ABSTRACT
BACKGROUND: This study systematically reviewed interventions mitigating financial hardship in patients with cancer and assessed effectiveness using a meta-analytic method. METHODS: PubMed, Cochrane, Scopus, CINAHL, and Web of Science were searched for articles published in English during January 2000-April 2023. Two independent reviewers selected prospective clinical trials with an intervention targeting and an outcome measuring financial hardship. Quality appraisal and data extraction were performed independently by two reviewers using a quality assessment tool. A random-effects model meta-analysis was performed. Reporting followed the preferred reporting items for systematic review and meta-analyses guidelines. RESULTS: Eleven studies (2211 participants; 55% male; mean age, 59.29 years) testing interventions including financial navigation, financial education, and cost discussion were included. Financial worry improved in only 27.3% of 11 studies. Material hardship and cost-related care nonadherence remained unchanged in the two studies measuring these outcomes. Four studies (373 participants; 37% male, mean age, 55.88 years) assessed the impact of financial navigation on financial worry using the comprehensive score of financial toxicity (COST) measure (score range, 0-44; higher score = lower financial worry) and were used for meta-analysis. There was no significant change in the mean of pooled COST score between post- and pre-intervention (1.21; 95% confidence interval, -6.54 to 8.96; p = .65). Adjusting for pre-intervention COST, mean change of COST significantly decreased by 0.88 with every 1-unit increase in pre-intervention COST (p = .02). The intervention significantly changed COST score when pre-intervention COST was ≤14.5. CONCLUSION: A variety of interventions have been tested to mitigate financial hardship. Financial navigation can mitigate financial worry among high-risk patients.
ABSTRACT
Biodegradable plastics (BPs) are widely used as alternatives to non-BPs due to their inherent ability to undergo facile degradation. However, the ecotoxicological impact of biodegradable microplastics (MPs) rarely remains scientific documented especially to aquatic ecosystem and organisms compared to conventional microplastics. Therefore, this study aimed to investigate the ecotoxicity of biodegradable polylactic acid (PLA) MPs to Daphnia magna with that of conventional polyethylene (PE) MPs with and without ultraviolet (UV) treatment (4 weeks). The acute toxicity (48 h) of PLA MPs was significantly higher than that of PE MPs, potentially attributable to their elevated bioconcentration resulting from their higher density. UV treatment notably reduced the particle size of PLA MPs and induced new hydrophilic functional groups containing oxygen. Thus, the acute lethal toxicity of PLA MPs exhibited noteworthy increase, compared to before UV treatment after UV treatment, which was greater than that of UV-PE MPs. In addition, UV-PLA MPs showed markedly elevated reactive oxygen species concentration in D. magna compared to positive control. However, there was no significant increase in the level of lipid peroxidation, possibly due to successful defense by antioxidant enzymes (superoxide dismutase and catalase). These findings highlight the ecotoxicological risks of biodegradable MPs to aquatic organisms, which require comprehensive long-term studies.
Subject(s)
Daphnia magna , Water Pollutants, Chemical , Animals , Ecosystem , Microplastics/toxicity , Plastics , Polyethylene/toxicity , Polyesters , Water Pollutants, Chemical/toxicity , DaphniaABSTRACT
BACKGROUND & AIMS: A two-step strategy combining a serum marker and magnetic resonance elastography (MRE) for detecting advanced fibrosis (stage 3-4) among patients with nonalcoholic fatty liver disease (NAFLD) has been proposed, but its diagnostic accuracy has not been evaluated. In this multicenter study, we aimed to investigate the diagnostic accuracy of a two-step strategy including Fibrosis-4 (FIB-4) followed by MRE. METHODS: In this multicenter study, 806 patients with biopsy-proven NAFLD who underwent contemporaneous MRE were enrolled and randomly assigned to training and validation cohorts. As a first step, patients with FIB-4 <1.3 were defined as test negative regardless of MRE. As a second step, among patients with FIB-4 ≥1.3, MRE <3.6 and ≥3.6 kPa were defined as test negative and positive. The primary outcome was the diagnostic accuracy for advanced fibrosis comparing MRE alone versus the two-step strategy. RESULTS: Area under the receiver characteristic curves of MRE alone and the two-step strategy were 0.840 and 0.853 in the training cohort (P = .4) and 0.867 and 0.834 in the validation cohort (P = .2), respectively, and the diagnostic accuracy was comparable between the 2 methods. In the entire cohort, negative predictive value (NPV) and positive predictive value (PPV) of MRE for advanced fibrosis were 92.2% and 73.7%, respectively, whereas NPV at the first and second step and PPV at the second step were 90.9%, 84.4%, and 77.0%, respectively. CONCLUSIONS: The diagnostic accuracy of the two-step strategy was comparable to MRE and could reduce cost by reducing excessive MRE. Therefore, the two-step strategy could be used as a screening method in a large population.
Subject(s)
Elasticity Imaging Techniques , Non-alcoholic Fatty Liver Disease , Humans , Non-alcoholic Fatty Liver Disease/pathology , Liver Cirrhosis/diagnostic imaging , Liver Cirrhosis/pathology , Elasticity Imaging Techniques/methods , Fibrosis , Predictive Value of Tests , Biopsy , Liver/diagnostic imaging , Liver/pathologyABSTRACT
BACKGROUND AND AIMS: Patients with NAFLD with significant hepatic fibrosis (Stage ≥ 2) are at increased risk of liver-related morbidity and are candidates for pharmacologic therapies. In this study, we compared the diagnostic accuracy of MEFIB (the combination of magnetic resonance elastography [MRE] and Fibrosis-4 [FIB-4]) and FAST (FibroScan-aspartate aminotransferase; combined liver stiffness measurement by vibration-controlled transient elastography, controlled attenuation parameter, and aspartate aminotransferase) for detecting significant fibrosis. APPROACH AND RESULTS: This prospective cohort study included 234 consecutive patients with NAFLD who underwent liver biopsy, MRE, and FibroScan at the University of California San Diego (UCSD cohort) and an independent cohort (N = 314) from Yokohama City University, Japan. The primary outcome was diagnostic accuracy for significant fibrosis (Stage ≥ 2). The proportions of significant fibrosis in the UCSD and Yokohama cohorts were 29.5% and 66.2%, respectively. Area under the receiver operating characteristic curve (95% CI) of MEFIB (0.860 [0.81-0.91]) was significantly higher than that of FAST (0.757 [0.69-0.82]) in the UCSD cohort (p = 0.005), with consistent results in the Yokohama cohort (AUROC, 0.899 [MEFIB] versus 0.724 [FAST]; p < 0.001). When used as the rule-in criteria (MEFIB, MRE ≥ 3.3 kPa and FIB-4 ≥ 1.6; FAST ≥ 0.67), the positive predictive value for significant fibrosis was 91.2%-96.0% for MEFIB and 74.2%-89.2% for FAST. When used as the rule-out criteria (MEFIB, MRE < 3.3 kPa and FIB-4 < 1.6; FAST ≤ 0.35), the negative predictive value for significant fibrosis was 85.6%-92.8% for MEFIB and 57.8%-88.3% for FAST. CONCLUSIONS: MEFIB has higher diagnostic accuracy than FAST for significant fibrosis in NAFLD, and our results support the utility of a two-step strategy for detecting significant fibrosis in NAFLD.
Subject(s)
Aspartate Aminotransferases/analysis , Elasticity Imaging Techniques/methods , Liver Cirrhosis , Liver , Magnetic Resonance Imaging/methods , Biopsy/methods , Cohort Studies , Elasticity , Female , Humans , Japan/epidemiology , Liver/diagnostic imaging , Liver/pathology , Liver Cirrhosis/diagnosis , Liver Cirrhosis/drug therapy , Liver Cirrhosis/etiology , Male , Middle Aged , Multimodal Imaging/methods , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/epidemiology , Patient Selection , Predictive Value of Tests , ROC Curve , Severity of Illness IndexABSTRACT
Copper sulfate (CuSO4) is actively used to control the proliferation of harmful algal blooms because of its fast and effective killing mechanism. However, its use unintentionally harms innocuous aquatic organisms. Therefore, there is a need to find non-toxic solutions for controlling algal blooms. In this study, Cu-based metal-organic framework (Cu-BDC MOF) chips (ca. 2 × 2 cm) were synthesized using waste polyethylene terephthalate (PET) bottles. The as-synthesized Cu-BDC MOF chips efficiently inhibited the cyanobacteria species Microcystis aeruginosa, which was comparable to the conventional dose of CuSO4 algaecide (1.00 mg L-1). Moreover, unlike the CuSO4 algaecide, Cu-BDC MOF chips did not cause any acute toxicity (48 h) to the water flea Daphnia magna. Both Cu-BDC MOF and Cu2O seemed to be responsible for the generation of reactive oxygen species, which resulted in the aggregation, photosynthesis disruption, and eventually growth inhibition of M. aeruginosa. This study suggests that the environmentally safe Cu-BDC MOF chip is a promising agent to sustainably control harmful algal blooms.
Subject(s)
Cyanobacteria , Herbicides , Metal-Organic Frameworks , Polyethylene Terephthalates/pharmacology , Harmful Algal Bloom , CopperABSTRACT
Microplastics and antibiotics are emerging as ubiquitous contaminants in farmland soil, harming crop quality and yield, and thus threatening global food security and human health. However, few studies have examined the individual and joint effects of degradable and/or non-degradable microplastics and antibiotics on crop plants. This study examined the individual and joint effects of polyethylene (PE) and polylactic acid (PLA) microplastics and the antibiotic oxytetracycline (OTC) on pak choi by measuring its growth, photosynthesis, antioxidant enzyme activity, and metabolite levels. Microplastics and/or oxytetracycline adversely affected root weight, photosynthesis, and antioxidant enzyme (superoxide dismutase, catalase, and ascorbate peroxidase) activities. The levels of leaf metabolites were significantly altered, causing physiological changes. Biosynthesis of plant secondary metabolites and amino acids was altered, and plant hormones pathways were disrupted. Separately and together, OTC, PE, and PLA exerted phytotoxic and antagonistic effects on pak choi. Separately and together with OTC, degradable microplastics altered the soil properties, thus causing more severe impacts on plant performance than non-degradable microplastics. This study elucidates the effects on crop plants of toxicity caused by co-exposure to degradable or non-degradable microplastic and antibiotics contamination and suggests mechanisms.
Subject(s)
Antioxidants , Oxytetracycline , Humans , Microplastics , Plastics , Oxytetracycline/toxicity , Soil , Plants , Anti-Bacterial Agents/toxicity , PolyestersABSTRACT
The maternal effect of microplastics (MPs) toxicity is likely influenced by age and brood of test species. This study investigated the maternal effect of polyethylene MP fragments (18.23 ± 8.02 µm) with benzophenone-3 (BP-3; 2.89 ± 0.20% w/w) on chronic toxicity to Daphnia magna over two generations. Neonate (< 24 h old) and adult (5 d old) daphnids in the F0 generation were exposed until 21 d old, then first and third brood neonates in the F1 generation were recovered in clean M4 medium for 21 d. Higher chronic toxicity and maternal effect of MP/BP-3 fragments were observed in the adult group compared with the neonate group, reducing growth and reproduction in both F0 and F1 generations. First brood neonates in the F1 generation showed a higher maternal effect of MP/BP-3 fragments than third brood ones, resulting in enhanced growth and reproduction relative to the control. This study provided insights into the ecological risk of MPs containing plastic additives in the natural environment.
Subject(s)
Plastics , Water Pollutants, Chemical , Animals , Daphnia , Microplastics , Polyethylene/toxicity , Maternal Inheritance , Reproduction , Water Pollutants, Chemical/toxicityABSTRACT
OBJECTIVE: Emerging data suggest that a 30% relative decline in liver fat, as assessed by MRI-proton density fat fraction (MRI-PDFF), may be associated with Non-Alcoholic Fatty Liver Disease Activity Score improvement, but the association between decline in MRI-PDFF and fibrosis regression is not known. Therefore, we aimed to examine the association between ≥30% relative decline in MRI-PDFF and fibrosis regression in non-alcoholic fatty liver disease (NAFLD). DESIGN: This prospective study included 100 well-characterised patients with biopsy-proven NAFLD with paired contemporaneous MRI-PDFF assessment at two time points. MRI-PDFF response was defined as ≥30% relative decline in MRI-PDFF. The primary outcome was ≥1 stage histological fibrosis regression. RESULTS: The median (IQR) age was 54 (43-62) years and body mass index was 31.9 (29-36) kg/m2. In multivariable-adjusted logistic regression analysis (adjusted for age, gender, diabetes status, race/ethnicity, interval between biopsies, gamma-glutamyl transferase, liver stiffness by magnetic resonance elastography and change in platelet counts), MRI-PDFF response was an independent predictor of fibrosis regression with an adjusted OR of 6.46 (95% CI 1.1 to 37.0, p=0.04). The proportion of patients with MRI-PDFF response with fibrosis regression, no change in fibrosis and fibrosis progression was 40.0%, 24.6% and 13.0%, respectively, and the proportion of patients with MRI-PDFF response increased with fibrosis regression (p=0.03). CONCLUSION: ≥30% reduction in MRI-PDFF in early phase trials can provide a useful estimate of odds of ≥1 stage improvement in fibrosis. These data may be helpful in sample size estimation in non-alcoholic steatohepatitis trials.
Subject(s)
Non-alcoholic Fatty Liver Disease , Fibrosis , Humans , Liver/diagnostic imaging , Liver/pathology , Magnetic Resonance Imaging , Middle Aged , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Non-alcoholic Fatty Liver Disease/pathology , Prospective Studies , ProtonsABSTRACT
BACKGROUND & AIMS: Patients with non-alcoholic fatty liver disease (NAFLD) and significant fibrosis (fibrosis stage ≥2) are candidates for pharmacological trials. The aim of this study was to perform a head-to-head comparison of the diagnostic test characteristics of three non-invasive stiffness-based models including MEFIB (magnetic resonance elastography [MRE] plus FIB-4), MAST (magnetic resonance imaging [MRI]-aspartate aminotransferase [AST]), and FAST (FibroScan-AST) for detecting significant fibrosis. METHODS: This prospective study included 563 patients with biopsy-proven NAFLD undergoing contemporaneous MRE, MRI proton density fat fraction (MRI-PDFF) and FibroScan from two prospective cohorts derived from Southern California and Japan. Diagnostic performances of models were evaluated by area under the receiver-operating characteristic curve (AUC). RESULTS: The mean age of the cohort was 56.5 years (51% were women). Significant fibrosis was observed in 51.2%. To detect significant fibrosis, MEFIB outperformed both MAST and FAST (both p <0.001); AUCs for MEFIB, MAST, and FAST were 0.901 (95% CI 0.875-0.928), 0.770 (95% CI 0.730-0.810), and 0.725 (95% CI 0.683-0.767), respectively. Using rule-in criteria, the positive predictive value of MEFIB (95.3%) was significantly higher than that of FAST (83.5%, p = 0.001) and numerically but not statistically greater than that of MAST (90.0%, p = 0.056). Notably, MEFIB's rule-in criteria covered more of the study population than MAST (34.1% vs. 26.6%; p = 0.006). Using rule-out criteria, the negative predictive value of MEFIB (90.1%) was significantly higher than that of either MAST (69.6%) or FAST (71.8%) (both p <0.001). Furthermore, to diagnose "at risk" non-alcoholic steatohepatitis defined as NAFLD activity score ≥4 and fibrosis stage ≥2, MEFIB outperformed both MAST and FAST (both p <0.05); AUCs for MEFIB, MAST, and FAST were 0.768 (95% CI 0.728-0.808), 0.719 (95% CI 0.671-0.766), and 0.687 (95% CI 0.640-0.733), respectively. CONCLUSIONS: MEFIB was better than MAST and FAST for detection of significant fibrosis as well as "at risk" NASH. All three models provide utility for the risk stratification of NAFLD. LAY SUMMARY: Non-alcoholic fatty liver disease (NAFLD) affects over 25% of the general population worldwide and is one of the main causes of chronic liver disease. Because so many individuals have NAFLD, it is not practical to perform liver biopsies to identify those with more severe disease who may require pharmacological interventions. Therefore, accurate non-invasive tests are crucial. Herein, we compared three such tests and found that a test called MEFIB was the best at detecting patients who might require treatment.
Subject(s)
Elasticity Imaging Techniques , Non-alcoholic Fatty Liver Disease , Humans , Female , Middle Aged , Male , Non-alcoholic Fatty Liver Disease/diagnosis , Prospective Studies , Aspartate Aminotransferases , FibrosisABSTRACT
Background MRI-derived proton density fat fraction (PDFF) is an accurate, reliable, and safe biologic marker for use in the noninvasive diagnosis of hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD). Because of the cost and limited availability of MRI, it is necessary to develop an accurate method to diagnose NAFLD with potential point-of-care access. Purpose To compare the diagnostic accuracy of the quantitative US (QUS) fat fraction (FF) estimator with that of the controlled attenuation parameter (CAP) in the diagnosis of NAFLD using contemporaneous MRI-derived PDFF as the reference standard. Materials and Methods Participants with or suspected of having NAFLD were prospectively recruited at the NAFLD Research Center between July 2015 and July 2019. All participants underwent MRI-derived PDFF measurement, transient elastography with CAP measurement, and QUS. QUS FF was derived using computed QUS parameters from the acquired radiofrequency US data using a calibrated reference phantom. The area under the receiver operating characteristic curve (AUC) was calculated to assess the accuracy of QUS FF and CAP in the diagnosis of hepatic steatosis (defined as MRI-derived PDFF ≥ 5%). AUCs were compared using the DeLong test. Results A total of 123 participants were included (mean age, 52 years ± 13 [SD]; 67 [54%] women). Of these participants, 100 (81%) had MRI-derived PDFF of 5% or more. QUS FF had a significantly higher AUC for diagnosis of NAFLD than did CAP (0.92 [95% CI: 0.87, 0.98] vs 0.79 [95% CI: 0.67, 0.90], P = .03). QUS FF had a sensitivity of 98% (98 of 100) and a specificity of 48% (11 of 23). CAP had a sensitivity of 87% (87 of 100) and a specificity of 57% (13 of 23). Conclusion The quantitative US fat fraction estimator is more accurate than the controlled attenuation parameter in the diagnosis of hepatic steatosis in patients with or suspected of having nonalcoholic fatty liver disease. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Ito in this issue.
Subject(s)
Elasticity Imaging Techniques , Non-alcoholic Fatty Liver Disease , Elasticity Imaging Techniques/methods , Female , Humans , Liver/diagnostic imaging , Magnetic Resonance Imaging/methods , Male , Middle Aged , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Prospective Studies , Protons , Reference StandardsABSTRACT
This reflection article shares insight from an immigrant who initially struggled with cultural differences between South Korea and the USA. Through his personal experiences and anecdotes from cross-cultural training, the author describes the importance of cultural competency to effectively communicate and treat diverse patient populations in the USA. Encouraging cultural discussions to recognize obvious and subtle cultural differences may help providers become better advocates for patients.
Subject(s)
Cultural Competency , Emigrants and Immigrants , Humans , Cultural Competency/education , Republic of Korea , United StatesABSTRACT
OBJECTIVE: Patients with non-alcoholic fatty liver disease (NAFLD) with ≥stage 2 fibrosis are at increased risk for liver-related mortality and are candidates for pharmacological therapies for treatment of NAFLD. The aim of this prospective cohort study is to examine the diagnostic accuracy of MR elastography (MRE) combined with fibrosis-4 (FIB-4) in diagnosing ≥stage 2 fibrosis (candidates for pharmacological therapies). DESIGN: This is a cross-sectional analysis of a prospective cohort (University of California at San Diego (UCSD)-NAFLD) including 238 consecutive patients with contemporaneous MRE and biopsy-proven NAFLD. Non-alcoholic steatohepatitis-Clinical Research Network-Histologic Scoring System was used to assess histology. The radiologist and pathologist were blinded to clinical, pathological and imaging data, respectively. Receiver operating characteristics (ROCs) were determined to examine the diagnostic accuracy of MRE and FIB-4 for diagnosis of ≥stage 2 fibrosis in NAFLD. We then validated these findings in an independent validation cohort derived from Yokohama City University in Japan (Japan-NAFLD Cohort; N=222 patients). RESULTS: In the UCSD-NAFLD (training) Cohort, MRE demonstrated a clinically significant diagnostic accuracy for the detection of ≥stage 2 fibrosis with an area under the ROC curve (AUROC) of 0.93 (95% CI 0.90 to 0.97) vs FIB-4 with an AUROC of 0.78 (95% CI 0.71 to 0.85), which was both clinically and statistically significant (p<0.0001). We then combined MRE with FIB-4 (MRE ≥3.3 kPa and FIB-4 ≥1.6) to develop a clinical prediction rule to rule in ≥stage 2 fibrosis patients which had positive predictive value (PPV) of 97.1% (p<0.02) in the UCSD-NAFLD cohort (AUROC of 0.90 (95% CI 0.85 to 0.95)) which remained significant at PPV of 91.0% (p<0.003) in the Japan-NAFLD Cohort (AUROC of 0.84 (95% CI 0.78 to 0.89)). CONCLUSION: MRE combined with FIB-4 (MEFIB) index may be used for non-invasive identification of candidates for (≥stage 2 fibrosis) pharmacological therapy among patients with NAFLD with a high PPV.
Subject(s)
Liver Cirrhosis/diagnostic imaging , Liver Cirrhosis/drug therapy , Magnetic Resonance Imaging/methods , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Non-alcoholic Fatty Liver Disease/drug therapy , Aged , California , Cross-Sectional Studies , Elasticity Imaging Techniques , Female , Humans , Japan , Male , Middle Aged , Predictive Value of Tests , Prospective StudiesABSTRACT
The Nonalcoholic fatty liver disease (NAFLD) Activity Score (NAS) has been applied as a method for evaluating treatment response, and a ≥2-point improvement in NAS has been commonly used as an accepted end point in phase 2b clinical trials in nonalcoholic steatohepatitis.1,2 Although liver fibrosis is the strongest histologic predictor of liver-related outcome and all-cause mortality in NAFLD,3,4 the association between change in NAS and change in fibrosis stage has not been fully verified. Therefore, we aimed to examine the association between change in NAS and change in fibrosis stage in well-characterized patients with NAFLD who had a paired liver biopsy assessment.
Subject(s)
Non-alcoholic Fatty Liver Disease , Biopsy , Fibrosis , Humans , Liver/pathology , Liver Cirrhosis/diagnosis , Liver Cirrhosis/pathology , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/pathology , Severity of Illness IndexABSTRACT
BACKGROUND: Environmental tobacco smoke exposure due to parents is a modifiable risk factor for childhood asthma, but many studies have evaluated parental smoking using self-reported data. Therefore, we aimed to analyze the relationship between parental cotinine-verified smoking status and asthma in their children. METHODS: This population-based cross-sectional study used data from the Korean National Health and Nutrition Examination Survey from 2014 to 2017. Participants aged 0 to 18 years with complete self-reported physician-diagnosed childhood asthma and measurement of their parental urinary cotinine levels were included. Parental urinary cotinine-verified smoking status was defined using both urinary cotinine levels and self-report, as active, passive, and non-smoker. Sample weights were applied to all statistical analyses because of a complex, multistage and clustered survey design. Logistic regression model was used to analyze the relationship between childhood asthma and parental smoking. RESULTS: A total of 5,264 subjects aged < 19 years were included. The prevalence of asthma was 3.4%. The proportions of paternal and maternal urinary cotinine-verified active smokers during the study period were 50.4% and 16.9%, respectively. When parental urinary cotinine level increased, the proportion of parental low household income was increased (P < 0.001). There was no significant association between the parental urinary cotinine-verified smoking group and childhood asthma group. However, the adjusted odds ratios of childhood asthma in the middle and highest tertile of paternal urinary cotinine levels compared with those in lowest tertile were 1.95 (95% confidence interval [CI], 0.98-3.89) and 2.34 (95% CI, 1.21-4.54), respectively. CONCLUSION: There seems to be a dose-related association between paternal urinary cotinine levels and the risk of childhood asthma. Because of the high rate of paternal smoking, further studies are needed to develop a targeted strategy to reduce parental smoking for childhood asthma.
Subject(s)
Asthma/etiology , Cotinine/urine , Environmental Exposure/adverse effects , Parents , Smoking/adverse effects , Tobacco Smoke Pollution/adverse effects , Adult , Alcohol Drinking/epidemiology , Asthma/epidemiology , Asthma/urine , Child , Cross-Sectional Studies , Female , Humans , Incidence , Male , Middle Aged , Nutrition Surveys , Republic of Korea/epidemiology , Risk Factors , Self Report , Smoking/epidemiology , Surveys and QuestionnairesABSTRACT
The clinical presentation of dural arteriovenous fistula (DAVF) can vary. A 47-year-old man complained of transient difficulty playing badminton and speech disturbance for 10 minutes. His symptoms were suspected to be visuomotor coordination deficit similar to optic ataxia and anomic aphasia. Magnetic resonance imaging and angiography revealed vasogenic edema and perfusion delay in the left temporo-occipital area and an abnormal connection between the left occipital artery and transverse sinus. Transverse sinus DAVF was diagnosed by conventional cerebral angiography. We believe that this is the unique case of DAVF manifested as visuomotor coordination deficit suspected optic ataxia and anomic aphasia.
Subject(s)
Central Nervous System Vascular Malformations/diagnosis , Central Nervous System Vascular Malformations/physiopathology , Ischemic Attack, Transient/diagnosis , Psychomotor Performance/physiology , Anomia/etiology , Aphasia/etiology , Central Nervous System Vascular Malformations/complications , Cerebral Angiography , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Middle AgedABSTRACT
Butylated hydroxytoluene (BHT) is recognized as a crucial pollutant in aquatic environments, but efforts to achieve its complete removal are without success. The aim of this study was to investigate the degradation efficiency of BHT in water using ozone microbubbles (OMB), coupled with toxicity change assessment at sub-lethal BHT concentrations (0.34, 0.45 and 0.90 µM) based on oxidative stress biomarkers in Daphnia magna. The efficiency of OMB on ozone gas mass transfer was assessed and the contribution of hydroxyl radicals (·OH) in the degradation of BHT was determined using p-chlorobenzoic acid (pCBA) probe compound and a ·OH radical scavenger (sodium carbonate, Na2CO3). The ozone gas mass transfer coefficient (kLa = 1.02 × 10-2 s-1) was much larger than the ozone self-decomposition rate (kd = 8 × 10-4 s-1) implying little influence of self-decomposing ozone in the volumetric ozone transfer during OMB generation. Generally, OMB improved ozone gas mass transfer (1.3-19-fold) relative to conventional ozone techniques, while indirect reaction of BHT with ·OH was dominant (82%) over the direct reaction with molecular ozone. Addition of 15, 25 and 35 mM Na2CO3 reduced BHT degradation by 30, 50 and 65%, respectively, indicating the significance of ·OH in the degradation of BHT. Increase in initial BHT concentration correspondingly reduced its removal rate by OMB possibly due to increase in metabolites produced during ozonation. Post BHT treatment exposure tests recorded significant (p < 0.05) reductions in oxidative stress (according to enzyme activities changes) in D. magna compared to pretreatment tests, demonstrating the effectiveness of OMB in detoxification of BHT. Overall, the results of the study indicate that OMB is extremely efficient in complete degradation of BHT in water and, consequently, significantly (p < 0.05) reducing its toxicity.
Subject(s)
Ozone , Water Pollutants, Chemical , Antioxidants , Butylated Hydroxytoluene/toxicity , Kinetics , Microbubbles , Water Pollutants, Chemical/toxicityABSTRACT
The effects of increasing temperature owing to thermal discharge and global warming on zooplanktons such as Daphnia magna are a growing concern. The purpose of this study was to evaluate the effects of elevated temperature (25 °C) on oxidative stress responses, growth, and reproduction of D. magna across 10 generations. The number of offspring per female at 21 d was significantly increased and the rate of adult somatic growth (5-21 d) was decreased in the F0 generation at 25 °C compared with those at the reference temperature 20 °C. However, the F3 generation showed the lowest number of offspring and the highest adult somatic growth rate and oxidative stress responses (5 d) at 25 °C. Moreover, all life-history traits seemed to recover to the levels of the control group from the F6 generation at 20 °C. These findings suggest that D. magna under continuous thermal stress exhibits non-adaptive responses in the early generations (F0-F3) and changes to adaptive responses in the later generations (F6-F9). However, the underlying epigenetic mechanism should be identified in the future.
Subject(s)
Aquatic Organisms/growth & development , Daphnia/growth & development , Heat-Shock Response , Oxidative Stress , Animals , Aquatic Organisms/physiology , Daphnia/physiology , Female , Heat-Shock Response/physiology , Models, Theoretical , Oxidative Stress/physiology , Reproduction/physiology , Temperature , Water/chemistryABSTRACT
Bioconcentration of 4-tert-Octylphenol (OP) in freshwater algae Chlorella vulgaris was investigated by considering the effects of algal growth and exudate excretion. The OP uptake in algae was approximately 113 mg kg-1 after 24 h, and the uptake rate constant was estimated as 2.4 × 104 L kg-1 d-1. The OP sorption onto exudates reduced OP bioavailability to C. vulgaris to 11% after 24 h, with a sorption coefficient of 9.7 × 103 L kg-1. The elimination of OP by algae growth (0.80 d-1) was dominant over real elimination (0.60 d-1). The calculated bioconcentration factor of OP in C. vulgaris following uptake and elimination rate constants was 4.0 × 104 L kg-1. Further, bioaccumulation of OP in Daphnia magna was investigated by considering both aqueous and dietary (C. vulgaris) exposures. Uptake and elimination rates of OP via water were 1.6 × 104 L kg-1 d-1 and 0.95 d-1, respectively, while ingestion rate and assimilation efficiency via diet were 0.41 d-1 and 58%, respectively. The OP accumulation in D. magna predominantly occurred via water (63%) relative to diet (37%), resulting in a bioaccumulation factor of 2.7 × 104 L kg-1. The estimated trophic transfer factor was 0.25, suggesting that OP biomagnification was unlikely in the C. vulgaris-D. magna trophic relationship.
Subject(s)
Bioaccumulation , Chlorella vulgaris/metabolism , Daphnia/metabolism , Models, Biological , Phenols/toxicity , Water Pollutants, Chemical/toxicity , Animals , Biological Availability , Chlorella vulgaris/drug effects , Food Chain , Phenols/metabolism , Toxicokinetics , Water Pollutants, Chemical/metabolismABSTRACT
Despite their proven reliability for revealing 'acceptable' degrees of toxicity in waste- and reclaimed waters, bioassays are rarely used to assess the toxicity of hazardous contaminants present in natural waters. In this study, we used organisms from different trophic levels to assess the toxicity of water samples collected from four different South Korean rivers. The main objective was to develop a multi-descriptor index of toxicity for undiluted river water. The responses of six test organisms (Aliivibrio fischeri, Pseudokirchneriella subcapitata, Heterocypris incongruens, Moina macrocopa, Danio rerio and Lemna minor) after laboratory exposure to water samples were considered for this index, as well as the frequency of teratologies in diatom assemblages. Each individual test was attributed a toxicity class and score (three levels; no toxicity = 0, low toxicity = 1, confirmed toxicity = 2) based on the organism's response after exposure and a total score was calculated. The proposed index also considers the number of test organisms that received the highest toxicity score (value = 2). An overall toxicity category was then attributed to the water sample based on those two metrics: A = no toxicity, B = slight toxicity, C = moderate toxicity; D = toxicity and E = high toxicity. The susceptibility of the test organisms varied greatly and the sensitivity of their response also differed among bioassays. The combined responses of organisms from different trophic levels and with different life strategies provided multi-level diagnostic information about the intensity and the nature of contamination.
Subject(s)
Environmental Monitoring , Water Pollutants, Chemical/toxicity , Aliivibrio fischeri , Animals , Araceae , Biological Assay , Fresh Water , Reproducibility of Results , Rivers , Toxicity Tests , Water Pollutants, Chemical/analysisABSTRACT
The present study evaluated the effects of temperature (20 and 25°C) on the oxidative stress responses and life-history traits of Daphnia magna depending on exposure time. Daphnid exposed to an elevated temperature for 21 days had notably higher activities of the antioxidant enzymes superoxide dismutase, catalase, glutathione peroxidase, and glutathione S-transferase while the enzyme activities did not differ significantly between the two temperature groups for daphnid exposed for 5 days. However, the results of body length were opposite where only the 5 days exposure daphnid had significantly longer bodies at 25°C compared to those at 20°C (p < 0.05). Despite the earlier reproduction for daphnids at 25°C, the cumulative number of offspring per female for 21 days was not significantly different from those at 20°C (p < 0.05). These findings suggest that D. magna undergo strategic changes in oxidative stress response, growth, and reproduction throughout the exposure period of 21 days.