Predictive variables for hemodialysis and death in Japanese spotted fever, and the association between distance from rivers and incidence.

The number of patients with Japanese spotted fever (JSF) and its case fatality rate have been increasing in Japan and other East Asian countries. Better clinical and laboratory biomarkers are needed to avoid misdiagnosing JSF and to predict severe cases. In addition to determining these predictors, we aimed to examine the association between the incidence of JSF and the distance from rivers, in Hiroshima Prefecture, one of the most JSF prevalent areas in Japan. Patients diagnosed with JSF from 2009 to 2017 in two hospitals in Onomichi City in Hiroshima Prefecture were studied, and their clinical characteristics and laboratory data were collected retrospectively from medical charts. A random forest was used to identify predictors of severe JSF leading to hemodialysis or death. A multivariable negative binomial regression model was utilized to analyze the association between the cumulative incidence in each postal code area and the distance from the residential postal code area to the closest river. Out of 82 patients with JSF (mean age at diagnosis, 74.1 ± 10.6 years; 34 (41.5 %) men), 6 cases were regarded as severe (among them 5 hemodialysis patients and 3 deaths). Twenty-eight (34.1 %) patients were misdiagnosed at least once at the initial hospital visit. Laboratory examination showed 34.5 % had atypical lymphocytes, 73.8 % had no eosinophils, 75.6 % had an elevated aspartate aminotransferase (AST) level, and 69.5 % had hyponatremia. Among cases without urine leucocytes, 63.3 % had proteinuria and 63.3 % had hematuria. Low serum total protein was the strongest predictor of severe JSF, followed by high blood urea nitrogen (BUN) and low albumin. Geospatial analysis showed a significant negative association between the cumulative incidence of JSF cases and the distance from rivers in an adjusted model: the cumulative incidence decreased by 0.51 times (95 % CI: 0.30 to 0.86) for every kilometer of distance from the residential postal code area to the closest river. Some laboratory data may be useful in averting misdiagnosis of JSF and in predicting severe cases. Additional studies should be done in order to clarify the mechanism and association of the incidence of JSF with the distance from the nearest river.

Ferritization treatment of copper in soil by electrokinetic remediation.

The usefulness of the combined use of the electrokinetic (EK) remediation and a ferrite treatment zone (FTZ) was demonstrated for a treatment of the contaminated soil with heavy metal ions. Copper ions in contaminated soil were transferred into the FTZ by the EK technology and were ferritized in this system. The distribution of copper in a migration chamber after EK treatment with FTZ for 48h showed the large difference in the total and eluted concentration of copper. This indicated that copper ions transferred by EK into the FTZ were ferritized there with ferrite reagent in soil alkalified by EK process. The copper-ferrite compound, which was not dissolved with diluted acid, was retained in the FTZ and accumulated there. The ratio of the ferritized amount of copper against total copper was 92% in the EK process with FTZ after 48 h.

Concentration of copper and a copper-EDTA complex at the pH junction formed in soil by an electrokinetic remediation process.

The formation and stability of a pH junction was investigated, and the precipitation and accumulation of a metal hydroxide at the pH junction was confirmed. Moreover, the possibility that metal ions could be accumulated as a Me-EDTA complex at the pH junction was demonstrated. As a result, the pH junction where the acidic and alkali fronts of soil meet and the pH of soil changes rapidly, appeared at the 0.6 position in the EK process for 6-12 h. Copper ions accumulated in the form of copper hydroxide. EDTA was also concentrated in the position, in general agreement with the position of the pH junction. In addition to copper hydroxide, a copper-EDTA complex was concentrated at the 0.6 position from the anode after EK treatment for 12 h. The copper-EDTA complex was retained in 0.7 position from the anode after 12 h and, after 24 h, the position shifted to 0.8-0.9 from the anode. The possibility of accumulating metal ions within a narrow area, such as a pH junction was demonstrated.