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However, deep-sea snails displayed elevated subcellular partitioning of Cu in the organelles (up to 60%) and may be more susceptible to Cu stress than the mussels. Our results demonstrated the metal-specificity of detoxification strategies in these deep-sea hydrothermal vent mollusks, and the mussels may be more adaptable to high metal exposures than the snails at hydrothermal vent.β-blockers are a class of medications widely used to treat cardiovascular disorders, including abnormal heart rhythms, high blood pressure, and angina pectoris. The prevalence of β-blockers has generated a widespread concern on their potential chronic toxicity on aquatic organisms, highlighting the necessity of comprehensive studies on their environmental distribution, fate, and toxicity. This review summarizes the up-to-date knowledge on the source, global distribution, analytical methods, transformation, and toxicity of β-blockers. read more β-blockers have been detected in various environmental matrices, displaying significant temporal and spatial variations. β-blockers can be reduced by 0-99% at wastewater treatment plants, where secondary processes contribute to the majority of removal. Advanced oxidation processes, e.g., photocatalysis and combined UV/persulfate can transform β-blockers more rapidly and completely than conventional wastewater treatment processes, but the transformation products could be more toxic than the parent compounds. Propranolol, especially its (S)-enantiomer, exhibits the highest toxicity among all β-blockers. Future research towards improved detection methods, more efficient and cost-effective removal techniques, and more accurate toxicity assessment is needed to prioritize β-blockers for environmental monitoring and control worldwide.Vehicular non-exhaust emissions account for a significant share of atmospheric particulate matter (PM) pollution, but few studies have successfully quantified the contribution of non-exhaust emissions via real-world measurements. Here, we conduct a comprehensive study combining tunnel measurements, laboratory dynamometer and resuspension experiments, and chemical mass balance modeling to obtain source profiles, real-world emission factors (EFs), and inventories of vehicular non-exhaust PM emissions in Chinese megacities. The average vehicular PM2.5 and PM10 EFs measured in the four tunnels in four megacities (i.e., Beijing, Tianjin, Zhengzhou, and Qingdao) range from 8.8 to 16.0 mg km-1 veh-1 and from 37.4 to 63.9 mg km-1 veh-1, respectively. A two-step source apportionment is performed with the information of key tracers and localized profiles of each exhaust and non-exhaust source. Results show that the reconstructed PM10 emissions embody 51-64% soil and cement dust, 26-40% tailpipe exhaust, 7-9% tire wear, and 1-3% brake wear, while PM2.5 emissions are mainly composed of 59-80% tailpipe exhaust, 11-31% soil and cement dust, 4-10% tire wear, and 1-5% brake wear. Fleet composition, road gradient, and pavement roughness are essential factors in determining on-road non-exhaust emissions. Based on the EFs and the results of source apportionment, we estimate that the road dust, tire wear, and brake wear emit 8.1, 2.5, and 0.8 Gg year-1 PM2.5 in China, respectively. Our study highlights the importance of non-exhaust emissions in China, which is essential to assess their impacts on air quality, human health, and climate and formulating effective controlling measures.In this article we introduce the idea of Markov resampling for Boosting methods. We first prove that Boosting algorithm with general convex loss function based on uniformly ergodic Markov chain (u.e.M.c.) examples is consistent and establish its fast convergence rate. We apply Boosting algorithm based on Markov resampling to Support Vector Machine (SVM), and introduce two new resampling-based Boosting algorithms SVM-Boosting based on Markov resampling (SVM-BM) and improved SVM-Boosting based on Markov resampling (ISVM-BM). #link# In contrast with SVM-BM, ISVM-BM uses the support vectors to calculate the weights of base classifiers. The numerical studies based on benchmark datasets show that the proposed two resampling-based SVM Boosting algorithms for linear base classifiers have smaller misclassification rates, less total time of sampling and training compared to three classical AdaBoost algorithms Gentle AdaBoost, Real AdaBoost, Modest AdaBoost. In addition, we compare the proposed SVM-BM algorithm with the widely used and efficient gradient Boosting algorithm-XGBoost (eXtreme Gradient Boosting), SVM-AdaBoost and present some useful discussions on the technical parameters.
Enhanced Recovery After Surgery (ERAS) protocols are gaining traction in the field of head and neck surgery following success in other specialties. Various institutions have reported on the feasibility of implementation and early outcomes in their centers. We report our experience of setting up an ERAS program in a high-volume tertiary cancer care center, including the challenges faced and overcome.
With multidisciplinary input, an ERAS protocol was developed consisting of pre-, intra-, and post-operative interventions based on current evidence. We then assessed an initial series of 104 patients on the ERAS protocol and tracked the compliance rates for various interventions.
Compliance rates to interventions including pre-operative medication (84.6%), multimodal analgesia (84.6%95.1%), early removal of urinary catheters (76.0%) and early mobilization (56.7%) show a wide variation. However, response rates in the assessment of patient-reported outcomes are low. We discuss factors surrounding the feasibility of implementing an ERAS protocol and tracking outcomes in a diverse, high volume center.
While there are challenges in implementation, results indicate that a successful ERAS pathway in major head and neck oncologic surgery is feasible. Engaging shareholders and making full use of technology in the form of electronic medical systems are essential to this success.
ERAS pathways should be encouraged in head and neck surgery, given their proven feasibility in a range of institutions. Further study is needed to confirm this program's impact on outcomes.
ERAS pathways should be encouraged in head and neck surgery, given their proven feasibility in a range of institutions. Further study is needed to confirm this program's impact on outcomes.
The current study aims at assessing the effectiveness of the guidelines set up by our clinic for the protection of patients and staff which enabled us to proceed with urgent and oncological surgery after the outbreak of the Covid-19 pandemic.
Our ENT department devised specific equipment to be worn by the staff for personal protection when dealing with Covid-19 patients both in aerosol generating and non-generating procedures. Moreover, restrictive measures were enforced both for the outpatient department and for the ward where only urgent practices were carried out and visitors were not allowed, while non-urgent elective surgery was postponed. link2 A codified scheme was followed to perform tracheostomy procedure in Covid-19 positive testing patients on the part of 3 specific teams of 2 surgeons each, while the resident educational program was reorganized to limit the spread of the infection.
In about a couple of months (from March 8th to May 3rd) a relevant amount of medical tests and surgical procedures were carried out on non COVID-19 patients and a certain number of tracheostomies were performed on COVID-19 patients. Consequently, all the ENT personnel were checked and found negative. Also, all the patients in the ward were swab tested and chest X-rayed, only one had a positive outcome and was adequately handled and treated.
Our ENT guidelines regarding personal protection equipment and multiple simultaneous diagnostic procedures have proved to be an essential instrument for the management of patients with both known and unknown COVID-19 status.
Our ENT guidelines regarding personal protection equipment and multiple simultaneous diagnostic procedures have proved to be an essential instrument for the management of patients with both known and unknown COVID-19 status.
Minimizing pharyngocutaneous fistula after total laryngectomy is a perpetual focus for head and neck surgeons. Multiple intrinsic and extrinsic factors have been implicated in the wound healing process. Activated fibrin glue uniquely promotes healing as a tissue adhesive as well as a biochemical growth factor.
We present a pilot case series of total laryngectomy with simple pharyngeal closure with a single surgeon. Fibrin tissue adhesive was incorporated in all patients along with standardized pre-operative, operative, and post-operative care. Outcomes measured included pharyngocutaneous fistula rate, perioperative complications, and other wound complications as well as long term swallowing function and voice rehab outcomes. We also present a review of the literature for the theoretical basis of using fibrin glue as well as other similar applications.
Fibrin tissue adhesive was successfully used in 18 consecutive patients undergoing total laryngectomy and pharyngoplasty. Despite the presence of a variety of wound healing risk factors including prior radiation and tobacco use, there were no pharyngocutaneous fistulas or other significant wound problems. No locoregional or free tissue overlay flap was done.
Fibrin tissue glue is a readily available, easily applied, and cost-effective adjunct that may reduce pharyngocutaneous fistula.
Fibrin tissue glue is a readily available, easily applied, and cost-effective adjunct that may reduce pharyngocutaneous fistula.
The aim of this study was to evaluate the vestibular functions and dual-task performances of individuals with noise induced hearing loss.
Fifty individuals with noise induced hearing loss and 25 healthy individuals were included in the study. Individuals with noise induced hearing loss were divided into 2 groups according to the pure tone average. link3 Twenty-five patients with bilateral pure tone average between 20dB HL and 40dB HL were included in group I and 25 patients with bilateral pure tone average higher than 40dB HL were included in group II. One-leg standing test, functional reach test, timed-up and go test, head impulse test, head shaking test, spontaneous nystagmus test and caloric test were carried out to evaluate the vestibular systems of all individuals. Visual analog scale was used to evaluate the imbalance intensity of individuals. In order to evaluate the dual-task performances of the individuals, individuals were given cognitive and motor tasks simultaneously with timed up and go test.
Individuals in group II had more abnormal caloric responses than the control group and individuals in group I. Also, individuals with higher hearing loss exhibited worse performance than other groups in eyes-closed one-leg standing test and dual-task situations.
Individuals with higher hearing loss (>40dB) had more abnormal vestibular test results and worse dual-task performance than other groups. Vestibular evaluation and dual-task performance evaluation of factory workers with noise induced hearing loss can provide useful information to determine the risk of falling and fall prevention strategies in these individuals.
40 dB) had more abnormal vestibular test results and worse dual-task performance than other groups. Vestibular evaluation and dual-task performance evaluation of factory workers with noise induced hearing loss can provide useful information to determine the risk of falling and fall prevention strategies in these individuals.
