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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 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.

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.

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.

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

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.

5-6 nm hydrophilic NixCo(1-x) NPs was synthesized by a cost-effective and scalable method and was coated onto conductive substrates without any binders or additives thanks to its small particle effect and possiblely magnetic effects. Then, the NixCo(1-x) NPs can be transformed into NixCo(1-x)(OH)2 by an OER-activating strategy. Optimized by the composition effect, the Ni0.8Co0.2/CF exhibits best activity for supercapacitors (2124F/g). Underling mechanism of the OER evolution process well studied by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Raman spectrometry, X-ray absorption near-edge spectra (XANES). Density functional theory (DFT) calculations was performed and verify the synergistic effect of nickel and cobalt and the support effect.

Hydrodesulfurization of 4, 6-dimethyldibenzothiophene is of great significance for emission reduction and environmental protection. Herein, the effects of Mg addition on CoMo/Al2O3 were systematically studied for the hydrodesulfurization of 4, 6-dimethyldibenzothiophene. The CoMo/Mg-Al2O3 was formed by incorporating Mg in the alumina lattice and showed excellent hydrodesulfurization performance compared to CoMo/Mg/Al2O3 formed after deposition of Mg on the alumina surface and to CoMo/Al2O3 without introducing Mg. Experimental characterization and theoretical calculations showed that the introduction of Mg is beneficial to the formation of β-CoMoO4, which significantly promoted the production of CoMoS active sites. Meanwhile, the introduction of Mg mainly improved the medium-strong surface basic sites.

Radiofrequency ablation (RFA) is a treatment option in the management of unresectable or recurrent hepatocellular carcinoma (HCC). It can be performed either through laparotomy or in a minimally invasive manner by percutaneous, laparoscopic or thoracoscopic routes. Percutaneous RFA is associated with reduced surgical trauma and thus can be performed in patients with significant comorbidities. The procedure can be repeated after short intervals for sequential ablation of multiple liver lesions. However, the associated risks should not be underestimated. This is the first report of a rare complication of duodenopleural fistula after percutaneous RFA of a recurrent subcapsular HCC. The risk of bowel perforation during the ablation of subcapsular HCC requires special attention, since only the position of the tip of the electrode, but not the zone of ablation, can be assessed accurately by imaging during the procedure. Our case demonstrated that there was leakage of bowel content from the duodenal injury site into the pleural cavity through the RFA track. Subsequent uncontrolled infection resulted in empyema thoracis and led to the death of the patient.

Background: Different irrigation methods have variable effects on the physiochemical properties of soils. The predicted widespread replacement of flood irrigation with drip irrigation will alter the micro-environment of the associated soils in terms of migration, transformation, morphology, and toxicology of heavy metals and pesticides. The dynamics of heavy metals in soil under drip irrigation have only been investigated with regard to the use of sewage and reclaimed water; studies comparing these patterns across different irrigation methods are scarce. Purpose: Here, we aimed to investigate the effects of drip and flood irrigation on heavy metal distribution in soil and the related risks in three typical agricultural systems in China. Methods: We used fixed-point sampling, digestion analytical methods, descriptive analyses, one-way analysis of variance (ANOVA), Nemerow pollution index analyses, and correlation analyses to investigate the different effects of drip and flood irrigation on heavy metals (Cd, Cr, Cu, Pb, and Zn) in soils from Hebei, Xinjiang, and Ningxia Provinces, China. Results and Discussion: Analyses of soil samples collected from drip-irrigated fields revealed significant differences in the concentrations of soil heavy metals at depths of 0–60 cm. Drip irrigation had a greater effect on heavy metal content in the soil surface than flood irrigation. In addition, heavy metals likely accumulated at the edges of the wetting fronts following prolonged irrigation. In comparison to drip irrigation, flood irrigation elevated pollution levels in the soil. The amount of fertiliser affected the leaching and migration of heavy metals in the soils by altering the physiochemical characteristics of the drip irrigation solution. Conclusion: Drip irrigation alters the dynamics of heavy metals in soil by influencing their migration and accumulation patterns. This effect can be attributed to the methods of adding water and fertilisers to the soil under drip irrigation. Altering these variables can impact the level of heavy metals that bioaccumulate in crops. This study provides a scientific basis for reducing heavy metal pollution under drip irrigation.

Background: Soil nutrients are the basic properties and essential characteristics of the soil. Study of areal variability of soil nutrients is an important fundamental work for regional planning, environmental protection, and regionally sustainable development. Dynamic changes in soil nutrients are affected by factors such as soil type, fertilization, farming, irrigation, altitude, and climate. This study takes the Tianshan Mountains, located in the central region of Xinjiang, China, as this region is not only a hub for agriculture, industry, transportation, and tourism, but also it is crucial as a forest-grassland transition zone. Purpose: Through field sampling, laboratory analysis and supported by statistical analysis, we investigated the soil nutrient characteristics and the soil nutrient index to gain a spatial image of soil nutrient status in Tianshan followed by the discussion of those influencing factors. Methods: We selected suitable locations along the forest-grassland transition zone to excavate pits of 40 cm × 40 cm in area and 100 cm in depth. A total of 133 soil samples were collected from 0–5 cm, 5–20 cm, and 20–40 cm in pairs (woodland, grassland). Five soil nutrients (soil organic matter (SOM), available nitrogen (AN), available phosphorus (AP), available potassium (AK) and total salts were selected for experimental, multivariate statistical, correlation and soil nutrient index analyses. Result and discussion: The results show that (1) the average soil nutrient indices of the western area (M-T and K-B sites) were 0.5 and 0.24, respectively, higher than 0.2 of the eastern area (B-A site); (2) in soil layers of different depths of these three locations, all nutrients except the total salts (SOM, AN, AP, and AK) decreased with the increase in depth; (3) more fertile soils distribute in the western area (M-T and K-B sites) than in others of the Tianshan Mountains, showing higher soil nutrient contents and nutrient indices, abundant vegetation with greater diversity, higher vegetation coverage (80%-90%), and higher altitude. Conclusion: It can be concluded that the differentiation of soil nutrient index between western and eastern section of Tianshan were attributed to theirs’ vegetation type and coverage, altitude, and more importantly, human activity..

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.

Heterosigmaakashiwo is an algal species that causes harmful algal blooms (HABs) with strong hemolytic toxicity on coastal aquatic organisms. This study investigated the mechanism of growth inhibition and changes in hemolytic toxin contents in algal culture after exposure to hypoxanthine, a compound secreted by algicidal bacterium Bacillus sp.strain B1. An algal inhibition rate of 86% was observed with 1.0 mM hypoxanthine treatment on day 15. The levels of superoxide dismutase and catalase in algal cell culture increased while that of glutathione decreased during the treatment. In addition,the level of hemolytic toxin contents increased on day 3 under hypoxanthine treatment, and significantly decreased on days 6, 9, 12, and 15. Twelve fatty acids in H.akashiwo were detected by GC-MS, and the changes in the contents of C16, C18, C18:4ω3, and C20:5ω3 in the treatment group were consistent with the change in hemolytic toxin content. The four fatty acids were tested for hemolysis and it was observed that the hemolysis rate of 25 μg/mL C18:4ω3 and 5 μg/mL C20:5ω3 reached more than 80%, but C16 and C18 exhibited no hemolytic capability.Therefore, our results showed that hypoxanthine inhibited the growth of H. akashiwo through the changes of levels of antioxidants and hemolytic toxin content in the cultures, and fatty acids C18:4ω3 and C20:5ω3 were contributors to hemolytic toxins. The results confirmed that hypoxanthine is a potential algal inhibitor to prevent HABs.

Background: To study the efficacy of surgery for recurrent T3 nasopharyngeal carcinoma (NPC) and to determine the prognostic significance of various skull base bone invasion., Method: Retrospective view of the surgical outcome for recurrent T3 NPC. Kaplan Meier and log rank tests were used to determine the 5-year overall and disease specific survival. Multivariate analysis was used to identify significant independent prognostic factors that affect the surgical outcome., Results: Between 1990 and 2017, 208 patients with recurrent T3 NPC were recruited. Salvage surgery was performed via the endoscopic endonasal approach (n = 22, 10.6%), endoscopic transpterygoid approach (n = 63, 30.3%) and the maxillary swing approach (n = 123, 59.1%). Thirty-eight (18.3%) patients required vascular bypass. The skull base bone involved by the tumours included: maxillary sinus (n = 13), clivus (n = 36), pterygoid process (n = 61), sphenoid sinus (n = 30), petrous part of the temporal bone (n = 42) and a combination of the above (n = 26). The mean follow-up duration was 41.7 months. Multivariate analysis identified tumours involving with both cortexes of the clivus and the lateral wall of the sphenoid sinus, as well as positive bone resection margins as the significant independent prognostic factors for surgical outcome., Conclusion: Outcome of surgical salvage is significantly worse for tumours that involve multiple bones at the skull base, particularly when both cortexes of the clivus and the lateral wall of the sphenoid sinus are invaded. Indication of aggressive surgery in such circumstances is controversial., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: To investigate the role of indocyanine green (ICG) lymphangiography in the reduction of drainage after neck dissection., Methods: Patients with oral cavity squamous cell carcinoma were randomized into Group A (study group) and Group B (control). In the study group, upon the completion of neck dissection, a total of 2.5 mg of ICG was injected submucosally at the four quadrants around the tumour. Another 2.5 mg of ICG was injected subdermally in the groin bilaterally. The neck was screened using Near Infrared fluorescence. The presence of lymphatic leakage was noted and plicated with silk stitches. The total drainage volume of post-operative day 1, day 2 and the total accumulated volume until drain removal was measured., Results: Twenty-two patients (Group A, n = 12; Group B, n = 10) were recruited. All patients in Group A had at least one site of lymphatic leakage identified. One patient in Group B developed chylous fistula and was excluded from analysis. The mean total drain output for day 1 and 2 after surgery, as well as the mean total output before drain removal, were significantly lower in Group A (22.4 ml vs. 86.2 ml [p = .02]; 14.2 ml vs. 72.8 ml [p = .02]; and 58.4 ml vs. 392 ml [p = .01], respectively), allowing earlier drain removal (2.2 days vs. 7.2 days, p = .02)., Conclusions: Intra-operative ICG lymphangiography is useful in the reduction of drainage volume after neck dissection for caners in the head and neck region., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: Nasopharyngeal carcinoma is a unique tumour which is endemic in Southern China including Hong Kong. While the treatment results for primary cancer has been encouraging, management of persistent or recurrent tumours has been challenging. Compared to other surgical approaches, the maxillary swing operation provides spacious access to the bilateral nasopharynx and the ipsilateral parapharyngeal space, allowing resection of tumours with wide margins. In this article, we will present our results in the surgical management of recurrent nasopharyngeal carcinoma., Materials and Methods: Retrospective review., Results: Over the years, we have performed salvage maxillary swing nasopharyngectomy for 312 patients. Microscopic negative resection margins were achieved in the majority (79.5%) of the patients. The overall local recurrence rate after surgery was 13.1%, the risk of which was significantly higher in patients with previous positive resection margins. The overall 5-year actuarial local tumour control and overall survival was 74% and 62%, respectively, which was significantly higher in patients with clear resection. For small tumours located in the posterior wall, minimally invasive approach can be used, which included the endoscopic resection, or more recently, the transoral robotic (TORS) assisted approach., Conclusion: The result of surgical salvage of recurrent nasopharyngeal carcinoma is promising. Every effort should be made to ensure microscopic clearance of disease as well as to minimize the potential complications of surgery that may adversely affect the subsequent quality of life., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: Anastomotic leakage from the free jejunal flap, if diagnosed late, can result in catastrophes. Our study aims to look for clinical parameters that allow early identification of leakage so that appropriate interventions can be taken., Method: Between 1980 and 2011, consecutive patients with free jejunal flap reconstruction of circumferential pharyngeal defects were included. A retrospective chart review was then performed comparing the clinical parameters (body temperature, heart rate, serum albumin, haemoglobin and white cell count) between patients with no leakage and those with clinical and radiological leakage., Level of Evidence: 4., Results: Ninety-six patients were included in the study. The median age was 62 years. Majority (69.8%) of the defects were created after resection of tumours in the hypopharynx. Five (5.2%) patients had clinical leakage and 12 (12.5%) had radiological leakage. There was no significant difference in body temperature, heart rate, incidence of atrial fibrillation and haemoglobin level between those with and without leakage. The serum white cell count was higher in the patients who leaked, but it became statistically significant only after day 7 postoperatively. The serum albumin level was significantly lower in patients with anastomotic leakage starting as early as day 3 after surgery, and the difference persisted until the leak was controlled. However, there was no significant difference in the plasma albumin level between those with clinical or radiological leak., Conclusion: Both serum albumin level and white cell count identified the presence of anastomotic leakage from the free jejunal flap. Serum albumin allows early prediction of leakage so that early interventions can be taken to avoid the damage resulting from the delay in diagnosis., (Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

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.