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Halides (X=Cl, Br, I) are naturally present in water, and halide concentrations can be high in water sources that are impacted by high salinity. Halides are also present in wastewater streams from various industrial operations such as pulp and paper, oil and gas, and mining. Drinking water guideline limits have been established for halides, and halide removal from water is important in several ways. Chloride concentration in water is more related to salinity, and its removal from water matters because of adverse health effects, water scarcity, corrosion, and industrial needs. In drinking water treatment, disinfection is essential to improve water quality and prevent the spread of water born pathogens. However, disinfectants also produce harmful disinfection by-products (DBPs) from precursors such as halides and natural organic matter (NOM) in the source water. Removing halides in the source water before disinfection is a preferred option to increase the disinfection efficiency and avoid forming more toxic DBPs. Some industrial-made isotopes are radioactive and carcinogenic, and iodide produces iodinated DBPs. Bromide removal is important because it produces brominated DBPs. Halides also affect AOPs and can cause more active radicals such as OH. and SO4-. to transform into less active radicals. This paper aims to comprehensively review the sources of halides, the chemistry, and interaction in forming DBPs, current regulatory limits and state-of-art removal technologies available, and their challenges.

In this study, pollution level, distribution, toxicity, molecular composition, probable sources as well as health risks of polycyclic aromatic hydrocarbons (PAHs) in urban and industrial soils of Kerman metropolis were investigated. Kerman is a fast-growing city and a fine example of an arid city in a developing country. For this purpose, concentrations of 16 individual PAHs in 30 samples taken from the city soils and its industrial zones were determined by gas chromatography/mass spectrometry. The ∑PAHs concentration in urban soil samples varied from 26.1 to 902.8 μg/kg, with the mean and median of 302.6 and 148.4 µg/kg, respectively. In comparison, ∑PAHs in industrial soils ranged from 26.8to 251.9 μg/kg, with the mean and median values of 65.9 and 42.9 µg/kg, respectively. Four-ring PAHs comprise the dominant compounds in urban soils, whereas, two- and three-ring PAHs proved to be the most abundant compounds in industrial soils. Source apportionment was conducted using ring classification, diagnostic ratios, PCA, and multilinear regression (MLR). Also, human health risk assessment was undertaken through employing US EPA standard statistical models. This survey revealed that PAH pollution in urban soils originates mainly from fossil fuel combustion and in industrial soils from petrogenic sources. On the whole, in the Kerman environment, the shares of petroleum combustion, natural gas combustion, and petrogenic sources were 45.32%, 34%, and 20.68% respectively. Based on this study, the ecological risk of PAHs was low-to-moderate, and incremental lifetime cancer risk for children and adults were 1.35 × 10−4 and 1.04 × 10−4 respectively, indicating rather high risks.

This is the study plan of the Karolinska NeuroCOVID study, a study of neurocognitive impairment after severe COVID-19, relating post-intensive care unit (ICU) cognitive and neurological deficits to biofluid markers and MRI. The COVID-19 pandemic has posed enormous health challenges to individuals and health-care systems worldwide. An emerging feature of severe COVID-19 is that of temporary and extended neurocognitive impairment, exhibiting a myriad of symptoms and signs. The causes of this symptomatology have not yet been fully elucidated.In this study, we aim to investigate patients treated for severe COVID-19 in the ICU, as to describe and relate serum-, plasma- and cerebrospinal fluid-borne molecular and cellular biomarkers of immune activity, coagulopathy, cerebral damage, neuronal inflammation, and degeneration, to the temporal development of structural and functional changes within the brain as evident by serial MRI and extensive cognitive assessments at 3-12 months after ICU discharge.To date, we have performed 51 3-month follow-up MRIs in the ICU survivors. Of these, two patients (~4%) have had incidental findings on brain MRI findings requiring activation of the Incidental Findings Management Plan. Furthermore, the neuropsychological and neurological examinations have so far revealed varying and mixed patterns. Several patients expressed cognitive and/or mental concerns and fatigue, complaints closely related to brain fog.The study goal is to gain a better understanding of the pathological mechanisms and neurological consequences of this new disease, with a special emphasis on neurodegenerative and neuroinflammatory processes, in order to identify targets of intervention and rehabilitation.

Narratives about important religious figures exist in a context, which often determines the portrayal of life events and activities in indirect and sometimes complex ways. These forms of persuasion come to us already theorized and theologized. It is important to read them carefully, contextualizing when they were written, paying particular attention to the purpose of how events and activities are presented with what primary sources and secondary studies. In describing the life and thought of the late Buddhist cleric Venerable Sheng Yen (1931–2009), arguably one of the most respected Chinese Buddhist masters of the 20th century, I use two autobiographies and a selection of secondary scholarship on modern Chinese history to counter his autobiographical narratives, highlighting the actual historical contingencies that might have shaped him and his vision for creating a modern form of Chan Buddhism. These contingencies include the trauma of natural disasters that displaced his family when he was born; the political instability of a war-torn China that shaped his boyhood; the tribulations of Japanese colonization that he witnessed; the volatile sociopolitical realities of the Communist takeover of China from which he was forced to escape; the industrial boom that impacted Taiwanese society and the mushrooming of local popular cultic traditions to which he responded with his creation of an orthodox Han Chinese Buddhism; and the socioreligious trajectories of different expressions of Buddhism that Sheng Yen was experiencing in China, Japan, Taiwan, and the United States. These events created in Sheng Yen a perpetual sense of crisis mentality; they also inspired his doctrinal and practice innovations and the establishment of a new lineage of Chan (Zen) Buddhism.

This article investigates the variety of factors that hinder the implementation of play (as defined by western scholars) in Asian preschools. Drawing on the theoretical frameworks of policy borrowing, enactment and glocalisation, we analyse three jurisdictions that illustrate distinctive problematics: India, Mainland China and Hong Kong. The methodology involves a bibliographic review. Each jurisdiction is presented as a narrative portrait, including key sociocultural characteristics, features of early childhood education system, role of play in government policies, and teachers’ beliefs and practices pertaining to play. The findings show that the distinctive factors hindering play relate to societal mindsets in India, a lack of curriculum clarity in China, and structural factors and parental pressures in Hong Kong. Common hurdles include a high societal emphasis on academic learning, lack of information on how play should contribute to achieve curriculum outcomes, and insufficient teacher preparation. The authors show that play is neither adequately defined nor justified in some Asian policy frameworks, and argue that play might not be viable in certain preschools (especially in half-day programmes). An alternative glocal notion is proposed – child-led activities – which would be less conceptually problematic and more culturally appropriate. The study highlights the need for the glocalisation of Asian early childhood education systems.

Numerous research papers on biosorption have been published in the past four decades. This paper reviews and compares heavy metal uptake capacities of various biological and non-biological materials. Adsorption mechanisms and processes of heavy metal ions (HMIs) onto biomasses are summarised and discussed, respectively. In general, all types of adsorbents exhibit certain uptake capacities for HMIs, but the capacity values for different types of biomasses and non-biological materials vary significantly. For HMIs, the reported values for bacterial biomasses typically range from 0.06 mmol·g−1 to 2.84 mmol·g−1; for fungi and yeasts, 0.03 mmol·g−1 to 2.44 mmol·g−1; for fresh water algae, 0.02 mmol·g−1 to 3.15 mmol·g−1; for marine algae, 0.23 mmol·g−1 to 3.77 mmol·g−1; for other biological materials/derivatives, 0.01 mmol·g−1 to 1.78 mmol·g−1 and for non-biological materials, 0.003 mmol·g−1 to 2.40 mmol·g−1. Thereinto, a few macroalgal species exhibit much higher adsorption capacities for HMIs relative to other types of adsorbents. Statistical analysis of heavy metal uptake capacities of various biological and non-biological materials indicates that marine algae are most suitable for the development of industrial biosorbents for the remediation of diluted HMIs-bearing effluents. Biosorption mechanisms of HMIs by biomasses include physical adsorption, ion exchange, electrostatic interaction, surface complexation and inorganic microprecipitation. the physicochemical properties of biosorbents and HMIs as well as external adsorption conditions significantly influence the adsorption process of HMIs onto biomasses. It could be concluded from numerous previous studies that pseudo-first-order and pseudo-second-order models are the most commonly utilised to characterise adsorption process. Up to date biosorption of HMIs remains largely in the laboratory stage. Combining microscopic mechanisms with macroscopic models may be one of the future research directions for removal of HMIs by biomasses.

Located in central Asia, Xinjiang is characterized as a diverse environment in China, consisting of vast deserts, dotted oases, and high mountains. Due to the combined effect of climate conditions under such a diverse environment, there are large differences in human activities, living styles, and eating habits in farmland and grazing pastures between Xinjiang and other regions of China. This study aimed to investigate the variations and mechanisms of elemental distribution in the hair of Uyghur communities among different ages and genders and under different land use backgrounds in an oasis region in Xinjiang. Hair samples from 524 residents from four traditional farmland areas and two grazing pasture areas in Bai Cheng County in Xinjiang were collected, and the levels of thirteen elements were analyzed. The results indicated that the average levels of Cu, Mg, Mn, Zn, Ni, Co, Pb, Fe, Ca, Cd, Cr, As, and Se in the hair of Uyghur communities were within the background levels of Chinese and global residents' hair. Overall, the levels of elements in the hair of women residents were higher than those of men residents. The levels of elements in the human hair of the middle-aged group were higher than those of child and older-aged groups. Elements Cr and Se in the hair of grazing pastures were higher than those of farmland areas. The levels of Cd, Pb, As, and Zn in the hair of farmland areas were higher than those of grazing pasture areas. The levels of Ca, Mg, Cu, and Fe in the hair of Uyghur communities were higher than those of other ethnic groups, while the toxic elements in the hair of residents in Bai Cheng were lower than those in other regions of China. Middle-aged people were exposed to higher levels of toxic elements in their daily activities compared to elderly and child groups. Also, adult groups need much more nutrients for their growth and intellectual development compared to child and elderly groups. The change in land use from grazing pastures to farmland increased the toxic trace element concentration levels in human hair. The significant differences in the overall concentration levels of elements in human hair among the different ethnic groups and regions can be attributed to the differences in lifestyles, cultural customs, dietary habits, and internal and external exposure routes.

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.

Sediment samples of different wetland types (saltmarsh, mangrove, tidal pool, mudflat and sandflat) from an urbanized estuary were analyzed to evaluate the contamination level and ecological risks of five heavy metals (Pb, Fe, Zn, Ni and Cr). The findings showed that the mean concentration (mg/kg) of heavy metals followed the order of Fe Zn Ni Pb Cr, while Pb and Fe concentrations exceeded the recommended guidelines. Heavy metals levels were highest in saltmarsh and mudflats. Contamination assessment indices e.g., contamination factor (CF), degree of contamination (CD), enrichment factor (EF), and geo-accumulation index (Igeo) revealed that the studied wetlands had low to moderate levels of pollution, meaning these sites receive medium levels of anthropogenic contamination compared with background values. For some of the studied metals, such as Pb, Zn, Fe, and Ni, the EF value was1 in certain types of wetland, indicating anthropogenic sources, while Cr was1 indicating natural sources. The pollution load index (PLI) value was determined to be1, indicating perfection of soil, and was in the following order: mudflatsaltmarshtidal poolmangrovesandflat. The ecological risk (RI) value was the highest for saltmarsh and the lowest for sandflats. However, the RI value for Cr, Zn, Ni, and Pb was30 suggesting that these metals pose a low risk in the local ecosystem. Cluster analysis (CA), principal component analysis (PCA), and Pearson's correlation specified that anthropogenic sources of metals.

Wetlands are highly productive and diverse ecosystems providing home to thousands of organisms. These ecosystems reduce water pollution, sequester carbon, support livelihoods, and increase food security. However, these ecological functions are being impeded due to increased levels of metals in the environment. Therefore, the primary objective of this study was to evaluate the degree of metal contamination in the surface sediment of a wetland, Tanguar Haor, for the first time. The result demonstrated that the mean concentrations of Fe, Cu, Zn, As, Pb and Hg varied from 13140.39 to 45675, 40.07 to 46.29, 47.60 to 57.15, 18.89 to 35.23, 1.24 to 2.64, and 0.35 to 0.42, respectively. The concentration of As was found to be higher than the average shale value. The concentration of Cu (44.19 μg/g) and Hg (0.38 μ/g) was very close to the shale value (45 μg/g and 0.40 μg/g, respectively), indicating a moderate level of contamination. The contamination level was further evaluated by multi-indices, e.g., the contamination factor (CF), the enrichment factor (EF), and the geo-accumulation index (Igeo). The average EF values for As (115.41), Cu (57.68), and Hg (55.47) were >50, indicating a high degree of contamination (extremely severe enrichment). However, CF values showed varied levels of pollution; for example, the majority of the area was only somewhat contaminated with As, Cu, and Hg, but less contaminated with Fe, Zn, and Pb. According to Igeo, sampling sites were found to be unpolluted or less polluted by heavy metals. Based on potential ecological risk assessment (PERI), the degree of risk from the six heavy metals decreased in the following sequence: As > Cu > Zn > Pb > Cr > Ni. PERI values indicated the study area has been exposed to moderate risk to As and low risk to other metals. This study provides an opportunity for frequent monitoring of heavy metals in this ecologically critical environment, and thus curbing heavy metal pollution.

Crystalline silicon (c-Si) has been widely used in semiconductor and energy-related industries. One of the biggest challenges of c-Si production is its high energy and environmental cost due to the requirement of high-temperature synthetic process and the accompanied intense greenhouse gas emission. Herein, we demonstrate a new process for preparing c-Si directly from hydride-terminated silicane (HSi) under mild conditions. We design a wet-chemistry approach that effectively creates Si-Si bonds between HSi flakes via nucleophilic attack by Lewis base reagent at room temperature. c-Si produced by such a chemical suturing process demonstrates promising capability in charge carrier migration and separation under visible light irradiation, which is of critical importance in photocatalysis. Compared to the existent c-Si manufacturing processes, the reported approach drastically reduces the energy consumption and provides a new strategy to tailor the electronic and photophysical properties of c-Si for optoelectronic and catalytic applications.

In aquatic environments, microplastics (MPs) are pervasive which could have a considerable negative impact on the environment, organisms and pose a risk to human health. However, knowledge about the exposure and ecological risk of MPs in the coastal ecosystems of developing countries is limited. In this study, we analyzed salt samples from five commonly consumed processed and unprocessed sea salts of different commercial brands originated from 15 salt pans in Bangladesh to assess the abundance, characteristics and potential risks of MPs. The quantities of MPs in unprocessed salts (average 195 ± 56 item/kg) were higher than those in the processed salts (average 157 ± 34 item/kg). One-way analysis of variance (ANOVA) showed significant (p 0.05) differences among the average numbers of MPs in both processed and unprocessed salts. MP levels in this study were 2-3 times higher than those reported from some other countries. Fiber-shaped and transparent MPs were dominant in both cases. MPs less than 0.5 mm in size were the most abundant in both unprocessed (58.2%) and processed (62.2%) salts. Fourier-transform infrared spectroscopy (FTIR) analysis confirmed five types of polymers, including polyethylene terephthalate (PET-35%), polypropylene (PP-27.5%), polyethylene (PE-25%), polystyrene (PS-10%), and Nylon (2.5%) in the studied salts. The sea salts were classified as potential hazard index (PHI) levels IV to V, indicating serious MP contamination, whereas potential ecological risk factor (E

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.

Nasopharyngeal carcinoma is endemic in south-eastern parts of Asia. Primary treatment modality is definitive radiotherapy ± chemotherapy depending on the stage of disease. Surgery serves as a means of salvage for persistent or recurrent diseases. Maxillary swing operation offers an anterolateral approach for removal of tumors in the nasopharynx ± parapharyngeal space extension including retropharyngeal lymph nodes. Maxillary swing operation may be combined with craniotomy for resection of locally advanced tumors involving the internal carotid artery, temporal bone and temporal dura. Encasement of internal carotid artery warrants prior extracranial intracranial bypass, so that the vessel can be removed en bloc with the tumor to ensure microscopic clearance. Exposed dura, skull base bone and internal carotid artery warrant coverage with well-vascularized muscle flap to facilitate wound healing. Attention to details peri-operation and meticulous tissue handling can help to prevent life threatening complications postoperation.

Nasopharyngeal carcinoma is treated with definitive radiotherapy +/- chemotherapy depending on the stage of disease. Surgery serves as a means of salvage for persistent or recurrent diseases. Maxillary swing approach offers an anterolateral approach to tumours in the nasopharynx, ipsilateral parapharyngeal space including retropharyngeal lymph nodes and skull base invasion. Tumours abutting on the petrous part of internal carotid artery can be safely removed after identification and protection of the internal carotid artery. Exposed skull base bone and internal carotid artery post tumour extirpation warrant coverage with well vascularized muscle flap such as the vastus lateralis muscle. Attention to details peri-operation and meticulous tissue handling can help to prevent life-threatening complications post operation.

OBJECTIVE/HYPOTHESIS To investigate the endovascular intervention or extracranial/intracranial (EC/IC) vascular bypass in the management of patients with head and neck cancer-related carotid blowout syndrome (CBS). STUDY DESIGN Retrospective case series. METHODS Retrospective analysis of clinical data of patients with head and neck cancer-related CBS treated by endovascular intervention and/or EC/IC vascular bypass, analysis of its bleeding control, neurological complications, and survival results. RESULTS Thrity-seven patients were included. Twenty-five were associated with external carotid artery (ECA); twelve were associated with internal or common carotid artery (ICA/CCA). All patients with ECA hemorrhage were treated with endovascular embolization. Of the 12 patients with ICA/CCA hemorrhage, 9 underwent EC/IC bypass, 1 underwent endovascular embolization, and 3 underwent endovascular stenting. For patients with ECA-related CBS, the median survival was 6 months, and the 90-day, 1-year, and 2-year survival rates were 67.1%, 44.7%, and 33.6%, respectively; the estimated rebleeding risk at 1-month, 6-month, and 2-year was 7.1%, 20.0%, and 31.6%, respectively. For patients with ICA/CCA-related CBS, the median survival was 22.5 months, and the 90-day, 1-year, and 2-year survival rates were 92.3%, 71.8%, and 41.0%, respectively; the estimated rebleeding risk at 1 month, 6 months, and 2 years is 7.7%,15.4%, and 15.4%, respectively. ICA/CCA-related CBS patients have significantly longer survival time and lower risk of rebleeding, which may be related to the more use of EC/IC vascular bypass as a definite treatment. CONCLUSIONS For patients with ICA/CCA-related CBS, if there is more stable hemodynamics, longer expected survival, EC/IC vascular bypass is preferred. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1548-1556, 2021.

This study describes a novel approach in the reduction of SARS-CoV-2 transmission during trans-oral robotic surgery (TORS). Eight patients underwent TORS between 01 February 2020 and 07 September 2020. A sterile plastic sheet draped over sterile supports with water-tight seal around each cannula was used to create a sterile working space within which the robotic arms could freely move during operation. This set-up acts as an additional physical barrier against droplet and aerosol transmission. Operative diagnosis; droplet count and distribution on plastic sheet and face shields of console and assistant surgeons, and scrub nurse were documented. TORS tumour excision was performed for patients with suspected tonsillar tumour (n = 3) and tongue base tumour (n = 2). TORS tonsillectomy and tongue base mucosectomy was performed for cervical nodal metastatic carcinoma of unknown origin (n = 3). Droplet contamination was noted on all plastic drapes (n = 8). Droplet contamination was most severe over the central surface at 97.2% (91.7–100.0%), with the highest droplet count along the centre-most column where it overlies the site of operation in the oral cavity 33.3% (n = 31). Droplet count decreased towards the periphery. Contamination rate was 2.8% (0.0–8.3%) over the right lateral surface. There was no droplet contamination over the vertex and left lateral surface of plastic drapes. No droplet contamination was noted on face shields of all parties. The use of sterile plastic drapes with water-tight seal around each robotic cannula can help reduce viral transmission to healthcare providers during TORS.

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.

BackgroundDyspnea is a prevalent symptom in the post-COVID-19 condition, though its mechanisms are largely unknown. Lung perfusion abnormalities have been reported in acute COVID-19 and could be suspected in patients with lingering dyspnea after the acute phase.ObjectivesTo detect pulmonary perfusion disturbances in non-hospitalized post-COVID condition with persistent dyspnea 4-13 months after the disease onset.MethodsNon-hospitalized individuals reporting persistent dyspnea after COVID-19 and matched healthy controls were prospectively recruited between October 2020 and May 2021 to undergo pulmonary dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), six-minute walk test, and self-reported scales questionnaires on dyspnea and physical activity. The DCE-MRI perfusion images were quantified into two parametric values: mean time-to-peak (TTP) and TTP ratio.ResultsTwenty-eight persons with post-COVID condition and persistent dyspnea (mean age 46.5±8.0 years, 75% women) and 22 healthy controls (mean age 44.1±10.8 years, 73% women) were included. The post-COVID group had higher mean pulmonary TTP (0.43±0.04 vs. 0.41±0.03, P=0.011) and higher TTP ratio (0.096±0.052 vs. 0.068±0.027, P=0.032). Notably, post-COVID males had the highest values (mean TTP 0.47±0.02, TTP ratio 0.160±0.039, PConclusionsLung perfusion disturbances were detected in males reporting post-COVID dyspnea using perfusion parameters from DCE-MRI. The distinct sex difference has implications for understanding the perplexing post-COVID pathophysiology and warrants future studies. DCE-MRI could provide biomarkers for such studies.

This study aims to assess the feasibility of using indocyanine green and robotic near infra-red fluorescent imaging (Firefly®) for sentinel lymph node biopsy in cN0 oral cavity cancer. Ten patients with early squamous cell carcinoma of the tongue (n = 8) and buccal mucosa (n = 2) were included. Peritumoral injection of 10 mg indocyanine green and real-time mapping of sentinel lymph nodes in the neck was performed using Firefly® via a retro-auricular trans-hairline incision. Sentinel lymph node was detected in all patients at 1.2 sentinel lymph node per person. Majority were situated in level II (91.7%). Mean time to detection of sentinel lymph node was 171.0 (68.0–312.0)s. Mean signal-to-background ratio was 5.62 (3.51–7.91). Frozen section of one sentinel lymph node was positive for malignancy, paraffin section of which confirmed the presence of metastatic disease. Modified radical neck dissection was performed for that particular patient, paraffin section of which did not show any tumor deposit. Frozen section and paraffin section of all other sentinel lymph nodes (n = 11) and neck dissection specimens yielded no malignancy. All resection margins were clear. Three patients completed adjuvant radiotherapy for pT2N0 (n = 2) and pT2N1 (n = 1) carcinoma of the tongue. Mean follow-up was 12.0 (4.0–18.0) months. All patients were alive at last follow-up with no disease recurrence. There were no adverse outcomes associated with the use of indocyanine green and robot-assisted neck dissection. Indocyanine green and Firefly® for sentinel lymph node biopsy in cN0 oral cavity cancer is feasible with no adverse effects.

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.

In just over half a century electronic equipment and products have revolutionized human lifestyle. At the product’s end of life, e-waste, its components material and other materials have influenced and infiltrated environment in every part of globe. The hazardous effect of plastic materials and debris to biodiversity is well established, but mitigation and planning are often hampered by lack of quantitative data on waste accumulation patterns in landfill. Here we document a study on the pyrolysis of non-metallic material of printed circuit board, the basic elemental part of electronic waste. The non-metallic material is separated from printed circuit board waste during the copper separation processes and was found in powder form at average size up to 177 μm. The purpose of this study is to experimentally investigate the pyrolysis behavior of the non metallic material of printed circuit boards (PCB) waste fraction at a temperature range of 300 ◦C to 600 ◦C by means of the Thermogravimetric Analysis (TGA) and seek to find out the effective pyrolysis temperature that could be used in pyrolysis process in production scale. The experimental results reveal that the chemical composition of the PCB reflects that the main decomposition of PCBs occurs between 250 ◦C and 450 ◦C, and effectively decomposed at 403 ◦C. The pyrolysis of PCBs showed a varying production of aromatic compounds such as phenol, bromophenol, styrene, methylstyrene, and bisphenol A as well as non-aromatic compounds such as acetone and bromomethane, which are strongly related with the initial chemical composition of PCBs.

Pymetrozine has replaced toxic organophosphate pesticides previously used for controlling pests of rice crops in China. Existing data on its environmental behavior are usually related to studies on artificial plots that do not adequately address the natural dynamics and residues in actual field conditions. Therefore, studies under field conditions were carried out to investigate the natural dynamics and residues of pymetrozine in two typical rice-growing areas in China - Hunan and Guangxi provinces. Samples of paddy soil and water were collected in relation to spraying events in the study areas. The quick, easy, cheap, effective, rugged and safe (QuEChERS) method was used to extract pymetrozine residues from the samples by a Waters ACQUITY UPLC (Milford, MA, USA) system interfaced with a triple-quadrupole mass spectrometer (Xevo TQ-D, Waters Corp., USA). The initial deposition of pymetrozine in paddy soils was higher than in paddy waters in both areas. The decay of pymetrozine followed an exponential trend consistent with the first order kinetics. The half-life of pymetrozine in paddy water was determined to be 3.0 and 3.8 days, whereas the half-life in soil was 3.8 and 3.5 days in the Guangxi and Hunan samples, respectively. The decline rates of pymetrozine in paddy soil and paddy water in this field study were faster than those conducted under non-field conditions reported in previous studies. Compared to other pesticides used in China as reported in previous studies, the environmental persistence of pymetrozine in both paddy water and soils in Guangxi and Hunan provinces is very low. This has important implications for the use of pymetrozine in agricultural systems globally.

This study was focused on the capacity investigation of a novel multistage flexible fiber biofilm reactor (MS-FFBR) to treat milk processing wastewater (MPW) with high organic loading (OLR). The MS-FFBR performance was evaluated at four intermediate stages separately and also the final effluent quality of the overall system with an influent chemical oxygen demand (CODin) ranged from 1500±20 to 6000±50 mg/L and hydraulic retention times (HRTs) of 8, 12, 16 h. By comparting the bioreactors into the four stages effectively enhanced the bioreactor's performance. The maximum TCOD removal efficiency was achieved at the first stage, which was about 89±20, 82±20 and 78±20 % at HRTs of 16, 12, 8 h, and low CODin of 1600±20, 1590±20, and 1673±20 mg/L, respectively. However, the first stage had less contribution to TCOD removal at high CODin concentrations, reported to be about 42±4 %, 46±4 %, and 25±4 % at CODin of 5960±40, 5830±40, and 5870±40 mg/L, respectively. Furthermore, the MS-FFBR was effective in removing total suspended solids (TSS) and turbidity. The bioreactor has reduced the effluent turbidity to 9.0±0.2, 20.0±0.6 and 16.1±0.5 NTU at low CODin concentrations of 1600±20, 1590±20, and 1670±20 mg/L and HRTs of 16, 12 and 8 h, respectively. The bioreactor revealed a high COD removal rate increased from 2.3±0.1 to 12.2±0.4 kg TCOD/m3d by increasing the OLR from 2.4±0.1 to 17.6±0.4 kg TCOD/m3d, confirming high reactor capacity for treatment of high strength wastewater. Kinetic studies confirmed that the biomass yield was low at various HRTs ranging 0.1-0.2 gVSS/gCOD.

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.

Pollution from shipping, industrial, and municipal wastewater discharges is a major source of heavy-metal contamination at seaports located near estuaries or along the coast. In this study, for the first time, nine metal(loid)s (Pb, Cd, Cr, Cu, Mn, Zn, Ni, Fe, and As) were analyzed from the surface sediment of two major seaports on the Bay of Bengal coast to evaluate the degree of pollution and ecological risk. The average concentrations of metal(loid)s followed the decreasing order of Fe (53,800 ± 4002 mg/kg) > Mn (590 ± 116.8 mg/kg) > Zn (67.59 ± 13.5 mg/kg) > Ni (62.8 ± 22.5 mg/kg) > Cr (36.59 ± 7.22 mg/kg) > Cu (32.63 ± 6.78 mg/kg) > Pb (16.78 ± 3.93 mg/kg) > As (6.33 ± 1.9 mg/kg) > Cd (0.71 ± 0.16 mg/kg). Both sites had much greater Fe concentrations (compared to other metals) than the levels that had been previously recorded at nearby localities. Furthermore, elements such as Fe and Ni surpassed the recommended NOAA and EPA limits for maximum samples from both ports. However, with the exception of one sampling point in Chattogram Port, the pollution-load-index (PLI) values were 0). In addition, the potential ecological-risk index (PERI) revealed that the both areas are under considerable (PERI > 80) to moderate (PERI > 40) risk due to Cd pollution. Correlation and Principal Component Analyses (PCA), demonstrated the anthropogenic sources of some metals, especially Fe, Ni, and Cd. As a result, it is suggested that the study area should be followed up on, to track changes and design a pollution-control strategy to reduce future pollution hazards.

Comprehensive efficiency analysis of wastewater treatment plants (WWPTs) in the alpine region with harsh environment and poor techniques as well as managing experience could provide targeted and effective improvement evidences for local wastewater treatment industry and help to improve the water quality of downstream reaches. In this paper, slack-based data envelopment analysis (SBM-DEA) was adopted to assess the operating efficiencies of WWPTs in northeast Qinghai-Tibet Plateau (QTP). Results showed that the average efficiency score for all WWPTs was 0.608, and 32.5% of WWPTs were efficient. Some WWPTs had large improvement potentials in operating costs and pollutant removal rates. Lowering expenditures and promoting facility construction for WWPTs to overcome the climate difficulties and improve management level was necessary according to their improvement potentials. In addition, the relative importance of the quantitative influential factors to efficiencies scores calculated by random forest regression (RFR) indicated that design capacity and temperature were important quantitative factors affecting the performance of WWPTs. Furthermore, geographical location and design capacity also had significant influence on the comprehensive efficiency of WWPTs verified by Kruskal-Wallis test. Our results highlight the importance of facilities upgrading, scientific management for WWPTs. And the relative improvement suggestions on overcoming the high and cold environment should also be considered for the efficient operations of WWTPs as well as the protection the aquatic environment.

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.

Fast-growing water demand, population growth, global climate change, and water quality deterioration all drive scientists to apply novel approaches to water resource management. Nanotechnology is one of the state-of-the-art tools in scientists’ hands which they can use to meet human water needs via reuse of water and utilizing unconventional water resources. Additionally, monitoring water supply systems using new nanomaterials provides more efficient water distribution networks. In this chapter, we consider the generic concepts of nanotechnology and its effects on water resources management strategies. A wide range of nanomaterials and nanotechnologies, including nano-adsorbents, nano-photocatalysts, and nano-membranes, are introduced to explain the role of nanotechnology in providing new water resources to meet growing demand. Also, nanomaterial application as a water alternative in industry, reducing water demand in the industrial sector, is presented. Another revolution made by nanomaterials, also discussed in this chapter, is their use in water supply systems for monitoring probable leakage and leakage reduction. Finally, we present case studies that clarify the influence of nanotechnology on water resources and their management strategies. These case studies prove the importance and inevitable application of nanotechnology to satisfy the rising water demand in the modern world, and show the necessity of nanotechnology awareness for today's water experts.

B-cell maturation antigen (BCMA) expression is highly expressed on the surface of MM cells and has been used to target MM tumor cells by CAR-T, Antibody-Drug-Conjugates (ADCs) and BCMA-CD3 bispecific antibodies. However, BCMA is critical for the viability of Multiple Myeloma (MM) tumor cells and to date there have not been any effective therapeutics developed to inhibit BCMA signaling. Here, we investigated the potential of using a soluble BCMA decoy receptor fusion protein (sBCMA-Fc) to trap the BCMA ligands, APRIL and BAFF to achieve ligand mediated BCMA signaling inhibition. Treatment with sBCMA-Fc has proven to be safe and efficacious in inhibiting tumor progression in numerous in vivo and syngeneic PDX tumors model. Mechanistically, global ribosome profiling analysis revealed a decrease in the translation efficiency of a subset of proteins in MM cells as a result of BCMA inhibition, indicating that increased BCMA signaling is a driver of dysregulated protein translation in MM cells. In particular, BCMA regulates the translation of ATM interactor (ATMIN/ACSIZ), and inhibition of ATMIN alone reduces the growth of MM cells, supporting its role as a downstream effector of BCMA in promoting MM expansion. Overall, our preclinical and mechanistic data support the concept that inhibition of BCMA signaling through sBCMA-Fc is a viable clinical strategy that alters the protein translation of a subset of proteins that are needed for MM viability and growth.

Milk processing industries consume significant volumes of sustainable water during processing and operating steps to meet hygienic requirements. Therefore, such industries are recognized as a potential source for producing large volume of contaminated water which generally contains biodegradable matters, and are subsequently suitable to be biologically treated. Based on this, many researchers have been moving towards milk processing wastewater (MPW) treatment via biological approaches. In present study, the performance of a single stage flexible fibre biofilm reactor (SS-FFBR) in mitigation of organic loading of the MPW was assessed. The performance of SS-FFBR in terms of the biological treatment was statistically modelled and analysed in terms of HRT and CODin by employing response surface methodology (RSM). From the results, it is clear increase in HRT and decrease in the CODin led to incrementing the COD removal percentage. In addition, a significant mutual interaction occurs between the variables and other responses. The optimum removal was reported at an HRT of 8 h and CODin of 3922 mg/L corresponded to high OLR of 11.67 kg COD/m3 d. The experimental results were in good agreement with model prediction.

This technique for setting guideline values differs from that currently used by regulatory agencies throughout the world. Data for benzene were evaluated from epidemiological studies on human populations (29 studies). Exposure durations were evaluated in terms of Long Term Exposure (LTE) and Lifetime Exposure. All data was reported as Lowest Observed Adverse Effect Levels (LOAEL) and converted into exposure doses using Average Daily Dose (ADD) and Lifetime Average Daily Dose (LADD). These values were plotted as a Toxicant Sensitivity Distribution (TSD) which was the cumulative probability of LOAEL-ADD and LOAEL-LADD. From the TSD plots, linear regression equations gave correlation coefficients (R2) ranging from 0.69 to 0.97 indicating normal distributions. Guideline Values (GVs) for LTE (8hr/day) and Lifetime (24hr/70yrs) exposure to benzene were calculated using data from human epidemiological studies as 5% level of cumulative probability (CP) of LOAEL–ADD and LOAEL–LADD from the cumulative probability distributions (CPD). The derived guideline values from the human epidemiological studies were 92 μg/kg/day for LTE and 3.4 μg/kg/day for lifetime exposure. GV for LTE is appropriate for occupational exposure and GV derived for lifetime exposure appropriate for the general population. The guideline value for occupational exposure limit was below all the guideline values developed by regulatory agencies. But the general population guideline is within the range of values formulated by European Union, ATSDR, EPAQS, USEPA and OEHHA for air quality for the general population. This is an alternative method which eliminates the application of safety factors and other sources of errors in deriving guideline values for benzene.

Pesticides play an important role in agricultural development. However, pesticide application can result in both acute and chronic human toxicities, and the adverse effects of pesticides on the environment and human health remain a serious problem. There is therefore a need to discuss the application methods for pesticides, the routes of pesticide exposure, and the health risks posed by pesticide application. The health problems related to pesticide application and exposure in developing countries are of particular concern. The purpose of this paper is to provide scientific information for policymakers in order to allow the development of proper pesticide application technics and methods to minimize pesticide exposure and the adverse health effects on both applicators and communities. Studies indicate that there are four main pesticide application methods, including hydraulic spraying, backpack spraying, basal trunk spraying, and aerial spraying. Pesticide application methods are mainly selected by considering the habits of target pests, the characteristics of target sites, and the properties of pesticides. Humans are directly exposed to pesticides in occupational, agricultural, and household activities and are indirectly exposed to pesticides via environmental media, including air, water, soil, and food. Human exposure to pesticides occurs mainly through dermal, oral, and respiratory routes. People who are directly and/or indirectly exposed to pesticides may contract acute toxicity effects and chronic diseases. Although no segment of the general population is completely protected against exposure to pesticides and their potentially serious health effects, a disproportionate burden is shouldered by people in developing countries. Both deterministic and probabilistic human health risk assessments have their advantages and disadvantages and both types of methods should be comprehensively implemented in research on exposure and human health risk assessment. Equipment for appropriate pesticide application is important for application efficiency to minimize the loss of spray solution as well as reduce pesticide residuals in the environment and adverse human health effects due to over-spraying and residues. Policymakers should implement various useful measures, such as integrated pest management (IPM) laws that prohibit the use of pesticides with high risks and the development of a national implementation plan (NIP) to reduce the adverse effects of pesticides on the environment and on human health.