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Background: This study investigated the effectiveness and safety of pharmacopuncture for pain relief and functional improvement in patients with traffic accident (TA)-induced acute tension headaches. Methods: The study employed a parallel, single-centered, pragmatic, randomized controlled trial design. Eighty patients complaining of acute tension headaches were randomized into the integrative Korean medicine treatment (IKM treatment) group and the pharmacopuncture group on suboccipital muscles (suboccipital muscles pharmacopuncture + IKM treatment), with 40 participants assigned to each group. The patients in the pharmacopuncture group underwent pharmacopuncture as an add-on therapy, consisting of three sessions. Both groups were reassessed 2 months post-intervention. To assess the outcomes, the Numeric Rating Scale (NRS) for Headache, NRS for Neck Pain, Headache Disability Index, Headache Impact Test-6, EuroQol 5-Dimension, and Patient Global Impression of Change were used. Results: The improvement in the outcomes of the pharmacopuncture group was significantly greater than that of the comparison group on day 4 of hospitalization in terms of pain (difference in NRS of headache -2.59, 95% CI -3.06 to -2.12; NRS of Neck pain -1.05, 95% CI -1.50 to -0.59) and function (difference in HDI -24.78, 95% CI, -31.79 to -17.76; HIT-6 -6.13, 95% CI, -9.47 to -2.78). Additionally, in 2 months of follow-up, the recovery rate of headache was significantly higher in the pharmacopuncture group than in the comparison group. Conclusions: The pharmacopuncture group demonstrated superior outcomes in symptom improvement than the comparison group did, providing insights into novel and useful applications of pharmacopuncture in the clinical practice of Korean medicine.

Pesticides are among the main drivers posing risks to aquatic environments, with effluents from wastewater treatment plants (WWTPs) serving as a major source. This study aimed to identify the primary pesticides for which there was a risk of release into aquatic environments through WWTP effluents, thereby enabling more effective contamination management in public water bodies. In this study, monitoring, risk assessment, and risk-based prioritization of 87 pesticides in effluents from three WWTPs in the Yeongsan River Basin, Korea, were conducted. A total of 59 pesticides were detected at concentrations from 0.852 ng/L to 82.044 μg/L and exhibited variable patterns across different WWTP locations. An environmental risk assessment based on the risk quotient (RQ) of individual pesticides identified 13 substances implicated in significant ecotoxicological risks, as they exceeded RQ values of 1 at least once. An optimized risk (RQ f )-based prioritization, considering the frequency of the measured environmental concentration (MEC) exceeding the predicted environmental concentration (PNEC), was conducted to identify pesticides that potentially posed risks and thus should be managed as a priority. Four pesticides had an RQ f value >1; metribuzin exhibited the highest RQ f value of 4.951, followed by 3-phenoxybenzoic acid, atrazin-2-hydroxy, and atrazine. Additionally, five pesticides (terbuthylazine, methabenzthiazuron, diuron, thiacloprid, and fipronil) and another four pesticides (propazine, imidacloprid, hexaconazole, and hexazione) had RQ f values >0.1 and > 0.01, respectively. By calculating the contributions of individual pesticides to the RQ f of these mixtures (RQ f, mix ) based on the concentration addition model, it was determined that >95 % of the sum of RQ f, mix was driven by the top seven pesticides. These findings highlight the importance of prioritizing pesticides for effective management of contamination sources., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sang Don Kim reports financial support was provided by National Research Foundation of Korea. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background and Purpose: This parallel, single-center, pragmatic, randomized controlled study aimed to investigate the effectiveness and safety of motion style acupuncture treatment (MSAT; a combination of acupuncture and Doin therapy) to reduce pain and improve the functional disability of patients with acute low back pain (aLBP) due to road traffic accidents., Materials and Methods: Ninety-six patients with aLBP admitted to the Haeundae Jaseng Hospital of Korean Medicine in South Korea due to traffic accidents were treated with integrative Korean medicine (IKM) with additional 3-day MSAT sessions during hospitalization (MSAT group, 48 patients) or without (control group, 48 patients), and followed up for 90 days., Results: The mean numeric rating scale (NRS) scores of low back pain (LBP) of the MSAT and control groups were both 6.7 (95% confidence interval [CI]: 6.3, 7.1) at baseline. After completing the third round of all applicable treatment sessions (the primary endpoint in this study), the mean NRS scores of the MSAT and control groups were 3.76 (95% CI: 3.54, 3.99) and 5.32 (95% CI: 5.09, 5.55), respectively. The difference in the mean NRS score between the two groups was 1.56 (95% CI: 1.25, 1.87)., Conclusion: IKM treatment combined with MSAT can reduce pain and improve the range of motion of patients with aLBP., Trial Registration: This trial is registered at ClinicalTrial.gov (NCT04956458)., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Context: Rotator cuff tear is one of the most common causes of shoulder pain and has become a prominent disease most frequently treated by surgery., Objectives: To investigate the long-term therapeutic effect of integrative Korean medicine (KM) as a conservative treatment in treating rotator cuff tears., Design: A multicenter observational study., Settings: The settings involve four regional network KM hospitals., Patients: The study participants are 288 patients aged 19-70 with rotator cuff tear identified by radiologist based on magnetic resonance imaging who received integrative KM treatment for the chief complaint of shoulder pain between 1 January 2015 and 31 March 2020., Intervention: None., Main Outcomes: The primary outcome was the pain score in the affected shoulder, measured by the numeric rating scale (NRS). The secondary outcomes were Shoulder Pain and Disability Index (SPADI), 5-Level Quality of life: EuroQol 5-Dimension (EQ-5D-5L), Patient Global Impression of Change (PGIC), and range of motion (ROM) scores., Results: Eligible patients for MCID achievement analysis for minimally clinical important change were 167, and 109 completed the follow-up survey. The mean NRS pain score in the affected shoulder was 5.80 ± 1.27 at admission, 3.50 ± 1.32 at discharge, and 3.83 ± 2.04 at follow-up.The mean SPADI score was 51.48 ± 20.18 at admission, 37.76 ± 19.23 at discharge, and 24.26 ± 21.80 at follow-up. The improvement at discharge (P-value < 0.001) and follow-up (P-value < 0.001) compared to those at admission was statistically significant. The results also presented a significant improvement in ROM for all motions at discharge after treatment (P-value < 0.001). The number of patients who achieved minimal clinically important difference in NRS was 116 (69.5%) at discharge and 71 (65.1%) at follow-up, and in SPADI was 82 (50.9%) at discharge and 77 (70.6%) at follow-up., Conclusion: The results of this study suggested that integrative KM treatment can help improve pain, functional impairment, QoL, and ROM in patients with a rotator cuff tear TRIAL REGISTRATION: NCT04566939., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

The increased consumption of plastics worldwide, has led to the emergence of nanoplastics as important environmental pollutants. Despite the presence of nanoplastics in aquatic environments, their effects on ecosystems remain largely unexplored due to the analysis complexity. This study investigated the organ accumulation and toxic effects of 50 nm polystyrene nanoplastics (PS-NPs) in Zacco platypus (Z. platypus; also known as pale chub fish) using pyrolyzer-gas chromatography-mass spectrometry (Pyr-GC/MS). PS-NPs accumulated in Z. platypus' brain, digestive tract, branchia, and liver, causing changes at cellular level. Over a 14-day exposure, the accumulated PS-NPs led to observable changes in fish behavior (e.g., Total traveled distance and maximum velocity). In addition, the oxidative stress in each organ of Z. platypus increased as the exposure concentration of PS-NPs increased. This study shows that accumulation of nanoplastics in fish, resulting in behavioral changes and biochemical toxicity. As the pattern of change magnifies with exposure time and concentration, from a long-term perspective, the influence of nanoplastics on aquatic ecosystems become evident. This underscores the urgency for continuous research into the potential risks of nanoplastics in aquatic ecosystems., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Sang Don Kim reports financial support was provided by Gwangju Institute of Science and Technology., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Context: Shoulder disorders impair the ability to work. In most cases, the primary symptoms caused by shoulder disorders consist of pain and limitations in the range of motion., Objectives: This study aimed to investigate the efficacy of motion style acupuncture treatment (MSAT), a conservative treatment modality for shoulder disorders., Design: prospective observational study SETTING: A Korean Medicine hospital PATIENTS: Eighty outpatients with shoulder disorders INTERVENTION: Either MSAT with integrative Korean medicine treatment (MSAT group; n = 40) or integrative Korean medicine treatment only (control group; n = 40)., Outcome Measures: The primary outcome was the shoulder range of motion (ROM), and the secondary outcomes were the numeric rating scale (NRS), visual analog scale (VAS), shoulder pain and disability index (SPADI), and 5-level EuroQol 5-dimension (EQ-5D-5L) scores., Results: At the primary endpoint (2 weeks from the start of the treatment), the MSAT group showed statistically significantly larger ROM for all motions, except adduction ROM, compared to the control group [Flexion ROM (165.10±4.14 vs. 150.49±4.06; P<0.001), extension ROM (43.24±1.55 vs. 40.56±1.51; P<0.05), abduction ROM (160.92±5.68 vs. 134.95±5.54; P<0.001), internal rotation ROM (73.38±2.96 vs. 65.00±2.89; P<0.001), and external rotation ROM (73.78±3.61 vs. 65.88±3.50; P<0.01)]. Additionally, the MSAT group showed significantly lower NRS, SPADI scores at week 2 than the control group; this trend was maintained until the 3-month follow-up., (Copyright © 2023. Published by Elsevier Inc.)

A moving bed biofilm reactor (MBBR) process in wastewater treatment plants (WWTPs) uses plastic carriers, called biofilm carrier, to increase their treatment efficiency. Biofilm carrier is made up of plastic, containing the OPEs as flame retardants or plasticizers, so OPEs in biofilm carrier are possible to release from WWTPs to the river. This study investigated the effect of the MBBR process in WWTP on aquatic environments, focusing on OPEs. OPE eluted from the biofilm carrier by leaching test was tris(2-chloroethyl) phosphate (TCEP), and the concentration of the effluent compared to the influent was increased in the WWTP of the MBBR process. 3609 mg/day of TCEP would be discharged into the water using the second-order model with rate constant [Formula: see text] = 0.000451 (ng L -1 ) -1  h -1 , which is the most suitable for the leaching concentration of TCEP. It was identified that TCEP in biofilm carrier was transformed into oxidative dechlorinated compounds and oxidative compounds by microorganisms in the bioreactor. As a result of the study, it was confirmed that not only TCEP but also transformation products of TCEP emitted into the water from the MBBR process of WWTP., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

The occurrence of PPCPs in aquatic environments and their potential adverse effects on aquatic organisms have raised worldwide concerns. To address this issue, a study was conducted to analyze 137 selected PPCPs in Korean surface waters, and an optimized risk-based prioritization was performed. The results revealed that 120 PPCPs were detected, with 98 quantified at concentrations ranging from few ng/L to 42,733 ng/L for metformin. The 95% upper confidence limit (UCL95) of the mean value of the measured environmental concentration (MEC) for Metformin was about eight times higher than the second highest compound, dimethyl phthalate, indicating that antidiabetic groups had the highest concentration among the therapeutic groups. An optimized risk-based prioritization was then assessed based on the multiplication of two indicators, the Frequency of Exceedance and the Extent of Exceedance of Predicted No-Effect Concentrations (PNECs), which can be calculated using the traditional risk quotient (RQ) approach. The study found that clotrimazole had the highest risk quotient value of 17.4, indicating a high risk to aquatic organisms, with seven and 13 compounds showing RQ values above 1 and 0.1, respectively. After considering the frequency of exceedance, clotrimazole still had the highest novel risk quotient (RQ f ) value of 17.4, with 99.6% of its MECs exceeding PNECs. However, the number of compounds with RQ f values above 1 decreased from seven to five, with cetirizine and flubendazole being excluded. Furthermore, only 10 compounds exhibited RQ f values above 0.1. The study also observed significant differences in the results between risk-based and exposure-based prioritization methods, with only five compounds, cetirizine, olmesartan, climbazole, sulfapyridine, and imidacloprid, identified in both methods. This finding highlights the importance of considering multiple methods for prioritizing chemicals, as different approaches may yield different results., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Moina micrura represents a promising model species for ecological and ecotoxicological investigations in tropical freshwater ecosystems. Illumina NovaSeq™ 6000 sequencing was employed in this study to analyze M. micrura across three distinct developmental stages: juvenile, adult, and male. Current study successfully annotated 51,547 unigenes (73.11%) derived from seven (7) different databases. A total of 554 genes were found to be significantly upregulated, while 452 genes showed significant downregulation between juvenile and male. Moreover, 1001 genes were upregulated, whereas 830 genes exhibited downregulation between the adult and male. Analysis of differentially expressed genes revealed upregulation of chitin, cuticle, myosin (MYO), mitogen-activated protein kinases (MAPK), fibrillin (FBN), cytochrome (CYP), glutathione s-transferase (GST), vitellogenin (VTG), acetylcholinesterase (AChE), and transforming growth factor beta (TGFB) under unfavorable environmental conditions (male), as compared to favorable environmental conditions (juveniles and adults). These alterations in gene expression significantly impact the phenological and life-history traits of M. micrura. Furthermore, the upregulation of hemoglobin (HMB), doublesex (DSX), juvenile hormone analogs (JHA), heat shock protein (HSP), and methyltransferase (METT) genes in males initiates the sex-switching effects observed in M. micrura. These findings hold substantial value for researchers interested in determining M. micrura sequences for future investigations of gene expression and comparative reproductive genome analysis within the Moina genus and cladoceran families., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Bisphenol A (BPA) is a well-known endocrine-disrupting compound that causes several toxic effects on human and aquatic organisms. The restriction of BPA in several applications has increased the substituted toxic chemicals such as bisphenol F (BPF) and bisphenol S (BPS). A native tropical freshwater cladoceran, Moina micrura, was used as a bioindicator to assess the adverse effects of bisphenol analogues at molecular, organ, individual and population levels. Bisphenol analogues significantly upregulated the expressions of stress-related genes, which are the haemoglobin and glutathione S-transferase genes, but the sex determination genes such as doublesex and juvenile hormone analogue genes were not significantly different. The results show that bisphenol analogues affect the heart rate and mortality rate of M. micrura. The 48-h lethal concentration (LC 50 ) values based on acute toxicity for BPA, BPF and BPS were 611.6 µg L -1 , 632.0 µg L -1 and 819.1 µg L -1 , respectively. The order of toxicity based on the LC 50 and predictive non-effect concentration values were as follows: BPA > BPF > BPS. Furthermore, the incorporated method combining the responses throughout the organisation levels can comprehensively interpret the toxic effects of bisphenol analogues, thus providing further understanding of the toxicity mechanisms. Moreover, the output of this study produces a comprehensive ecotoxicity assessment, which provides insights for the legislators regarding exposure management and mitigation of bisphenol analogues in riverine ecosystems., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Per- and polyfluoroalkyl substances (PFAS) are gaining worldwide attention because of their toxicity, bioaccumulative and resistance to biological degradation in the environment. PFAS can be categorised into endocrine disrupting chemicals (EDCs) and identified as possible carcinogenic agents for the aquatic ecosystem and humans. Despite this, only a few studies have been conducted on the aquatic toxicity of PFAS, particularly in invertebrate species such as zooplankton. This study evaluated the acute toxicity of two main PFAS, perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS), by using freshwater cladocerans (Moina micrura) as bioindicators. This study aimed to assess the adverse effects at different levels of organisations such as organ (heart size and heart rate), individual (individual size and mortality) and population (lethal concentration, LC 50 ). PFOA was shown to be more hazardous than PFOS, with the LC 50 values (confidence interval) of 474.7 (350.4-644.5) μg L -1 and 549.6 (407.2-743.9) μg L -1 , respectively. As the concentrations of PFOS and PFOA increased, there were declines in individual size and heart rate as compared to the control group. The values of PNECs acquired by using the AF method (PNEC AF ) for PFOA and PFOS were 0.4747 and 0.5496 μg L -1 , respectively. Meanwhile, the PNEC values obtained using the SSD method (PNEC SSD ) were 1077.0 μg L -1 (PFOA) and 172.5 μg L -1 (PFOS). PNEC AF is more protective and conservative compared to PNEC SSD . The findings of this study have significant implications for PFOS and PFOA risk assessment in aquatic environments. Thus, it will aid freshwater sustainability and safeguard the human dependency on water resources., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Chemical accidents have threatened drinking water safety and aquatic systems when hazardous chemicals flow into inland waterbodies through pipelines in industrial complexes. In this study, a forecasting system was developed for the prevention of drinking water resource pollution by considering chemical transport/fate through both pipelines and river channels. To this end, we coupled a pipe network model (Storm Water Management Model) with a calibrated hydrodynamic model (Environmental Fluid Dynamics Code). In addition, we investigated whether chemical transport through pipelines would make a difference in chemical concentration predictions. For both pipelines and river channels, the results showed lower peak concentrations than those without pipelines, whereas the time of peak concentration did not change significantly. When chemicals were transported with both pipelines and river channels, the peak concentrations were 25.81% and 41.91% lower than those of chemicals carried directly into the Han and Geum Rivers without the pipeline transport. Further, our system is automated from scenario generation to analysis and usage is straightforward, with a simple input of accident information. The results of this study can be utilized to establish a safe water supply system and preliminary countermeasures against accidental water pollution in the future., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The usage of cladocerans as non-model organisms in ecotoxicological and risk assessment studies has intensified in recent years due to their ecological importance in aquatic ecosystems. The molecular assessment such as gene expression analysis has been introduced in ecotoxicological and risk assessment to link the expression of specific genes to a biological process in the cladocerans. The validity and accuracy of gene expression analysis depends on the quantity, quality and integrity of extracted ribonucleic acid (RNA) of the sample. However, the standard methods of RNA extraction from the cladocerans are still lacking. This study evaluates the extraction of RNA from tropical freshwater cladocerans Moina micrura using two methods: the phenol-chloroform extraction method (QIAzol) and a column-based kit (Qiagen Micro Kit). Glycogen was introduced in both approaches to enhance the recovery of extracted RNA and the extracted RNA was characterised using spectrophotometric analysis (NanoDrop), capillary electrophoresis (Bioanalyzer). Then, the extracted RNA was analysed with reverse transcription polymerase chain reaction (RT-PCR) to validate the RNA extraction method towards downstream gene expression analysis. The results indicate that the column-based kit is most suitable for the extraction of RNA from M. micrura, with the quantity (RNA concentration = 26.90 ± 6.89 ng/μl), quality (A260:230 = 1.95 ± 0.15, A280:230 = 1.85 ± 0.09) and integrity (RNA integrity number, RIN = 7.20 ± 0.16). The RT-PCR analysis shows that the method successfully amplified both alpha tubulin and actin gene at 33-35 cycles (i.e. Ct = 32.64 to 33.48). The results demonstrate that the addition of glycogen is only suitable for the phenol-chloroform extraction method. RNA extraction with high and comprehensive quality control assessment will increase the accuracy and reliability of downstream gene expression, thus providing more ecotoxicological data at the molecular biological level on other freshwater zooplankton species., Competing Interests: The authors have declared that no competing interests exist.

Purpose: Cervical myelopathy (CM) is generally considered an indication for surgery in Western medicine. Case reports have indicated that Korean medicine (KM) treatments are effective in improving CM-associated symptoms. We investigated the effectiveness of non-surgical KM treatment of CM patients through a retrospective chart review and follow-up survey., Patients and Methods: We retrospectively analyzed the medical records and surveyed follow-up data of CM patients with neurological symptoms admitted to KM hospitals between January 2011 and January 2018. The admission and discharge assessments included the numeric rating scale (NRS) for neck and arm pain, neck disability index (NDI), and 5-level EuroQol 5-dimension (EQ-5D-5L). A follow-up survey was conducted about whether surgery was subsequently performed or recommended, symptom recurrence, discomfort in daily living, current treatment, as well as NRS, NDI, EQ-5D-5L, and patient global impression of change (PGIC) scores., Results: The NRS for neck pain decreased from 4.88 ± 2.03 (95% CI: 4.23‒5.52) at admission to 3.23 ± 1.64 (95% CI: 2.70‒3.75) at discharge and 2.24 ± 1.84 (95% CI: 1.43‒3.05) at follow-up. The NRS for radiating arm pain decreased from 5.42 ± 1.55 (95% CI: 4.93‒5.92) to 3.77 ± 1.54 (95% CI: 3.28‒4.27) at discharge and 2.43 ± 1.60 (95% CI: 1.72‒3.13) at follow-up. The NDI decreased significantly from 36.24 ± 18.79 (95% CI: 30.24‒42.24) at admission to 30.89 ± 15.54 (95% CI: 25.93‒35.86) at discharge and 13.35 ± 11.95 (95% CI: 8.08‒18.63) at follow-up. The EQ-5D score improved significantly from 0.70 ± 0.21 (95% CI: 0.63‒0.77) to 0.78 ± 0.17 (95% CI: 0.73‒0.84) at discharge and 0.84 ± 0.08 (95% CI: 0.80‒0.88) at follow-up. At the follow-up, four patients experienced persistent pain and were undergoing treatment (19.1%), while 20 patients (95.8%) reported symptom improvement., Conclusion: From a long-term perspective, integrative KM treatment may help to reduce pain and improve function, and improve quality of life of CM patients., Competing Interests: The authors declare no conflicts of interest for this work., (© 2022 Cho et al.)

Organophosphate esters (OPEs) are flame retardant and plasticizer chemicals added to electronics, furniture, textiles, and other building materials and consumer products. In this study, fillets of fish often caught by anglers in the North American Great Lakes, Lake Trout (Salvelinus namaycush) across four Great Lakes and nearshore fish species near the large urban and industrial centers of Toronto and Hamilton, Canada, were analyzed for 22 OPEs. A rapid microextraction of homogenized tissues with methanol dramatically reduced preparation and sample handling time while achieving recoveries of 69-141%, and the optimized liquid chromatographic separation improved isomeric separations, including aryl-OPEs. Twelve of the 22 OPEs were detected, with frequencies of detection ranging from 8.3% to 98%, and five compounds were detected in >50% of the fish. The average ± standard deviation for the sum of 12 OPEs (ΣOPE 12 ) ranged from 9.6 ± 0.9 (L. Erie 2017) to 74 ± 44 (L. Superior 2001) ng/g wet weight in Lake Trout, and 12 ± 2.7 to 35 ± 30 ng/g wet weight in nearshore fish species from the Toronto and Hamilton areas. The aryl-OPEs were dominant in Lake Trout, comprising 32-77% of total ΣOPE 12 concentrations. In nearshore fish, the OPE patterns reflected the relative degree of exposure to run-off and wastewater inputs in the sampled receiving environments. The intake of OPEs via human consumption of Great Lakes Lake Trout and nearshore fish was estimated to range 6.5-31 ng/kg body weight/day, which is approximately 1-2 orders of magnitude lower than exposures via indoor air and ingestion/inhalation of dusts, and 3 orders of magnitude lower than estimated reference doses. The inclusion of additional OPE analytes enabled patterns of exposure and accumulation to be distinguished in fish of different species and location, and were related to source and food web influences., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: This two-arm, parallel, pragmatic, multicenter, clinical randomized, controlled trial with a 12-week follow-up period aimed to compare the effectiveness of pharmacopuncture therapy and physical therapy strategies for chronic neck pain., Methods: Eight sessions of pharmacopuncture therapy or physical therapy were administered within 2 weeks. The primary outcome was the visual analogue scale (VAS) score for neck pain. The secondary outcomes were the scores of the Northwick Park questionnaire (NPQ), VAS score for radiating arm pain, numeric rating scale (NRS) for neck and arm bothersomeness, neck disability index (NDI), patient global impression of change (PGIC), 12-item short form health survey (SF-12), and EuroQoL 5-dimension 5-level (EQ-5D-5L) instrument. The protocol was registered with Clinicaltrials.gov (NCT04035018) and CRIS (KCT0004243)., Results: We randomly allocated 101 participants with chronic neck pain to the pharmacopuncture therapy ( n = 50) or physical therapy group ( n = 51). At the primary endpoint (week 5) the pharmacopuncture therapy group showed significantly superior effects regarding VAS score for neck pain and arm bothersomeness, NRS for neck pain, NDI, NPQ, and PGIC compared with the physical therapy group. These effects were sustained up to 12 weeks after follow-up., Conclusion: Compared with physical therapy, pharmacopuncture therapy had superior effects on the pain and functional recovery of patients with chronic neck pain.

Organic pollutants that are introduced into the aquatic ecosystem can transform by various mechanisms. Biotransformation is an important process for predicting the remaining structures of pollutants in the ecosystem, and their toxicity. This study focused on triphenyl phosphate (TPHP), which is a commonly used organophosphate flame retardant and plasticizer. Since TPHP is particularly toxic to aquatic organisms, it is essential to understand its biotransformation in the aquatic environment. In the aquatic ecosystem, based on consideration of the producer-consumer-decomposer relationship, the biotransformation products of TPHP were identified, and their toxicity was predicted. Liquid chromatography-high resolution mass spectrometry was used for target, suspect, and non-target analysis. The obtained biotransformation products were estimated for toxicity based on the prediction model. As a result, 29 kinds of TPHP biotransformation products were identified in the aquatic ecosystem. Diphenyl phosphate was detected as a common biotransformation product through a hydrolysis reaction. In addition, products were identified by the biotransformation mechanisms of green algae, daphnid, fish, and microorganism. Most of the biotransformation products were observed to be less toxic than the parent compound due to detoxification except some products (hydroquinone, beta-lyase products, palmitoyl/stearyl conjugated products). Since various species exist in a close relationship with each other in an ecosystem, an integrated approach for not only single species but also various connected species is essential., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Organophosphate flame retardants (OPFRs) are substances added to plastics, textiles, and furniture, and are used as alternatives to brominated flame retardants. As the use of OPFRs increases in the manufacturing industry, the concentration in the aquatic environment is also increasing. In this study, OPFRs introduced into a wastewater treatment plant (WWTP) were identified, and the toxicity of biotransformation molecules generated by the biological reaction was predicted. Tris (2-butoxyethyl) phosphate, tris (2-butoxyethyl) phosphate, and triphenyl phosphate were selected as research analytes. Chemicals were analyzed using high-resolution mass spectrometry, and toxicity was predicted according to the structure. As a result, tris (1-chloro-2-propyl) phosphate showed the highest concentration, and the removal rate of OPFRs in the WWTP was 0-57%. A total of 15 biotransformation products were produced by microorganisms in the WWTP. Most of the biotransformation products were predicted to be less toxic than the parent compound, but some were highly toxic. These biotransformation products, as well as OPFRs, could flow into the water from the WWTP and affect the aquatic ecosystem.

Introduction: this study aimed to investigate the long-term clinical efficacy and satisfaction degree of integrative Korean medicine (KM) treatment for patients with failed back surgery syndrome (FBSS)., Methods: we performed a follow-up questionnaire survey and retrospective analysis of medical records for patients with FBSS who underwent inpatient treatment for ≥ 1 week. The primary evaluation indices were numeric rating scale (NRS) scores for low back pain (LBP) and leg pain at admission and discharge. Sub-evaluation indices included the Oswestry Disability Index (ODI) and EuroQol 5-dimension (EQ-5D) score. The follow-up questionnaire survey obtained information regarding previous surgeries; reasons for satisfaction/dissatisfaction with surgical and KM treatment; and current status., Results: compared with at admission, there was a significant post-treatment decrease in the NRS scores for LBP and leg pain, as well as the ODI score. Further, there was a significant post-treatment increase in the EQ-5D score. Regarding the patients' global impression of change for KM treatment administered during admission and at the follow-up questionnaire survey, 101 (95.3%) patients selected "minimally improved" or better., Conclusion: integrative KM treatment could effectively reduce pain, as well as improve function and health-related quality of life, in patients with FBSS.

In this study, an ecological impact was assessed for the short-term leak scenario through the AQUATOX-EFDC model, which combines the proven ecological model AQUATOX with the hydrodynamic model EFDC. A case study of the coupled AQUATOX-EFDC model was conducted for 30-30,000 kg toluene leak scenarios in the Jeonju River in South Korea. A 21-day scenario simulation was conducted, and the impact of the toluene spill accident was evaluated by comparing the biomass between the control simulation and the perturbed simulation. As a result of the simulation, it was found that in the scenario in which 3000 kg of toluene was leaked for a day, a substantial change was expected in the range of 0-640 m from the accident site. Additionally, for a 30,000 kg leak, a substantial change was expected in the range of 0-2300 m from the accident site, and the greatest damage was observed for the fish species group, the top predators. As a result, the AQUATOX-EFDC simulation showed a significant ecological impact, and the proposed model will be helpful to understand the ecological impact and establish the management strategy for the ecological risk of the chemical spill.

A large quantity of volatile organic compounds (VOCs) can be released into water environments from oil spills and chemical exposure accidents. A recently developed solid ceramic dosimeter (SCD) could be used for long-term measuring of low VOCs concentrations in water. However, calibration and field testing of these SCDs have thus been far insufficient to apply for VOCs monitoring in a water environment in a chemical industrial area. We conducted laboratory calibration experiments and stability tests of the SCD. The mass accumulation of 14 target VOCs from 2 to 100 μg/L was increased linearly with time in the sampler. The absorption rate of the VOCs was related to Henry's law constant. The average diffusion coefficient of the 14 VOCs in the SCD wall was 1.02 × 10 -9 m 2 /s. The SCD was utilized in a petrochemical plant complex in South Korea with an industrial wastewater reservoir. After a total of 7 days of deployment, chloroform, ethylbenzene, and toluene were detected by both passive sampling and grab sampling at the same VOC concentrations.

Fine dust (PM2.5) is generated from various sources, and many studies have reported on the sources of PM2.5. However, the current research on PM2.5 toxicity based on its sources is insufficient. In this study, we developed a framework for the prioritization of fine dust (PM2.5) sources on the basis of the multi-endpoint toxicities using the multi-criteria decision-making method (MCDM). To obtain the multi-endpoint toxicities of PM2.5 sources, cell mortality, reactive oxygen species (ROS), inflammation and mutagenicity were measured for diesel exhaust particles (DEP), gasoline exhaust particles (GEP), rice straw burning particles (RBP), coal combustion particles (CCP) and tunnel dust particles (TDP). The integrative toxicity score (ITS) of the PM2.5 source was calculated using MCDM, which consist of four steps: (1) defining the decision-making matrix, (2) normalization and weighting, (3) calculating the ITS (linear aggregation) and (4) a global sensitivity analysis. The indicator of cell mortality had the highest weight (0.3780) followed by inflammation (0.2471), ROS (0.2178) and mutagenicity (0.1571). Additionally, the ITS based on the sources contributing to PM2.5 resulted in the following order: DEP (0.89), GEP (0.44), RBP (0.40), CCP (0.23) and TDP (0.06). The relative toxicity index (RTI), which represents the ratio of toxicity due to the difference in sources, increases as the contribution of the highly toxic sources increases. The RTI over 1 is closely associated with an increased contribution from highly toxic sources, such as diesel exhaust, gasoline exhaust and biomass burning. It is necessary to investigate the toxicity of various PM2.5 sources and PM2.5 risk based on the sources.

Triphenyl phosphate (TPHP), one of the organophosphate flame retardants, has been widely used in manufacturing, thereby causing a gradual increase in TPHP concentrations in aquatic environments. However, the information on the biotransformation mechanism of TPHP in invertebrates is lacking. The study identified the biotransformation products of TPHP in Daphnia magna, which showed particularly high toxicity in aquatic organisms, and determined the rates of depuration. Daphnia magna, a standard species for toxicity studies, was exposed to triphenyl phosphate and transferred to the pure medium. The biotransformation products of TPHP and its depuration rates were determined by liquid chromatography-high resolution mass spectrometry. Nine biotransformation products (five in the positive mode and four in the negative mode) of triphenyl phosphate were identified in D. magna. Based on the depuration ratio, the major biotransformation mechanism is estimated to be cysteine conjugation and sulfation. Certain biotransformation products (diphenyl phosphate, hydroxylated triphenyl phosphate, and thiol triphenyl phosphate) might induce toxicity in biota. The results could be used to predict main biotransformation processes and toxic products of organophosphate flame retardants in aquatic invertebrates., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Increasing evidence suggests that the toxicity of fine dust particles (PM 2.5 ) is linked to specific components rather than their mass. However, research on the chemical composition and health risk of PM 2.5 is insufficient. This study analyzed the metals, polycyclic aromatic hydrocarbon (PAHs), organochlorine pesticides (OCPs), and polychlorinated biphenyls (PCBs) present in PM 2.5 and evaluated their risk to health during outdoor activities. The concentration of metals was one order of magnitude higher than that of PAHs and the concentration and detection frequency of OCPs and PCBs were considerably lower than those of metals and PAHs. The lifetime excess cancer risk (LECR) for carcinogens in PM 2.5 exceeded de minimis risk (1 × 10 -6 ) as 1.33-3.44 × 10 -6 (at 5th-95th percentile) as Cr(VI), As, and Cd showed high contributions. Children in the 2 < years <18 age group had a high risk of cancer due to early-life susceptibility. The proportion of ∑Metals to LECR was approximately 95%, while ∑PAHs attributed to 5% of total LECR. The effects of ∑OCPs and 2,3',4,4',5'-Pentachlorobiphenyl (PCB-123) on LECR were negligible. The hazard quotient (HQ) for non-carcinogens was <1, and non-carcinogenic effects were not expected. Mn, BaP, Pb, As, and Cd were the key determinants of the HQ values and among the identified PM 2.5 sources they are closely related to industrial activities, oil combustion, and gasoline exhaust. Therefore, control strategies for these sources can effectively reduce PM 2.5 risk. This study measured the concentrations of toxic compounds in ambient PM 2.5 and considered only PM 2.5 exposure during outdoor activities. PM 2.5 health risk during the entire day would be higher than the PM 2.5 risk determined in this study, and further research is required for this evaluating this risk., (Copyright © 2019 Elsevier B.V. All rights reserved.)

In this study, we investigated cadmium toxicity created by adsorption kinetics in several mixtures containing two types of multi-walled carbon nanotubes (COOH-MWCNT and NH 2 -MWCNT) and natural kaolinite. Characteristics of two types of MWCNTs were measured by zeta potential and ATR FT-IR graphs and TEM images. The solution of CNTs and kaolinite was tested to study Cd adsorption kinetics and mechanisms of differentiation-associated toxicity using Daphnia magna in a binary system (Cd-MWCNTs and Cd-kaolinite) and a ternary system (Cd-MWCNTs-kaolinite). In the binary system, Cd removal efficiency was nearly 100% and 40% for MWCNTs and kaolinite because of surface charge, respectively, with increasing sorbent concentration. In the ternary system, the trend of adsorption rate was similar to that of binary system. In comparison with percent mortality in the binary system, the solution in the ternary system showed higher toxicity due to the interaction of MWCNTs-kaolinite coagulated particles, thereby decreasing Cd adsorption onto CNTs and kaolinites. Overall, kaolinite can affect the adsorption process of Cd on MWCNTs in negative ways, depending on adsorption state. In conclusion, our studies suggest that kaolinite differs with adsorption ability of Cd by MWCNTs, and toxicity is likely to be produced by multivariable regression in the adsorption state.

Studies investigating toxic organic pollutants in fine dust (PM2.5), such as polycyclic aromatic hydrocarbons (PAHs), organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs), are insufficient, despite the pollutants' potent toxicity. The objective of this study is to develop an analytical method for determining PAHs, OCPs and PCBs in ambient PM2.5 using selective pressurized liquid extraction (SPLE). To maximize the extraction efficiency of target analytes, the extraction parameters of SPLE, particularly solvent type, temperature, static time, and cycle number, were optimized. The highest recoveries were observed under the conditions of dichloromethane:acetone (9:1), 100℃, 5 min of static time, and 1 cycle extraction, which is selected as the optimal method of SPLE. In the method validation, the results showed that the suggested method can quantify 17 PAHs, 20 OCPs, and 63 PCBs in PM2.5. Using urban dust SRM (1648a) and ambient PM2.5 samples, the applicability of the method was also confirmed. Total concentration of PAHs was the highest (2639.42-7377.75 pg/m 3 ) followed by OCPs (80.57-674.69 pg/m 3 ) and PCBs (1.39-9.34 pg/m 3 ). Most of the PAHs were detected, whereas 2-7 compounds among 20 OCPs and 2-6 compounds among 63 PCBs were determined. The developed analytical method is highly efficient in terms of process (a one-step extraction process), time (15 min extraction time per one sample) and solvent usage (less than 30 mL per one sample), showing good performance. This method can be applied to investigate the organic toxicants in PM2.5, and it can contribute to monitoring and risk assessment, leading to an effective risk management policy for PM2.5 in Korea., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Although particulate matter (PM) is composed of various chemicals, investigations regarding the toxicity that results from mixing the substances in PM are insufficient. In this study, the effects of low levels of three PAHs (benz[a]anthracene, benzo[a]pyrene, and dibenz[a,h]anthracene) on Ni toxicity were investigated to assess the combined effect of Ni-PAHs on the environment. We compared the difference in cell mortality and total glutathione (tGSH) reduction between single Ni and Ni-PAHs co-exposure using A549 (human alveolar carcinoma). In addition, we measured the change in Ni solubility in chloroform that was triggered by PAHs to confirm the existence of cation-π interactions between Ni and PAHs. In the single Ni exposure, the dose-response curve of cell mortality and tGSH reduction were very similar, indicating that cell death was mediated by the oxidative stress. However, 10 μM PAHs induced a depleted tGSH reduction compared to single Ni without a change in cell mortality. The solubility of Ni in chloroform was greatly enhanced by the addition of benz[a]anthracene, which demonstrates the cation-π interactions between Ni and PAHs. Ni-PAH complexes can change the toxicity mechanisms of Ni from oxidative stress to others due to the reduction of Ni 2+ bioavailability and the accumulation of Ni-PAH complexes on cell membranes. The abundant PAHs contained in PM have strong potential to interact with metals, which can affect the toxicity of the metal. Therefore, the mixture toxicity and interactions between diverse metals and PAHs in PM should be investigated in the future.

Fine particulate matters less than 2.5 µm (PM 2.5 ) in the ambient atmosphere are strongly associated with adverse health effects. However, it is unlikely that all fine particles are equally toxic in view of their different sizes and chemical components. Toxicity of fine particles produced from various combustion sources (diesel engine, gasoline engine, biomass burning (rice straw and pine stem burning), and coal combustion) and non-combustion sources (road dust including sea spray aerosols, ammonium sulfate, ammonium nitrate, and secondary organic aerosols (SOA)), which are known major sources of PM 2.5 , was determined. Multiple biological and chemical endpoints were integrated for various source-specific aerosols to derive toxicity scores for particles originating from different sources. The highest toxicity score was obtained for diesel engine exhaust particles, followed by gasoline engine exhaust particles, biomass burning particles, coal combustion particles, and road dust, suggesting that traffic plays the most critical role in enhancing the toxic effects of fine particles. The toxicity ranking of fine particles produced from various sources can be used to better understand the adverse health effects caused by different fine particle types in the ambient atmosphere, and to provide practical management of fine particles beyond what can be achieved only using PM mass which is the current regulation standard.

Propranolol (PRO), a human β-AR (β-adrenergic receptor) antagonist, is considered to result in specific effects in a non-target species, D. magna, based on our previous studies. The present study investigated the effects of β-AR agents, including an antagonist and agonist using pharmacologically relevant endpoints as well as a more holistic gene expression approach to reveal the impacts and potential mode of actions (MOAs) in the model non-target species. Results show that the responses in cardiac endpoints and gene expression in D. magna are partially similar but distinguishable from the observations in different organisms. No effect was observed on heart size growth in PRO and isoprenaline (ISO) exposure. The contraction capacity of the heart was decreased in ISO exposure, and the heart rate was decreased in PRO exposure. Time-series exposures showed different magnitudes of effect on heart rate and gene expression dependent on the type of chemical exposure. Significant enrichment of gene families involved in protein metabolism and biotransformation was observed within the differentially expressed genes, and we also observed differential expression in juvenile hormone-inducible proteins in ISO and PRO exposure, which is suspected of having endocrine disruption potential. Taken together, deviation between the effects of PRO and ISO in D. magna and other organisms suggests dissimilarity in MOAs or attributes of target bio-molecules between species. Additionally, PRO and ISO may act as endocrine disruptors based on the gene expression observation. Results in the present study confirm that it is challenging to predict ecological impact of active pharmaceutical ingredients (APIs) based on the available data acquired through human-focused studies. Furthermore, the present study provided unique data and a case study on the impact of APIs in a non-target organism., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Perfluorooctane sulfonate (PFOS) has been found in wastewater treatment plants (WWTPs) and in surface water as a result of domestic uses of textiles, electronics, and surfactants. The detection of PFOS in the aqueous environment has been linked to hazardous biological effects including estrogenicity and genotoxicity. To provide an alternative to conventional processes, one of the radical-based advanced oxidation and reduction processes being tested for treatment of refractory compounds in water, involves the use of an electron beam. Therefore, the aims of this study were to investigate the degradation efficiency of PFOS (100mg/L) by electron beam, to evaluate the predicted toxicity of the radiolysis products using the ECOSAR model, and to identify the radiolytic products of PFOS. As a result of using the ECOSAR model, the toxicity levels of by-products after electron beam treatment were reduced by decreasing the carbon-chain number of PFOS. The molecular structures of the radiolytic products were elucidated using authentic standards via liquid chromatography and tandem mass spectrometry, and by the interpretation of MS 2 fragmentation patterns of each product using liquid chromatography with quadrupole time of-flight mass spectrometry (LC-QTOF-MS). In total, ten radiolytic products were confirmed by LC-MS/MS, HPLC, and IC data matching with commercial standards. The two radiolytic substances produced during irradiation with an electron beam were predicted by LC-QTOF-MS. This study led to an understanding of the role of electron beams in the transformation of parent compounds and to the decomposition products created when an electron beam is applied to treat perfluorinated compounds., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The objective of this study was to determine whether the water effect ratio (WER) or biotic ligand model (BLM) could be applied to efficiently develop water quality criteria (WQC) in Korea. Samples were collected from 12 specific sites along the Yeongsan River (YSR), Korea, including two sewage treatment plants and one estuary lake. A copper toxicity test using Daphnia magna was performed to determine the WER and to compare to the BLM prediction. The results of the WER from YSR samples also indicated significantly different copper toxicities in all sites. The model-based predictions showed that effluent and estuary waters had significantly different properties in regard to their ability to be used to investigate water characteristics and copper toxicity. It was supposed that the slight water characteristics changes, such as pH, DOC, hardness, conductivity, among others, influence copper toxicity, and these variable effects on copper toxicity interacted with the water composition. The 38% prediction was outside of the validation range by a factor of two in all sites, showing a poor predictive ability, especially in STPs and streams adjacent to the estuary, while the measured toxicity was more stable. The samples that ranged from pH 7.3-7.7 generated stable predictions, while other samples, including those with lower and the higher pH values, led to more unstable predictions. The results also showed that the toxicity of Cu in sample waters to D. magna was closely proportional to the amounts of acidity, including the carboxylic and phenolic groups, as well as the DOC concentrations. Consequently, the acceptable prediction of metal toxicity in various water samples needs the site-specific results considering the water characteristics such as pH and DOC properties particularly in STPs and estuary regions., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Factors affecting the sorptive removal of nitro explosives (2,4,6-trinitrotoluene [TNT] and hexahydro-1,3,5-trinitro-1,3,5-triazine [RDX]) to polymer/biomass-derived biochar were investigated through batch experiments. Compared with that of rice ( L.) straw (RS)-derived biochar, the sorption of TNT and RDX to polymer/RS-derived biochar was greatly enhanced by >2.5 and 4 times, respectively. The type and amount of polymer did not significantly affect the sorption of nitro explosives to polymer/RS-derived biochar. Pyrolysis temperature did not affect the sorption capacity. Surface treatment with acid or an oxidant did not significantly change the sorption capacity, suggesting that polymer residues may be strongly responsible for the enhancement. Possible polymer residues were identified via gas chromatography mass spectrometry analysis. The toxicity characteristic leaching procedure and Microtox bioassay analyses indicated that polymer/RS-derived biochar did not show possible harmful effects. Our results suggest that polymer/RS-derived biochar can be effectively used as a sorbent to remove nitro explosives both in the natural environment and engineered systems., (Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.)

Corn and rice husks, agro-wastes available in large quantities in Tanzania, were used to remove Pb 2+ from aqueous solution. Husks were used in raw form, pyrolyzed form, and chemically modified form. Material characterization was carried out using the BET method, FTIR spectroscopy, SEM, pH PZC , and cation exchange capacity analysis. Langmuir, Freundlich, Dubinin-Radushkevich (D-R), and Temkin isotherms were used to elucidate Pb 2+ sorption mechanisms. The surface area and cation exchange capacity (CEC) of untreated and chemically treated biochars were significantly higher than that of raw husks. Sorption data for Pb 2+ for all biosorbents fit the Freundlich and D-R models well with high R 2 values. Most of the synthesized biosorbents in this study indicated >90% for Pb 2+ removal, with the ZnCl 2 -treated corn husk biochar sorption capacities ranking highest in all modeling results. Surface morphological features (e.g., micropores and fissures) and acidic and unsaturated functional groups may have significantly contributed to the observed Pb 2+ removal efficiencies., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Studies are underway to gather information about the mode of action (MOA) of emerging pollutants that could guide practical environmental decision making. Previously, we showed that propranolol, an active pharmaceutical ingredient, had adverse effects on Daphnia magna that were similar to its pharmaceutical action. In order to characterize the mode of action of propranolol in D. magna, which is suspected to be organ-specific pharmaceutical action or baseline toxicity, we performed time-series monitoring of behavior along with heart rate measurements and nuclear magnetic resonance (NMR) based metabolite profiling. Principle component analysis (PCA) and hierarchical clustering were used to categorize the mode of action of propranolol among 5 chemicals with different modes of action. The findings showed that the mode of action of propranolol in D. magna is organ-specific and vastly different from those of narcotics, even though metabolite regulation is similar between narcotic and non-narcotic candidates. The method applied in this study seems applicable to rapid characterization of the MOA of other cardiovascular pharmaceutical ingredients., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Given the risk of environmental pollution by pharmaceutical compounds and the effects of these compounds on exposed ecosystems, ecologically relevant and realistic assessments are required. However, many studies have been mostly focused on individual responses in a single generation exposed to one-effect concentrations. Here, transcriptional responses of the crustacean Daphnia magna to the antibiotic tetracycline across multiple generations and effect concentrations were investigated. The results demonstrated that tetracycline induced different transcriptional responses of daphnids that were dependent on dose and generation. For example, reproduction-related expressed sequence tags (ESTs), including vitellogenin, were distinctly related to the dose-dependent tetracycline exposure, whereas multigenerational exposure induced significant change of molting-related ESTs such as cuticle protein. A total of 65 ESTs were shared in all contrasts, suggesting a conserved mechanism of tetracycline toxicity regardless of exposure concentration or time. Most of them were associated with general stress responses including translation, protein and carbohydrate metabolism, and oxidative phosphorylation. In addition, effects across the dose-response curve showed higher correlative connections among transcriptional, physiological, and individual responses than multigenerational effects. In the multigenerational exposure, the connectivity between adjacent generations decreased with increasing generation number. The results clearly highlight that exposure concentration and time trigger different mechanisms and functions, providing further evidence that multigenerational and dose-response effects cannot be neglected in environmental risk assessment.

The overuse of oxytetracycline (OTC) in aquaculture has become a problem because of its chronic toxic effects on marine ecosystems. The present study assessed the ecological risk of OTC in the coastal waters near the Jangheung Flatfish Farm using a site-specific multimedia fate model to analyze exposure. Before the model was applied, its performance was validated by comparing it with field data. The coastal waters in the testbed were sampled and analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) followed by solid-phase extraction (SPE). The concentrations of OTC measured varied from 7.05 to 95.39ng/L. The results of validating the models showed that the site-specific multimedia fate model performed better (root mean square error (RMSE): 24.217, index of agreement (IOA): 0.739) than conventional fugacity approaches. This result demonstrated the utility of this model in supporting effective future management of aquaculture effluent. The results of probabilistic risk assessment indicated that OTC from aquaculture effluent did not cause adverse effects, even in a maximum-use scenario., (Copyright © 2017 Elsevier Inc. All rights reserved.)

We investigated the multigenerational effect of PFOS to individual fitness (e.g., body weight, acetylcholinesterase and glutathione S-transferase) and population growth (e.g., offspring number and time to first brood) of Daphnia magna during continuous and discontinuous exposures. The intrinsic rate of population growth was also calculated. In the continuous exposure, population growth-related adverse effects were detected during all test periods, and the adverse effect tended to be weaker in later generations. On the other hand, individual fitness-related adverse effects were observed from F1 not in F0 and deteriorated as the generation number increased. These results imply that individual fitness worsens although the population growth is restored in later generations. Upon discontinuous exposure, a few but significant adverse effects were observed during the non-exposure period and highest effects were detected during the re-exposure period. This encourages the study of different exposure scenarios, which may result in unexpected and higher PFOS toxicity. Consequently, this study confirms adverse effects of PFOS to Daphnia magna in multigenerational period and supports reasons for studies linking individual fitness changes to population dynamics and covering diverse exposure scenarios to evaluate the risk of PFOS in a water environment., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Multigenerational bioaccumulation and biotransformation activity and short-term kinetics (e.g., uptake and depuration) of propranolol in Daphnia magna were investigated at environmental concentration. The body burden and the major metabolite, desisopropyl propranolol (DIP), of propranolol were quantified using LC-MS/MS at the end of each generation after exposure for 11 generations. The accumulation of propranolol in D. magna at an environmental concentration of 0.2 μg/L was not much different between the parent (F0) and the eleventh filial (F10) generation. However, at 28 μg/L, its accumulation was 1.6 times higher-up to 18.9 μg/g-in the F10 generation relative to the F0. In contrast to propranolol, DIP intensity gradually increased from F0 to F10 at 0.2 μg/L, reflecting an increase in detoxification load and biotransformation performance; no increasing trend was observed at 28 μg/L. The bioaccumulation factor (BAF) showed higher values with a lower concentration and longer period of exposure. The average values of the BAF for 21 days of long-term exposure in successive 11 generations were 440.4 ± 119.7 and 1026.5 ± 208.6 L/kg for 28 μg/L and 0.2 μg/L, respectively. These are comparable to the BAF of 192 for the short-term 72-h exposure at 28 μg/L in the parent generation. It is also recommended that future studies for pharmaceutical ingredients be conducted on drug-drug interaction and structural characteristics on the prediction of biotransformation activity and bioaccumulation rate., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The oxidative and reductive transformation of nitro explosives in contaminated soils with Fe-bearing materials and persulfate (S2O8(2-)) was examined via batch experiments. Zero-valent cast iron [Fe(0)], steel dust from a steel manufacturing plant, and FeS rapidly reduced 2,4,6-trinitrotoluene (TNT) and hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) in soil under anaerobic conditions as long as a sufficient amount of water was present. The Fe-bearing materials also effectively activated persulfate to enhance the oxidative transformation of TNT and RDX in soil-water systems. Kinetically, reductive and oxidative transformations removed more than 90% of the explosives from a soil-water system within 5 h under the given conditions. Pseudo-first-order rates in the range of 0.7-23.4 h(-1) were observed. By increasing the concentration of persulfate or Fe-bearing materials, the oxidative transformation could be promoted. Treated soils via redox reactions using the Fe-bearing materials did not show significant toxicity, except for the case of TNT-contaminated soils oxidized by FeS-assisted persulfate. Considering the kinetics of explosive degradation and the toxicity of treated wastewaters and soils, Fe(0) or steel dust-assisted persulfate oxidation may be a safe option as an ex situ remediation process for the treatment of explosive-contaminated soils.

This study investigated the toxicity changes and sorption of pharmaceuticals and endocrine disrupters in the presence of humic acid (HA). For the sorption experiment, a dead end filtration (DEF) system was used to separate bound and free-form target compounds. An algae growth inhibition test and E-screen assay were conducted to estimate the toxic effect of pharmaceutically active compounds (PhACs) and endocrine disrupting chemicals (EDCs), respectively. The permeate concentration was confirmed using liquid chromatography-mass spectrometry. In the sorption test, we observed significant sorption of PhACs and EDCs on colloidal HA, except for sulfamethoxazole (SMX). The values of log KCOC derived from DEF determinations ranged from 4.40 to 5.03. The removal efficiency varied with the HA concentration and the target chemical properties. Tetracycline and 4-octylphenol showed the highest sorption or removal efficiency (≈50%), even at 5 mg C/L HA. The algal growth inhibition of PhACs and the estrogenic effects of EDCs were significantly decreased in proportion to HA concentrations, except for SMX. In addition, the chemical analysis results showed a positive relationship with the bioassay results. Consequently, the sorption of PhACs and EDCs onto colloidal HA should be emphasized in natural environments because it significantly reduces bioavailable concentrations and toxicity to aquatic organisms.

Purpose: To describe the effect of the C1 bursting fracture on the location of the internal carotid artery (ICA) around the atlas., Methods: The authors analyzed the morphology of the atlas and the ICA in 15 patients with C1 bursting fracture and compared with control group (77 patients) without any pathology. All patients were evaluated with CT angiography for the anatomical assessment. The laterality of the ICA, the distances of the ICA from the midline, anterior tubercle, and ventral surface of the C1 lateral mass were compared between two groups. The distance between the lateral margin of the longus capitis muscle and the inner edge of the transverse foramen was also measured., Results: Medially located ICA was more common in the C1 bursting fracture group than control group (76.7 vs 42.8 %). There were no significant differences between 2 groups for the distance from the midline, anterior tubercle, and ventral surface of the C1 lateral mass, respectively. The distance of the longus capitis muscle to transverse foramen was 2.52 ± 2.09 and 4.15 ± 3.09 mm in each group, and there was statistically significant difference (p < 0.01)., Conclusions: Lateral displacement of the bony structure of C1 bursting fracture changes the relative location of the ICA medially, which increase the injury risk during the bicortical C1 screw insertion. These data suggest that CT angiography or enhanced CT scans can give critical information to choose the ideal fixation technique and the proper trajectory of the screws for C1 bursting fracture.

Citrate-coated AgNPs (c-AgNPs) have negatively charged surfaces and their surface interactions with heavy metals can affect metal toxicity in aquatic environments. This study used Daphnia magna to compare the acute toxicities and bioaccumulation of As(V), Cd, and Cu when they interact with c-AgNPs. The 24-h acute toxicities of As(V) and Cu were not affected by the addition of c-AgNPs, while bioaccumulation significantly decreased in the presence of c-AgNPs. In contrast, both the 24-h acute toxicity and bioaccumulation of Cd increased in the presence of c-AgNPs. These toxicity and bioaccumulation trends can be attributed to the interactions between the AgNP surface and the heavy metals. As(V) and c-AgNPs compete by negative charge, decreasing As(V) toxicity. Copper adheres readily to c-AgNP citrate, decreasing Cu bioavailability, and thus reducing Cu toxicity and bioaccumulation. Citrate complexes with divalent cations such as Ca and Mg reduce the competition between divalent cations and Cd on biotic ligand, increasing toxicity and bioaccumulation of Cd. This study shows that surface properties determine the effect of c-AgNPs on heavy metal toxicities and bioaccumulations; hence, further studies on the effect of nanoparticle by it surface properties are warranted., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Toxicity identification evaluation (TIE) was applied to the effluent from a pharmaceutical industrial complex, following the US EPA TIE guidelines. The whole effluent toxicity (WET) test found toxicity greater than 16toxic units (TU) in the effluent. Dissolved non-polar organic compounds were identified as the major contributor to the observed toxicity in the TIE manipulations in phases I and II. Among the 48 organic compounds identified, three compounds (i.e., acetophenone, benzoimide, and benzothiazole) were related to the pharmaceutical production procedure; however, no contribution to toxicity was predicted in the compounds. The results of the ECOSAR model, which predicts toxicity, indicated that the alkane compounds caused significant toxicity in the effluent. The toxicity test and heavy metal analysis, which used IC and ICP/MS, identified that particulate and heavy metals, such as Cu and Zn, contributed to the remaining toxicity, except dissolved organics. The results showed the applicability of the TIE method for predicting regional effluents produced by the industrial pharmaceutical complex in this study. Although the location was assumed to be affected by discharge of pharmaceutical related compounds in the river, no correlations were observed in the study. Based on the results, advanced treatment processes, such as activated carbon adsorption, are recommended for the wastewater treatment process in this location., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

To evaluate the effects of propranolol on Daphnia magna (D. magna), we employed a multi-generational exposure period for eight generations and an environmentally relevant low concentration with 1.5 ng/L, 0.2 μg/L and 26 μg/L to reflect a realistic exposure scenario. Physiological endpoints were checked, including growth, number of neonates, heart rate, frequency of abdominal appendage movement and malformation rate of neonates. In the results, growth and abdominal appendage movement were affected by environmental concentration during several generations, and the responses showed consistent tendencies of response increase with concentration increase. Heart rate was the only endpoint affected throughout all exposure generations. Inhibitory and acceleratory effects on heart rate, growth and abdominal appendage movement suggest that it is necessary to cover sub-lethal endpoints of non-targeted organisms in eco-toxicity study because the physiological responses were detected at much lower concentrations than the results of traditional toxicity tests, including environmental concentration., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The achievement of a successful pregnancy and delivery after oocyte activation with calcium ionophore is reported in a couple having low fertilization rates after intracytoplasmic sperm injection (ICSI) of in-vitro matured oocytes. A couple, in which the wife had polycystic ovary syndrome and the husband had moderate oligoteratozoospermia, showed a low fertilization rate in a previous in-vitro maturation cycle (2/11 [18.2%]). The most likely cause of complete fertilization failure or low fertilization rates is failure of oocyte activation. Therefore, artificial oocyte activation by calcium ionophore was combined with ICSI to achieve viable fertilized oocytes. Oocytes were stimulated with calcium ionophore for 30 min after ICSI. The fertilization rate of oocytes activated with calcium ionophore (13/15 [86.7%] and 7/9 [77.8%]) was higher than that of the non-activated oocytes. In the latest cycle, three embryos derived from the activated oocytes were transferred into the uterus on day 3. Subsequently, two gestational sacs were identified on ultrasound. The patient delivered dizygotic twins (girl 2260 g and boy 2760 g) at 35 weeks and 6 days gestation by caesarean section. This result suggests that calcium ionophore could be useful for oocyte fertilization in couples with low fertilization rates after ICSI of in-vitro matured oocytes., (Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Objective: To identify the accuracy and efficiency of the computed tomographic (CT)-based navigation system on upper cervical instrumentation, particularly C1 lateral mass and C2 pedicle screw fixation compared to previous reports., Methods: Between May 2005 and March 2014, 25 patients underwent upper cervical instrumentation via a CT-based navigation system. Seven patients were excluded, while 18 patients were involved. There were 13 males and five females; resulting in four degenerative cervical diseases and 14 trauma cases. A CT-based navigation system and lateral fluoroscopy were used during the screw instrumentation procedure. Among the 58 screws inserted as C1-2 screws fixation, their precise positions were evaluated by postoperative CT scans and classified into three categories : in-pedicle, non-critical breach, and critical breach., Results: Postoperatively, the precise positions of the C1-2 screws fixation were 81.1% (47/58), and 8.6% (5/58) were of non-critical breach, while 10.3% (6/58) were of critical breach. Most (5/6, 83.3%) of the critical breaches and all of non-critical breaches were observed in the C2 pedicle screws and there was only one case of a critical breach among the C1 lateral mass screws. There were three complications (two vertebral artery occlusions and a deep wound infection), but no postoperative instrument-related neurological deteriorations were seen, even in the critical breach cases., Conclusion: Although CT-based navigation systems can result in a more precise procedure, there are still some problems at the upper cervical spine levels, where the anatomy is highly variable. Even though there were no catastrophic complications, more experience are needed for safer procedure.

The potential bioaccumulation and distribution of antibiotics in non-target organisms have been inadequately studied in spite of their widespread occurrence in aquatic systems. We investigated the ability of tetracycline to bioaccumulate through aqueous and dietary routes in an aquatic organism, the freshwater crustacean Daphnia magna. D. magna was exposed to algal food (Pseudokirchneriella subcapitata) contaminated with tetracycline for dietary uptake. Tetracycline was transferred to D. magna more through aqueous uptake than through dietary uptake. The uptake rate constant of tetracycline for D. magna was kin,water=0.33±0.045 via the aqueous route and kin,food=0.16±0.012 via the dietary route for 1.0mgL(-1) tetracycline. Bioconcentration factors of 4.40±0.91Lkg(-1) and 3.66±0.50Lkg(-1) for 0.1 and 1.0mgL(-1) tetracycline were found for D. magna. The biomagnification factor of 0.19±0.04 indicates that magnification of tetracycline through the food web will not occur. The change in the internal concentration of the target compound was also studied for multigenerational (F1-F4) exposure. The internal concentration in D. magna showed a decreasing trend with increasing generations except for the parent generation. The bioaccumulation tendency showed a biphasic change in multigenerational exposure., (Copyright © 2014 Elsevier B.V. All rights reserved.)

The effects of pharmaceuticals have been underestimated during single generation exposure. Therefore, in this study, we investigated toxic responses at the physiological and whole organism level in tetracycline-exposed Daphnia magna over four consecutive generational lifecycles. The results showed that tetracycline affected energy-related physiological functions in concentration- and generation-dependent manners, and especially maintenance costs increased. Consequently, multigenerational exposure to tetracycline induced changes in energy balance, resulting in the change of higher levels of biological responses. In contrast, D. magna acclimated to tetracycline exposure over multiple generations, as evidenced by the increased LC50 values. Transgenerational adaptation was related to the neonatal sensitivity and energy reserves of the organism. The results also emphasized the idea that the number of generation is an important factor for toxicity. The present study confirmed that toxic stress induces metabolic changes in an organism, thereby leading to increased energy consumption that results in adverse effects on reproduction., (Copyright © 2014 Elsevier Ltd. All rights reserved.)