Microplastic Ingestion by Gelatinous Zooplankton May Lower Efficiency of the Biological Pump.

The impacts of microplastics on some individual organisms have been well studied but what is less clear is what impacts microplastics have on wider ecosystem processes. Using salps as model organisms, we studied the effect of microplastic ingestion on the downward flux of high-density particulate organic matter in the form of salp faecal pellets. While to date most microplastic studies used virgin microplastics at unrealistic environmental concentrations here we exposed Salpa fusiformis to fractured and UV exposed polyethylene and polystyrene microplastics possessing a biofilm. It was found that when exposed to environmentally relevant concentrations, reported for the Mediterranean and the South Pacific Gyre, only few faecal pellets had microplastics incorporated within them. Under potential future scenarios, however, up to 46% of faecal pellets contained microplastics. Incorporated microplastics significantly altered the size, density and sinking rates of salp faecal pellets ( p-value < 0.05 in each instance). Sinking rates decreased by 1.35-fold (95% CI = 1.18, 1.56) for faecal pellets with polyethylene microplastics and 1.47-fold (95% CI = 1.34, 1.61) for polystyrene. These results suggest that today, microplastic ingestion by salps has minimal impact on the biological pump. However, under future microplastic concentrations (or in areas such as convergent zones), microplastics may have the potential to lower the efficiency of the biological pump.

Predictors of survival in early oral cancer.

OBJECTIVE: Despite the substantial rate of neck conversion reported among patients with early oral cancer, a policy of routine elective neck dissection has been criticized on the grounds that it confers little survival advantage while subjecting many to potentially avoidable morbidity. However, the identification of factors predictive of survival may allow for the identification of those patients who are more likely to benefit from elective neck treatment. STUDY DESIGN AND SETTING: The clinical and histologic material of 71 patients with stage I or II squamous carcinoma of the oral cavity were reviewed. Patients were followed up for a minimum of 3 years after their surgery, and the impact of these variables on 3-year survival was assessed. RESULTS: Increased tumor thickness was significantly predictive of decreased survival (P = 0.030). Although having no prognostic value alone, when combined with thickness, both pattern of invasion and gender increased the significance of the latter in predicting outcome. Conclusion and significance Measuring tumor thickness and pattern of invasion in patients with early oral cancer may allow for the identification of those patients with more aggressive disease who are more likely to benefit from elective neck treatment.

Long-term otological outcome of hamular fracture during palatoplasty.

OBJECTIVE: It has been suggested that fracture of the hamulus during palatoplasty in children with cleft palate may lead to adverse otological sequelae, however, there is little evidence to support this. STUDY DESIGN AND SETTING: The otological records of 42 children with repaired cleft palate (excluding submucous cleft palate) aged 8 years old or older were examined. A questionnaire regarding the incidence, treatment, and outcome of middle ear problems was completed by the parents of 68 children with repaired cleft palate, aged 9 years old or older. RESULTS: There was no significant difference between children who did and did not undergo hamular fracture with regard to tympanic membrane appearance, audiometry, history of ear problems (P = 1.000), ear infections (P = 0.622), ventilation tube insertion (P = 0.532), or surgery for chronic otitis media (P = 1.000). Parents of children not undergoing hamular fracture reported a higher incidence of below normal hearing (P = 0.023).Conclusion and significance There is no evidence that hamular fracture during palatoplasty affects long-term otological outcome in cleft palate.

Incidence and outcome of middle ear disease in cleft lip and/or cleft palate.

OBJECTIVE: Otitis media with effusion is known to be very common among children with cleft palate, however, less is known regarding the natural history and outcome in this group. The purpose of the present study was to examine the incidence, natural history, treatment, and outcome of middle ear disease in children with clefts. METHODS: A questionnaire was sent to the parents of all children registered on the cleft lip and palate database at our institution. The medical records of all respondents were also reviewed. Statistical analysis of the results was performed using Fisher's exact test in contingency tables and binary logistic regression analyses, where appropriate. RESULTS: 397 fully completed questionnaires were returned. Ear disease was much more common in children with cleft palate, or cleft lip and palate, than in children with cleft lip. Among children with cleft palate, ear problems (infections and/or hearing loss) were most prevalent in the 4-6-year-old age group. However, ear problems persisted at a substantial level for many years after this; only after the age of 12 years did problems appear to settle. The incidence of below normal current hearing and of surgery for chronic otitis media was significantly related to history of ear infections (P=0.000 and 0.000, respectively), and to increased number of ventilation tube insertions (P=0.000 and 0.000, respectively). CONCLUSIONS: Middle ear disease is common in children with cleft palate, and, unlike the case for children without clefts, has a prolonged recovery, and a substantial incidence of late sequelae. The higher incidence of below normal hearing and surgery for chronic otitis media in children undergoing a greater number of ventilation tube insertions, although most likely reflecting an increased underlying severity of otitis media in these children, also underlines the lack of long-term benefits of ventilation tubes in this group.

Middle ear disease in children with congenital velopharyngeal insufficiency.

OBJECTIVE: To examine the incidence and natural history of middle ear disease in children with congenital velopharyngeal insufficiency (VPI) without cleft palate. SETTING AND SUBJECTS: Children with congenital VPI attending the combined cleft clinic at a tertiary cleft center. The diagnosis of congenital VPI in all cases was confirmed be the observation of hypernasality, nasal air escape, or both by a speech and language therapist and the demonstration of incompetence of the velopharyngeal sphincter by means of nasoendoscopy or videofluoroscopy. Children with overt cleft palate or postsurgical VPI were excluded. DESIGN: The children's medical records were reviewed, and a questionnaire regarding history of ear problems was sent to all parents. Children were divided into those with Pruzansky type I VPI (showing bifid uvula, midline diastasis of soft palate, or submucous cleft of the hard palate) and Pruzansky type II VPI (no visible stigmata). MAIN OUTCOME MEASURES: Incidence of reported ear problems, ear infections, hearing loss, and surgical intervention for middle ear disease in the whole group and in each of the subgroups. RESULTS: Seventy-one parents returned completed questionnaires. The overall incidence of middle ear disease was 63%, with 28% reported to have below-normal hearing. There was no significant difference between children with Pruzansky types I and II VPI with respect to incidence of otopathology or hearing loss. CONCLUSIONS: Irrespective of the presence of any visible palatal abnormalities, children with congenital VPI showed a substantial incidence of otopathology and should thus be closely monitored.