There is growing concern about the concept that exposure to environmental chemicals may be contributing to the obesity epidemic. However, there is no consensus on the obesogenic effects of emerging contaminants from a toxicological and environmental perspective. The potential human exposure and experimental evidence for obesogenic effects of emerging contaminants need to be systematically discussed. The main objective of this review is to provide recommendations for further subsequent policy development following a critical analysis of the literature for humans and experimental animals exposed to emerging contaminants. This article reviews human exposure to emerging contaminants (with a focus on antimicrobials, preservatives, water and oil repellents, flame retardants, antibiotics and bisphenols) and the impact of emerging contaminants on obesity. These emerging contaminants have been widely detected in human biological samples. Epidemiological studies provide evidence linking exposure to emerging contaminants to the risks of obesity in humans. Studies based on animal models and adipose cells show the obesogenic effects of emerging contaminants and identify modes of action by which contaminants may induce changes in body fat accumulation and lipid metabolic homeostasis. Some knowledge gaps in this area and future directions for further investigation are discussed.

Introduction: In 2019 the World Health Organisation published a report which concluded microplastics in drinking water did not present a threat to human health. Since this time a plethora of research has emerged demonstrating the presence of plastic in various organ systems and their deleterious pathophysiological effects. Methods: A scoping review was undertaken in line with recommendations from the Johanna Briggs Institute. Five databases (PubMed, SCOPUS, CINAHL, Web of Science and EMBASE) were systematically searched in addition to a further grey literature search. Results: Eighteen articles were identified, six of which investigated and characterised the presence of microplastics and nanoplastics (MNPs) in the human urinary tract. Microplastics were found to be present in kidney, urine and bladder cancer samples. Twelve articles investigated the effect of MNPs on human cell lines associated with the human urinary tract. These articles suggest MNPs have a cytotoxic effect, increase inflammation, decrease cell viability and alter mitogen-activated protein kinases (MAPK) signalling pathways. Conclusion: Given the reported presence MNPs in human tissues and organs, these plastics may have potential health implications in bladder disease and dysfunction. As a result, institutions such as the World Health Organisation need to urgently re-evaluate their position on the threat of microplastics to public health. Impact statement: This scoping review highlights the rapidly emerging threat of microplastic contamination within the human urinary tract, challenging the World Health Organisation's assertion that microplastics pose no risk to public health. The documented cytotoxic effects of microplastics, alongside their ability to induce inflammation, reduce cell viability and disrupt signalling pathways, raise significant public health concerns relating to bladder cancer, chronic kidney disease, chronic urinary tract infections and incontinence. As a result, this study emphasises the pressing need for further research and policy development to address the challenges surrounding microplastic contamination.

At the Seminar 6 on "Regional knowledge sharing and identification of opportunities for enhanced reduction of Marine Plastics Debris" held during the ASEAN-Japan Environment Week during August 22-24, 2023, Hotta made a keynote presentation to provide discussion points for the following panel discussions. This seminar was orgnaized with the following background and purposes. East and Southeast Asian regions are recognised as the biggest contributors to marine plastic pollution due to rapid economic growth, unsustainable production and consumption patterns, and the lack of appropriate waste management infrastructure.ASEAN member states are also taking initiatives through regional and national policy responses including launching of ASEAN Regional Action Plan for Combating Marine Debris (2021-2025) and development of national action plans in respective countries.With an ongoing process for developing an international legally binding instrument on plastic pollution through Intergovernmental Negotiating Committee (INC) in mind, this event aims to (1) share the progress made thus far in the region in its combat against marine plastic debris, (2) formulate a regional input to the INC process, and (3) explore the areas of future ASEAN-Japan collaboration at this commemorative year of ASEAN-Japan relations.

Background: Anaplastic lymphoma kinase-tyrosine kinase inhibitors (ALK-TKIs) are mainly used in the treatment of ALK-positive advanced non-small cell lung cancer (NSCLC), but a comprehensive clinical evaluation of ALK-TKIs is lacking. Hence, a comparison of ALK-TKIs for first-line treatment of ALK-positive advanced NSCLC is essential to provide rational drug use and a basis for improving national policies and systems. Methods: According to the Guideline for the Administration of Clinical Comprehensive Evaluation of Drugs (2021) and the Technical Guideline for the Clinical Comprehensive Evaluation of Antitumor Drugs (2022), a comprehensive clinical evaluation index system of first-line treatment drugs for ALK-positive advanced NSCLC was established by literature review and expert interviews. We conducted a systematic literature review, meta-analysis, and other relevant data analyses, combined with an indicator system, to establish a quantitative and qualitative integration analysis for each indicator and each dimension of crizotinib, ceritinib, alectinib, ensartinib, brigatinib, and lorlatinib. Results: The comprehensive clinical evaluation results of all dimensions were as follows: in terms of safety, alectinib had a lower incidence of grade 3 and above adverse reactions; for effectiveness, alectinib, brigatinib, ensartinib, and lorlatinib showed better clinical efficacy, and alectinib and brigatinib have been recommended by several clinical guidelines; in terms of economy, second-generation ALK-TKIs have more cost-utility advantages, and both alectinib and ceritinib have been recommended by the UK and Canadian Health Technology Assessment (HTA) agencies; for suitability, accessibility, and innovation, alectinib has a higher degree of physician recommendations and patient compliance. Except for brigatinib and lorlatinib, all other ALK-TKIs have been admitted to the medical insurance directory; the accessibility of crizotinib, ceritinib, and alectinib is good, meeting the needs of patients. Second-and third-generation ALK-TKIs have higher blood-brain barrier permeability, stronger inhibition ability, and innovation than first-generation ALK-TKIs. Conclusions: Compared with other ALK-TKIs, alectinib performs better across six dimensions and has a higher comprehensive clinical value. The results provide better drug choice and rational use for patients with ALK-positive advanced NSCLC.

PURPOSE OF REVIEW: Continuous progress in cancer care has led to its increased use in oral anticancer agents that are easily managed by patients at home with fewer costs and hospitalizations. However, correct self-care behaviors are needed for the safe use of these medications. This review aimed to synthesize studies on self-care behaviors in patients treated with oral anticancer agents. METHODS: This systematic review used a convergent qualitative synthesis design for mixed studies. Studies on adult patients with cancer using any kind of oral anticancer agent and describing self-care maintenance, self-care monitoring, and/or self-care management behaviors were searched on PubMed, EMBASE, and CINAHL. After data extraction, the findings were retained for qualitative synthesis. FINDINGS: Of 3419 records, 19 studies were included in this review. From the qualitative synthesis, all the retrieved behaviors were synthesized in the three self-care dimensions. Five themes and 18 subthemes were identified. Self-care maintenance included "adherence to the medications" and "prevention." Self-care monitoring consisted of "health surveillance and recognition of illness changes." Self-care management included "seeking help" and "autonomous management of side effects." Overall, most of the behaviors described focused only on adherence. CONCLUSION: The findings of this systematic review could guide future studies on self-care and drive future interventions aimed at improving self-care in this vulnerable population. Nurses and other healthcare professionals should provide self-care support to patients taking oral anticancer agents. In particular, they should promote behaviors aimed at improving well-being, preserving health, or managing side effects.

The global demand for plastic is expected to double in the next 20 years. The increasing demand for Single-Use Plastic Products (SUPPs) has become one of the main environmental problems in many developing countries, including Sri Lanka, through direct and indirect means, in the way of excessive consumption and the pollution of the environment through waste generation. In this way, there is a pressing need to accelerate the sustainability evaluation, comparison, impact mitigation, and policy recommendation of SUPPs to address environmental impacts and sustainable development. Therefore, this study aims to quantify and compare the environmental impacts of SUPPs for policy decision-making in Sri Lanka using life cycle assessment (LCA) techniques. Accordingly, the most popular and widely used single-use plastic products, which are under consideration for regulation in Sri Lanka, and their possible alternatives, are considered for this LCA study. The results reveal that SUPPs produced using polystyrene (PS), polypropylene (PP), low-density polyethylene (LDPE), high-density polyethylene (HDPE), and polyethylene terephthalate (PET) have a significant contribution in all life cycle stages, in terms of global warming potential (GWP) and endpoint impact categories. However, the outcomes of the study reveal that the net GWP impact of SUPPs that have recycling practices at the end of life shows better performance compared to incineration and landfill. In addition, the polylactic acid- (PLA)-based products also show a significant impact on mid- and end-point GWP impact categories. Remarkably, the midpoint analysis of PLA-based products and their alternatives emphasized that PLA production was the most impactful for most of the midpoint impact categories due to PLA resin production, which contributes significantly to all impact categories. In particular, for the pesticide bottles with the preferred end-of-life option of incineration, the HDPE indicates a 7.6% lower GWP compared to PET. For reusable steel cutlery, the largest GWP-associated life cycle stage is the user phase (97.5%), which includes cleaning the cutlery. However, the overall reduction in GWP in the use of steel, considering the best (PS with recycling) and worst (PS with incineration) case scenarios, with single-use items are 0.01 and 0.05 kg CO2 (eq), respectively. In the case of pesticide bottles, with the preferred end-of-life option being incineration, the HDPE indicates a 7.6% lower GWP compared to PET. the study reveals that conducting LCA will facilitate scientific decision-making for policy interventions related to SUPPs and their processes. Notably, the study shows that, at present, the capability of conducting LCA studies to evaluate the sustainability performance of SUPPs in Sri Lanka is limited due to the lack of life cycle inventory (LCI) data availability on SUPPs and relevant waste management practices in Sri Lanka.

Microplastics (MPs) have been identified as an emerging soil pollutant and a global environmental concern. Scientists have recently paid attention to the contamination of soil by MPs as their detrimental impacts on soil systems are largely unknown. MPs are considered to be vectors for other soil contaminants, such as potentially toxic elements (PTEs) and organic contaminants. PTEs are persistent contaminants and are often released into soils in large quantities. MPs adsorb PTEs, mainly via electrostatic attraction and surface complexation, and increase their mobility in soils. These complexes can be easily absorbed by plants; hence, the accumulation of PTEs in plants can be enhanced in both microplastic and PTE-contaminated soils. Furthermore, there is a high risk of food chains contamination by PTEs due to crops grown in both microplastic and PTE-contaminated soils. Consequently, countermeasures including policy- and governance-based approaches that target circular economy as well as reduce, reuse, recycle (3R) applications are being discussed around the world to minimize the environmental contamination of MPs.

Microplastic pollution is a global enviromental issues. This is the first time in recent decades that quantitative and qualitative evidence from bibliometrics and Altmetric has been used to conduct an in-depth statistical analysis of global microplastics research knowledge and demonstrate research progress, trends and hotspots. We comprehensively searched the Web of Science Core Collection scientific database from its inception (1986) to September 21, 2019. The study shown that the number of papers on microplastics has increased significantly since 2011. Worldwide, researchers in the field come mostly from Western Europe, mainly spread in the UK, Netherlands and Belgium. With the exception of China, the contribution of developing countries was very limited. Moreover, this study systematically elaborated the hotspots in this field (especially in ecological toxicity and human health risks). The results shown that research on marine systems and marine plankton is still dominant. Since human beings are the ultimate consumers of the food chain, microplastics may have potential effects on the human respiratory system and gastrointestinal tract. Towards that end, some topics and perspectives are noted that could indicate the current scientific hotspots and guide future research directions.