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      • Combined effects of sulfamethazine and sulfamethoxazole on a freshwater microalga, <i>Scenedesmus obliquus</i>: toxicity, biodegradation, and metabolic fate

        Xiong, Jiu-Qiang,Kim, Sun-Joon,Kurade, Mayur B.,Govindwar, Sanjay,Abou-Shanab, Reda A.I.,Kim, Jung-Rae,Roh, Hyun-Seog,Khan, Moonis Ali,Jeon, Byong-Hun Elsevier 2019 Journal of hazardous materials Vol.370 No.-

        <P><B>Abstract</B></P> <P>This study investigated the environmental effects of two common emerging contaminants, sulfamethazine (SMZ) and sulfamethoxazole (SMX), and their mixture using a green microalga, <I>Scenedesmus obliquus</I>. The calculated EC<SUB>50</SUB> values of SMZ, SMX, and their mixture (11:1 wt/wt) after 96 h were 1.23, 0.12, and 0.89 mg L<SUP>-1</SUP>, respectively. The toxicity of the mixture could be better predicted using a concentration addition model than an independent action model. The risk quotients of SMZ, SMX, and their mixture were >1 during the experiment, indicating their high potential risks on aquatic microorganisms. Despite their toxicity, <I>S. obliquus</I> exhibited 17.3% and 29.3% removal of 0.1 mg L<SUP>-1</SUP> and 0.2 mg L<SUP>-1</SUP> after 11 days of cultivation. The changes of SMZ and SMX removal were observed when combined, which showed a significantly improved removal of SMZ (up to 3.4 folds) with addition of SMX (0.2 mg L<SUP>-1</SUP>). The metabolic pathways of SMZ and SMX were proposed according to mass spectroscopic analysis, which showed six metabolites of SMX and seven intermediates of SMZ, formed as a result of ring cleavage, hydroxylation, methylation, nitrosation, and deamination.</P> <P><B>Highlights</B></P> <P> <UL> <LI> <I>Scenedesmus obliquus</I> was tolerant to SMZ, SMX, and their mixture, and could withstand their high doses. </LI> <LI> 96 h EC<SUB>50</SUB> of SMZ, SMX, and their mixture for <I>S. obliquus</I> was 1.23, 0.12, and 0.89 mg L<SUP>-1</SUP>. </LI> <LI> The risk quotients of SMZ, SMX, and their mixture were >1. </LI> <LI> The removal of SMZ and SMX was more in the mixture than their individual medium. </LI> <LI> Metabolic pathways of SMZ and SMX by <I>S. obliquus</I> were proposed. </LI> </UL> </P>

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        Utilization of Vertebroplasty/ Kyphoplasty in the Management of Compression Fractures: National Trends and Predictors of Vertebroplasty/Kyphoplasty

        Brannan E. O’Neill,Jamila A. Godil,Spencer Smith,Ali I. Rae,Christina H. Wright,James M. Wright,Donald A. Ross,Josiah N. Orina,Jesse J. Liu,Clifford Lin,Travis C. Philipp,Jonathan Kark,Jung U. Yoo,Won 대한척추신경외과학회 2023 Neurospine Vol.20 No.4

        Objective: The purpose of this study is to examine the utilization of kyphoplasty/vertebroplasty procedures in the management of compression fractures. With the growing elderly population and the associated increase in rates of osteoporosis, vertebral compression fractures have become a daily encounter for spine surgeons. However, there remains a lack of consensus on the optimal management of this patient population. Methods: A retrospective analysis of 91 million longitudinally followed patients from 2016 to 2019 was performed using the PearlDiver Patient Claims Database. Patients with compression fractures were identified using International Classification of Disease, 10th Revision codes, and a subset of patients who received kyphoplasty/vertebroplasty were identified using Common Procedural Terminology codes. Baseline demographic and clinical data between groups were acquired. Multivariable regression analysis was performed to determine predictors of receiving kyphoplasty/vertebroplasty. Results: A total of 348,457 patients with compression fractures were identified with 9.2% of patients receiving kyphoplasty/vertebroplasty as their initial treatment. Of these patients, 43.5% underwent additional kyphoplasty/vertebroplasty 30 days after initial intervention. Patients receiving kyphoplasty/vertebroplasty were significantly older (72.2 vs. 67.9, p < 0.05), female, obese, had active smoking status and had higher Elixhauser Comorbidity Index scores. Multivariable analysis demonstrated that female sex, smoking status, and obesity were the 3 strongest predictors of receiving kyphoplasty/vertebroplasty (odds ratio, 1.27, 1.24, and 1.14, respectively). The annual rate of kyphoplasty/vertebroplasty did not change significantly (range, 8%–11%). Conclusion: The majority of vertebral compression fractures are managed nonoperatively. However, certain patient factors such as smoking status, obesity, female sex, older age, osteoporosis, and greater comorbidities are predictors of undergoing kyphoplasty/vertebroplasty.

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