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Dietary mycotoxin exposure and human health risks : a protocol for a systematic review

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Abstract
Background Mycotoxins are toxic fungal secondary metabolites that contaminate a wide spectrum of essential foods worldwide, such as grain-based products, nuts and spices, causing adverse health effects pertaining to their carcinogenic, nephrotoxic and hepatotoxic nature, among others. Aim The aim of this systematic review (SR) is to systematically search for, appraise and synthesize primary research evidence to identify what is known about dietary mycotoxin-related health effects and what remains unknown, as well as the uncertainty around findings and the recommendations for the future. Search strategy and eligibility criteria Search strategies, as well as eligibility criteria were structured according to a predefined PECO (population, exposure, comparison, and outcome) research question and developed in an iterative scoping process. Several bibliographic databases, including Embase, Cochrane Library, Pubmed, Web of Science Core Collection and Scopus, will be searched. Primary research on any measured or modelled dietary exposure to a single or multiple mycotoxins, and adverse human health outcomes (i.e. cancer, non-carcinogenic diseases, and reproductive & developmental adverse outcomes) will be included, and references will be imported into Covidence. In vitro, ex vivo, in silico, animal and review studies, as well as expert’s opinions, secondary literature, conference abstracts, presentations, posters, book chapters, dissertations and studies involving non-dietary mycotoxin exposure, will be excluded. Study selection Two independent reviewers will screen titles and abstracts, and review full-texts. Any disagreements will be resolved by a third reviewer based on two-third majority. Data extraction Data from retained eligible studies will be extracted by the principal reviewer, and peer-checked by a second reviewer. Study quality assessment Eligible studies will be evaluated for risk of bias (Overall High-Quality Assessment Tool, OHAT) and certainty of evidence (Grading of Recommendations Assessment, Development and Evaluation, GRADE). Evidence synthesis A detailed summary of the included studies will be provided within a tabular format and narratively discussed. Heat maps will be constructed to provide information on available knowledge (gaps), and a meta-analysis may be performed based on the variability in predefined PECO elements and depending on the heterogeneity of studies. Conclusion This protocol describes the methodology for the conduct of a SR on mycotoxin-related human health risks, that could guide future research and inform regulatory decisions, as emphasized by the European Commission within the field of regulatory risk assessment for emerging chemicals.
Keywords
FEED OCCURRENCE, FOOD, AFLATOXINS, TOXICITY, IMPACT, TOXIN, ACID

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MLA
Goessens, Tess, et al. “Dietary Mycotoxin Exposure and Human Health Risks : A Protocol for a Systematic Review.” ENVIRONMENT INTERNATIONAL, vol. 184, 2024, doi:10.1016/j.envint.2024.108456.
APA
Goessens, T., Mouchtaris-Michailidis, T., Hadush, K. T., Nguyen, T. N., Vertriest, F., Bader, Y., … De Boevre, M. (2024). Dietary mycotoxin exposure and human health risks : a protocol for a systematic review. ENVIRONMENT INTERNATIONAL, 184. https://doi.org/10.1016/j.envint.2024.108456
Chicago author-date
Goessens, Tess, Thanos Mouchtaris-Michailidis, Kokeb Tesfamariam Hadush, Truong Nhat Nguyen, Febe Vertriest, Yasmine Bader, Sarah De Saeger, Carl Lachat, and Marthe De Boevre. 2024. “Dietary Mycotoxin Exposure and Human Health Risks : A Protocol for a Systematic Review.” ENVIRONMENT INTERNATIONAL 184. https://doi.org/10.1016/j.envint.2024.108456.
Chicago author-date (all authors)
Goessens, Tess, Thanos Mouchtaris-Michailidis, Kokeb Tesfamariam Hadush, Truong Nhat Nguyen, Febe Vertriest, Yasmine Bader, Sarah De Saeger, Carl Lachat, and Marthe De Boevre. 2024. “Dietary Mycotoxin Exposure and Human Health Risks : A Protocol for a Systematic Review.” ENVIRONMENT INTERNATIONAL 184. doi:10.1016/j.envint.2024.108456.
Vancouver
1.
Goessens T, Mouchtaris-Michailidis T, Hadush KT, Nguyen TN, Vertriest F, Bader Y, et al. Dietary mycotoxin exposure and human health risks : a protocol for a systematic review. ENVIRONMENT INTERNATIONAL. 2024;184.
IEEE
[1]
T. Goessens et al., “Dietary mycotoxin exposure and human health risks : a protocol for a systematic review,” ENVIRONMENT INTERNATIONAL, vol. 184, 2024.
@article{01HNW9X4TJ2T8QR965JRQ9Q3B4,
  abstract     = {{Background 
Mycotoxins are toxic fungal secondary metabolites that contaminate a wide spectrum of essential foods worldwide, such as grain-based products, nuts and spices, causing adverse health effects pertaining to their carcinogenic, nephrotoxic and hepatotoxic nature, among others.

Aim 
The aim of this systematic review (SR) is to systematically search for, appraise and synthesize primary research evidence to identify what is known about dietary mycotoxin-related health effects and what remains unknown, as well as the uncertainty around findings and the recommendations for the future.

Search strategy and eligibility criteria 
Search strategies, as well as eligibility criteria were structured according to a predefined PECO (population, exposure, comparison, and outcome) research question and developed in an iterative scoping process. Several bibliographic databases, including Embase, Cochrane Library, Pubmed, Web of Science Core Collection and Scopus, will be searched. Primary research on any measured or modelled dietary exposure to a single or multiple mycotoxins, and adverse human health outcomes (i.e. cancer, non-carcinogenic diseases, and reproductive & developmental adverse outcomes) will be included, and references will be imported into Covidence. In vitro, ex vivo, in silico, animal and review studies, as well as expert’s opinions, secondary literature, conference abstracts, presentations, posters, book chapters, dissertations and studies involving non-dietary mycotoxin exposure, will be excluded.

Study selection 
Two independent reviewers will screen titles and abstracts, and review full-texts. Any disagreements will be resolved by a third reviewer based on two-third majority.

Data extraction 
Data from retained eligible studies will be extracted by the principal reviewer, and peer-checked by a second reviewer.

Study quality assessment 
Eligible studies will be evaluated for risk of bias (Overall High-Quality Assessment Tool, OHAT) and certainty of evidence (Grading of Recommendations Assessment, Development and Evaluation, GRADE).

Evidence synthesis 
A detailed summary of the included studies will be provided within a tabular format and narratively discussed. Heat maps will be constructed to provide information on available knowledge (gaps), and a meta-analysis may be performed based on the variability in predefined PECO elements and depending on the heterogeneity of studies.

Conclusion 
This protocol describes the methodology for the conduct of a SR on mycotoxin-related human health risks, that could guide future research and inform regulatory decisions, as emphasized by the European Commission within the field of regulatory risk assessment for emerging chemicals.}},
  articleno    = {{108456}},
  author       = {{Goessens, Tess and Mouchtaris-Michailidis, Thanos and Hadush, Kokeb Tesfamariam and Nguyen, Truong Nhat and Vertriest, Febe and Bader, Yasmine and De Saeger, Sarah and Lachat, Carl and De Boevre, Marthe}},
  issn         = {{0160-4120}},
  journal      = {{ENVIRONMENT INTERNATIONAL}},
  keywords     = {{FEED OCCURRENCE,FOOD,AFLATOXINS,TOXICITY,IMPACT,TOXIN,ACID}},
  language     = {{eng}},
  pages        = {{13}},
  title        = {{Dietary mycotoxin exposure and human health risks : a protocol for a systematic review}},
  url          = {{http://doi.org/10.1016/j.envint.2024.108456}},
  volume       = {{184}},
  year         = {{2024}},
}

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