Modeling Mechanochemical Depolymerization of PET in Ball-Mill Reactors Using DEM Simulations.

Developing efficient and sustainable chemical recycling pathways for consumer plastics is critical for mitigating the negative environmental implications associated with their end-of-life management. Mechanochemical depolymerization reactions have recently garnered great attention, as they are recognized as a promising solution for solvent-free transformation of polymers to monomers in the solid state. To this end, physics-based models that accurately describe the phenomena within ball mills are necessary to facilitate the exploration of operating conditions that would lead to optimal performance. Motivated by this, in this paper we develop a mathematical model that couples results from discrete element method (DEM) simulations and experiments to study mechanically-induced depolymerization. The DEM model was calibrated and validated via video experimental data and computer vision algorithms. A systematic study on the influence of the ball-mill operating parameters revealed a direct relationship between the operating conditions of the vibrating milling vessel and the total energy supplied to the system. Moreover, we propose a linear correlation between the high-fidelity DEM simulation results and experimental monomer yield data for poly(ethylene terephthalate) depolymerization, linking mechanical and energetic variables. Finally, we train a reduced-order model to address the high computational cost associated with DEM simulations. The predicted working variables are used as inputs to the proposed mathematical expression which allows for the fast estimation of monomer yields.

Desmethylclomipramine triggers mitochondrial damage and death in TGF-ß-induced mesenchymal type of A549 cells.

Lung cancer is the leading cause of cancer deaths, where the metastasis often causes chemodrug resistance and leads to recurrence after treatment. Desmethylclomipramine (DCMI), a bioactive metabolite of clomipramine, shows the therapeutic efficacy with antidepressive agency as well as potential cytostatic effects on lung cancer cells. Here, we demonstrated that DCMI effectively caused transforming growth factor (TGF)-ß1-mediated mesenchymal type of A549 cells to undergo mitochondrial death via myeloid cell leukemia-1 (Mcl-1) suppression and activation of truncated Bid (tBid). TGF-ß1 induced epithelial mesenchymal transition in A549 cells with the increase of fibronectin and decrease of E-cadherin, the activation of Akt/glycogen synthase kinase-3ß (GSK-ß)/Mcl-1 axis, and the hypo-responsiveness to cisplatin. DCMI initiated a dose-dependent cytotoxicity on TGF-ß1-mediated mesenchymal type of A549 cells through inactivating Akt/GSK-ß/Mcl-1 axis, in which mitochondria instability and caspase-9/3 activation also occurred concurrently. Pharmacological inhibition of caspase-8 and cathepsin B partly reversed tBid expression and mitochondrial damage to further attenuate DCMI-mediated cytotoxicity. Additionally, DCMI presented partial therapeutic effects in treating mesenchymal type of A549 tumor bearing nude mice through an acceleration of cancer cell death. Taken together, DCMI exerts antitumor effects via initiating the mechanisms of Akt/GSK-ß/Mcl-1 inactivation and cathepsin B/caspase-8-regulated mitochondrial death, which suggests its potential role in mesenchymal type of cancer cell therapy.

Predicting the impact of rare variants on RNA splicing in CAGI6.

Variants which disrupt splicing are a frequent cause of rare disease that have been under-ascertained clinically. Accurate and efficient methods to predict a variant's impact on splicing are needed to interpret the growing number of variants of unknown significance (VUS) identified by exome and genome sequencing. Here, we present the results of the CAGI6 Splicing VUS challenge, which invited predictions of the splicing impact of 56 variants ascertained clinically and functionally validated to determine splicing impact. The performance of 12 prediction methods, along with SpliceAI and CADD, was compared on the 56 functionally validated variants. The maximum accuracy achieved was 82% from two different approaches, one weighting SpliceAI scores by minor allele frequency, and one applying the recently published Splicing Prediction Pipeline (SPiP). SPiP performed optimally in terms of sensitivity, while an ensemble method combining multiple prediction tools and information from databases exceeded all others for specificity. Several challenge methods equalled or exceeded the performance of SpliceAI, with ultimate choice of prediction method likely to depend on experimental or clinical aims. One quarter of the variants were incorrectly predicted by at least 50% of the methods, highlighting the need for further improvements to splicing prediction methods for successful clinical application.

Dose-Escalated Radiation Therapy as Primary Treatment for Residual Bladder Cancer After Transurethral Resection.

Purpose: The aim of this study was to determine whether escalating the local radiation dose can improve the outcome of residual bladder cancer after transurethral resection of bladder tumor without increasing treatment-related toxicity. Methods and Materials: The treatment plans and medical records of patients with bladder cancer treated with curative-intent radiation therapy between 2008 and 2020 were reviewed. Those who had residual tumors in the computed tomography simulation images were included. A cumulative radiation dose higher than 6600 cGy was defined as dose escalation. The effect of dose escalation on 3-year locoregional control, progression-free survival, and overall survival was evaluated. Results: A total of 149 patients with residual tumors were identified. The median follow-up period was 27.5 months. Among them, 51 patients received an escalated radiation dose, and 98 received a standard dose in the residual tumor area. Patients in the dose-escalation group had higher 3-year locoregional control (65.6% vs 27.8%; P < .001) and progression-free survival (42.6% vs 18.2%; P < .001) than the standard-dose group. Overall survival also showed a trend favoring the dose-escalation group (54.9% vs 36.2%; P = .059). In the multivariate analyses, the differences between the dose-escalation and standard-dose groups were significant in terms of locoregional control (hazard ratio, 0.32; CI, 0.18-0.59; P = <.001) and progression-free survival (hazard ratio, 0.51; CI, 0.32-0.82; P = .005). There was no statistical difference in acute and chronic treatment-related toxicities between the 2 groups. Conclusions: The outcome of residual bladder cancer after transurethral resection of bladder tumor could be improved by dose-escalated radiation therapy.

Kinetic Phenomena in Mechanochemical Depolymerization of Poly(styrene).

Synthetic polyolefinic plastics comprise one of the largest shares of global plastic waste, which is being targeted for chemical recycling by depolymerization to monomers and small molecules. One promising method of chemical recycling is solid-state depolymerization under ambient conditions in a ball-mill reactor. In this paper, we elucidate kinetic phenomena in the mechanochemical depolymerization of poly(styrene). Styrene is produced in this process at a constant rate and selectivity alongside minor products, including oxygenates like benzaldehyde, via mechanisms analogous to those involved in thermal and oxidative pyrolysis. Continuous monomer removal during reactor operation is critical for avoiding repolymerization, and promoting effects are exhibited by iron surfaces and molecular oxygen. Kinetic independence between depolymerization and molecular weight reduction was observed, despite both processes originating from the same driving force of mechanochemical collisions. Phenomena across multiple length scales are shown to be responsible for differences in reactivity due to differences in grinding parameters and reactant composition.

TBX20 loss-of-function variants in families with left ventricular non-compaction cardiomyopathy.

TBX20 encodes a cardiac transcription factor that is associated with atrial septal defects. Recent studies implicate loss-of-function TBX20 variants with left ventricular non-compaction cardiomyopathy (LVNC), although clinical and genetic data in families are limited. We report four families with TBX20 loss-of-function variants that segregate with LVNC. Genetic testing using genome or exome sequencing was performed in index cases, variants were validated with Sanger sequencing, and cascade genetic testing was performed in family members. A multi-exon deletion, small deletion, essential splice site variant and nonsense variant in TBX20 were found in four families. The index cases in two families were symptomatic children with identical congenital heart diseases and LVNC who developed different cardiomyopathy phenotypes with one developing heart failure requiring transplantation. In another family, the child index case had LVNC and congestive heart failure requiring heart transplantation. In the fourth family, the index case was a symptomatic adult with LVNC. In all families, the variants segregated in relatives with isolated LVNC, or with congenital heart disease or cardiomyopathy. Family members displayed a clinical spectrum from asymptomatic to severe presentations including heart failure. Our data strengthen TBX20 loss-of-function variants as a rare cause of LVNC and support TBX20 inclusion in genetic testing of LVNC.

Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review.

Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique "transaxillary capsulorrhaphy" to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

Structural and Adsorption Properties of ZIF-8-7 Hybrid Materials Synthesized by Acid Gas-Assisted and De Novo Routes.

The tuning of micropore environments in zeolitic imidazolate frameworks (ZIFs) by mixed-linker synthesis has the potential for enabling new molecular separation properties. However, de novo synthesis of mixed-linker (hybrid) ZIFs is often challenging due to the disparate chemical properties of the different linkers. Here, we elucidate the structure and properties of an unconventional ZIF-8-7 hybrid material synthesized via a controlled-acid-gas-assisted degradation and reconstruction (solvent-assisted crystal redemption, SACRed) strategy. Selective insertion of benzimidazole (ZIF-7 linker) into ZIF-8 using SACRed is used as a facile method to generate a ZIF-8-7 hybrid material that is otherwise difficult to synthesize by de novo methods. Detailed crystal structure and textural characterizations clarify the significant differences in the microstructure of the SACRed-derived ZIF-8-7 hybrid material relative to a de novo synthesized hybrid of the same overall linker composition as well as the parent ZIF-8 material. Unary and binary adsorption measurements reveal the tunability of adsorption characteristics as well as the prevalence of nonideal cooperative mixture adsorption effects that lead to large deviations from predictions made with ideal adsorbed solution theory.

Visualizing the DNA repair process by a photolyase at atomic resolution.

Photolyases, a ubiquitous class of flavoproteins, use blue light to repair DNA photolesions. In this work, we determined the structural mechanism of the photolyase-catalyzed repair of a cyclobutane pyrimidine dimer (CPD) lesion using time-resolved serial femtosecond crystallography (TR-SFX). We obtained 18 snapshots that show time-dependent changes in four reaction loci. We used these results to create a movie that depicts the repair of CPD lesions in the picosecond-to-nanosecond range, followed by the recovery of the enzymatic moieties involved in catalysis, completing the formation of the fully reduced enzyme-product complex at 500 nanoseconds. Finally, back-flip intermediates of the thymine bases to reanneal the DNA were captured at 25 to 200 microseconds. Our data cover the complete molecular mechanism of a photolyase and, importantly, its chemistry and enzymatic catalysis at work across a wide timescale and at atomic resolution.

Application of high-dimensional uniform manifold approximation and projection (UMAP) to cluster existing landfills on the basis of geographical and environmental features.

Due to extreme conditions, which are influenced by the location of landfills, the release of pollutants has been recently proven to be more severe in estuary landfills, as these landfill locations are affected by both sea-water and river-water interactions. To identify geographic and environmental features linked to the extreme conditions of certain landfills, a high-dimensional clustering method combining Uniform Manifold Approximation and Projection (UMAP) with the Louvain algorithm is proposed. A case study was conducted using 17 noteworthy features that transform to Landfill Suitability Index (LSI) applied to hundreds of landfill sites in Taiwan. This study clustered landfills into 10 clusters and identified several clusters with significant extreme locations, including estuary landfills (7.9 %), fault-water-body landfills (8.2 %), and densely-populated-water-body landfills (17.6 %). Furthermore, a critical discovery of endangered Platalea minor habitats near these estuary landfills was made. Additionally, this work identified "healthy" landfills (11.2 %) that are minimally affected by the considered features. These findings demonstrate the promising potential of our framework for managers to systematically improve landfill management strategies. Moreover, our framework was tested by incorporating rainfall and flooding features in relation to climate change scenarios. To address the demand for land release from occupied landfills in Taiwan, there is a pressing need to expedite the transition to a circular economy, and our framework can provide further assistance in this regard. This approach is promising, as it provides a new method to evaluate the environmental risks linked to landfills and also identifies potential opportunities related to landfill mining. Finally, this work was extended to include a case study in England, which has 19,801 landfills and a dataset containing 15 relevant landfill features; in this case study, our framework identified 110 landfill clusters, and several placed in extreme locations, demonstrating that our framework is flexible for use in other regions outside of Taiwan.

NME3 binds to phosphatidic acid and mediates PLD6-induced mitochondrial tethering.

Mitochondria are dynamic organelles regulated by fission and fusion processes. The fusion of membranes requires elaborative coordination of proteins and lipids and is particularly crucial for the function and quality control of mitochondria. Phosphatidic acid (PA) on the mitochondrial outer membrane generated by PLD6 facilitates the fusion of mitochondria. However, how PA promotes mitochondrial fusion remains unclear. Here, we show that a mitochondrial outer membrane protein, NME3, is required for PLD6-induced mitochondrial tethering or clustering. NME3 is enriched at the contact interface of two closely positioned mitochondria depending on PLD6, and NME3 binds directly to PA-exposed lipid packing defects via its N-terminal amphipathic helix. The PA binding function and hexamerization confer NME3 mitochondrial tethering activity. Importantly, nutrient starvation enhances the enrichment efficiency of NME3 at the mitochondrial contact interface, and the tethering ability of NME3 contributes to fusion efficiency. Together, our findings demonstrate NME3 as a tethering protein promoting selective fusion between PLD6-remodeled mitochondria for quality control.

Remediation of groundwater contaminated with trichloroethylene (TCE) using a long-lasting persulfate/biochar barrier.

Groundwater contamination by chlorinated solvents causes potential threats to water resources and human health. Therefore, it is important to develop effective technologies to remediate contaminated groundwater. This study uses biodegradable hydrophilic polymers, hydroxypropyl methylcellulose (HPMC), hydroxyethyl cellulose (HEC) and polyvinyl pyrrolidone (PVP) as binders to manufacture persulfate (PS) tablets for the sustained release of persulfate to treat trichloroethylene (TCE) in groundwater. The release time for different tablets decreases in the order: HPMC (8-15 days) > HEC (7-8 days) > PVP (2-5 days). The efficiency with which persulfate is released is: HPMC (73-79%) > HEC (60-72%) > PVP (12-31%). HPMC is the optimal binder for the manufacture of persulfate tablets and persulfate is released from a tablet of HPMC/PS ratio (wt/wt) of 4/3 for 15 days at a release rate of 1127 mg/day. HPMC/PS/biochar (BC) ratios (wt/wt/wt) between 1/1/0.02 and 1/1/0.0333 are suitable for PS/BC tablets. PS/BC tablets release persulfate for 9-11 days at release rates of 1243 to 1073 mg/day. The addition of too much biochar weakens the structure of the tablets, which results in a rapid release of persulfate. TCE is oxidized by a PS tablet with an efficiency of 85% and a PS/BC tablet eliminates more TCE, with a removal efficiency of 100%, due to oxidation and adsorption during the 15 days of reaction. Oxidation is the predominant mechanism for TCE elimination by a PS/BC tablet. The adsorption of TCE by BC fits well with the pseudo-second-order kinetics and the pseudo-first-order kinetics, which describes the removal of TCE by PS and PS/BC tablets. The results of this study show that a PS/BC tablet can be used in a permeable reactive barrier for long-term passive remediation of groundwater.

Adjuvant Chemoradiotherapy Associated with Improved Overall Survival in Resected Esophageal Squamous Cell Carcinoma after Neoadjuvant Chemoradiotherapy in Intensity-Modulated Radiotherapy Era.

BACKGROUND: The prognosis of patients with resected esophageal squamous cell carcinoma after neoadjuvant chemoradiotherapy is particularly poor in those who were staged as ypT3/T4 and/or ypN+. This study investigated whether adjuvant chemoradiotherapy was associated with improved clinical outcomes in these patients. METHODS: we identified patients with esophageal squamous cell carcinoma who were staged as ypT3/T4 and/or ypN+ after being treated with neoadjuvant chemoradiotherapy followed by esophagectomy between the years 2013 and 2019. Patients were divided into two groups based on whether they received adjuvant chemoradiotherapy. The Kaplan-Meier method and Cox regression modeling were performed for survival analyses and multivariable analysis, respectively. RESULTS: 76 eligible patients were included in the analyses. The median follow-up for the study cohort was 43.4 months. On Kaplan-Meier analyses of the overall population, adjuvant chemoradiotherapy was associated with significantly improved median overall survival (31.7 months vs. 16.3 months, p = 0.036). On Kaplan-Meier analyses of the 35 matched pairs generated by propensity score matching, adjuvant chemoradiotherapy was associated with significantly longer median overall survival (31.7 months vs. 14.3 months; p = 0.004) and median recurrence-free survival (18.9 months vs. 11.7 months; p = 0.020). In multivariable analysis, adjuvant chemoradiotherapy was independently associated with a 60% reduction in mortality (p = 0.003) and a 48% reduction in risk of recurrence (p = 0.035) after adjusting for putative confounders. In addition, microscopic positive resection margin and Mandard tumor regression grade 3-4 were independently associated with increased mortality and risk of recurrence. While a greater number of lymph nodes dissected was independently associated with significantly improved overall survival, the number of positive lymph nodes was independently associated with significantly worse overall survival and a trend (p = 0.058) towards worse recurrence-free survival. CONCLUSIONS: This study demonstrated that adjuvant CRT was independently associated with a significantly improved survival and lower risk of recurrence than observation in esophageal squamous cell carcinoma patients staged as ypT3 and/or ypN+ after receiving neoadjuvant chemoradiotherapy and radical surgery. The results of this study have implications for the design of future clinical trials and may improve treatment outcomes of patients in this setting who cannot afford or are without access to adjuvant nivolumab.

Nationwide Prevalence and Outcomes of Long-Term Nasogastric Tube Placement in Adults.

Tube feeding (TF) is commonly used for patients with severe swallowing disturbance, and patients with chronic dysphagia are often provided with a long-term nasogastric tube (NGT). However, nationwide epidemiological data on long-term NGT placement are limited. The present study identified the prevalence and outcomes of patients with long-term NGT placement in Taiwan. Data were obtained from the Longitudinal Health Insurance Database. Patients with NGT placement for more than 3 months between 2000 and 2012 were enrolled in this cohort study. An NGT cohort of 2754 patients was compared with 11,016 controls matched for age, sex, residential area, and comorbidities. The prevalence rate of long-term NGT reached 0.063% in 2005 and then remained stable at 0.05-0.06%. The major causes of NGT placement were stroke (44%), cancer (16%), head injury (14%), and dementia (12%). Men (63%) were more likely to have long-term NGT placement than women (37%). The adjusted hazard ratios were 28.1 (95% CI = 26.0, 30.3) for acute and chronic respiratory infections; 26.8 (95% CI = 24.1, 29.8) for pneumonia, 8.84 (95% CI = 7.87, 9.93) for diseases of the esophagus, stomach, and duodenum; and 7.5 (95% CI = 14.7, 20.8) for mortality. Patients with NGT placement for more than 6 months had a higher odds ratio (1.58, 95% CI = 1.13, 2.20) of pneumonia than those with NGT placement for less than 6 months. Only 13% and 0.62% of the patients underwent rehabilitation therapy and percutaneous endoscopic gastrostomy, respectively. Long-term NGT use was associated with a higher risk of comorbidities and mortality. Stroke was the main illness contributing to long-term NGT use. Further interventions are necessary to improve the negative effects of long-term TF.

Post-Intracranial Hemorrhage Antithrombotic Therapy in Patients With Atrial Fibrillation.

Background To investigate the effectiveness and safety of withholding or restarting antithrombotic agents, and different antithrombotic therapies among patients with atrial fibrillation post-intracranial hemorrhage. Methods and Results This is a nationwide retrospective cohort study involving patients with atrial fibrillation receiving antithrombotic therapies who subsequently developed intracranial hemorrhage between January 1, 2011 and December 31, 2017. The risk of ischemic stroke (IS), recurrent intracerebral hemorrhage (ICH), and all-cause mortality were investigated between patients receiving no treatment versus patients reinitiating oral anticoagulants (OACs) or antiplatelet agents, and warfarin versus non-vitamin K antagonist OACs. We applied inverse probability of treatment weighting to balance the baseline characteristics and Cox proportional hazards model to estimate the hazard ratios (HRs) of different outcomes of interest. Compared with no treatment, OACs reduced the risk of IS (HR, 0.61; 0.42-0.89), without increase in the risk of ICH (1.15, 0.66-2.02); antiplatelet agent users showed a similar risk of IS (1.13, 0.81-1.56) and increased risk of ICH (1.81, 1.07-3.04). Use of OACs or antiplatelet agents did not reduce the risk of all-cause mortality (0.85, 0.72-1.01; and 0.88, 0.75-1.03, respectively). Compared with warfarin, non-vitamin K antagonist OAC users showed a similar risk of IS (0.92, 0.50-1.70), non-significantly reduced risk of ICH (0.53, 0.22-1.30), and significantly reduced all-cause mortality (0.60, 0.43-0.84). Conclusions OACs are recommended in patients with atrial fibrillation and intracranial hemorrhage because they reduced the risk of IS with no increase in the risk of subsequent ICH. Non-vitamin K antagonist OACs are recommended over warfarin owing to their survival benefits.

Prehospital-Stroke-Scale Parameterized Hospital Selection Protocol for Suspected Stroke Patients Considering Door-to-Treatment Durations.

Background To mitigate uncertainty that may arise in the judgment of emergency medical technicians when relying on a prehospital stroke scale at the scene, we propose a hospital selection protocol that considers the uncertainty of a prehospital stroke scale and the actual door-to-treatment durations, and we have developed a web-based system to be used with mobile devices. Methods and Results This hospital selection protocol incorporates real-time, estimated transport time obtained from Google Maps, historical median door-to-treatment duration at hospitals that only provide the standard intravenous thrombolysis treatment, and at hospitals with endovascular thrombectomy for probable large-vessel occlusion cases. We have validated the efficiency of the proposed protocol and compared it with other strategies used by emergency medical technicians when deciding on a receiving hospital. Using the proposed protocol for the triage reduces the time from onset to receiving definitive treatment by nearly 11 minutes. We found that the nearest endovascular thrombectomy-capable hospital from the scene may not be the most ideal if the door-to-treatment durations are discriminative. The results show that, when the tolerable bypass transport threshold and administration time are reduced to 9 minutes and 30.5 minutes, respectively, 228 patients out of 7678 cases, whose receiving hospitals were changed to endovascular thrombectomy-capable hospitals, received definitive treatment in a shorter time. The results of our analysis give recommendations for appropriate allowable bypass transport time for regional planning. Conclusions By applying almost-real value parameters, we have validated a web-based model, which can be universally adapted for optimal, time-saving hospital selection for patients with stroke.

Candidemia in hospitalized cirrhotic patients with bloodstream infection: A retrospective analysis and brief summary of published studies.

BACKGROUND: Candidemia is a life-threatening condition; however, the predictive markers for candidemia and mortality are inadequate in cirrhotic patients. This study was conducted to propose candidate predictors for the occurrence of candidemia and 30-day mortality in hospitalized cirrhotic patients with bloodstream infection (BSI) and review the related literature. METHODS: Cirrhotic patients with BSI between January 2011 and March 2020 were screened from the databank of a medical center and eligible patients were enrolled. Patients were separated into candidemia and bacteremia groups according to the results of blood cultures. Baseline characteristics, clinical presentation, and biochemistry data were collected at this time, as were microbiological data, medical management, use of antimicrobial agents, and outcome of the patients. The parameters and 30-day mortality were compared between candidemia and bacteremia groups. A combination of the MeSH terms and text terms related to candidemia and cirrhosis was searched in the electronic databases. RESULTS: Four hundred and sixty cirrhotic patients with BSI were enrolled. Thirty-five patients with candidemia (7.6%) were identified. Nosocomial infection, intensive care unit (ICU) admission, antibiotics exposure ≥14 days, white cell count >10 K/mm3, and model for end-stage liver disease (MELD) score >24 were associated with candidemia. The 30-day mortality was 65.7% in the candidemia group and 37.9% in the bacteremia group (p = 0.001). Nosocomial infection, ICU admission, hepatoma, hepatic encephalopathy, international normalized ratio ≥1.2, platelet ≤150 K/mm3, estimated glomerular filtration rate <60 mL/min/1.73m2, and MELD score >24 were associated with 30-day mortality. Six studies were identified. The results were consistent with our findings regarding low incidence of candidemia, and relevant risk factors are listed. CONCLUSION: Candidemia had low incidence but high mortality in hospitalized cirrhotic patients with BSI. New predictors were proposed for the occurrence of candidemia and 30-day mortality in these patients.

Development of novel persulfate tablets for passive trichloroethylene (TCE)-contaminated groundwater remediation.

In this study, a biodegradable binder, hydroxypropyl methyl cellulose (HPMC), was used for the first time to mix with persulfate powder for developing novel persulfate-releasing tablets to remediate trichloroethylene (TCE)-contaminated groundwater. To obtain feasible parameters for the preparation of persulfate tablets, different pressures, HPMC/tablet mass ratios, and persulfate dosages were evaluated. The results showed that the persulfate tablet released 2868 mg-persulfate/day for 12 days under the optimal manufacturing parameters of HPMC/tablet mass ratio of 0.5 and pressure of 4.90 × 108 N/m2. Persulfate diffusion and gel layer erosion were dominant mechanisms for controlling the persulfate released in water. The persulfate release time and rate can be controlled by adjusting the persulfate dosage at the optimal HPMC/tablet ratio. In the column experiment, TCE with an initial concentration of 70 mg/L reached 55% removal efficiency by the tablet, which showed that the developed tablet was capable of degrading highly concentrated TCE. The results of electron spin resonance (ESR) spectroscopy showed that both SO4-· and ·OH were responsible for the oxidation of TCE. During 150 days of incubation, the biodegrading efficiency of HPMC by microbes in soil and activated sludge was 67% and 80%, respectively, under aerobic conditions, while 58% of HPMC was removed by soil bacteria under anaerobic conditions. The results showed that persulfate tablets could be used as a passive groundwater remediation system. There is no waste generated after persulfate is completely released during groundwater remediation. The developed persulfate tablets are environmentally friendly and meet the green remediation aspect.