Abstract Marginalized populations experience disproportionate rates of preterm birth and early term birth. Exposure to per- and polyfluoroalkyl substances (PFAS) has been reported to reduce length of gestation, but the underlying mechanisms are unknown. In the present study, we characterized the molecular signatures of prenatal PFAS exposure and gestational age at birth outcomes in the newborn dried blood spot metabolome among 267 African American dyads in Atlanta, Georgia between 2016 and 2020. Pregnant people with higher serum perfluorooctanoic acid and perfluorohexane sulfonic acid concentrations had increased odds of an early birth. After false discovery rate correction, the effect of prenatal PFAS exposure on reduced length of gestation was associated with 8 metabolomic pathways and 52 metabolites in newborn dried blood spots, which suggested perturbed tissue neogenesis, neuroendocrine function, and redox homeostasis. These mechanisms explain how prenatal PFAS exposure gives rise to the leading cause of infant death in the United States. 

https://www.nature.com/articles/s41467-023-38710-3.pdf

Newborn metabolomic signatures of maternal per- and polyfluoroalkyl substance exposure and reduced length of gestation

Abstract Many quality indicators have been proposed for colonoscopy, but most colonoscopists and endoscopy groups focus on measuring the adenoma detection rate and the cecal intubation rate. Use of proper screening and surveillance intervals is another accepted key indicator but it is seldom evaluated in clinical practice. Bowel preparation efficacy and polyp resection skills are areas that are emerging as potential key or priority indicators. This review summarizes and provides an update on key performance indicators for colonoscopy quality.

https://academic.oup.com/gastro/article-pdf/doi/10.1093/gastro/goad009/49504891/goad009.pdf

Key quality indicators in colonoscopy

The concentrations of per- and polyfluoroalkyl substances (PFAS) were determined in raw influent, final effluent, and treated biosolids at Canadian wastewater treatment plants (WWTPs) to evaluate the fate of PFAS through liquid and solids trains of typical treatment process types used in Canada and to assess time trends of PFAS in wastewater between 2009 and 2021. Data for 42 PFAS in samples collected from 27 WWTP across Canada were used to assess current concentrations and 48 WWTPs were included in the time trends analysis. Although regulated and phased-out of production by industry since the early 2000s and late 2000s/early2010s, respectively, perfluorooctanesulfonate (PFOS), perfluorooctanoate (PFOA), and other long-chain PFAS continue to be widely detected in Canadian wastewater and biosolids. Short-chain PFAS that are not currently regulated in Canada were also widely detected. In general, elevated concentrations of several PFAS were observed at WWTPs that receive landfill leachate. Except for PFOS, concentrations of long-chain perfluoroalkyl carboxylates (PFCAs) and perfluoroalkane sulfonates (PFSAs) generally decreased over time in influent, effluent, and biosolids, which is attributable to industrial production phase-outs and regulations. Concentrations of PFOS did not decrease over time in wastewater media. This indicates that regulatory action and industrial phase-outs of PFOS are slow to be reflected in wastewater. Concentrations of short-chain PFCAs in wastewater influent and effluent consistently increased between 2009 and 2021, which reflect the use of short-chain PFAS as replacements for phased-out and regulated longer-chained PFAS. Short-chain PFAS were infrequently detected in biosolids. Continued periodic monitoring of PFAS in wastewater matrices in Canada and throughout the world is recommended to track the effectiveness of regulatory actions, particularly activities to address the broad class of PFAS. 

Per- and polyfluoroalkyl substances (PFAS) in Canadian municipal wastewater and biosolids: Recent patterns and time trends 2009 to 2021.

Contact to perfluoroalkyl substances and thyroid health effects: A meta-analysis directing on pregnancy.

The placenta is a temporary endocrine organ that facilitates gas, nutrient, and waste exchange between maternal and fetal compartments, partially shielding the fetus from potentially hazardous environmental toxicants. However, rather than being "opaque", the placenta is translucent or even transparent to some potential fetal developmental hazards, including toxic trace elements (TEs), perfluoroalkyl and polyfluoroalkyl substances (PFAS), and environmental phenols (EPs) to which women with pregnancy are frequently exposed. These agents are both passively and actively transferred to the fetal compartment, where endocrine disruption, oxidative stress, and epigenetic changes may occur. These pathologies may directly impact the fetus or deposit and accumulate in the placenta to indirectly impact fetal development. Thus, it is critical for clinicians to understand the potential placental toxicity and transfer of widely distributed environmental agents ubiquitous during pregnancy. With such knowledge, targeted interventions and clinical recommendations can be developed to limit those risks. 

Environmental toxicants and placental function.

Background A large body of emerging evidence suggests that per- and polyfluoroalkyl substances (PFAS) affect birth outcomes in various pathways, but the evidence is inconsistent. Therefore, this study aimed to systematically review the epidemiological evidence on PFAS exposure and birth outcomes. Methods Three electronic databases were searched for epidemiological studies through February 13, 2021. We used random-effects meta-analysis for eight birth outcome indicators to calculate summary effect estimates for various exposure types. The risk of bias and the overall quality and level of evidence for each exposure-outcome pair were assessed. Results The initial search identified 58 potentially eligible studies, of which 46 were ultimately included. Many PFAS were found to have previously unrecognized statistically significant associations with birth outcomes. Specifically, birth weight (BW) was associated with PFAS, with effect sizes ranging from −181.209 g (95% confidence interval (CI) = −360.620 to −1.798) per 1 ng/ml increase in perfluoroheptanesulfonate (PFHpS) to −24.252 g (95% CI = −38.574 to −9.930) per 1 ln (ng/ml) increase in perfluorodecaoic acid (PFDA). Similar patterns were observed between other PFAS and birth outcomes: perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) with birth length (BL) and ponderal index (PI), PFOS and perfluorododecanoic acid (PFDoDA) with head circumference (HC), PFHpS with gestational age (GA), and perfluorononanoic acid (PFNA) and PFHpS with preterm birth (PTB). Additionally, PFDA showed a statistically significant association with small for gestational age (SGA). The level of the combined evidence for each exposure-outcome pair was considered to be “moderate”. Conclusion This study showed that PFAS exposure was significantly associated with increased risks of various adverse birth outcomes and that different birth outcome indicators had different degrees of sensitivity to PFAS. Further studies are needed to confirm our results by expanding the sample size, clarifying the effects of different types or doses of PFAS and the time of blood collection on birth outcomes, and fully considering the possible confounders.

Association Between Exposure to Per- and Polyfluoroalkyl Substances and Birth Outcomes: A Systematic Review and Meta-Analysis

BACKGROUND AND AIMS
The effect of linked color imaging (LCI) compared with white light imaging (WLI) is conflicting. The aim of this meta-analysis is to compare the efficacy of LCI versus WLI for the adenoma detection.


METHODS
PubMed, Embase, Google Scholar and Cochrane Library were searched up to the end of Aug 18, 2021. All randomized controlled trials (RCTs) comparing LCI with WLI were included. Dichotomous data were pooled to obtain the relative risk (RR) with a 95% confidence interval (CI), whereas continuous data were pooled using a mean difference (MD) with 95%CI.


RESULTS
A total of 10 RCTs involving 5,510 patients were included. The use of LCI was associated with a statistically significant improvement in adenoma detection rate (ADR), polyp detection rate (PDR), mean adenomas per patient (MAP) and mean polyp per patient (MPP) when compared to WLI (ADR: RR=1.15, 95%CI: 1.07-1.23, p=0.0001, PDR: RR=1.15, 95%CI: 1.08-1.22, p<0.0001; MAP: MD=0.18, 95%CI: 0.09- 0.28, p=0.0002; MPP: MD=0.13, 95%CI: 0.01, 0.25, p=0.03). When stratified by size, LCI group had a higher detection rate of small adenomas (<10 mm) than the WLI group. Besides, LCI showed a significant decrease in adenoma miss rate (AMR) when compared to WLI. There were no statistically significant differences between the two groups in advanced ADR (AADR), sessile serrated lesion detection rate (SDR), cecal intubation rate, insertion time, and withdrawal time.


CONCLUSIONS
The pooled evidence suggests that LCI can significantly improve the detection of ADR, especially for small adenomas (<10 mm). Moreover, the AMR were significantly lower using LCI compared with WLI.

/pdf/the-effect-of-linked-color-imaging-for-adenoma-detection-a-2nbh6ij2.pdf

The Effect of Linked Color Imaging for Adenoma Detection. A Meta-analysis of Randomized Controlled Studies.

Gene polymorphisms of pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1) and interleukin-6 (IL-6) may influence the risk of Graves' disease, but the results of so far published studies remain inconclusive. Therefore, the authors conducted this meta-analysis to assess relationships between TNF-α/IL-1/IL-6 polymorphisms and the risk of Graves' disease by pooling the findings of all relevant studies. A comprehensive literature searching of Pubmed, Embase, Web of Science and CNKI was conducted by the authors, and twenty-eight studies were found to be eligible for pooled analyses. The pooled meta-analyses results showed that genotypic frequencies of TNF-α rs1800629, IL-1A rs1800587, IL-6 rs1800795 and IL-6 rs1800796 polymorphisms among patients with Graves' disease and control subjects differed significantly. Moreover, we found that genotypic frequencies of TNF-α rs1800629 and IL-6 rs1800795 polymorphisms among patients with Graves' disease and control subjects in Caucasians differed significantly, and genotypic frequencies of IL-1A rs1800587, IL-1B rs16944, IL-6 rs1800795 and IL-6 rs1800796 polymorphisms among patients with Graves' disease and control subjects in Asians also differed significantly. Nevertheless, we did not detect such genotypic frequencies differences for TNF-α rs361525 and IL-1B rs1143627 polymorphisms. This meta-analysis suggests that TNF-α rs1800629, IL-1A rs1800587, IL-6 rs1800795 and IL-6 rs1800796 polymorphisms may influence the risk of Graves' disease in overall population. Moreover, TNF-α rs1800629 and IL-6 rs1800795 polymorphisms may influence the risk of Graves' disease in Caucasians, while IL-1A rs1800587, IL-1B rs16944, IL-6 rs1800795 and IL-6 rs1800796 polymorphisms may influence the risk of Graves' disease in Asians.

Gene polymorphisms of pro-inflammatory cytokines may affect the risk of Graves' disease: a meta-analysis

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Association Between Exposure to Per- and Polyfluoroalkyl Substances and Birth Outcomes: A Systematic Review and Meta-Analysis

The Effect of Linked Color Imaging for Adenoma Detection. A Meta-analysis of Randomized Controlled Studies.

Gene polymorphisms of pro-inflammatory cytokines may affect the risk of Graves' disease: a meta-analysis