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Dried fish is a crucial protein source for coastal populations in developing countries, but it is becoming increasingly contaminated with heavy metals due to the use of traditional drying methods. This study assessed Cd, Cr, Pb, and Mn levels and their health risks in four commonly consumed dried fish species (Harpodon nehereus, Trichiurus lepturus, Penaeus affinis, and Amblypharyngodon mola) from the central coast of Bangladesh. Results showed Mn levels (17.47 ± 4.69 mg/kg) exceeded FAO limits (4.35 mg/kg), with the highest concentrations in H. nehereus. Cd levels (0.24 ± 0.16 mg/kg) in A. mola were also above safety thresholds. Lead was found in all species except P. affinis, with the highest concentration in A. mola (0.432 ± 0.06 mg/kg), which was within safe limits. Risk assessments revealed higher health risks for children, with elevated Target Hazard Quotient (THQ) and Hazard Index (HI) values compared to adults. H. nehereus had the highest THQ values for Cr (0.0014 mg/kg) and Mn (0.00044 mg/kg). Multivariate analyses indicated contamination from both anthropogenic and natural sources. The study stressed the need for better monitoring and mitigation to ensure the safety and nutritional value of dried fish.

The recent detection of microplastics (MPs) in a large number of commercially important food items and beverages, including tap water, has drawn significant attention because of direct exposure and negative health effects on humans. Nevertheless, there is insufficient information on microplastic contamination in the tap water of developing countries. In the present study, we primarily analyzed supplied tap water samples from four major cities in Bangladesh to determine and characterize MPs using a stereomicroscope and Fourier transform infrared spectroscopy (FTIR). Several indices were employed to calculate human health exposures to microplastics. MPs were found in all of the water samples tested, with an overall mean of 35.33 ± 19.55 particles/L. The results of this study diverge from those of comparable research conducted globally, revealing that tap water in Bangladesh exhibited higher levels of contamination compared to other nations. MPs were found in three different shapes (fibers, fragments, and films), with fibers dominating the samples (96.2%), and 98.1% of the microplastics were less than 0.5 mm in size. Six different colors of MPs were observed, and transparent particles were dominant (63.9% of all observed MPs). FTIR infrared spectrum analysis revealed two major types of polymers: low-density polyethylene (LDPE) and high-density polyethylene (HDPE). The projected daily consumption of microplastics was determined to be 2.65 particles per person per day, raising potential concerns for human health. The findings show that the treatment process of the water supply system is inadequate. Additionally, the sources of microplastics in tap water may come from where the water was collected for treatment and may be linked to a variety of anthropogenic activities, such as urbanization, sewage discharge, industrial waste disposal, and runoff from catchment areas.

Groundwater (GW) plays a crucial role as the primary source of potable water in numerous developing nations. However, the increasing presence of microplastics (MPs) represents a concealed danger, threatening activities that guarantee safe drinking water in these countries. Despite this, there is limited awareness about the widespread existence of MPs in these regions of the world. In this study, we investigated the contamination levels, distribution, morphological characteristics, chemical composition, and associated public health risk of MPs in groundwater samples from six coastal districts of Bangladesh using stereomicroscopy and Fourier transform infrared spectroscopy (FTIR). MPs were prevalent at all sampling stations, with average concentrations of 24.63 ± 16.13 items/L and a range of 4–75 items/L. The majority of MPs (97.6%) were fibers, indicating a likely origin from fabric disintegration during drying, washing, discarded fishing nets, personal care items, and municipal waste. Smaller-sized MPs (

The current knowledge regarding the presence of microplastics (MPs) in the digestive tracts of fish, particularly the non-edible parts, provides limited assistance in assessing the risk to human health and establishing guideline values for policy-making purposes. Therefore, we conducted the first investigation into MPs within the commercially significant catfish species S. silondia, form a major tropical estuary assessing their accumulation, characteristics, and associated risks in various tissues, particularly the consumable muscle. A sum of 132 MPs were identified, and the mean abundance of MPs were 7.40 ± 4.12 item/DT, 3.20 ± 1.69 item/gill and 2.60 ± 1.65 item/muscle found in digestive tract (DT), gill and muscle of the fish, respectively. The strong relationships of MPs among three different tissues (y = 0.6069x - 22.69, R2 = 0.7589) indicated the pathways and how MPs were influenced by the physiology of organisms. The prevalence of MPs in fish muscle demonstrated their trophic transmission to humans. Moreover, fishes with higher weight had higher MPs in their gill, and DT. The dominant type, color and size of MPs were fibrous (89.67%), violet (41%) and 1) indicated moderately to highly contaminated fish with MPs ingestion. While the complete understanding of the direct negative effects of microplastics (MPs) on human health remains elusive, their presence in estuarine fish raises concerns for both human and ecosystem health. The findings will be useful for assessing the hazards to human health from exposure to MPs and for creating effective risk management plans to reduce those risks.

Microplastic contamination in terrestrial environments has risen significantly, far exceeding levels in marine environments. This shift underscores the concerning prevalence of microplastics (MPs) in sewage sludge and soil, raising environmental apprehensions. Microplastics from various sources accumulate in sewage systems, consequently, sewage sludge and soil have transformed into primary reservoirs of microplastic pollutants, capable of infiltrating aquatic ecosystems. While using sludge to enrich soil provides nutrients, it simultaneously introduces substantial microplastic content, posing environmental hazards. These microplastics can accumulate in the soil, altering its properties and potentially polluting deeper soil layers and groundwater, compounding environmental risks. This review scrutinizes the abundance, types, and shapes of microplastics in sewage sludge and soil, evaluating their impacts and suggesting future research directions. Statistical analysis reveals higher microplastic concentrations in sludge (271 Particles/kg dry weight) than in soil (34.6 Particles/kg). Strong correlations between microplastic concentrations in soil and sludge (R2 = 0.95) underscore the significant influence of sludge application on soil ecosystems. The p-value of 0.0001 indicates a significant correlation between MP amounts in soil and sludge, while the p-value of 0.47 suggests no significant association between MP concentrations in wastewater and sludge. Research confirms that microplastics influence sludge properties, microbial communities, and soil characteristics, contingent on microplastic attributes and soil conditions. Predominantly, microplastic shapes found in sludge and soil are fibers and fragments, often linked to agricultural fertilizer use. Microplastics detrimentally affect soil bulk density and aggregate stability, impairing soil structure and surface. Furthermore, their presence alters pollutant transport behavior in soil, emphasizing the imperative to investigate microplastics’ effects and transport mechanisms for mitigating environmental and health risks.

The global concern over trace and heavy metal contamination in aquatic environments necessitates the development of effective remediation strategies. Using aquatic plants for heavy metal removal is a relatively economical and sustainable technology worldwide. This study involved collecting sediment and aquatic plant samples (Acanthus ilicifolius, Typha elephantina, and Cynodon dactylon) from a highly urbanized estuary to analyze metal concentrations in sediment, assess ecological risks, and explore the phytoremediation potential. Trace and heavy metals were detected using Energy Dispersive X-ray Fluorescence Spectroscopy (EDXRF). The sediment metal concentrations were found in decreasing order of Fe, Ti, Mn, Rb, Zr, Zn, Sr, Cu, Co, and As. Fe, Sr, and As concentrations were below certified values, whereas Cu, Zn, and Rb exceeded them. Cumulatively, the pollution load index (PLI) values were close to 1 (0.845), indicating that the study area is likely experiencing metal pollution. The Contamination Factor (CF) values, ranging from 1 to 3, indicated a moderate degree of sediment pollution for Ti, Mn, Cu, Zn, and Rb. The Enrichment Factor (EF) values similarly showed moderate enrichment for these metals, with Cu exhibiting the highest degree of enrichment. Ecological risk assessment highlighted the only metal, Cu, as posing the greatest risk among the studied metals. In terms of phytoremediation potential, the bioconcentration factor (BCF) followed the decreasing order of C. dactylon > A. ilicifolius > T. elephantina for most metals, with low BCF values (A. ilicifolius species were greater than 1, indicating low accumulation potential but hyper-metabolizing capabilities, allowing the plant to accumulate metals in its aerial parts, making it effective for phytostabilization.

The widespread occurrence of heavy metals in aquatic environments, resulting in their bioaccumulation within aquatic organisms like fish, presents potential hazards to human health. This study investigates the concentrations of five toxic heavy metals (Pb, Hg, Zn, Cu, and Cr) and their potential health implications in two economically important fish species (Otolithoides pama and Labeo bata) from a subtropical estuarine wetland system (Feni estuary, Bangladesh). Muscle and gill samples from 36 individual fish were analyzed using energy dispersive X-ray fluorescence (EDXRF). The results revealed that the average quantities of heavy metals in both fishes’ muscle followed the declining order of Zn (109.41–119.93 mg/kg) > Cu (45.52–65.43 mg/kg) > Hg (1.25–1.39 mg/kg) > Pb (0.68–1.12 mg/kg) > Cr (0.31–5.82 mg/kg). Furthermore, Zn was found to be present in the highest concentration within the gills of both species. While the levels of Cu, Zn, and Cr in the fish muscle were deemed acceptable for human consumption, the concentrations of Pb and Hg exceeded the permissible limits (>0.5 mg/kg) for human consumption. Different risk indices, including estimated daily intake (EDI), target hazard quotient (THQ), hazard index (HI), and carcinogenic or target risk (TR), revealed mixed and varying degrees of potential threat to human health. According to the EDI values, individuals consuming these fish may face health risks as the levels of Zn, Cu, and Cr in the muscle are either very close to or exceed the maximum tolerable daily intake (MTDI) threshold. Nevertheless, the THQ and HI values suggested that both species remained suitable for human consumption, as indicated by THQ (−6 to 10−4), except for Zn, which exceeded it (>10−4). The correlation matrix and multivariate principal component analysis (PCA) findings revealed that Pb and Cr primarily stemmed from natural geological backgrounds, whereas Zn, Cu, and Hg were attributed to human-induced sources such as agricultural chemicals, silver nanoparticles, antimicrobial substances, and metallic plating. Given the significance of fish as a crucial and nutritious element of a balanced diet, it is essential to maintain consistent monitoring and regulation of the levels and origins of heavy metals found within it.

Microplastics (MPs), an emerging pollutant, have drawn attention on a global scale and have been found in various ecosystems. Nevertheless, there is currently a lack of information regarding the contamination levels of MPs in aquaculture ponds worldwide. In this study, sediment and water samples were collected from five types of fish ponds, namely, homestead ponds (S1), commercial aquaculture ponds (S2), ponds near a residential area (S3), ponds near a small-scale industrial area (S4), and ponds near a large-scale industrial area (S5), to identify, characterize, and assess the contamination risk of MPs. Stereomicroscopic and Fourier-transform infrared (FTIR) spectroscopy analyses revealed that the MPs ranged from 3.33 item/kg to 136.67 item/kg in sediment and 16.6 item/L to 100 item/L in water samples. Overall, the abundance of MPs was extremely high in S5, followed by S4, S2, S3, and S1, which clearly showed the levels increased with the intensity of human activities. The levels of MPs in both sediment and water showed significant differences (p < 0.05) within and between ponds, as well as in comparison between water and sediment samples. The concentrations of MPs surpassed those noted in aquaculture ponds of different nations. The majority of MPs consisted of fragments and films in both sediment and water samples. Furthermore, transparent and white-colored MPs were the prevailing types found in the sediment and water samples of the aquaculture ponds. Around 34% of MPs present in sediment and 30% in water fell within the size range of 0.5–1 mm. Polymers like polypropylene (PP), polyethylene (PE), and polyethylene terephthalate (PET) were prevalent in both sediment and water samples. The contamination factor reached exceptionally elevated levels (>30 for sediment and >3 for water), signifying that the sampled regions, particularly S4 and S5 (industrial sites), displayed significant MP contamination. Moreover, the pollution load index values of the sediment (3.0 ± 1.5) and water samples (1.5 ± 0.3) also indicated the areas were contaminated with MPs. Multivariate analysis indicated that the elevated concentration of MPs in the studied region could be attributed to the discharge of effluents and other human-induced activities.

The contamination and risk assessment of heavy metals (HMs) in highly priced tiger shrimp and its associated ecosystems and farming conditions (hatcheries and commercial grow-out ponds) were scarcely investigated in South Asian countries. In this study, we determined the five HMs (Cu, Zn, Pb, Cd, and Cr) concentrations in PL14 (fourteen days of Post-Larva) of Penaeus monodon, commercial diets, surface water, and sediments from hatcheries, farms, rivers using ICP-MS for two years. The results revealed that surface sediments of rivers and hatcheries had the highest amounts of Cr (65.85 ± 0.82 and 72.50 ± 0.42 mg/kg), Cu (18.82 ± 3.96 and 19.26 ± 4.61 mg/kg), and Zn (63.74 ± 11.14 and 87.42 ± 17.96 mg/kg), whereas commercial farms had the greatest levels of Cd (0.09 ± 0.05 mg/kg). Pb was significantly higher in sediment of hatcheries and farms than in other sites. Except for Zn in surface waters, all metals were found above the recommended limit. In case of supplied feed, all values were in the safe limit excepting Cr (3.39 ± 1.45 to 108.92 ± 3.49 mg/kg). On the other hand, among the metals, only Cr (VI) ranging from 1.75 ± 1.39 mg/kg in P. monodon samples exceeded the suggested international guidelines. The Igeo values of all the metals were Igeo 1) indicating potential health hazards. The low CR values for Cd, Cr Pb were 3.1 × 10−4, 3.7 × 10−4 and 1.6 × 10−4, respectively indicates no cancer risks upon consuming P. monodon.

Abstract Background Pulmonary embolism (PE) is a common and potentially life-threatening condition. Since it is considered a ‘do not miss’ diagnosis, PE tends to be over-investigated beyond the evidence-based clinical decision support systems (CDSS), which in turn subjects patients to unnecessary radiation and contrast agent exposure with no apparent benefits in terms of outcome. The purpose of this study was to evaluate the yield of ‘clinical hunch’ (gestalt) and four CDSS: the PERC Rule, Wells score, revised Geneva score, and Years criteria. Methods A review was conducted on the Electronic Medical Records (EMR) of 1566 patients from the Emergency Department at a tertiary teaching hospital who underwent CTPA from the 1st of January 2018 to the 31st of December 2019. The scores for the four CDSS were calculated retrospectively from the EMR data. We considered that a CTPA had been ordered on a clinical hunch when there was no mention of CDSS in the EMR, and no D-dimer test. A bypass of CDSS was confirmed when any step of the diagnostic algorithms was not followed. Results Of the total 1566 patients who underwent CTPA, 265 (17%) were positive for PE. The diagnosis yield from the five decision groups (clinical hunch and four CDSS) was as follows—clinical hunch, 15%; PERC rule, 18% (6% when bypassed); Wells score, 19% (11% when bypassed); revised Geneva score, 26% (13% when bypassed); and YEARS criteria, 18% (6% when bypassed). Conclusion Clinicians should trust the evidence-based clinical decision support systems in line with the international guidelines to diagnose PE.

Microplastics (MPs) have become pervasive in the environment, posing a threat to the environment, living organisms, and human health. Therefore, MPs have been extensively investigated in bodies of water, soils, and the atmosphere. However, there is limited information about MPs contamination in drinking water sold in plastic packaging from underdeveloped countries. In this study, we analyzed water samples from 10 different common brands of bottled water to detect and characterize MPs using stereomicroscopic and FTIR techniques. Oral consumption of MPs per capita was also estimated. Interestingly, our findings demonstrated that MPs were present in every brand. The average abundance of MPs varied from 14 ± 6.8 particles/L to 56 ± 23 particles/L, with a mean of 35 ± 19 particles/L in all brands. This number of MPs in the studied country was comparatively higher than those found in other countries. MPs were found in four different shapes (fibers, fragments, films, and beads), with fibers dominating the samples (90%). MPs were sorted into eight different colors, with the transparent one accounting for about 66% of the overall count, and 94% of the MPs were

Key Clinical Message When faced with a slowly enlarging firm mass in the parotid gland accompanied by a histological picture of unusual sclerosis with abundant Langerhans cells and eosinophilic infiltrates, sclerosing mucoepidermoid carcinoma with eosinophilia should be considered as one of the differential diagnoses. Further studies are warranted for accurate diagnosis and appropriate treatment. Abstract Sclerosing mucoepidermoid carcinoma of the salivary gland with eosinophilia is a rare tumor mostly negative for the MAML2 rearrangement commonly seen in salivary mucoepidermoid carcinoma. It was not listed as an entity in the 2022 WHO Classification of Head and Neck Tumors. We presented one case initially diagnosed as Langerhans cell histiocytosis and recurred as a frankly invasive carcinoma. Molecular studies showed CSF1 gene derangement and provided new understanding concerning the Langerhans cell and eosinophilic reaction. Further molecular studies on this entity would throw light on its oncogenesis and refine its nomenclature.

Heavy metal contamination in aquaculture farm sediment may create a major risk to ecosystem and human health via the food web as a result of poor handling, incorrect waste management, and extensive use of artificial feed to increase yield and make profit. In this study, heavy metals (e.g., Cd, Cr, Pb, Cu, Zn, Mn, and Ni) were analyzed to examine the accumulation, sources, and contamination levels from the bottom sediment samples in 12 different commercial aquaculture farms from a South Asian coastal area using atomic absorption spectrometer (AAS). The findings revealed that the mean concentrations of heavy metals (µg/g) followed the decreasing order of Mn (48.75 ± 6.75) > Zn (7.09 ± 2.61) > Ni (6.85 ± 2.08) > Cr (5.01 ± 1.04) > Cu (3.00 ± 0.54) > Pb (2.77 ± 0.80) > Cd (0.22 ± 0.07). Contamination factor (CF < 1) and geo-accumulation index (Igeo < 0) for all metals implying the unpolluted status of fish farms by heavy metals. The mean pollution load index (PLI) was found 0.11 refereeing to very low level of contamination. Positive significant correlations (p < 0.05) between Cu-Cr (r = 0.65), Mn-Cd (r = 0.594), Zn-Pb (r = 0.591), Zn-Cu (r = 0.586) and Zn-Cr (r = 0.757) indicated their similar sources of origin. Multivariate analysis like cluster analyses (CA) and principal component analysis (PCA) specified that Cr, Cu, and Zn might have anthropogenic sources. Therefore, future research is recommended to determine element mobility from the feed to pond sediment and fish, and thereby reduce environmental risk to ecosystem and human health.

Background and purpose: The use of external beam radiotherapy (EBRT) and contact X-Ray brachytherapy (CXB) is emerging as an effective alternative in patients with early stage rectal cancer with the intent of organ preservation (OP). Short course radiotherapy (SCRT) is an alternative EBRT schedule for patients not fit for chemotherapy or for longer courses of EBRT. There are no multicentre studies that have reported on the outcomes of SCRT with a CXB boost, therefore we present these from patients from centres from the UK and Sweden. Materials and methods: From the Guildford Colorectal Database or local databases, 258 patients who underwent SCRT and CXB with the intent of OP from five centres treated between 2007 and 2019 were identified. Response and survival data was analysed and presented. Results: With a median age of 81, 226 patients were treated with radiotherapy alone (RTA) and 32 immediately after local excision (ILE). Median follow-up was 24 months. 70% and 97% of patients in the RTA and ILE groups respectively had a complete clinical response (cCR) after SCRT with CXB. Of those, local relapse was seen in 16% of the RTA and 3% of the ILE group. Median survival was 40 months after CXB in the RTA and 52 months in the ILE group. 94% of patients remained stoma-free to the point of latest follow-up. Conclusion: This data suggests that CXB when combined with SCRT, in a mainly elderly and comorbid population, provides good palliation with stoma-avoidance. Oncological outcomes compare with previously published work. A greater focus is required on quality of life outcomes after OP.

Abstract Microplastics (MPs) have become an emerging global pollutant due to their widespread dispersion and potential threats to marine ecosystems. However, studies on MPs in estuarine and coastal ecosystems of Bangladesh are very limited. Here, we conducted the first study on abundance, distribution, characteristics, and risk assessment of microplastics in the sediment of Karnaphuli River estuary, Bangladesh. Microplastic particles were extracted from sediments of 30 stations along the estuary by density separation and then enumerated and characterized using a stereomicroscope and Fourier Transform Infrared (FT-IR) spectroscopy. In the collected sediment of the Karnaphuli River estuary, the number of MPs varied from 22.29 to 59.5 items kg−1 of dry weight. The mean abundance was higher in the downstream and left banks of the estuary, whereas the predominant shape, colour, and size of MPs were films (35%), and white (19%), and 1–5 mm (30.38%), respectively. Major polymer types were polyethylene terephthalate, polystyrene, polyethylene, cellulose, and nylon. MPs were found to pose risks (low to high) in the sediment of the estuary, with the highest risk occurring at one station near a sewage outlet, according to the results of risk analyses using the pollution risk index, polymer risk index (H), contamination factors, and pollution load index (PLI). The single value index, PLI, clearly demonstrated that all sampling sites were considerably polluted with microplastics (PLI > 1). H values showed toxic polymers, even in lower proportions, possess higher polymeric hazard scores and vice versa. This investigation uncovered new insights on the status of MPs in the sediments of the Karnaphuli River estuary, laying the groundwork for future research and control of microplastic pollution and management.

Microplastics (MPs) ingestion by fish signifies a worldwide threat to human health but limited research has examined their existence within the consumable portions (muscle) of fish. Thus, this study was undertaken to unveil the prevalence, characterization, and contamination extent of MPs across various body tissues, including the muscle of the king mackerel (S. guttatus) from the lower Meghna estuary in Bangladesh—a pioneering investigation in this region. In our analysis, we identified a total of 487 MPs, with an average abundance of 48.7 ± 20.3 MPs/individual. These MPs were distributed across different tissues, with respective concentrations of 0.84 ± 0.45 items/g in the digestive tract, 2.56 ± 0.73 items/g in the gills, and 0.3 ± 1.72 items/g in the muscle tissue. The observed variations among these tissue types were statistically significant (p < 0.05). Moreover, a significant positive correlation indicated that fish with higher weight had higher MPs in their gills and DT (digestive tract). The majority were 1) indicated a high contamination level for MPs pollution of S. guttatus in the lower Meghna River estuary.

Potentially toxic elements (PTEs) such as Hg, As, and Pb have become concentrated in the aquatic ecosystem as a result of increased human activities. However, these substances frequently have synergistic or antagonistic effects on the human body or other animals. As a result, there are concerns world-wide that commercially available food products, especially fish, may be contaminated with hazardous elements. In this study, samples of four selected fishes, Gutum (Lepidocephalichthys guntea), Baim (Macrognathus pancalus), Baila (Glossogobius giuris), Meni (Nandus nandus) were analyzed from one of the largest freshwater wetlands (designed as a Ramsar Site) in South Asia to evaluate PTEs contamination status and human health risk assessment. The result demonstrated that the degree of contamination for six PTEs decreased in the following sequences for fish: Fe > Zn > Cu > Pb > As > Hg. The edible part of G. giuris had the maximum value for Hg (0.42 μg/g dw), while N. nandus predominantly accumulated As ( Hg > Cu > Zn > Pb. The values for each index were less than 1, indicating that there were no substantial health risks for the consumers. The carcinogenic risks (CR) derived from the intake of Pb ranged from 4.92 × 10−8 to 4.14 × 10−8 for males and 5.45 × 10−8 to 4.59 × 10−8 for females, which also did not exceed the standard limit (1.00 × 10−6). This study demonstrated that, under the existing consumption rate, there was no potential health harm to consumers from consuming the studied fishes. This study offers a chance to regularly check PTEs in this environment, reducing the contamination of heavy metals.

This investigation measured the extent of heavy metal concentrations (Cr, Pb, Fe, Zn and Ni) in nine finfish and shellfish species from a tropical estuary to determine the degree of pollution and evaluate the human health risk from the exposure to heavy metals through consumption of fish. The hierarchy of mean concentrations (mg/kg) of the heavy metals were: Zn (398.47) > Fe (83.015) > Cr (0.906) > Ni (0.233) > Pb (0.128). The metal concentrations in the edible tissues were ranked in the following sequence: A. bato > C. cirrhosus > A. grammepomus > M. dobsoni > P. paradiseus > O. pama > M. rosenbergii > N. smithi > S. phasa. The results demonstrated that the concentration of Cr and Zn was considerably higher than the guideline values of FAO. Estimated daily intake (EDI), hazard quotient (HQ), hazard index (HI), and cancer risk (CR) values were within the acceptable threshold for both adults and children. However, the EDIs of local consumers in the research area for both adults and children were lower than the recommended daily amount (RDA), following the order of Zn > Fe > Cr > Ni > Pb. The HQs of the elements followed the order of Zn > Cr > Fe > Pb > Ni. The investigated HI was not exceeding the recommended limit.

Biopolymers have recently shown great potential to replace traditional binding materials in geotechnical engineering; however, more research is required to reach a deeper understanding of biopolymer-treated soil behavior. The objective of this study was to investigate the most important parameters that affect the behavior of biopolymer-treated soil, including biopolymer content, dehydration time, soil type effect, and durability. Sodium alginate and agar biopolymers were used due to their stability under severe conditions and the reasonable costs to study these parameters. A broad range of soil particle sizes was used to optimize the kaolinite-sand combination. As one of the main concerns in the behavior of biotreated soils, durability was investigated under five cycles of wetting and drying. In addition, a comprehensive microstructural study was performed by FTIR analysis and SEM images, as well as chemical interaction analysis. The results indicated that the optimized biopolymer content was in the range of 0.5–1% (to soil weight) and the dehydration time was 14 days. A soil combination of 25% kaolinite and 75% sand provided the highest compressive strength. Under wetting and drying conditions, biopolymers significantly increased soil resistance against strength reduction and soil mass loss. This study provides an understanding how agar and sodium alginate changes the behavior of the soil and can be used as a reference for further studies in the future.

Kuakata beach, known as Daughter of Sea in Bangladesh, has drawn a growing number of tourists from all over the world, leading to the higher use of single plastic products. This study was a first attempt to describe the occurrence, spatial distribution, and ecological risk of microplastics (MPs) in Kuakata beach sediments. A total of 24 surface sediment samples were collected from the intertidal zone of the beach, and MPs were extracted using the density separation method and a stereomicroscope. Fourier transform infrared (FTIR) spectroscopy was used for qualitative and quantitative identification. The results revealed that the average MPs in the beach sediment were 232 ± 52 items kg–1 dry weight, which was much higher than many other sandy beaches throughout the world. Analyses of variance showed a significant (p < 0.01) difference among the mean abundance of MPs in sampling points. Fibers were dominated in every sampling point with an average of 123 ± 27 item kg–1. Most of the MPs observed were colored (60%), and the rest were transparent (40%). It was found that the size range of 1–5 mm MPs constituted over half (55%) of total MPs covering an average value of 127 ± 34 items kg–1. Three polymer types were identified in the sediment samples through FTIR analysis which followed the decreasing order of polyethylene terephthalate > polyethylene > polypropylene. Correlation analysis showed a positive relationship between the abundance of MPs and the finer grain size of sediment (p = 0.055; r = 0.7), indicating grain size-controlled the density of MPs. The pollution load index was assessed to estimate the ecological risk and found that the beach sediment of Kuakata belonged to the risk category I of the pollution index. This investigation provided preliminary information on MPs pollution in the marine ecosystem that the policymakers can use to take appropriate management approaches.

Slaughterhouse wastewater (SWW) possesses very high organic and nutrient concentrations and its residues are moderately solubilized, which leads to pollution affecting the environment and human health. The objective of this study was to investigate the effective removal of ammonium in slaughter wastewater by up flow anaerobic sludge blanket (UASB) technology combined with an expanded granular sludge bed (EGSB) using anammox and PVA gel as the biomass carrier. Ammonium loading rates (NLRs) increased from 0.25 kg N-NH4+/m3.d to 0.75 kg N-NH4+/m3.d with hydraulic retention times (HRTs) of 12, 6, and 4 h. The system was operated in 2 phases. In phase 1, the removal of ammonium by employing the combination of UASB technology and EGSB using anammox was examined. The removal efficiencies of nitrite were 52% (NLRs=0.25 kg N-NH4+/m3.d), 69% (NLRs=0.5 kg N-NH4+/m3.d) and 64% (NLRs=0.75 kg N-NH4+/m3.d). On the other hand, the removal efficiencies of ammonium were about 37% (NLRs=0.25 kg N-NH4+/m3.d), 64% (NLRs=0.5 kg N-NH4+/m3.d) and 55% (NLRs=0.75 kg N-NH4+/m3.d). In phase 2, a PVA gel was supplied to the EGSB as the biomass carrier for growing the anammox sludge. The result showed that the removal efficiencies of nitrite were about 55% (NLRs=0.25 kg N-NH4+/m3.d), 77% (NLRs=0.5 kg N-NH4+/m3.d), and 73% (NLRs=0.75 kg N-NH4+/m3.d). In addition, the removal efficiencies of ammonium were about 56% (NLRs=0.25 kg N-NH4+/m3.d), 68% (NLRs=0.5 kg N-NH4+/m3.d), and 60% (NLRs=0.75 kg N-NH4+/m3.d).

Abstract This paper explores blood written texts, particularly Buddhist scriptures, as unique artifacts of sanctity. It also examines the extraordinary uses of blood in premodern times and how people have negotiated socioreligious relationships in their production of blood writings, which were seen as a product of meticulous, controlled ritual practice, an act of asceticism par excellence. We typically think of written text as a means to an end, an expression of ideas and knowledge that privilege the written word as the carrier of message, something to be read and understood. However, Buddhist “blood writing” challenges these received notions of how meaning is communicated; blood writings are far more than carriers of a message. When we view these documents, when we experience their material presence and, at the same time, understand their extraordinary mode of production, we have a unique opportunity to appreciate the socioreligious significance of such texts in the premodern world of East Asia.

Abstract Nasopharyngeal carcinoma is endemic in southern parts of China including Hong Kong. Primary treatment entails radiotherapy ± chemotherapy depending on disease stage at presentation. Surgery is offered as a means of salvage for persistent and recurrent disease. Comprehensive preoperative work‐up, careful patient selection, attention to details perioperation and multidisciplinary approach is essential in ensuring optimal outcomes after salvage surgery for recurrent nasopharyngeal carcinoma patients. Since the COVID‐19 outbreak, we are faced with unprecedented challenges with priorities of care and resources being shifted to combat the virus. These include patient selection and timing of treatment, while preventing disease transmission to heath care providers. Practices and recommendations made in this document are intended to support safe clinical practice and efficient use of resources during this challenging time.

Trace-element or heavy-metal pollution has emerged as a serious concern in terms of both environmental and human health issues. This study measured six trace and toxic heavy metals (Pb, Cd, Cr, Ni, Cu, and Zn) in four marine fish and shrimp species to assess their accumulation levels and evaluate the risks to human health. The mean concentrations of the metals in fish and shrimp species (Labeo bata, Sillaginopsis panijus, Platycepalus fuscus, and Penaeus monodon) followed the decreasing order of Zn (40.8 ± 9.7 μg/g) > Cu (17.8 ± 7.1 μg/g) > Pb (6.2 ± 1.8 μg/g) > Ni (0.4 ± 0.3 μg/g) > Cd (0.06 ± 0.02 μg/g > Cr (below detection level). Among the metals, only Pb in finfish and Pb, Cu, and Zn in shrimp samples exceeded the national recommended limits, representing possible risks to consumers. The mean metal concentrations in the studied fish/shrimp species followed the descending order of P. monodon > S. panijus > P. fuscus > L. bata, which implies that bottom dwellers and omnivores had higher levels of metals. However, the estimated daily intake (EDI) concentrations of Zn and Cu for the studied species were lower than the RDA (Recommended Daily Allowance). In addition, the Target Hazard Quotient (THQ) and hazard index (HI or TTHQ) values for all species were < 1, indicating that consumers might not experience carcinogenic health risks. A strong significant (p < 0.05) correlation between Cu and Pb (r = 0.623) and Zn and Cu (r = −0.871) indicated they were from the same source of origin. Cluster analysis (CA) and principal component analysis (PCA) demonstrated possible anthropogenic sources of toxic metals in the study area, specifically industrial wastes and agricultural chemicals.

The performance of a biofilm system, single-stage flexible fibre biofilm reactor (SS-FFBR) treating milk processing wastewater (MPW) is evaluated under various process and operational conditions. The system behavior is analyzed with different biological and physical parameters. Results show that the high COD removal efficiency of 95% is obtained at a low CODin concentration of 809 mg/L. However, the COD removal is slightly decreased to 91.7% once the CODin concentration incremented to nearly 4000 mg/L. The effect of organic loading rate (OLR) on the SS-FFBR performance is examined as total suspended solids removal efficiency, dissolved oxygen, and turbidity. The SS-FFBR showed considerable performance, so that 89.9% and 89.7% removal efficiencies in terms of COD and TSS removals, respectively, obtained at the highest OLR of 11.7 kg COD/m3d. TSS removal efficiency of 96.7% is obtained at a low OLR of 1.145 kg COD/m3d. A linear relationship between the OLR and COD removal rate was revealed. The COD removal rate was incremented from 1.08 to 10.68 kg COD/m3d as the OLR increased from 1.145 to 11.7 kg COD/m3d. Finally, the operating system is a promising technique recommended to treat various industrial wastewaters with high OLR.

Toxic metal pollution is a global issue, and the use of metal-accumulating plants to clean contaminated ecosystems is one of the most rapidly growing ecologically beneficial and cost-effective technologies. In this study, samples of sediment and three mangrove species (Excoecaria agallocha, Avicennia officinalis, Sonneratia apetala) were collected from the world’s largest mangrove forest (along the Northern Bay of Bengal Coast) with the aim of evaluating metal concentrations, contamination degrees, and phytoremediation potentiality of those plants. Overall, the heavy metals concentration in sediment ranged from Cu: 72.41–95.89 mg/kg; Zn: 51.28–71.20 mg/kg; Fe: 22,760–27,470 mg/kg; Mn: 80.37–116.37 mg/kg; Sr: 167.92–221.44 mg/kg. In mangrove plants, the mean concentrations were in the order of E. agallocha > A. officinalis > S. apetala. The mean (± SD) concentration of each metal in the plant tissue (root) was found following the descending order of Fe (737.37 ± 153.06) > Mn (151.13 ± 34.26) > Sr (20.98 ± 6.97) > Cu (16.12 ± 4.34) > Zn (11.3 ± 2.39) mg/kg, whereas, in the leaf part, the mean concentration (mg/kg) of each metal found in the order of Fe (598.75 ± 410.65) > Mn (297.27 ± 148.11) > Sr (21.40 ± 8.71) > Cu (14.25 ± 2.51) > Zn (12.56 ± 2.13). The contamination factor (CF) values for the studied metals were in the descending order of Cu > Sr > Zn > Fe > Mn. The values of Igeo (Geo-accumulation index) and CF showed that the area was unpolluted to moderately polluted by Zn, Fe, Mn, Cu and Sr. Enrichment factor (EF) values in both sampling stations portrayed moderate to minimum enrichment. Phytoremediation potentiality of the species was assessed by bio-concentration factor (BCF) and translocation factor (TF). BCF values showed less accumulation for most of the heavy metals (1). However, the BCF value depicts that Mn was highly bioconcentrated in E. agallocha, but the translocation on leaves tissue were minimum, which reveals that E. agallocha is phytoextractor for Mn, and accumulated in root tissues. All the examined plants can be used as phytoextractors as they have bioconcentration factors 1. However, A. officinalis is clearly more suitable for metal extraction than S. apetala and E. agallocha in terms of hyper-metabolizing capabilities.

Globally, both natural water bodies and aquaculture systems are being severely contaminated by heavy metals due to rising anthropogenic activities. Fish living in aquatic environments can easily accumulate metals in their bodies, which can then be transferred to consumers and put them at risk. In this study, metal concentrations (Pb, Cd, Cr, As, Mn, Cu, Zn) in different organs (gill, liver, and muscle) of farmed and wild Barramundi (Lates calcarifer) fish from the northern Bay of Bengal were evaluated to quantify and compare contamination levels and related human health risk. Heavy metal concentrations were higher in liver tissues of farmed Barramundi than in wild Barramundi, with the following relative mean values in the liver, gills, and muscle: Zn > Cu > Pb > Mn > Cd > Cr > As; Zn > Cr > Cu > Pb > Mn > Cd > As; Zn > Pb > Cu > Cr > Mn > Cd > As; Zn > Pb > Cu > Cr > Mn > Cd > As; and Zn > Pb > Cu > Cr > Mn > Cd > As, respectively. The differences in heavy metal accumulation observed between farmed and wild fish were probably related to the differences in their environmental conditions and dietary element concentrations. However, ANOVA indicated that the variation of metals in wild and Barramundi was not statically significant. Pb concentrations in the liver tissue of farmed Barramundi exceeded the national and international threshold limits, whereas concentrations of other metals were within the limit. Among the examined organs in both fish species (wild and farmed), muscle had the lowest concentration compared to others, and liver was the target organ for Pb, Cu, and Cd accumulations. Metals such as Zn and Mn exhibited higher concentration in the gills. However, all the studied heavy metals were below the maximum permissible limits of national and international standards, but the mean concentrations of Pb and Cd values in the liver of farmed Barramundi exceeded all international and national guidelines. Based on the contamination factors (CF) and pollution indices (PLI and MPI), the degree of contamination in the fish organs was as follows: gills > liver > muscle. The major accumulation tissues for both farmed and wild fish were found to be the gills (MPI = 0.970) and the liver (MPI = 0.692). Based on the estimated daily intake (EDI), the fish samples examined in this study are safe for human consumption as within the recommended daily allowance (RDA) range established by various authorities. According to the Target Hazard Quotient (THQ) and Carcinogenic Risk (CR) calculations, though the Barramundi fishes depicted no potential hazard to humans, farmed fish posed a higher health risk than wild fish.

Shrimp is one of the major export products in South Asian countries and also an eminent source of nutrition for humans. Hence, any negative effect of this industry may affect not only the country’s economy but also human health. Therefore, in this study, we aimed to assess heavy metal contamination and associated human health risks in cultured shrimp (Penaeus monodon) and aquaculture sludge collected from three shrimp farms of the Cox’s Bazar district, Bangladesh. The results showed that among the eight metals studied, Pb (17.75 ± 1.5 mg/kg) and Cu (9.43 ± 2.8 mg/kg) levels in all shrimp samples were higher than the recommended limit, whereas the concentrations of Cd (0.09 ± 0.03 mg/kg), Mn (4.83 ± 2.2 mg/kg), As (0.04 ± 0.02 mg/kg), Hg (0.02 ± 0.006 mg/kg), Zn (18.89 ± 2.9 mg/kg) and Cr (0.69 ± 0.6 mg/kg) were within the permissible level. The concentrations of Mn (1043.37 ± 59.8 mg/kg), Cr (30.38 ± 2.1 mg/kg), Zn (74.72 ± 1.13 mg/kg) and Cu (31.14 ± 1.4 mg/kg) in the sludge of all farms were higher than the recommended limit, whereas the concentrations of Pb (20.23 ± 1.9 mg/kg), Cd (0.09 ± 0.2 mg/kg), As (0.44 ± 0.34 mg/kg) and Hg (0.08 ± 0.02 mg/kg) in all sludge samples were lower than the threshold limits. However, the estimated daily intake (EDI), targeted hazard quotient (THQ) and hazard index (HI) assessed for potential human health risk implications suggested that Pb and Cr may pose non-carcinogenic health effects, although carcinogenic risks (CR) values were acceptable for consumers. However, the pollution load index (PLI) of the studied area was below 1, which indicates low deterioration of the area. Geoaccumulation index (Igeo) and contamination factor (CF) analyses revealed that study area is unpolluted and sludge is enriched with metals in the following order: Mn > Zn > Cu > Cr > Cd > Hg > Pb > As.

The lower Meghna River, the easternmost part of the Ganges Delta, faces severe anthropogenic perturbations as it receives a huge discharge and industrial effluents. To measure the metal concentrations and human health hazards, edible tissues of 15 commercially important fish species were collected from the local fish markets and the lower Meghna River, Bangladesh. Trace and heavy metals such as Pb, Cr, Cu, Zn, Mn, Fe, Hg, Ni, Ca, Co, Se, Rb, Sr, and As were detected using the Energy Dispersive X-ray Fluorescence (EDXRF) method. The hierarchy of mean metal concentrations obtained was: Fe (162.198 mg/kg) > Zn (113.326 mg/kg) > Ca (87.828 mg/kg) > Sr (75.139 mg/kg) > Cu (36.438 mg/kg) > Se (9.087 mg/kg) > Cr (7.336 mg/kg) > Mn (6.637 mg/kg) > Co (3.474 mg/kg) > Rb (1.912 mg/kg) > Hg (1.657 mg/kg) > Ni (1.467 mg/kg) > Pb (0.521 mg/kg) > As (BDL). Based on the metal concentration obtained, the carnivorous species contained more metals than omnivores and herbivores. Similarly, the euryhaline and benthic feeder fishes had more metals than the stenohalines and demersal fishes. The metal pollution index (MPI) suggested that the highly consumed fish species Tilapia (Oreochromis mossambicus) and Rui (Labeo rohita) accumulated higher metals than other fishes. Both the Targeted Hazard Quotient (THQ) and Hazard Index (HI) values for adult and child consumers were −6 to 10−4), but the CR exposure of Pb was negligible for all the consumers. The correlation, principal component analysis (PCA), and cluster analysis were conducted to identify the sources of metals identified from the fish tissue. The results indicated that the probable sources of the pollutants were anthropogenic, arising from agricultural activities, electroplating materials, and lubricants used near the study area. However, the present study showed a different metal concentration in the samples at different levels but within the threshold levels non-carcinogenic and carcinogenic health risks; hence, the fishes of the area, in general, are safe for human consumption.

The lack of appropriate models restricts pre-clinical research for nasopharyngeal carcinoma (NPC). Here the authors report the development and characterization of NPC patient-derived xenografts (PDXs), and EBV positive NPC cell line from patient tumor, and suggest their potential use in future NPC research.

Importance: Orbital floor fracture is common among patients suffering from facial trauma. Open reduction and reconstruction of the orbital floor with Medpor is the treatment of choice in our centre to correct diplopia and enophthalmos. Objective: Application of locally available 3D printing service in perioperative planning of orbital floor reconstruction with porous polyethylene. Design: We present two patients who suffered from orbital floor fracture complicated by diplopia. Open reduction and orbital floor reconstruction with Medpor was performed with the guidance of a 3D printed customized model of the orbital floor defect. Participants: Both patients were admitted through the Emergency Department to surgical ward after facial trauma. CT scan of the face showed orbital floor fracture with entrapment of inferior rectus muscle. Clinically patients also suffered from diplopia on extreme gaze. Results: With the aid of 3D printed model, it shortened operative time and duration of anaesthesia. Defect-specific Medpor could be trimmed and molded easily from the model and thus reduced fatigue of the material. Furthermore, the model was helpful in patient education and explanation of the surgical procedure. Conclusions and relevance: Application of 3D printing in medical specialties is rapidly developing in the past few years. In orbital floor fracture reconstruction, 3D printed model provides a customized solution, decreases operative time and duration of anaesthesia. Keywords: Three-dimensional printing, Rapid prototyping, Orbital floor reconstruction, Blowout fracture

Hollow fiber nanofiltration (NF) membranes have gained increased attention in recent years, partly driven by the availability of alternatives to polyamide-based dense separation layers. Moreover, the global market for NF has been growing steadily in recent years and is expected to grow even faster. Compared to the traditional spiral-wound configuration, the hollow fiber geometry provides advantages such as low fouling tendencies and effective hydraulic cleaning possibilities. The alternatives to polyamide layers are typically chemically more stable and thus allow operation and cleaning at more extreme conditions. Therefore, these new NF membranes are of interest for use in a variety of applications. In this review, we provide an overview of the applications and emerging opportunities for these membranes. Next to municipal wastewater and drinking water processes, we have put special focus on industrial applications where hollow fiber NF membranes are employed under more strenuous conditions or used to recover specific resources or solutes.

Soil improvement using biopolymers has attracted considerable attention in recent years, with the aim to reduce the harmful environmental effects of traditional materials, such as cement. This paper aims to provide a review on the environmental assessment of using biopolymers as binders in soil improvement, biopolymer-treated soil characteristics, as well as the most important factors affecting the behavior of the treated soil. In more detail, environmental benefits and concerns about the use of biopolymers in soil improvement as well as biopolymer–soil interaction are discussed. Various geotechnical properties are evaluated and compared, including the unconfined compressive strength, shear strength, erosion resistance, physical properties, and durability of biopolymer-treated soils. The influential factors and soil and environmental conditions affecting various geotechnical characteristics of biopolymer-treated soils are also discussed. These factors include biopolymer concentration in the biopolymer–soil mixture, moisture condition, temperature, and dehydration time. Potential opportunities for biopolymers in geotechnical engineering and the challenges are also presented.

Abstract Background Programmed cell death protein 4 (PDCD4) is a novel tumor suppressor protein involved in programmed cell death. Its association with cancer progression has been observed in multiple tumor models, but evidence supporting its association with solid tumors in humans remains controversial. This study aimed to determine the clinical significance and prognostic value of PDCD4 in solid tumors. Methods A systematic literature review was performed to retrieve publications with available clinical information and survival data. The eligibility of the selected articles was based on the criteria of the Dutch Cochrane Centre proposed by the Meta-analysis Of Observational Studies in Epidemiology group. Pooled odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) for survival analysis were calculated. Publication bias was examined by Begg’s and Egger’s tests. Results Clinical data of 2227 cancer patients with solid tumors from 23 studies were evaluated. PDCD4 expression was significantly associated with the differentiation status of head and neck cancer (OR 4.25, 95% CI 1.87–9.66) and digestive system cancer (OR 2.87, 95% CI 1.84–4.48). Down-regulation of PDCD4 was significantly associated with short overall survival of patients with head and neck (HR: 3.44, 95% CI 2.38–4.98), breast (HR: 1.86, 95% CI 1.36–2.54), digestive system (HR: 2.12, 95% CI 1.75–2.56), and urinary system cancers (HR: 3.16, 95% CI 1.06–9.41). Conclusions The current evidence suggests that PDCD4 down-regulation is involved in the progression of several types of solid tumor and is a potential marker for solid tumor prognoses. Its clinical usefulness should be confirmed by large-scale prospective studies.

Previous studies have showed that spatial memory declines with age but have not clarified the relevance of different landmark cues for specifying heading directions among different age groups. This study examined differences between younger, middle-aged and older adults in route learning and memory tasks after they navigated a virtual maze that contained: (a) critical landmarks that were located at decision points (i.e., intersections) and (b) non-critical landmarks that were located at non-decision points (i.e., the sides of the route). Participants were given a recognition memory test for critical and non-critical landmarks and also given a landmark-direction associative learning task. Compared to younger adults, older adults committed more navigation errors during route learning and were poorer at associating the correct heading directions with both critical and non-critical landmarks. Notably, older adults exhibited a landmark-direction associative memory deficit at decision points; this was the first finding to show that an associative memory deficit exist among older adults in a navigational context for landmarks that are pertinent for reaching a goal, and suggest that older adults may expend more cognitive resources on the encoding of landmark/object features than on the binding of landmark and directional information. This study is also the first to show that older adults did not have a tendency to process non-critical landmarks, which were regarded as distractors/irrelevant cues for specifying the directions to reach the goal, to an equivalent or larger extent than younger adults. We explain this finding in view of the low number of non-critical cues in our virtual maze (relative to a real-world urban environment) that might not have evoked older adults’ usual tendency toward processing or encoding distractors. We explain the age differences in navigational and cognitive performance with regards to functional and structural changes in the hippocampus and parahippocampus, and recommend further investigations into the functional connectivity between the prefrontal cortex and hippocampus for a better understanding of the landmark-direction associative learning among the elderly. Finally, it is hoped that the current behavioral findings will facilitate efforts to identify the neural markers of Alzheimer’s disease, a disease that commonly involves navigational deficits.

Human telomerase reverse transcriptase (hTERT) plays a critical role in the pathogenesis of human malignancies. Overexpression of hTERT is essential in controlling the propagation of cancer cells. The CpG island located at hTERT promoter region is subjected to methylation modification in human cancer. In this perspective article, we discussed the diagnostic value of methylated hTERT in human cancers. The definitive diagnosis of most solid tumor is based on histological and immunohistochemical features. In certain circumstance, however, the use of methylated hTERT might be useful in overcoming the limitation of the conventional methods. Methylated hTERT showed a good diagnostic power in discriminating cancer from benign or normal tissues. Nevertheless, difference in detection method, methylation site, cancer type and histological subtype of cancer makes it difficult to evaluate the actual diagnostic accuracy of methylated hTERT. Therefore, we performed subgroup analysis to assess the effects of these factors on the diagnostic efficiency of methylated hTERT. We demonstrated that quantitative MSP (qMSP) assay offers the highest discriminative power between normal and cancer in comparison with different detection methods. In addition, the methylated sites selected by different studies had an impact on the detection performance. Moreover, the diagnostic power of methylated hTERT was affected by cancer type and histological subtype. In conclusion, the existing evidence demonstrated that methylated hTERT is effective in cancer detection. Detailed profiling of the methylation sites to local the common methylation hotspot across human cancers is warranted to maximize the diagnostic value of methylated hTERT in cancer detection.

Ethical dilemmas arise in managing head and neck cancers during pregnancy. The timing of treatment is an important determinant on foetal wellbeing. Diagnostic and treatment modalities may harm the foetus, while delaying or choosing suboptimal treatment in order to preserve foetal health may worsen maternal outcome. A multidisciplinary approach should be adopted to enable parents and clinicians to make the best clinical decision. We report on two cases. Case 1 is a 34-year-old female who presented with squamous cell carcinoma of the tongue at 29 weeks' gestation. Partial glossectomy, selective neck dissection and posterior tibial flap reconstruction was performed at 31 weeks. She underwent induction and early delivery at 38 weeks prior to receiving radiotherapy. Case 2 is a 36-year-old female who presented with carcinoma of the cervical oesophagus complicated by tracheal invasion, thyroid and cervical lymph node metastasis at 13 weeks' gestation. Pregnancy was terminated at 16 weeks. She received a course of neoadjuvant chemoirradiation.

Background. To examine the results of treatment of Extramammary Paget’s disease (EMPD) in ethnic Chinese. Method. Between 1990 and 2010, patients treated for EMPD were reviewed. Data were analyzed retrospectively. Results. Forty-eight patients were treated by surgical resection. Local recurrence rate was 14.6%. The postresection defects were repaired by primary closure (8.3%), partial thickness skin graft (72.9%), or local/regional flaps (18.8%). Dermal invasion was found in 9 patients (18.8%). Seven patients (14.6%) developed regional lymph node metastasis (concurrent with surgery, 𝑛=1; subsequent to surgery, 𝑛=6), and 3 patients (6.3%) had systemic metastasis after surgery. The presence of dermal invasion was associated with significantly higher incidence of regional lymph nodes and systemic metastasis. The incidence of associated internal malignancy was 8.3%. Conclusion. The mainstay of treatment for EMPD is surgery. Pathological dermal invasion increases the chance of regional lymph node as well as systemic metastasis. The association with internal malignancy warrants preoperative endoscopic examination in all patients.

Objectives. This study aims to report our experience in the management of HNBCC in ethnic Chinese over a 10-year period. Methods. A retrospective review of all ethnic Chinese patients with HNBCC treated in a tertiary centre from 1999 to 2009. Results. From 1999 to 2009, 225 patients underwent surgical excision for HNBCC. Majority were elderly female patients. Commonest presentation was a pigmented (76.2%) ulcer (64.8%) over the nose (31.6%). Median skin margin taken on tumour excision was 2.0 mm; primary skin closure was achieved in 51.8%. Postresection skin margin was clear in 75.4%. Of those with inadequate skin margins, 56.7% opted for further treatment, 43.4% for observation. Recurrence rates were 2.6% and 13.8%, respectively (𝑃=0.106). Overall recurrence rate was 5.5%. Conclusions. HNBCC commonly presented as pigmented ulcers over the nose of elderly female patients in our locality. Adequate tumour excision ± reconstruction offered the best chance of cure. Reexcision of those with inadequate skin margins improved local tumour control.

Groundwater (GW) plays a crucial role as the primary source of potable water in numerous developing nations. However, the increasing presence of microplastics (MPs) represents a concealed danger, threatening activities that guarantee safe drinking water in these countries. Despite this, there is limited awareness about the widespread existence of MPs in these regions of the world. In this study, we investigated the contamination levels, distribution, morphological characteristics, chemical composition, and associated public health risk of MPs in groundwater samples from six coastal districts of Bangladesh using stereomicroscopy and Fourier transform infrared spectroscopy (FTIR). MPs were prevalent at all sampling stations, with average concentrations of 24.63 ± 16.13 items/L and a range of 4-75 items/L. The majority of MPs (97.6%) were fibers, indicating a likely origin from fabric disintegration during drying, washing, discarded fishing nets, personal care items, and municipal waste. Smaller-sized MPs (<0.5 mm), transparent and violet-colored, were predominantly observed. Additionally, FTIR confirmed the presence of plastic polymers, including low-density polyethylene (LDPE), highdensity polyethylene (HDPE), ethylene vinyl acetate (EVA), and polyethylene terephthalate (PETE). Despite the high visibility observed or focus given for PETE, PE was found to be abundant. These are thought to have come from runoff from agricultural fields, seeping from landfills where plastic trash is disposed of, synthetic fabrics, and inappropriate plastic product disposal. Estimated dietary intake was recorded as 1.85 particles/person/day (i.e., 675 particles/year), suggesting the possible health risk to consumers. Hazard analyses based on the polymeric risk score revealed diverse risks associated with polymer levels, with PETE indicating a medium risk and other polymers, e.g., HDPE, LDPE, and EVA at 39%, 31%, and 17%, respectively, showing a minor risk to human health from drinking water from the studied sources. This is the first study from the regions, and the findings will be valuable for identifying sources, implementing control measures, shaping policies, and safeguarding public health against plastic pollution. [ABSTRACT FROM AUTHOR]