Volume 11 · Issue 04 · 2025

Diet provides essential metals, which are required for the growth, development, and well-functioning of the body. Nonetheless, some natural and human activities add toxic heavy metals to the diet, consequently introducing them to our bodies, resulting in several disorders and death. The intestine, the metabolism and absorption site of metals, uptakes them through transporters, active processes, and passive processes. It harbors Enteric nervous system (ENS), connecting directly to central nervous system (CNS) and the micro-organisms acting as an endocrine organ, thus regulating the movement of metals into the host. Gut microbes mediate the uptake of essential metals and prohibit toxic metals. However, the imbalance in their concentration manifests into various neurodegenerative diseases via gut involving Firmicutes/Bacteriodetes ratio, Akkermansia, Bifidobacteria, Escherichia, Enterococcus, Bacteroides, and Clostridium. Most importantly, with population aging, the incidence of neurodegenerative disorders is rapidly flourishing, marking the need for novel theranostic approaches to overcome it. Several research have demonstrated the significance of gut microbial homeostasis and its influence on brain functions, often termed as gut-brain axis, necessary for the sustainment of overall health and well-being of the human body. This review presents the novel diagnostic potential of microbes for specific disorders and dietary metals in combination with the therapeutic approach. Furthermore, they propose its utilization as a theranostic tool to investigate the links between mentioned dietary metals and neurological illnesses via the gut.

Gankyrin (PSMD10) is a 25 kDa oncogenic protein and regulatory subunit of the 26S proteasome, characterized by a sevenfold ankyrin repeat domain. Gankyrin is overexpressed in various malignancies, particularly gastrointestinal (GI) cancers. Gankyrin contributes to tumorigenesis by modulating key signaling pathways and engaging in oncogenic protein-protein interactions with tumor suppressors, including p53 and Rb, thereby promoting cell proliferation, metastasis, and resistance to treatment. Recent advances have shed light on the structural basis of gankyrin's molecular interactions, its potential as a diagnostic and prognostic biomarker, and emerging therapeutic strategies. Together, targeting gankyrin represents a promising strategy for precision oncology in GI cancers.

The global burden of diabetes mellitus disproportionately affects low- and middle-income countries (LMICs), where limited healthcare infrastructure hampers timely and effective disease management. Wearable technologies, such as continuous glucose monitors (CGMs), insulin pumps, and fitness trackers, offer a transformative opportunity to bridge care gaps by enabling real-time monitoring, personalized feedback, and improved glycemic control. Evidence shows how wearables enhance patient engagement, support clinical decision-making, and reduce complications. However, significant barriers such as cost, digital illiteracy, poor system integration, and data privacy concerns impede widespread adoption in LMICs. Case studies from Ghana, China, and Ethiopia illustrate these devices' potential and challenges in resource-limited settings. Policy interventions, such as public-private partnerships, subsidies, simplified interfaces, and digital literacy programs, are essential to overcome these obstacles. Furthermore, integrating wearable data into national health systems and leveraging artificial intelligence can improve individualized care and long-term outcomes. As mobile phone use increases in LMICs, coupling wearables with mHealth platforms could further empower self-management. With targeted investments and regulatory support, wearable technologies can be pivotal in advancing equitable, proactive, and data-driven diabetes care across underserved populations.

Nicotine has been associated with cognitive functions such as memory and attention, with serum neurofilament light chain (sNfL) as a biomarker for neurological diseases such as Alzheimer's disease (AD) and multiple sclerosis (MS). However, the associations between nicotine and its metabolites and sNfL levels remain underexplored. This study aims to investigate the associations of serum and urine levels of cotinine and trans-3’-hydroxycotinine (hydroxycotinine) with sNfL levels in a broad population.

Employing data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014, this cross-sectional study applied multivariable linear regression models and restricted cubic splines to examine the links between cotinine, hydroxycotinine (both in serum and urine), and sNfL levels.

A total of 2052 participants were included in the serum analysis (mean age, 46.8 years; SD, 15.3; weighted 52.1% women) and 661 participants in the urine analysis (weighted 49.5% women). sNfL levels were positively associated with both serum and urine concentrations of cotinine and hydroxycotinine. Adjusted analyses revealed increases in sNfL levels in association with these substances, noting nonlinear associations for serum and urine cotinine and hydroxycotinine with sNfL levels.

These findings demonstrate robust positive associations between nicotine metabolites and sNfL levels and identify novel U-shaped associations at lower exposure levels. The results raise the hypothesis that very low nicotine metabolite levels may be associated with lower axonal injury markers, warranting further longitudinal and mechanistic studies to clarify causality.

University students are internationally recognized as a population at risk due to unhealthy lifestyle behaviors and elevated health risks. Supporting positive behavioral change requires understanding their intentions to adopt healthier habits. This study aimed to psychometrically evaluate and culturally validate the healthy lifestyle intention scale (HLIS) in three countries and regions.

A cross-sectional methodological study was conducted in 2023 among university students in Finland (n = 753), Singapore (n = 750), and Hong Kong, China (n = 767). The HLIS was developed based on the Adherence to Treatment of Patients with Chronic Disease Instrument. Psychometric evaluation included Spearman's ρ, Cronbach's ɑ, and both exploratory and confirmatory factor analyses.

Findings from all three countries and regions indicated that Spearman's ρ values ranged from weak to high across the dimensions of self-readiness (0.23-0.69), family support (0.42-0.78), peer support (0.48-0.80), and social media influence (0.48-0.80). Cronbach's ɑ values demonstrated acceptable internal consistency (0.41-0.92). Structural validity was supported by confirmatory factor analysis. While the Finnish model suggested a need for further refinement (comparative fit index [CFI] = 0.81, root mean square error of approximation [RMSEA] = 0.11), the models for Singapore (CFI = 0.92, RMSEA = 0.07) and Hong Kong, China (CFI = 0.92, RMSEA = 0.07) showed strong fit indices.

The current version of the HLIS demonstrates promising psychometric properties for assessing health-related behavioral intentions among university students in a cross-cultural context. Further validation with more diverse international samples is recommended.

Chronic diseases represent a growing public health challenge globally, particularly in developing regions like Sub-Saharan Africa. Somaliland faces a dual burden of communicable and non-communicable diseases amidst post-conflict recovery, yet data on non-communicable disease (NCD) prevalence and determinants remain scarce. This study aimed to ascertain the prevalence and identify socio-demographic factors associated with self-reported chronic diseases among adults in Somaliland.

This cross-sectional study utilized data from the Somaliland Health and Demographic Survey (SLHDS) 2020. The final sample of 11,153 adults had a highly skewed age distribution (94.6% aged 35-44), a primary limitation of this analysis. The outcome was a self-reported physician diagnosis of any chronic disease. A multilevel mixed-effect logistic regression model was employed to identify significant determinants while adjusting for confounders.

The analysis identified several factors associated with reporting a chronic disease. Higher odds were observed among female-headed households (adjusted odds ratio [AOR]: 1.26; 95% CI: 1.06-1.48) and divorced individuals (AOR: 1.92; 95% CI: 1.55-2.37). Conversely, lower odds were associated with higher education (AOR: 0.53; 95% CI: 0.34-0.82) and nomadic residence (AOR: 0.34; 95% CI: 0.22-0.51). Unexpectedly, lack of electricity and no savings were also associated with lower odds, likely reflecting diagnostic access bias and reverse causation.

Findings suggest that self-reported chronic diseases are associated with specific socio-demographic vulnerabilities in Somaliland. The results should be interpreted with extreme caution and viewed as hypothesis-generating at best. Future research using objective measures and representative sampling is urgently needed to validate these associations and accurately quantify the NCD burden.

尊敬的编辑：

对小编来说，

Lin及其同事利用32,609名参与者的Fu-CARE队列报告了高密度脂蛋白胆固醇/低密度脂蛋白胆固醇（HDL-C/LDL-C）比率与全因死亡率之间的U形关联，风险最低为0.30-0.50[1].他们的大样本和性别特异性受限三次样条建模值得称赞，但几个方法论问题削弱了因果推断和翻译价值。

S.Lehrer和P.H.Rheinstein，“大麻与慢性阻塞性肺病和COVID-19感染的关系”，慢性病与转化医学8(2022)：238-241, https://doi.org/10.1002/cdt3.38.