We investigated the presence and fate of 16 antibiotics belonging to seven groups (β-lactams, fluoroquinolones, macrolides, sulfonamides, tetracyclines, trimethoprim and amphenicols) in effluents of ...sewage plants and receiving waters in Hong Kong. Cefalexin, amoxicillin, ofloxacin and erythromycin–H
2O were ubiquitous in sea water throughout Victoria Harbour, indicating continuous discharge to the environment. This is one of the few studies reporting the frequent occurrence of cefalexin and amoxicillin in sewage effluents and sea water (170–5070 and 64–1670
ng/L in sewage; 6.1–493 and 0.64–76
ng/L in sea water, respectively). Mass flows from seven sewage plants discharged an estimated total of 14.4
kg/day to the Harbour. Typhoon shelters also appeared to play an important role as sources of antibiotics, as evidenced by elevated concentrations within their boundaries. Mass balance estimations suggested significant quantities of antibiotics are discharged to the Harbour without passage through treatment plants.
Summary
Background : Population‐based data on gastro‐oesophageal reflux disease in Chinese are lacking. The prevalence, clinical spectrum and health care‐seeking behaviour of subjects with ...gastro‐oesophageal reflux disease were studied.
Methods : Ethnic Chinese (3605) were invited to participate in a telephone survey using a validated gastro‐oesophageal reflux disease questionnaire and the Hospital Anxiety and Depression Scale.
Results : A total of 2209 subjects (58% female; mean age, 40.3 years) completed the interview. The annual, monthly and weekly prevalence rates of gastro‐oesophageal reflux disease were 29.8%, 8.9% and 2.5%, respectively. Gastro‐oesophageal reflux disease symptoms were associated with non‐cardiac chest pain odds ratio (OR), 2.3; 95% confidence interval (95% CI), 1.7–3.1, dyspepsia (OR, 1.9; 95% CI, 1.4–2.5), globus (OR, 1.8; 95% CI, 1.2–2.7), acid feeling in the stomach (OR, 5.8; 95% CI, 4.5–7.5) and the use of non‐steroidal anti‐inflammatory drugs (OR, 2.3; 95% CI, 1.5–3.6), but not with dysphagia, bronchitis, asthma, hoarseness and pneumonia. Patients with gastro‐oesophageal reflux disease had a significantly higher anxiety and depression score and required more days off work when compared with subjects without. The frequency of heartburn (P = 0.032), female gender (P < 0.001), degree of depression (P = 0.004) and social morbidity (P < 0.001) were independent factors associated with health care‐seeking behaviour.
Conclusion : The prevalence of gastro‐oesophageal reflux disease was lower than that in Western populations, but carried a significant socio‐economic burden in the studied Chinese population. The frequency of heartburn, female gender and psychosocial factors were associated with health care utilization in gastro‐oesophageal reflux disease.
Neuroretinal rim (NRR) measurement can aid the diagnosis of glaucoma. A few studies reported that Cirrus optical coherence tomography (OCT) had NRR segmentation errors. The current study investigated ...segmentation success of NRR in myopic eyes using the Cirrus built-in software and to determine the number of acquisitions required to identify NRR thinning. Right eye of 87 healthy adult myopes had an optic disc scanned using Cirrus HD-OCT for five successive acquisitions. A masked examiner evaluated 36 radial line images of each scan to screen for segmentation errors using the built-in software at the Bruch's membrane opening (BMO) and/or internal limiting membrane (ILM). Participants with three accurate NRR acquisitions had their average NRR thickness determined. This result was compared with average of the two acquisitions and the first acquisition. Among 435 OCT scans of the optic disc (87 eyes × 5 acquisitions), 129 (29.7%) scans had segmentation errors that occurred mainly at the ILM. The inferior-temporal and superior meridians had slightly more segmentation errors than other meridians, independent of axial length, amount of myopia, or presence of peripapillary atrophy. Sixty-five eyes (74.7%) had at least three accurate NRR measurements. The three acquisitions had high reliability in NRR thickness in the four quadrants (intraclass correlation coefficient > 0.990, coefficient of variation < 3.9%). NRR difference between the first acquisition and the average of three acquisitions was small (mean difference 2 ± 13 μm, 95% limits of agreement within ± 30 μm) among the four quadrants. Segmentation errors in NRR measurements appeared regardless of axial length, amount of myopia, or presence of peripapillary atrophy. Cirrus segmentation lines should be manually inspected when measuring NRR thickness.
Background
Retrospective studies suggested that cerebral microbleeds (MB) on magnetic resonance images (MRI) increase risk of intracerebral haemorrhage (ICH).
Objective
To compare the benefit of ...anti-thrombotic agents in stroke prevention (absolute risk reduction 2.49 –6 %) versus risk of ICH in ischaemic stroke patients with MB.
Materials and methods
We prospectively studied patients admitted consecutively for acute ischaemic stroke between 1999 and 2004. MB on MRI were documented. Primary end points were subsequent ICH, recurrent cerebral infarct (CI) and mortality.
Results
A total of 908 patients were recruited. MB were identified in 252 (27.8 %) patients. Mean follow-up period was 26.6 ± 15.4 months. Risk of subsequent ICH increased significantly with quantity of MB: 0.6 % (no MB), 1.9 % (1 MB), 4.6 % (2–4 MB) and 7.6 % (≥ 5 MB) (p < 0.001). There was also a significant increase in mortality from ICH: 0.6 %, 0.9 %, 1.5 % and 3.8 % respectively (p = 0.054). Rate of recurrent CI was 9.6 %, 5.6 %, 21.5 % and 15.2 % respectively (p = 0.226). Mortality from CI and myocardial infarction did not increased with quantity of MB. Survival analyses showed that age, presence of MB, mixed cortical-subcortical distribution of MB were independent predictors of subsequent ICH.
Conclusion
Risk and mortality of ICH increased with quantity of MB. As tendency to recurrent CI exceed that of ICH, anti-thrombotic agents are still warranted. However, in patients with ≥ 5 MB, the high risk and mortality of ICH seem to outweigh the modest benefit of antithrombotic agents. Extra precautions should be taken to minimize risk of ICH. Further studies in patients on Coumadin and assessment of functional outcome are warranted to support these preliminary findings.
Organic UV filters are common ingredients of personal care products (PCPs), but little is known about their distribution in and potential impacts to the marine environment. This study reports the ...occurrence and risk assessment of twelve widely used organic UV filters in surface water collected in eight cities in four countries (China, the United States, Japan, and Thailand) and the North American Arctic. The number of compounds detected, Hong Kong (12), Tokyo (9), Bangkok (9), New York (8), Los Angeles (8), Arctic (6), Shantou (5) and Chaozhou (5), generally increased with population density. Median concentrations of all detectable UV filters were <250 ng/L. The presence of these compounds in the Arctic is likely due to a combination of inadequate wastewater treatment and long-range oceanic transport. Principal component analysis (PCA) and two-way analysis of variance (ANOVA) were conducted to explore spatiotemporal patterns and difference in organic UV filter levels in Hong Kong. In general, spatial patterns varied with sampling month and all compounds showed higher concentrations in the wet season except benzophenone-4 (BP-4). Probabilistic risk assessment showed that 4-methylbenzylidene camphor (4-MBC) posed greater risk to algae, while benzophenone-3 (BP-3) and ethylhexyl methoxycinnamate (EHMC) were more likely to pose a risk to fishes and also posed high risk of bleaching in hard corals in aquatic recreational areas in Hong Kong. This study is the first to report the occurrence of organic UV filters in the Arctic and provides a wider assessment of their potential negative impacts in the marine environment.
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•The occurrence of 12 organic UV filters in marine surface water was investigated.•They were widespread, with higher concentrations observed in the wet season.•Incomplete WWTP removal and recreational activities are their main sources.•Their occurrence in the Arctic is likely due to oceanic transport.•UV filters could pose high risks to marine organisms at different trophic levels.
Vascular endothelial growth factor (VEGF) has a central role in breast cancer development and progression, but the mechanisms that control its expression are poorly understood. Breast cancer tissue ...microarrays revealed an inverse correlation between the Forkhead transcription factor Forkhead box class O (FOXO)3a and VEGF expression. Using the lapatinib-sensitive breast cancer cell lines BT474 and SKBR3 as model systems, we tested the possibility that VEGF expression is negatively regulated by FOXO3a. Lapatinib treatment of BT474 or SKBR3 cells resulted in nuclear translocation and activation of FOXO3a, followed by a reduction in VEGF expression. Transient transfection and inducible expression experiments showed that FOXO3a represses the proximal VEGF promoter, whereas another Forkhead member, FOXM1, induces VEGF expression. Chromatin immunoprecipitation and oligonucleotide pull-down assays showed that both FOXO3a and FOXM1 bind a consensus Forkhead response element (FHRE) in the VEGF promoter. Upon lapatinib stimulation, activated FOXO3a displaces FOXM1 bound to the FHRE before recruiting histone deacetylase 2 (HDAC2) to the promoter, leading to decreased histones H3 and H4 acetylation, and concomitant transcriptional inhibition of VEGF. These results show that FOXO3a-dependent repression of target genes in breast cancer cells, such as VEGF, involves competitive displacement of DNA-bound FOXM1 and active recruitment of transcriptional repressor complexes.
FOXM1 is implicated in genotoxic drug resistance but its mechanism of action remains elusive. We show here that FOXM1-depletion can sensitize breast cancer cells and mouse embryonic fibroblasts ...(MEFs) into entering epirubicin-induced senescence, with the loss of long-term cell proliferation ability, the accumulation of γH2AX foci, and the induction of senescence-associated β-galactosidase activity and cell morphology. Conversely, reconstitution of FOXM1 in FOXM1-deficient MEFs alleviates the accumulation of senescence-associated γH2AX foci. We also demonstrate that FOXM1 regulates NBS1 at the transcriptional level through an forkhead response element on its promoter. Like FOXM1, NBS1 is overexpressed in the epirubicin-resistant MCF-7Epi(R) cells and its expression level is low but inducible by epirubicin in MCF-7 cells. Consistently, overexpression of FOXM1 augmented and FOXM1 depletion reduced NBS1 expression and epirubicin-induced ataxia-telangiectasia mutated (ATM)phosphorylation in breast cancer cells. Together these findings suggest that FOXM1 increases NBS1 expression and ATM phosphorylation, possibly through increasing the levels of the MRN(MRE11/RAD50/NBS1) complex. Consistent with this idea, the loss of P-ATM induction by epirubicin in the NBS1-deficient NBS1-LBI fibroblasts can be rescued by NBS1 reconstitution. Resembling FOXM1, NBS1 depletion also rendered MCF-7 and MCF-7Epi(R) cells more sensitive to epirubicin-induced cellular senescence. In agreement, the DNA repair-defective and senescence phenotypes in FOXM1-deficent cells can be effectively rescued by overexpression of NBS1. Moreover, overexpression of NBS1 and FOXM1 similarly enhanced and their depletion downregulated homologous recombination (HR) DNA repair activity. Crucially, overexpression of FOXM1 failed to augment HR activity in the background of NBS1 depletion, demonstrating that NBS1 is indispensable for the HR function of FOXM1. The physiological relevance of the regulation of NBS1 expression by FOXM1 is further underscored by the strong and significant correlation between nuclear FOXM1 and total NBS1 expression in breast cancer patient samples, further suggesting that NBS1 as a key FOXM1 target gene involved in DNA damage response, genotoxic drug resistance and DNA damage-induced senescence.
► Tributyltin was not the most toxic antifouling biocides for 12 marine species. ► Irgarol was more toxic than TBT on the growth of autotrophic species. ► Toxicity of copper pyrithione was comparable ...to that of TBT for most test species. ► Copper pyrithione showed a higher toxicity than TBT on fish larvae. ► The toxicity data are useful for ecological risk assessment in tropics/subtropics.
Since 1990s, various booster biocides have been increasingly used as substitutes of organotins. However, knowledge about their toxicities on tropical/sub-tropical marine species is significantly lacking. This study comprehensively investigated the acute toxicities of copper, tributyltin (TBT), and five commonly used booster biocides including Irgarol, diuron, zinc pyrithione (ZnPT), copper pyrithione (CuPT) and chlorothalonil on the growth or survival of 12 marine species in which eight of them are native species of subtropical Hong Kong. We found that Irgarol was more toxic than TBT on the growth of autotrophic species. The toxicity of CuPT was comparable to that of TBT on almost all test species, while it showed higher toxicity than TBT on medaka fish larvae. As the usage of these biocides is expected to further increase worldwide, accurate assessments of their ecological risks are required for better informed decision on their management. This study provided useful datasets for such purposes.
Occurrence, removal, consumption and environmental risks of sixteen antibiotics were investigated in several sewage treatment plants (STPs) featuring different treatment levels in Hong Kong, China. ...Cefalexin, ofloxacin and erythromycin-H2O were predominant with concentrations of 1020–5640, 142–7900 and 243–4740ng/L in influent, respectively; their mass loads were comparable to levels reported in urban regions in China and were at the high end of the range reported for western countries. The target antibiotics behaved differently depending on the treatment level employed at the STPs and relatively higher removal efficiencies (>70%) were observed for cefalexin, cefotaxime, amoxicillin, sulfamethoxazole and chloramphenicol during secondary treatment. ß-lactams were especially susceptible to removal via the activated sludge process while macrolides were recalcitrant (<20%) in the dissolved phase. Two fluoroquinolones, ofloxacin (4%) and norfloxacin (52%), differed greatly in their removal efficiencies, probably because of disparities in their pKa values which resulted in different sorption behaviour in sludge. Overall antibiotic consumption in Hong Kong was back-calculated based on influent mass flows and compared with available prescription and usage data. This model was verified by a good approximation of 82% and 141% to the predicted consumption of total ofloxacin, but a less accurate estimate was obtained for erythromycin usage. Risk assessment indicated that algae are susceptible to the environmental concentrations of amoxicillin as well as the mixture of the nine detected antibiotics in receiving surface waters.
► Sixteen antibiotics quantified in sewage treatment plants in Hong Kong. ► Cefalexin, ofloxacin and erythromycin-H2O were predominant in influent. ► Higher removal efficiencies of some antibiotics after secondary treatment. ► Amoxicillin and a mixture of nine detected antibiotics may pose a risk to algae.
The dairy industry in the developed world has undergone profound changes over recent decades. In this paper, we present an overview of some of the most important recent changes in the dairy industry ...that affect health and welfare of dairy cows, as well as the science associated with these changes. Additionally, knowledge gaps are identified where research is needed to guide the dairy industry through changes that are occurring now or that we expect will occur in the future. The number of farms has decreased considerably, whereas herd size has increased. As a result, an increasing number of dairy farms depend on hired (nonfamily) labor. Regular professional communication and establishment of farm-specific protocols are essential to minimize human errors and ensure consistency of practices. Average milk production per cow has increased, partly because of improvements in nutrition and management but also because of genetic selection for milk production. Adoption of new technologies (e.g., automated calf feeders, cow activity monitors, and automated milking systems) is accelerating. However, utilization of the data and action lists that these systems generate for health and welfare of livestock is still largely unrealized, and more training of dairy farmers, their employees, and their advisors is necessary. Concurrently, to remain competitive and to preserve their social license to operate, farmers are increasingly required to adopt increased standards for food safety and biosecurity, become less reliant on the use of antimicrobials and hormones, and provide assurances regarding animal welfare. Partly because of increasing herd size but also in response to animal welfare regulations in some countries, the proportion of dairy herds housed in tiestalls has decreased considerably. Although in some countries access to pasture is regulated, in countries that traditionally practiced seasonal grazing, fewer farmers let their dairy cows graze in the summer. The proportion of organic dairy farms has increased globally and, given the pressure to decrease the use of antimicrobials and hormones, conventional farms may be able to learn from well-managed organic farms. The possibilities of using milk for disease diagnostics and monitoring are considerable, and dairy herd improvement associations will continue to expand the number of tests offered to diagnose diseases and pregnancy. Genetic and genomic selection for increased resistance to disease offers substantial potential but requires collection of additional phenotypic data. There is every expectation that changes in the dairy industry will be further accentuated and additional novel technologies and different management practices will be adopted in the future.
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