estimated Daily Intake (EDI) was calculated as 0.1403 ng/kg body weight/day, and health risk characterization was performed using the Margin of Exposure (MOE) approach in accordance with the European Food Safety Authority (EFSA) recommendations for chronic exposure assessment. MOE calculations enabled a refined characterization of health risks under realistic (0.5 cup/day), average (1 cup/day), and high (3 cups/day) consumption scenarios. The MOE values for carcinogenic (neoplastic) effects ranged from 34,450 to 206,847, all exceeding the EFSA reference threshold of 10,000 and indicating a low level of concern for carcinogenic risk associated with Turkish coffee consumption. For non-carcinogenic (non-neoplastic) kidney effects, MOE values ranged from 11,238 to 67,475 across the different consumption scenarios, all exceeding the EFSA reference threshold of 200, indicating a low level of concern for the general population. In conclusion, the findings demonstrate that Turkish coffee consumption does not pose an OTA-related carcinogenic or non-neoplastic health risk for the general population under current consumption patterns. Nevertheless, considering the widespread consumption of Turkish coffee, continued monitoring and strict implementation of control measures throughout the production chain remain advisable to ensure long-term consumer safety.

本研究通过分析在土耳其全境收集的65份研磨和烘焙的土耳其咖啡样本,评估了土耳其咖啡中赭曲霉毒素A (OTA)的含量及其在当前消费模式下的潜在健康影响。53个样本(82%)检测到OTA污染。根据平均OTA浓度,估计每日摄入量(EDI)计算为0.1403 ng/kg体重/天,并根据欧洲食品安全局(EFSA)关于慢性暴露评估的建议,使用暴露边际(MOE)方法进行健康风险表征。MOE计算能够在现实(0.5杯/天)、平均(1杯/天)和高(3杯/天)消费情景下精确描述健康风险。致癌(肿瘤)效应的MOE值从34,450到206,847不等,都超过了欧洲食品安全局的参考阈值10,000,表明对土耳其咖啡消费相关致癌风险的关注程度较低。对于非致癌性(非肿瘤性)肾脏效应,在不同的消费情景中,MOE值从11,238到67,475不等,都超过了欧洲食品安全局的参考阈值200,表明对一般人群的关注程度较低。总之,研究结果表明,在目前的消费模式下,土耳其咖啡的消费不会对普通人群造成与ota相关的致癌或非肿瘤健康风险。然而,考虑到土耳其咖啡的广泛消费,在整个生产链中继续监测和严格执行控制措施仍然是明智的,以确保消费者的长期安全。
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引用次数: 0
The Benzoylation of the Splicing Factor Skip Is Critical for Development, Oxidative Stress Response and Pathogenicity in Aspergillus flavus. 剪接因子Skip的苯甲酰化对黄曲霉的发育、氧化应激反应和致病性至关重要。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-02-06 DOI: 10.3390/toxins18020083
Xuan Chen, Yuqi Zhang, Wenxin Luo, Shihua Wang

Alternative splicing of pre-mRNA is a crucial mechanism in gene expression regulation. As a core component of the spliceosome, the biological function of the Skip protein in Aspergillus flavus remains unknown. Quantitative real-time PCR (qPCR) analysis revealed the presence of two skip gene copies in A. flavus. Single-copy deletion of Skip resulted in slowed growth, reduced conidiation, abolished sclerotial formation, increased aflatoxin biosynthesis, and diminished crop colonization. Meanwhile, Skip was found to regulate the oxidative stress response by modulating the alternative splicing of yapA. Subsequently, immunoprecipitation and Western blot analyses identified lysine 325 (K325) as the benzoylated site on the Skip protein, which catalyzed by the acyltransferase EsaA. Mutation of benzoylated site K325 directly impaired fungal morphogenesis, pathogenicity, and stress adaptation. These findings established the crucial role of Skip and its benzoylation in A. flavus and suggested a potential target for controlling its infection in important crops.

前mrna的选择性剪接是基因表达调控的重要机制。作为剪接体的核心组成部分,Skip蛋白在黄曲霉中的生物学功能尚不清楚。实时荧光定量PCR (Quantitative real-time PCR, qPCR)分析显示,黄曲霉中存在两个跳跃基因拷贝。Skip的单拷贝缺失导致生长减慢,分生减少,巩膜形成消除,黄曲霉毒素生物合成增加,作物定植减少。同时,Skip通过调节yapA的选择性剪接来调节氧化应激反应。随后,免疫沉淀和Western blot分析发现赖氨酸325 (K325)是Skip蛋白上的苯甲酰化位点,由酰基转移酶EsaA催化。苯甲酰化位点K325的突变直接损害了真菌的形态发生、致病性和胁迫适应性。这些发现确定了Skip及其苯甲酰化在黄曲霉中的重要作用,并为控制其在重要作物中的感染提供了潜在的靶点。
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引用次数: 0
Potential Application of Nanocellulose Derived from Bagasse and Durian Rind for Mitigation of Mycotoxin Contamination in Poultry Diets. 甘蔗渣和榴莲皮纳米纤维素在缓解家禽日粮霉菌毒素污染中的潜在应用。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-02-06 DOI: 10.3390/toxins18020085
Chaiwat Arjin, Kwancheewa Jaima, Apinya Satsook, Parichat Thipchai, Kanticha Pratinthong, Pornchai Rachtanapun, Korawan Sringarm

This study was aimed at producing nanocellulose from sugarcane bagasse and durian rind residues for applications to determine adsorption capacity against mycotoxin in poultry diets. Durian rind-derived nanocellulose exhibited finer fiber (12-21 nm diameter and 197-350 nm length) and higher yield (42.1%) than bagasse-derived nanocellulose (18-36 nm diameter and 82-169 nm length), with FTIR confirming purer cellulose I/II structures. The in vitro test adsorption capacity against ochratoxin (OTA) was determined at an incubation time of 180 min to establish working conditions. It was found that the working conditions of bagasse-derived nanocellulose and durian rind-derived nanocellulose were 33 mg/mL and 36.5 mg/mL, respectively. Subsequently, using these working conditions, adsorption capacity was determined via an in vitro digestibility test. Bagasse-derived nanocellulose exhibited an adsorption capacity against OTA of 35.59%, while durian rind-derived nanocellulose achieved an OTA adsorption rate of 39.53% at a contact time of 3 h. Naturally contaminated poultry feeds collected from nine farms in Chiang Mai, Thailand, indicated that both types of nanocelluloses achieved minimum-maximum OTA adsorption rates of 42-43%, aflatoxin B1 (AFB1) at 29-30%, and fumonisin B1 (FB1) at 21-23% across the nine farms' mean values. These findings suggest that nanocellulose derived from sugarcane bagasse and durian rind has potential as a sustainable biosorbent for improving mycotoxin management in poultry production.

本研究旨在从甘蔗渣和榴莲皮渣中制备纳米纤维素,用于测定家禽日粮中对霉菌毒素的吸附能力。榴莲皮衍生的纳米纤维素比甘蔗渣衍生的纳米纤维素(直径18-36 nm,长度82-169 nm)具有更细的纤维(直径12-21 nm,长度197-350 nm)和更高的产率(42.1%),FTIR证实了更纯净的纤维素I/II结构。测定其对赭曲霉毒素(OTA)的体外吸附能力,培养时间为180 min,建立工作条件。结果表明,甘蔗渣基纳米纤维素和榴莲皮基纳米纤维素的工作条件分别为33 mg/mL和36.5 mg/mL。随后,在这些工作条件下,通过体外消化率试验确定吸附量。甘蔗渣基纳米纤维素对OTA的吸附能力为35.59%,而榴莲皮基纳米纤维素在接触3 h时的OTA吸附率为39.53%。从泰国清迈的9个农场采集的自然污染家禽饲料中,9个农场的平均值显示,两种纳米纤维素对OTA的最小-最大吸附率为42-43%,黄曲霉毒素B1 (AFB1)为29-30%,伏马菌素B1 (FB1)为21-23%。这些发现表明,从甘蔗渣和榴莲皮中提取的纳米纤维素有潜力作为一种可持续的生物吸附剂,用于改善家禽生产中的霉菌毒素管理。
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引用次数: 0
Effects of Hemodiafiltration Versus Hemodialysis on Uremic Toxins, Inflammatory Markers, Anemia, and Nutritional Parameters: A Systematic Review and Meta-Analysis. 血液滤过与血液透析对尿毒症毒素、炎症标志物、贫血和营养参数的影响:系统回顾和荟萃分析。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-02-06 DOI: 10.3390/toxins18020086
Wannasit Wathanavasin, Solos Jaturapisanukul, Preeyaporn Janwetchasil, Charat Thongprayoon, Wisit Cheungpasitporn, Tibor Fülöp

Hemodiafiltration (HDF) is increasingly used because of its enhanced theoretical clearance of diverse uremic toxins, particularly middle molecules and inflammatory cytokines, relative to conventional hemodialysis (HD), yet evidence on its biochemical benefits remains conflicting. Therefore, this meta-analysis was performed to evaluate the effects of HDF versus HD on uremic toxins, inflammation, anemia, and nutritional parameters. A systematic literature search was conducted using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials to identify relevant studies. Only randomized controlled trials (RCTs) were included. Random-effects meta-analyses were performed to evaluate changes in the prespecified outcomes. Twenty-four RCTs involving 6072 dialysis patients were included. Compared with conventional HD, HDF was associated with significant reductions in serum phosphorus (weighted mean difference [WMD] -0.28 mg/dL; 95% CI -0.44 to -0.12) and β2-microglobulin (WMD -4.84 mg/dL; 95% CI -6.13 to -3.54). HDF also significantly reduced serum urea and C-reactive protein (CRP) levels, along with weekly erythropoietin requirements. Serum albumin levels were slightly but significantly lower in the HDF group than in the conventional HD group (WMD -0.06 g/dL; 95% CI -0.10 to -0.01); however, the clinical significance of such a difference remains uncertain. Higher convective volumes were identified as a key determinant of greater reductions in β2-microglobulin and CRP. Compared with conventional HD, HDF demonstrated superior reductions in several surrogate endpoints, including serum phosphorus, urea, β2-microglobulin, CRP, and weekly erythropoietin requirements. Reduced need for phosphate binders and anemia management may lower treatment-related costs.

与传统血液透析(HD)相比,血液滤过(HDF)由于其理论上增强了对多种尿毒症毒素(特别是中间分子和炎症细胞因子)的清除能力而越来越多地被使用,但其生化益处的证据仍然存在争议。因此,本荟萃分析旨在评估HDF与HD对尿毒症毒素、炎症、贫血和营养参数的影响。使用PubMed、Scopus和Cochrane Central Register of Controlled Trials进行系统文献检索,以确定相关研究。仅纳入随机对照试验(rct)。进行随机效应荟萃分析以评估预先指定结果的变化。纳入24项随机对照试验,涉及6072例透析患者。与传统HD相比,HDF与血清磷(加权平均差[WMD] -0.28 mg/dL; 95% CI -0.44至-0.12)和β2微球蛋白(WMD -4.84 mg/dL; 95% CI -6.13至-3.54)的显著降低相关。HDF还显著降低血清尿素和c反应蛋白(CRP)水平,以及每周促红细胞生成素需求。HDF组血清白蛋白水平略低于常规HD组(WMD为-0.06 g/dL, 95% CI为-0.10 ~ -0.01);然而,这种差异的临床意义仍然不确定。较高的对流体积被确定为β2-微球蛋白和CRP减少的关键决定因素。与传统HD相比,HDF在几个替代终点,包括血清磷、尿素、β2-微球蛋白、CRP和每周促红细胞生成素需求方面表现出优越的降低。减少对磷酸盐结合剂和贫血管理的需求可能降低与治疗相关的费用。
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引用次数: 0
Variation Among Grain Elevator Testing Sites and Analytical Cross-Reactivity of Commercial Immunoassay Kits for Deoxynivalenol Detection in Maize. 玉米脱氧雪腐烯醇市售免疫分析试剂盒检测玉米中脱氧雪腐烯醇的检测位点差异及交叉反应性
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-02-04 DOI: 10.3390/toxins18020081
Beatrice Gedion, Victor Limay-Rios, J David Miller, David C Hooker, Arthur W Schaafsma

Commercial immunoassay-based test kits are widely used for rapid screening of deoxynivalenol (DON) in maize; however, inconsistent results are frequently observed under commercial testing conditions. This study evaluated two distinct contributors to such variability: analytical cross-reactivity of commercial DON immunoassays and between-site variability arising from routine grain elevator testing practices. Under controlled laboratory conditions, all kits accurately measured DON but responded differently to co-occurring DON derivatives. In naturally contaminated maize, immunoassay results reflected the combined presence of DON and co-occurring derivatives, consistent with differences in antibody specificity. An interlaboratory comparison involving multiple grain elevators analyzing identical blinded samples demonstrated substantial between-site variability in reported DON concentrations, with about 16% of results deviating by more than ±20% from the LC-MS/MS reference value. Collectively, these findings show that inconsistent DON test outcomes arise from the combined effects of antibody cross-reactivity and site-specific testing variability, rather than from any unreliability of the analytical methods themselves. This finding highlights the importance of interpreting rapid DON measurements considering these factors.

基于免疫分析的商业检测试剂盒广泛用于玉米脱氧雪腐镰梨醇(DON)的快速筛选;然而,在商业测试条件下,经常观察到不一致的结果。本研究评估了造成这种变异的两个不同因素:商业DON免疫测定法的分析交叉反应性和常规谷物升降机检测方法引起的位点间变异。在受控的实验室条件下,所有试剂盒都能准确测量DON,但对同时发生的DON衍生物的反应不同。在自然污染的玉米中,免疫分析结果反映了DON和共发生衍生物的联合存在,这与抗体特异性的差异一致。一项涉及多个谷物升降机分析相同盲法样品的实验室间比较显示,报告的DON浓度在站点之间存在显著差异,约16%的结果与LC-MS/MS参考值偏差超过±20%。总的来说,这些发现表明,不一致的DON检测结果是由于抗体交叉反应性和位点特异性检测变异性的综合影响,而不是由于分析方法本身的不可靠性。这一发现强调了在考虑这些因素的情况下解释快速DON测量的重要性。
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引用次数: 0
Simultaneous Quantification of Fumonisins and Their Hydrolyzed Metabolites in Donkey Matrices: A Tool for Exposure Assessment and Toxicokinetic Studies. 驴基质中伏马菌素及其水解代谢物的同时定量:暴露评估和毒性动力学研究的工具。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-02-04 DOI: 10.3390/toxins18020080
Dongying Tian, Yunduo Zheng, Yandong Li, Qianwen Xing, Gang Lin, Ronghua Zhu, Quigang Ma, Peilong Wang, Ruiguo Wang

A novel, sensitive, and robust LC-MS/MS method was developed and fully validated for the simultaneous determination of fumonisins (FB1, FB2, FB3) and their hydrolyzed metabolites (HFB1, HFB2, HFB3) in donkey plasma, urine, and feces-three critical matrices for toxicokinetic studies. Sample preparation was optimized for each matrix: salting-out assisted liquid-liquid extraction (SALLE) with perchloric acidification for urine and feces, and a dilute-evaporate-shoot (DES) approach for plasma. Chromatographic separation was achieved on a BEH C18 column with water-ACN containing 0.5% formic acid. The method demonstrated excellent linearity (R2 ≥ 0.99), acceptable accuracy (mean recoveries: 73.3-111.5%), and good precision (intra- and inter-day RSDs < 20%). The limits of quantification (LOQ) for FBs and HFBs were 0.1-0.15 μg/L in plasma, 1.0 μg/L in urine, and 60 μg/kg in feces. To our knowledge, this is the first reported method capable of quantifying this comprehensive panel of analytes across multiple biological matrices in donkeys, providing an essential tool for future exposure assessments and pharmacokinetic research in this species.

建立了一种新的、灵敏的、可靠的LC-MS/MS方法,并充分验证了同时测定驴血浆、尿液和粪便中伏马毒素(FB1、FB2、FB3)及其水解代谢物(HFB1、HFB2、HFB3)的方法,这是毒性动力学研究的三个关键基质。对每种基质的样品制备进行了优化:尿液和粪便采用高氯酸盐析辅助液-液萃取(SALLE)法,血浆采用稀释-蒸发-注射(DES)法。色谱柱为BEH C18,水- acn含0.5%甲酸。方法线性良好(R2≥0.99),准确度可接受(平均加样回收率为73.3 ~ 111.5%),精密度良好(日内、日间rsd < 20%)。血浆中FBs和hbs的定量限为0.1 ~ 0.15 μg/L,尿液中为1.0 μg/L,粪便中为60 μg/kg。据我们所知,这是首次报道的能够对驴体内多种生物基质的综合分析物进行量化的方法,为该物种未来的暴露评估和药代动力学研究提供了重要工具。
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引用次数: 0
Botulinum Toxin Injections for Drooling Improve Dysphagia in Patients with Parkinson's Disease. 注射肉毒杆菌毒素治疗流口水可改善帕金森病患者的吞咽困难。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-02-02 DOI: 10.3390/toxins18020073
Domenico Antonio Restivo, Mario Stampanoni Bassi, Angelo Alito, Simona Portaro, Adriana Tisano, Salvatore Greco, Rosario Marchese-Ragona, Angelo Quartarone

Drooling and dysphagia are frequent and disabling complications in Parkinson's disease (PD) and often coexist, with drooling mainly resulting from impaired saliva clearance due to reduced oral motor control and potentially worsening swallowing function. This study aimed to evaluate whether botulinum toxin type A (BoNT/A) injections into the major salivary glands, beyond controlling drooling, could also improve swallowing performance using clinical and neurophysiological measures. Twenty PD patients with severe drooling and dysphagia underwent bilateral ultrasound-guided BoNT/A injections into the parotid and submandibular glands. Assessments were performed at baseline and at 1, 8, and 12 weeks post-injection. Dysphagia severity was evaluated using the Penetration-Aspiration Scale and the Dysphagia Severity Rating Scale. Neurophysiological assessment included electromyographic recordings from suprahyoid/submental and cricopharyngeal muscles, together with mechanomyography analysis of laryngeal movement during swallowing. Following BoNT/A treatment, a consistent reduction in drooling was observed, accompanied by significant improvements in clinical dysphagia scores and neurophysiological swallowing parameters across all follow-up time points. These findings suggest that incobotulinumtoxinA injections into salivary glands not only reduce drooling but also enhance swallowing function in PD patients, possibly by facilitating oral floor and oropharyngeal motor coordination secondary to improved saliva management.

流口水和吞咽困难是帕金森病(PD)常见的致残性并发症,经常共存,流口水主要是由于口腔运动控制减弱和吞咽功能潜在恶化导致的唾液清除受损。本研究旨在评估A型肉毒杆菌毒素(BoNT/A)注射到主要唾液腺中,除了控制流口水外,是否还可以通过临床和神经生理指标改善吞咽性能。20例严重流口水和吞咽困难的PD患者在超声引导下双侧腮腺和下颌下腺注射BoNT/A。在基线和注射后1、8和12周进行评估。吞咽困难严重程度采用穿透-吸入量表和吞咽困难严重程度评定量表进行评估。神经生理学评估包括舌骨上肌/颏下肌和环咽肌的肌电图记录,以及吞咽时喉部运动的肌力图分析。在BoNT/A治疗后,观察到流口水的持续减少,伴随着临床吞咽困难评分和神经生理吞咽参数在所有随访时间点的显着改善。这些发现表明,在PD患者的唾液腺中注射肉毒杆菌毒素不仅可以减少流口水,还可以增强吞咽功能,可能是通过促进口腔底部和口咽运动协调来改善唾液管理。
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引用次数: 0
Squeeze-Excitation Attention-Guided 3D Inception ResNet for Aflatoxin B1 Classification in Almonds Using Hyperspectral Imaging. 利用高光谱成像技术进行杏仁黄曲霉毒素B1分类的挤压激励注意引导3D Inception ResNet。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-02-02 DOI: 10.3390/toxins18020076
Md Ahasan Kabir, Ivan Lee, Sang-Heon Lee

Almonds are a highly valued nut due to their rich protein and nutritional content. However, they are vulnerable to aflatoxin B1 (AFB1) contamination in warm and humid environments. Consumption of AFB1-contaminated almonds can pose serious health risks, including kidney damage, and may lead to significant economic losses. Consequently, a rapid and non-destructive detection method is essential to ensure food safety by identifying and removing contaminated almonds from the supply chain. Hyperspectral imaging (HSI) and 3D deep learning provide a non-destructive, efficient alternative to current AFB1 detection methods. This study presents an attention-guided Inception ResNet 3D Network (AGIR-3DNet) for fast and precise detection of AFB1 contamination in almonds utilizing HSI. The proposed model integrates multi-scale feature extraction, residual learning, and attention mechanisms to enhance spatial-spectral feature representation, enabling more precise classification. The proposed 3D model was rigorously tested, and its performance was compared against 3D Inception and various conventional machine learning models. Compared to conventional machine learning models and deep learning architectures, AGIR-3DNet outperformed and achieved superior validation accuracy of 93.30%, an F1-score (harmonic mean of precision and recall) of 0.94, and an area under the receiver operating characteristic curve (AUC) value of 0.98. Furthermore, the model enhances processing efficiency, making it faster and more suitable for real-time industrial applications.

杏仁是一种价值很高的坚果,因为它含有丰富的蛋白质和营养成分。然而,在温暖潮湿的环境中,它们很容易受到黄曲霉毒素B1 (AFB1)的污染。食用受afb1污染的杏仁会造成严重的健康风险,包括肾脏损伤,并可能导致重大的经济损失。因此,一种快速和非破坏性的检测方法是必不可少的,通过识别和从供应链中去除受污染的杏仁来确保食品安全。高光谱成像(HSI)和3D深度学习为当前AFB1检测方法提供了一种非破坏性、高效的替代方法。本研究提出了一个注意力引导的Inception ResNet 3D网络(AGIR-3DNet),用于利用HSI快速准确地检测杏仁中AFB1的污染。该模型集成了多尺度特征提取、残差学习和注意机制,增强了空间光谱特征表征,实现了更精确的分类。提出的3D模型经过严格测试,并与3D盗梦空间和各种传统机器学习模型进行了性能比较。与传统机器学习模型和深度学习架构相比,AGIR-3DNet的验证准确率为93.30%,精度和召回率的调和平均值为0.94,接收者工作特征曲线下面积(AUC)值为0.98。此外,该模型提高了处理效率,使其更快,更适合于实时工业应用。
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引用次数: 0
A Community Engagement Approach to Snakebite Prevention in Rural Uganda: Exploring Knowledge, Attitudes, and Practices. 乌干达农村预防蛇咬伤的社区参与方法:探索知识、态度和实践。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-02-02 DOI: 10.3390/toxins18020078
Kevin Arbuckle, Yowasi Byaruhanga, Hazel J Nichols, Cris M Kaseke, Francis Mwanguhya, Jessica Mitchell

Snakebite envenoming is classified as a Neglected Tropical Disease and causes mortality, morbidity, and economic impacts for hundreds of thousands of people per year, particularly in tropical, low- and middle-income countries. Most research on snakebite interventions focuses on improving clinical management rather than bite prevention. However, prevention may provide a better mechanism to minimise snakebite impacts, particularly in rural areas where access to effective medical treatment is limited. This study reports on the preliminary testing phase of a participatory workshop intervention run in rural Uganda in 2022-23, which used a community engagement approach designed to reduce snakebites through discussing snake behaviour and biology. A mixed methods survey and semi-structured interviews were conducted, both with workshop attendees and non-attendees, after the delivery of the workshops. We found that a fearful attitude toward snakes often led to human-snake conflict, with snake killings occurring commonly, and some bites occurring during attempted killings. Workshops appeared to challenge negative attitudes, as understanding snake behaviour seemed to build compassion toward snakes and therefore has the potential to reduce human-snake conflict. Those who attended workshops were more likely to suggest 'giving snakes space,' rather than attempting to kill them, and were more likely to suggest hospital treatment if bitten. We also found that many effective methods for snakebite prevention are already known to the community, but those who attended the workshop were aware of a wider range of prevention methods and were more likely to implement less ecologically damaging and more effective strategies. This emphasises that appropriate knowledge resides within the community to prevent snakebites, and so community engagement approaches can improve prevention practices while recognising that the ownership and knowledge for such changes is generated by the local people themselves.

蛇咬伤被列为一种被忽视的热带病,每年造成数十万人死亡、发病和经济影响,特别是在热带、低收入和中等收入国家。大多数关于蛇咬伤干预的研究侧重于改善临床管理,而不是咬伤预防。然而,预防可能提供一种更好的机制,以尽量减少蛇咬伤的影响,特别是在获得有效医疗的机会有限的农村地区。本研究报告了2022-23年在乌干达农村开展的参与性研讨会干预的初步测试阶段,该研讨会采用了旨在通过讨论蛇的行为和生物学来减少蛇咬伤的社区参与方法。在研讨会结束后,对研讨会参与者和非参与者进行了混合方法调查和半结构化访谈。我们发现,对蛇的恐惧态度往往会导致人蛇之间的冲突,咬蛇事件经常发生,有些人在试图杀人时被咬伤。讲习班似乎挑战了消极态度,因为理解蛇的行为似乎建立了对蛇的同情,因此有可能减少人蛇之间的冲突。那些参加研讨会的人更有可能建议“给蛇空间”,而不是试图杀死它们,如果被蛇咬伤,更有可能建议去医院治疗。我们还发现,许多有效的预防蛇咬伤的方法已经为社区所知,但那些参加研讨会的人意识到更广泛的预防方法,更有可能实施更少的生态破坏和更有效的策略。这强调了社区内部存在预防蛇咬伤的适当知识,因此社区参与方法可以改善预防实践,同时认识到这些变化的所有权和知识是由当地人自己产生的。
{"title":"A Community Engagement Approach to Snakebite Prevention in Rural Uganda: Exploring Knowledge, Attitudes, and Practices.","authors":"Kevin Arbuckle, Yowasi Byaruhanga, Hazel J Nichols, Cris M Kaseke, Francis Mwanguhya, Jessica Mitchell","doi":"10.3390/toxins18020078","DOIUrl":"10.3390/toxins18020078","url":null,"abstract":"<p><p>Snakebite envenoming is classified as a Neglected Tropical Disease and causes mortality, morbidity, and economic impacts for hundreds of thousands of people per year, particularly in tropical, low- and middle-income countries. Most research on snakebite interventions focuses on improving clinical management rather than bite prevention. However, prevention may provide a better mechanism to minimise snakebite impacts, particularly in rural areas where access to effective medical treatment is limited. This study reports on the preliminary testing phase of a participatory workshop intervention run in rural Uganda in 2022-23, which used a community engagement approach designed to reduce snakebites through discussing snake behaviour and biology. A mixed methods survey and semi-structured interviews were conducted, both with workshop attendees and non-attendees, after the delivery of the workshops. We found that a fearful attitude toward snakes often led to human-snake conflict, with snake killings occurring commonly, and some bites occurring during attempted killings. Workshops appeared to challenge negative attitudes, as understanding snake behaviour seemed to build compassion toward snakes and therefore has the potential to reduce human-snake conflict. Those who attended workshops were more likely to suggest 'giving snakes space,' rather than attempting to kill them, and were more likely to suggest hospital treatment if bitten. We also found that many effective methods for snakebite prevention are already known to the community, but those who attended the workshop were aware of a wider range of prevention methods and were more likely to implement less ecologically damaging and more effective strategies. This emphasises that appropriate knowledge resides within the community to prevent snakebites, and so community engagement approaches can improve prevention practices while recognising that the ownership and knowledge for such changes is generated by the local people themselves.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"18 2","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12944939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147290805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Good Clinical Practices for the Management of Cervical Dystonia with BoNT-A: A Delphi-Based Approach from the Italian Expert Group. BoNT-A治疗颈肌张力障碍的良好临床实践:来自意大利专家组的基于delphi的方法。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-02-02 DOI: 10.3390/toxins18020079
Roberto Eleopra, Marcello Esposito, Anna Rita Bentivoglio, Maria Concetta Altavista, Roberto Erro, Patrizia Maria Caglioni, Anna Castagna

Cervical dystonia (CD) is the most common adult-onset focal dystonia, with heterogeneous clinical presentation and significant functional impairment. Currently, no structured Italian good clinical practice documents specifically addressing CD have been published. Optimizing CD management requires expert-based recommendations to guide diagnosis, treatment, and follow-up. A two-round Delphi process was conducted, involving a scientific board of six neurologists with expertise in CD management and an external panel of 56 Italian experts (neurologists and physiatrists managing CD patients). Fifty-two statements were developed, discussed, and voted using a 5-point Likert scale, with consensus defined as ≥75% agreement ('strongly agree' or 'somewhat agree'). In Round 1, 48 of 52 statements (92.4%) reached consensus; the four remaining statements were revised, and two were re-voted in Round 2, both achieving consensus. Final recommendations emphasize comprehensive patient assessment in multiple postural conditions; individualized botulinum neurotoxin type A (BoNT-A) dosing taking into account tonic and phasic components, pain, and dysphagia; the use of instrumental guidance; standardized outcome measures; and integration of physiotherapy and psychological support. This article provides structured good clinical practice recommendations for CD management and offers clinicians, especially those with limited experience, a practical framework to standardize care, optimize treatment, and improve patient outcomes.

宫颈肌张力障碍(CD)是成人发病最常见的局灶性肌张力障碍,具有异质性临床表现和显著的功能损害。目前,没有结构化的意大利良好临床实践文件专门针对乳糜泻已发表。优化乳糜泻管理需要基于专家的建议来指导诊断、治疗和随访。进行了两轮德尔菲程序,包括由6名具有乳糜泻管理专业知识的神经科医生组成的科学委员会和56名意大利专家(神经科医生和管理乳糜泻患者的物理医生)组成的外部小组。采用5分李克特量表制定、讨论和投票了52项陈述,共识定义为≥75%的同意(“非常同意”或“有点同意”)。在第一轮中,52个陈述中有48个(92.4%)达成共识;其余四项发言经修订,其中两项在第二轮重新表决,均取得协商一致意见。最后建议强调在多种体位条件下对患者进行综合评估;个体化A型肉毒杆菌神经毒素(BoNT-A)剂量,考虑强补性和相位性成分、疼痛和吞咽困难;使用工具性指导;标准化结果测量;以及物理治疗和心理支持的结合。本文为乳糜泻管理提供了结构化的良好临床实践建议,并为临床医生,特别是经验有限的临床医生,提供了一个规范护理、优化治疗和改善患者预后的实用框架。
{"title":"Good Clinical Practices for the Management of Cervical Dystonia with BoNT-A: A Delphi-Based Approach from the Italian Expert Group.","authors":"Roberto Eleopra, Marcello Esposito, Anna Rita Bentivoglio, Maria Concetta Altavista, Roberto Erro, Patrizia Maria Caglioni, Anna Castagna","doi":"10.3390/toxins18020079","DOIUrl":"10.3390/toxins18020079","url":null,"abstract":"<p><p>Cervical dystonia (CD) is the most common adult-onset focal dystonia, with heterogeneous clinical presentation and significant functional impairment. Currently, no structured Italian good clinical practice documents specifically addressing CD have been published. Optimizing CD management requires expert-based recommendations to guide diagnosis, treatment, and follow-up. A two-round Delphi process was conducted, involving a scientific board of six neurologists with expertise in CD management and an external panel of 56 Italian experts (neurologists and physiatrists managing CD patients). Fifty-two statements were developed, discussed, and voted using a 5-point Likert scale, with consensus defined as ≥75% agreement ('strongly agree' or 'somewhat agree'). In Round 1, 48 of 52 statements (92.4%) reached consensus; the four remaining statements were revised, and two were re-voted in Round 2, both achieving consensus. Final recommendations emphasize comprehensive patient assessment in multiple postural conditions; individualized botulinum neurotoxin type A (BoNT-A) dosing taking into account tonic and phasic components, pain, and dysphagia; the use of instrumental guidance; standardized outcome measures; and integration of physiotherapy and psychological support. This article provides structured good clinical practice recommendations for CD management and offers clinicians, especially those with limited experience, a practical framework to standardize care, optimize treatment, and improve patient outcomes.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"18 2","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12944977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147290804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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