Search Results (5,433)

Environmental contamination by potentially toxic elements remains a public health concern in groundwater-dependent regions. This exploratory community-based cross-sectional study examined associations among a historical area-level arsenic screening classification, questionnaire-derived potential-exposure indicators, and self-reported symptom count in 275 adults from 37 standardized locality clusters in Satu Mare County, Romania. The arsenic Health Risk Index (HRI) screening classification was derived entirely from drinking-water measurements collected in a preceding regional study during 2022–2024; no water samples or exposure biomarkers were obtained in the present survey. The questionnaire-derived potential exposure index was calculated as the unweighted sum of seven binary indicators covering residential, drinking-water, occupational, dental, and dietary characteristics (theoretical range, 0–7; observed range, 0–6) and was analyzed continuously. Symptom count (theoretical range, 0–8) was analyzed primarily using negative binomial regression with locality-clustered standard errors and adjustment for age, sex, smoking, alcohol consumption, HRI classification, and self-reported comorbidity. Each one-point increase in the potential exposure index was associated with a modestly higher expected symptom count (adjusted incidence rate ratio = 1.106, 95% CI: 1.031–1.186; p = 0.005), whereas the area-level HRI classification was not statistically associated with symptom count (adjusted incidence rate ratio = 1.135, 95% CI: 0.829–1.554; p = 0.431). The association remained positive across alternative index specifications, although the drinking-water-focused estimate was smaller and less precise. These findings represent exploratory associations between reported potential-exposure characteristics and nonspecific self-reported symptoms; they do not establish individual arsenic exposure, contaminant-specific effects, or causality. Full article

Environmental concerns regarding the ecotoxicological effects of antifouling biocides have led to the development of products targeting biofilm-forming bacteria. However, the potential for sublethal biocide exposure to promote bacterial adaptation and increase the risk of resistance development poses a potential threat to marine ecosystems and human health, yet it remains insufficiently understood. Although this study focuses on conventional antifouling biocides, the findings are intended to inform the future development and evaluation of both conventional and environmentally friendly antifouling technologies by highlighting the importance of assessing resistance induction at sublethal concentrations. In this study, the effects of three representative antifouling biocides on marine bacterial growth and bacterial adhesion were investigated. Sea-Nine 211 (DCOIT), copper sulphate (CuSO₄), and tributyltin oxide (TBTO; included as a historical reference compound due to its environmental persistence) were tested at four concentrations (0.01, 0.1, 1.0, and 10 µg/mL) against six marine biofilm-forming bacteria: Vibrio proteolyticus, V. aestuarianus, V. harveyi, V. natriegens, Shewanella putrefaciens and Pseudoalteromonas elyakovii. The results showed that Sea-Nine 211 exhibited a strong antibacterial effect at 10 µg/mL against all tested species except V. harveyi, whereas at the lowest concentration it promoted bacterial adhesion in V. proteolyticus. In contrast, TBTO and CuSO₄ showed limited antibacterial activity and increased microbial adhesion at the three lowest concentrations tested. These findings demonstrate that antifouling biocides can induce distinct responses depending on the concentration, ranging from growth inhibition to enhanced bacterial adhesion. Given that reducing biocide release has been proposed as a strategy to mitigate environmental impacts, our results highlight two potential challenges: (i) reduced antifouling efficacy at sublethal concentrations and (ii) an increased risk of bacterial adaptation associated with enhanced adhesion. To support future monitoring and resistance risk assessment, we propose a conceptual Resistance Risk Index (RRI) framework that could contribute to the sustainable management of antifouling agents while accounting for local environmental conditions. Full article

Background: Hypertension is a major public health challenge and a leading contributor to cardiovascular morbidity and mortality worldwide. Although obesity is a well-established risk factor for hypertension, the body composition characteristics most strongly associated with hypertension remain unclear. This study aimed to investigate the associations between body composition parameters and hypertension among Thai adults. Methods: This case–control study included 208 Thai adults aged ≥18 years, comprising 103 normotensive individuals and 105 individuals with hypertension. Blood pressure indices included systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), and rate-pressure product (RPP). Body composition was assessed using bioelectrical impedance analysis (BIA) and included overall and regional body composition parameters, including visceral fat level, fat mass, body fat percentage, and skeletal muscle mass. Differences between groups were examined, and multivariable logistic regression analyses were performed to identify factors independently associated with hypertension. Results: Compared with normotensive participants, individuals with hypertension were significantly older (p < 0.001) and more likely to be male (p = 0.010). They also exhibited significantly greater adiposity-related characteristics, including higher body weight (p = 0.001), body mass index (p = 0.001), body fat percentage (p = 0.023), fat mass (p < 0.001), visceral fat level (p < 0.001), and waist-to-hip ratio (p = 0.037), together with higher SBP, DBP, PP, MAP, and RPP (all p < 0.001). In Model 3, older age (OR = 1.06, 95% CI: 1.04–1.09; p < 0.001), male sex (OR = 5.35, 95% CI: 1.69–16.95; p = 0.004), and higher visceral fat level (OR = 1.16, 95% CI: 1.06–1.26; p < 0.001) were associated with hypertension, whereas skeletal muscle mass was not (OR = 1.03, 95% CI: 0.95–1.12; p = 0.438). Each one-unit increase in visceral fat level was associated with a 16% increase in the odds of hypertension. The final model demonstrated acceptable discrimination (AUC = 0.79, 95% CI: 0.72–0.85). Conclusions: A higher BIA-derived visceral fat level was associated with hypertension among Thai adults after adjustment for age, sex, and skeletal muscle mass, whereas skeletal muscle mass showed no independent association in the same model. These findings suggest that visceral fat distribution may provide complementary information in cardiometabolic assessment. However, prospective studies using imaging-based assessments are required to confirm these findings. Full article

This study evaluated potentially toxic element (PTEs) contamination (As, Cd, Co, Cr, Cu, Ni, Pb, and Zn) in soil and grapevine leaves across 36 sites in a historical vineyard near Iași, Romania, transitioning toward residential development. Soil samples were analyzed using energy-dispersive X-ray fluorescence (ED-XRF), while leaf tissues collected during the véraison stage (mid-August) underwent microwave-assisted acid digestion followed by inductively coupled plasma mass spectrometry (ICP-MS). Soil analyses revealed that average concentrations of Cr, Ni, and Pb exceeded national normal legal thresholds, while Cu and As surpassed alert permissible limits. Contamination factor ($CF$) and Geoaccumulation Index ($I_{geo}$) metrics confirmed significant anthropogenic Cu enrichment from historical viticultural treatments. Soil-to-leaf transfer factors ($TF$) approached or exceeded 1 for Cu and Zn, though grapevine was not identified as a hyperaccumulator. Spearman correlation modeling demonstrated a statistical decoupling between soil concentrations and foliar tissue levels for Cu ($r_s=-0.21$) and Zn ($r_s=0.075$), confirming that canopy accumulation is governed by historical agrochemical spraying and atmospheric deposition rather than root-driven uptake. Conversely, Pb ($r_s=0.43$) exhibited a moderate direct soil-to-leaf pathway. The potential ecological risk ($PER$) index indicated moderate-to-considerable cumulative risk, primarily driven by Cu ($E_{Cu}=68.64$) and Cd ($E_{Cd}=59.17$). Human health risk assessments established direct ingestion as the primary exposure pathway, with current non-carcinogenic hazards remaining within tolerable limits ($HI<1$). However, the proposed residential conversion increases exposure risks for vulnerable cohorts, underscoring the necessity of systematic soil screening and remediation prior to land redevelopment. Full article

Background: Periodontitis and psoriasis are chronic inflammatory diseases that share common risk factors and immune-mediated pathogenic pathways, suggesting a potential bidirectional relationship. Periodontal inflammation contributes to systemic inflammatory burden, which may influence the severity of immune-mediated diseases, such as psoriasis. Objective: The aim of this systematic review is to evaluate the effects of periodontal therapy on psoriasis severity in patients affected by both conditions. Methods: This review followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251155439). Eligible studies included adults (≥18 years) with both psoriasis and periodontitis undergoing periodontal therapy compared with no periodontal treatment. The primary outcome was Psoriasis Area and Severity Index (PASI), while secondary outcomes included periodontal clinical parameters (PPD, CAL, FMBS). Results: A total of 228 records were identified; after screening and full-text evaluation, two randomized controlled trials, including a total of 166 patients, met the inclusion criteria. Both studies evaluated non-surgical periodontal therapy and reported significant reductions in PASI scores in treated patients compared with controls. Periodontal parameters (PPD, CAL, FMBS) also improved significantly following treatment in both studies. Conclusions: Evidence from the included trials indicates that non-surgical periodontal therapy may reduce psoriasis severity while simultaneously improving periodontal health in patients with both conditions. Periodontal treatment may serve as a beneficial adjunct to dermatological therapy. However, findings are limited by small sample sizes and short follow-up periods. Larger, long-term randomized controlled trials are needed to confirm these results. Full article

Background and Objectives: Body mass index (BMI) has a complex relationship with skeletal health. Higher BMI is often associated with higher bone mineral density (BMD), but this apparent densitometric advantage may not fully reflect bone microarchitecture. Trabecular bone score (TBS) may provide complementary information in overweight and obese postmenopausal women. This study evaluated the associations between BMI, BMD, and TBS in postmenopausal women and assessed whether increased BMI is associated with discordant skeletal phenotypes characterized by non-osteoporotic densitometric status but impaired trabecular microarchitecture. Materials and Methods: This retrospective observational study screened 110 DXA/TBS reports from patients evaluated in a tertiary DXA center. Inclusion criteria were female sex, postmenopausal status, available BMI or sufficient anthropometric data for BMI calculation, valid lumbar spine DXA, at least one valid hip DXA assessment, and valid lumbar TBS assessment. Four cases were excluded: two male patients and two non-menopausal female patients. The final analytical cohort included 106 postmenopausal women. Lumbar spine and hip BMD, T-scores, TBS, Bone Resilience Index, anthropometric variables, and menopausal variables were extracted from DXA/TBS reports. BMI was analyzed both continuously and by category: under/normal-weight, overweight, and obesity. Correlation analyses, group comparisons, and linear regression models were used to evaluate the relationship between BMI and skeletal parameters. Discordant skeletal phenotypes were defined descriptively as non-osteoporotic DXA findings combined with degraded TBS. Results: The final cohort had a mean age of 65.2 ± 7.6 years and a mean BMI of 27.3 ± 4.5 kg/m². BMI was positively associated with lumbar spine BMD (r = 0.392, p < 0.001), minimum femoral neck BMD (r = 0.382, p < 0.001), and minimum total hip BMD (r = 0.508, p < 0.001), but negatively associated with TBS (r = −0.307, p = 0.001). Mean TBS decreased across BMI categories, from 1.283 ± 0.084 in the under/normal-weight group to 1.255 ± 0.088 in the overweight group and 1.199 ± 0.109 in the obesity group. In the fully adjusted regression model including BMI, age, years since menopause, lumbar spine BMD, and lowest hip T-score, BMI remained an independent negative predictor of TBS (β = −0.0126, p < 0.001). Discordant skeletal phenotypes combining non-osteoporotic DXA status with degraded TBS were more frequent in patients with obesity. Conclusions: In postmenopausal women, higher BMI was associated with higher BMD but lower TBS, supporting a divergent relationship between densitometric findings and DXA-derived trabecular texture parameters. These findings suggest that TBS may complement BMD in describing skeletal imaging status in overweight and obese women. Because fracture outcomes and complete clinical risk data were not available, the present results should be interpreted as evidence of imaging discordance rather than direct evidence of clinical underdiagnosis or misclassification. Full article

Background/Objectives: Obesity is associated with respiratory infection risk, but its relationship with post-discharge healthcare burden remains unclear. This study examined the associations of body mass index (BMI) and waist circumference (WC), evaluated separately, with hospitalization and post-discharge outcomes in analyses stratified by sex among South Korean adults with claims-defined hospitalizations involving influenza or pneumonia. Methods: This retrospective cohort study used the 2018 National Health Insurance Service (NHIS) Customized Research Database linked to health-screening data. Adults aged 20–89 years with claims-defined hospitalizations involving influenza or pneumonia were included if BMI and WC measurements were available from the most recent NHIS health-screening examination conducted within two years before the index admission. Length of stay and index hospitalization costs were summarized descriptively. Cox proportional hazards models were used to estimate hazard ratios (HRs) for all-cause and pneumonia-related readmission within two years after discharge, and two-part models were used to estimate readmission-related costs, expressed in US dollars (USD). Results: The cohort included 175,774 patients, of whom 80,257 (45.7%) were male. Category-specific associations varied according to the anthropometric measure, outcome, and sex stratum. In female patients, the highest WC category had the largest estimated all-cause readmission HR (HR 1.195, 95% confidence interval 1.157–1.235), and the highest model-based mean cost of the first all-cause readmission was also observed in this category (USD 1407.4). In male patients, several higher BMI categories had lower estimated readmission HRs than the reference category; however, these estimates should not be interpreted as protective effects because competing mortality was not accounted for using competing-risk methods. Patterns for pneumonia-related readmission and costs were less consistent. Conclusions: BMI and WC showed category-specific associations with readmission, while model-based mean readmission costs varied across anthropometric categories and sex strata. Higher WC categories were associated with higher all-cause readmission HRs in the female stratum; however, the independent or incremental prognostic value of BMI and WC was not evaluated. Full article

Although conventionally quantified as an urban–rural thermal anomaly, urban heat islands are systematic expressions of development choices that shape unequal exposures and health risks across cities. This article develops an integrated urban development-health framework explaining how imperviousness, vegetation deficit, landscape configuration, urban morphology, thermally absorptive materials and nocturnal heat retention connect heat exposure with physical disease, mental well-being and climate-responsive planning. A critical integrative review reported using PRISMA 2020 and PRISMA-ScR principles, organised evidence from urban climate, public health, environmental epidemiology and planning. The synthesis covers the Normalized Difference Vegetation Index (NDVI), Normalized Difference Built-up Index (NDBI), Local Climate Zones (LCZs), sky-view factor (SVF), height-to-width ratio (H/W), land-surface temperature (LST), Universal Thermal Climate Index (UTCI), Physiological Equivalent Temperature (PET), wet-bulb globe temperature (WBGT) and nocturnal minimum temperature, together with cardiovascular, respiratory, psychiatric, sleep, mortality and well-being outcomes. Six recurrent amplification pathways were identified: imperviousness and low canopy cover; nocturnal heat retention; social vulnerability; blue-green and cool infrastructure; heat–pollution–humidity interaction; and sleep/mental-health disruption. The Urban Heat-Health Development Index (UHHDI) and Urban Heat-Health Amplification Pattern (UHHAP) are proposed as transparent, review-derived tools for urban diagnosis and policy prioritisation. A Spanish/Mediterranean climatic-zone transition analysis illustrates how future climatic severity can be translated into planning-relevant exposure potential. The findings support a shift from simply describing urban heat to diagnosing development-driven heat-health risk, with implications for urban regeneration, thermal justice, public-health adaptation and healthy-city governance. Full article

Objective: The long-term management of cardiovascular diseases (CVDs) requires comprehensive rehabilitation strategies aimed at optimizing functional recovery and promoting behavioral changes. These interventions may include digital technologies that emerged as promising approaches to facilitate lifestyle changes, such as dietary behavior and physical activity (PA). Aim: This review aimed to synthesize the current evidence for the potential impact of remotely delivered nutrition interventions with or without a combination of PA interventions on biochemical biomarkers, cardiovascular indexes, anthropometric parameters, levels of PA, exercise and functional capacity, adherence to the Mediterranean Diet (MD), diet quality and quality of life, rehospitalization, urgent visits, death and acute events in adults (≥18 years) with CVDs. Secondary outcomes were accessibility, safety, usability, and adherence. Methods: The PubMed, Web of Science, and Scopus databases were comprehensively searched up to 2026 for Randomized Controlled Trials (RCTs) published in English, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The methodological quality was assessed using the revised Cochrane Risk of bias tool for RCTs (RoB2). Results: 11 RCTs met the inclusion criteria. Sample sizes ranged from 66 to 879 participants. The duration of the interventions varied from 4 weeks to 12 months. The interventions were delivered remotely using a range of digital health technologies, including web-based programs, mobile phones, wearable devices, smartphone applications, and mini-apps. Favorable changes were observed in diet quality and in adherence to MD and PA levels, with no intervention-related adverse events reported. The RoB2 assessment indicated that the majority of included studies (6 out of 11) were classified as having some concerns regarding risk of bias. Conclusions: Remotely combined nutrition and PA interventions are a feasible and effective approach for improving mainly patient-reported outcomes in adults with CVDs. These findings support integrating remote multimodal rehabilitation into routine cardiovascular care and highlight the potential of telehealth-based models to enhance patients’ access to rehabilitation services. Full article

Numerous studies have examined the contribution of polycyclic aromatic hydrocarbons (PAHs) to soil contamination, resulting from legacy oil extraction and storage activities in the energy sector, and the human health risks. In this research, a human health risk assessment (HHRA) was performed on a site contaminated with crude oil, incorporating spatial analysis to identify hotspots of carcinogenic and non-carcinogenic risk from PAH-contaminated soil. In total, eight soil sampling locations were considered. The HHRA was conducted using a software tool developed by the National University of Science and Technology POLIETHNICA of Bucharest according to the United States Environmental Protection Agency (US EPA) and American Society for Testing and Materials (ASTM International) standards. The results obtained in the current assessment were validated against the Risk-net software 3.2 (an Italian tool for risk assessment validated by the ISPRA). The assessment considered a residential scenario (adult and child receptors) using four different exposure pathways: soil ingestion, dermal contact, vapor inhalation (due to the volatilization process) and groundwater ingestion (because of the leaching process). The carcinogenic risk (CR = 1 × 10⁻⁵) and total hazard index (THI < 1) in the studied area were above the threshold values for both adults’ and children’s receptors. The highest concern is given to the process of PAHs leaching from soil to groundwater. The highest carcinogenic concern is benzo(a)pyrene for children’s exposure via groundwater ingestion (CR = 3.53 × 10⁻⁵), while the highest toxic effect is registered for the contaminant naphthalene (THI = 6.22) for the same receptor and exposure pathway. Full article

Background: Lung cancer remains the leading cause of cancer-related mortality in the United States, characterized by poor overall survival rates (OS), particularly for advanced-stage disease. While smoking is a primary risk factor, other contributors include environmental exposures, genetics, comorbidities, and socioeconomic factors. Methods: We included 232 patients with lung cancer (96% NSCLC). Patients were categorized into DNA damage response (DDR)-mutant (DDR^mt, n = 67, 29%) and DDR-wild-type (DDR^wt, n = 165, 71%) groups. We evaluated the correlations between individual and socioeconomic factors between DDR^mt and DDR^wt lung cancer patients. Results:Nineteen DDR genes were identified, with ARID1A(31.3%), CHEK2 (19.4%), ATM (14.9%), BRCA2 (14.9%), ATRX (11.9%), MUTYH (11.9%), ATR (8.9%), and MSH6 (5.9%) being the most common. The DDR^mt group had a significantly higher median tumor mutational burden (TMB) (12 vs. 9; p = 0.006) and a higher prevalence of adenocarcinoma (85.1% vs. 64.8%, p = 0.003). Logistic regression identified adenocarcinoma histology (OR = 10.03, p = 0.002) and lower area deprivation index (OR = 0.98, p = 0.04) as predictors of DDR mutation status. Having advanced stage at diagnosis was associated with, age (p = 0.03), lack of lung cancer screening (p < 0.001), and adenocarcinoma histology (p < 0.001). While median OS was 61 months for the DDR^mt group vs. 44 months for the DDR^wt group (p = 0.654), patients with ATR mutations had significantly shorter survival (13 vs. 67 months; p = 0.0008). Population-level factors, including food insecurity (HR = 2.33, p = 0.002), lack of insurance (HR = 2.39, p = 0.008), and proximity to potential chemical accidents (HR = 1.73, p = 0.037), were significant predictors of OS. Conclusions: These findings suggest that DDR^mt lung cancers represent a biologically distinct subgroup characterized by higher tumor mutational burden and enrichment for adenocarcinoma histology; however, DDR mutation status alone was not associated with overall survival. Instead, outcomes appeared to vary by individual DDR gene, with ATR alterations identifying a subgroup with particularly poor survival. In parallel, food insecurity, lack of insurance, and proximity to potential environmental hazards were associated with outcomes, highlighting the need to integrate genomic biomarkers with social and environmental determinants of health. These data suggest the need for future prospective studies incorporating treatment-response data, longitudinal social determinants of health (SDOH) assessment, and environmental exposure measures to define how DDR alterations can guide precision oncology strategies while addressing modifiable barriers to equitable cancer care. Full article

Background/Objectives: Urinary incontinence after radical prostatectomy remains a significant concern affecting postoperative quality of life. This study aimed to investigate whether the early postoperative International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score is associated with mid-term urinary continence outcomes, using a patient-reported outcome approach. Methods: We retrospectively analyzed patients who underwent robot-assisted radical prostatectomy between May 2020 and July 2023 at the International University of Health and Welfare Narita Hospital and completed follow-up at one and six months postoperatively. Urinary incontinence severity was assessed using the ICIQ-SF (range 0–21, with higher scores indicating more severe symptoms). The primary outcome was incontinence at 6 months, defined as any pad use. Multivariable logistic regression and exploratory receiver operating characteristic (ROC) analyses were performed. Results: A total of 74 patients with complete follow-up data at both time points were included in the analysis. The ICIQ-SF score at one month was significantly associated with urinary incontinence at six months in both univariable and multivariable analyses. In the adjusted model, a higher one-month ICIQ-SF score independently predicted urinary incontinence at six months (odds ratio 1.15; 95% confidence interval 1.04–1.27; p = 0.005). Age, body mass index, and nerve-sparing status were not significantly associated with incontinence at six months. Exploratory ROC analysis demonstrated acceptable discriminative ability (area under the curve (AUC) 0.74, 95% confidence interval (CI) 0.61–0.87). A cut-off value of 13 yielded a sensitivity of 76.9% and a specificity of 59.1%. Conclusions: The ICIQ-SF score assessed one month after radical prostatectomy significantly predicts persistent urinary incontinence at six months. Early postoperative ICIQ-SF assessment may help identify patients at higher risk of persistent urinary incontinence. Further prospective studies are warranted to determine whether risk-stratified postoperative management based on early ICIQ-SF assessment improves clinical outcomes. Full article

Background/Objectives: Birth size is a population-level marker of fetal growth, maternal health, and perinatal care. In Kazakhstan, long-term national and regional patterns in newborn anthropometry have not been jointly examined across birth weight, birth length, the Rohrer index, low birth weight (LBW), and macrosomia. This study aimed to quantify national annual trends in these five indicators for 2013–2022, compare region-specific trajectories, and examine whether the two ends of the birth-weight distribution changed in different directions. Methods: This retrospective ecological time-trend study used de-identified individual newborn records (birth weight, birth length, sex, birth date, and region; 3,483,810 live births, 2013–2022) from the Electronic Register of Inpatients of the Ministry of Health of the Republic of Kazakhstan. These individual-level records were used to calculate the Rohrer index and to apply exclusion criteria at the newborn level, but national trend models were deliberately fitted on the 10 annual observations, and regional heterogeneity was tested with a single region × year interaction model rather than individual births or independent per-region regressions to avoid pseudoreplication. Results: Mean birth weight increased from 3429.5 g (2013) to 3518.4 g (2022), and mean birth length increased from 52.5 to 53.3 cm. Recorded LBW prevalence declined from 3.09% to 1.46%, while macrosomia increased from 12.59% to 16.02%. Pooled regional birth weight ranged from 3392.6 g to 3548.6 g, LBW from 0.9% to 5.3%, and macrosomia from 11.7% to 18.1%; region-specific trends after false-discovery-rate correction showed that only North Kazakhstan Region had a statistically robust increase in LBW. Conclusions: Official registry data for Kazakhstan, analyzed at the individual level and aggregated for trend modeling, showed a decade-long increase in mean birth weight and length, an observed decline in recorded LBW prevalence, and an increase in macrosomia prevalence, with statistically confirmed heterogeneity in regional trajectories. Because this study lacked gestational age or maternal characteristics, these findings should be interpreted as ecological surveillance patterns that support continued monitoring of both ends of the birth-weight distribution, rather than as evidence of individual-level changes in fetal growth or maternal metabolic risk. Full article

Rumors, misleading claims, and other factually risky information units may gain visibility during crises before verification processes are complete. Existing detection systems often address factual status or diffusion separately, whereas operational monitoring requires identifying units that are both factually risky and highly amplified by a forecast horizon. This paper proposes the Disinformation Diffusion Virality Risk Index (DDVRI), an explainable early-warning framework for estimating this joint risk from evidence observed during a prespecified early window. The formulation defines early histories, adjudicated factual labels, fold-specific amplification thresholds estimated without test outcomes, optional absolute amplification floors, block-structured early representations, calibrated risk scores, and capacity-constrained alerting rules. The proposed framework is evaluated using two open datasets, one focused on crisis rumors and another focused on COVID-19 health misinformation with social engagement information. The results support DDVRI as a probabilistic early-warning and prioritization methodology for rare cases that combine factual risk and high-amplification, rather than as a general fake-news classifier or an automatic moderation system. Full article

Background/Objectives: Oral diseases are a major public health challenge and share behavioral and socioeconomic determinants with other noncommunicable diseases. Although physical activity has been proposed as one of these shared determinants, evidence at the population level remains limited. This study investigated the association between physical activity and oral health indicators using nationwide Brazilian surveillance data. Methods: An ecological study was conducted using aggregated data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL) and the Brazilian National Oral Health Survey (SB Brasil) (2022–2023). Physical activity participation and weekly volume were evaluated against untreated dental caries, toothache, pain intensity, tooth loss, and the Decayed, Missing, and Filled Teeth (DMFT) index. Weighted multivariable linear regression models with heteroskedasticity-consistent standard errors were applied. Results: The analysis included 28,707 VIGITEL participants and 14,753 SB Brasil observations. After adjustment, physical activity participation was inversely associated with untreated dental caries, whereas weekly physical activity volume showed no association with any oral health outcome. No significant associations were observed for tooth loss, dental pain, pain intensity, or the DMFT index. Conclusions: Higher population-level participation in physical activity was associated with a lower prevalence of untreated dental caries but not with other oral health indicators. These findings may suggest that physical activity and oral health share common behavioral and social determinants, supporting integrated public health strategies targeting upstream risk factors. Full article