A Comprehensive Review on Metallic Trace Elements Toxicity in Fishes and Potential Remedial Measures

Metallic trace elements toxicity has been associated with a wide range of morphological abnormalities in fish, both in natural aquatic ecosystems and controlled environments. The bioaccumulation of metallic trace elements can have devastating effects on several aspects of fish health, encompassing physiological, reproductive, behavioural, and developmental functions. Considering the significant risks posed by metallic trace elements-induced toxicity to fish populations, this review aims to investigate the deleterious effects of prevalent metallic trace elements toxicants, such as mercury (Hg), cadmium (Cd), chromium (Cr), lead (Pb), arsenic (As), and copper (Cu), on the neurological, reproductive, embryonic, and tissue systems of fish. Employing diverse search engines and relevant keywords, an extensive review of in vitro and in vivo studies pertaining to metallic trace elements toxicity and its adverse consequences on fish and their organs was conducted. The findings indicate that Cd was the most prevalent metallic trace elements in aquatic environments, exerting the most severe impacts on various fish organs and systems, followed by Cu and Pb. Moreover, it was observed that different metals exhibited varying degrees and types of effects on fish. Given the profound adverse effects of metallic trace elements contamination in water, immediate measures need to be taken to mitigate water pollution stemming from the discharge of waste containing metallic trace elements from agricultural, industrial, and domestic water usage. This study also compares the most common methods for treating metallic trace elements contamination in water

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous