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Triazole antifungal drugs (TAD) are widely used to treat invasive fungal infections due to their broad antifungal spectrum and low toxicity. Despite their preference in the clinic, multiple Adverse Events (AE) are still reported each year. Objective: We aimed to characterize the distribution of Adverse Events associated with Triazole antifungal drugs in different systems and to identify Important Medical Events (IME) signals for Triazole antifungal drugs. Methods: The U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) was queried for Adverse Events related to Triazole antifungal drugs from 2012 to 2022. The Adverse Events caused by all other drugs and non-TAD antifungal drugs were analyzed as references. Reporting odds ratio and Bayesian confidence propagation neural network of information components were used to evaluate the association between Triazole antifungal drugs and Important Medical Events. Visual signal spectrum is mapped to identify potential adverse reaction signals. Results: Overall, 10,262 Adverse Events were reported to be associated with Triazole antifungal drugs, of which 5,563 cases were defined as Important Medical Events. Common adverse drug reactions (ADR) mentioned in the instructions such as delirium and hypokalemia were detected, as well as unlabeled ADRs such as rhabdomyolysis and hepatitis fulminant. Cholestasis, drug-induced liver injury, QT interval prolongation and renal impairment have notable signals in all Triazole antifungal drugs, with 50 percent of patients developing a severe clinical outcome. Isavuconazole had the lowest signal intensity and demonstrated a superior safety profile. Conclusion: Most results are generally consistent with previous studies and are documented in the prescribing instructions, but some IMEs are not included, such as hepatitis fulminant. Additional pharmaco-epidemiological or experimental studies are required to validate the small number of unlabeled ADRs. TAD-related Important Medical Eventshave a considerable potential to cause clinically serious outcomes. Clinical use of Triazole antifungal drugs requires more attention.

The effects of high-intensity impulsive noise generated by pile driving on fish are a major concern in environmental impact assessments. Numerical acoustic models are essential for predicting underwater-acoustic-related problems in complex coastal environments prior to offshore construction. However, underwater noise modeling for impact pile driving has often been performed using simplistic propagation models that are inadequate for three-dimensional (3D) environments. A 3D parabolic equation method (PE) was established in this study to better predict broadband transmission loss (TL) from impact pile driving in complex coastal environments and its influence on the large yellow croaker (Pseudosciaena crocea). The effects of 3D propagation were investigated using two realistic scenarios with different bathymetric complexities. The values and attenuation rate of the broadband TL for the steeply sloped bottom were significantly greater than those for the flat and weakly varying bottoms over 3 km. At a water depth of 5 m, a difference of approximately 10 dB was observed between the two TL scenarios at a distance of 4.5 to 5 km. The simulation results are in reasonable agreement with the field measurement data, with a difference of less than 3 dB. The zones of behavioral response and injury in the large yellow croaker were estimated using the For3D model. The results showed that the effects of the noise generated by the impact pile driving on the large yellow croaker were evident and three-dimensional. Therefore, 3D propagation effects should be considered when analyzing the influence of underwater noise on marine animals.

Underwater noise from anthropogenic activities can have negative behavioral and physical effects on marine life, including physical changes, injuries, and death. Impact pile driving and vibratory pile driving are generally used for the construction of ocean-based foundations. Based on the field data under the same marine engineering and marine environment, this paper addresses the characteristics of underwater noise from impact and vibratory pile driving, their differences, and the effects of noise on populations of the large yellow croaker (Pseudosciaena crocea). The impact pile driving pulse had a median peak-to-peak sound pressure source level (SPLpp) of 244.7 dB re 1 μPa at 1 m and a median sound exposure source level (SELss) of 208.1 dB re 1 μPa2s at 1 m by linear regression. The waveform of vibratory pile driving appears to be continuous with a low SPLpp, but the cumulative SEL (SELcum) in 1 min is very high, reaching 207.5 dB re 1 μPa2s at 1 m. The range of behavioral response for adult large yellow croaker (20–23 cm) is predicted to be 4,798 m for impact pile driving and 1,779 m for vibratory pile driving. The study provides evidence of the comparative potential effects of vibratory and impact pile driving on the large yellow croaker and reference for the conservation of croaker.