State-of-the-art review of soil erosion control by MICP and EICP techniques: Problems, applications, and prospects

In recent years, the application of microbially induced calcite precipitation (MICP) and enzyme-induced carbonate precipitation (EICP) techniques have been extensively studied to mitigate soil erosion, yielding substantial achievements in this regard. This paper presents a comprehensive review of the recent progress in erosion control by MICP and EICP techniques. To further discuss the effectiveness of erosion mitigation in-depth, the estimation methods and characterization of erosion resistance were initially compiled. Moreover, factors affecting the erosion resistance of MICP/EICP-treated soil were expounded, spanning from soil properties to treatment protocols and environmental conditions. The development of optimization and upscaling in erosion mitigation via MICP/EICP was also included in this review. In addition, this review discussed the limitations and correspondingly proposed prospective applications of erosion control via the MICP/EICP approach. The current review presents up-to-date information on the research activities for improving erosion resistance by MICP/EICP, aiming at providing insights for interdisciplinary researchers and guidance for promoting this method to further applications in erosion mitigation.

Significant increase in the prevalence of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus, particularly the USA300 variant ΨUSA300, in the Japanese community

IMPORTANCE

USA300 is an MRSA clone producing PVL, a toxin associated with SSTIs. ΨUSA300 is a USA300 variant recently identified in Japan by Takadama et al. (15). Here, we found that the prevalence rate of PVL-positive MRSA in S. aureus was elevated in the Japanese community, and ΨUSA300 accounted for most of them. ΨUSA300 strains have been isolated from several areas in Japan and were associated with deep-seated SSTIs. This study highlighted the emerging threat posed by ΨUSA300 in Japan.

Eco-friendly soil stabilization method using fish bone as cement material

The method of soil improvement by calcium phosphate precipitation is a novel, environmentally friendly, and non-toxic technique. Such technology provides advantages over ureolytic induced calcite precipitation (UICP), the most popular and widely used method in the field of geotechnical engineering. In this paper, an investigation of the consolidation of fine and coarse sand samples by enzyme induced calcium phosphate precipitation (EICPP) was carried out. Tuna bones were used as an alternative source of calcium and phosphorus ions, as one of the most popular fish species in Japan and the main source of food industry waste. Unconfined compressive strength (UCS) of the samples after 21 days of daily injection of the solution showed an increase in strength up to 6,05 MPa in fine and up to 4,3 MPa in coarse sand samples. X-ray powder diffraction (XRD), scanning electron microscope (SEM), and energy dispersive X-ray spectroscopy (SEM-EDS) analysis were performed to investigate the nature and type of deposition. Analyses confirmed that deposition is composed of brushite with needle-like crystals in the case of Toyoura sand and flower-like crystals in the case of Mikawa sand. SEM-EDS showed a presence of both, calcium, and phosphorus in the precipitate, indicating the presence of calcium phosphate compounds (CPCs). This study reveals that tuna bones are a rich source of calcium and phosphorus for EICPP, which results in a strengthening of silicate soil up to 3.4-6.05 MPa and is able to reduce ammonia emissions by 85.7 % - 97.5 % compared to UICP.

Where has the lymphoma gone? Pericardial effusion adenosine deaminase may play a key role in diagnosing primary effusion lymphoma-like lymphoma: a case report

Background

Primary effusion lymphoma (PEL) is a non-Hodgkin lymphoma that is exclusively generated by body cavity effusion. Primary effusion lymphoma develops in patients infected with human immunodeficiency virus (HIV) and is associated with the human herpes virus (HHV)-8 infection. However, there are sporadic cases without HHV-8 infections or any history of immunodeficiency, called 'PEL-like lymphoma'.

Case summary

An 83-year-old man was admitted to our institution because of shortness of breath, fatigue, and facial oedema. Laboratory findings were unremarkable, including negative results for HIV antibodies. Transthoracic echocardiography revealed massive pericardial effusion surrounding the entire heart, which resulted in the early diastolic collapse of the right ventricular free wall, indicating elevated intra-pericardial pressure. He underwent pericardial centesis and 700 mL of pericardial fluid was drained. Adenosine deaminase (ADA) in the pericardial effusion showed an abnormally high value of 221 U/L. Cytological examination revealed a cellular population compatible with diffuse large B-cell lymphoma with prominent blastic characteristics and negative for HHV-8 latent nuclear antigens. Thus, the patient was diagnosed with HHV-8 unrelated HIV-negative PEL-like lymphoma. He was followed for more than 10 months in complete remission after a single pericardial drainage without any chemotherapy.

Discussion

Exhaustive drainage of the lymphomatous effusion may induce complete remission in some patients with PEL-like lymphoma. Furthermore, the ADA value in the pericardial effusion may serve as a valuable guide to facilitate the accurate diagnosis of PEL-like lymphoma.

Lessons from a case with stiff left atrial syndrome complicated by iatrogenic inter-atrial shunts: a case report

Background

In patients with stiff left atrial (LA) syndrome, reservoir function is significantly impaired due to extensive LA fibrosis; consequently, the increase in LA pressure during haemodynamic stress is prominent, easily leading to pulmonary venous hypertension and subsequent pulmonary congestion, and eventually results in intractable heart failure.

Case summary

A 79-year-old female with mitral stenosis and atrial fibrillation underwent valve replacement, Cox-Maze IV procedure, LA plication, and appendage ligation 4 years prior to presentation. Thereafter, she underwent a total of two catheter ablation procedures for recurrent atrial tachycardia. Transthoracic echocardiography revealed two continuous colour jets across the interatrial septum, with a peak pressure gradient of 23 mmHg, which was consistent with the residual puncture hole at the catheter ablation procedures. Although transoesophageal echocardiography showed no evidence of prosthetic valve dysfunction, the pulmonary venous flow signal showed a significantly blunted systolic forward flow, extremely small retrograde reversal flow during atrial contraction, and prominent diastolic flow velocities, all of which indicated significantly impaired LA function. Cardiac catheter examination revealed a characteristic pulmonary capillary wedge pressure waveform, which consisted of a steep ascending limb of v wave with a large peak, consistent with stiff LA syndrome.

Discussion

Treatment of patients with stiff LA syndrome is quite challenging and restricted to the use of diuretics only, which has limited efficacy and eventually results in intractable heart failure. In this case, owing to the inter-atrial pressure-relieving gateway, the patient was only mildly symptomatic despite the existence of a non-compliant LA.

Baseline investigation on soil solidification through biocementation using airborne bacteria

Microbial induced carbonate precipitation (MICP) through the ureolysis metabolic pathway is one of the most studied topics in biocementation due to its high efficiency. Although excellent outcomes have proved the potential of this technique, microorganisms face some obstacles when considering complicated situations in the real field, such as bacterial adaptability and survivability issues. This study made the first attempt to seek solutions to this issue from the air, exploring ureolytic airborne bacteria with resilient features to find a solution to survivability issues. Samples were collected using an air sampler in Sapporo, Hokkaido, a cold region where sampling sites were mostly covered with dense vegetation. After two rounds of screening, 12 out of 57 urease-positive isolates were identified through 16S rRNA gene analysis. Four potentially selected strains were then evaluated in terms of growth pattern and activity changes within a range of temperatures (15°C-35°C). The results from sand solidification tests using two Lederbergia strains with the best performance among the isolates showed an improvement in unconfined compressive strength up to 4-8 MPa after treatment, indicating a high MICP efficiency. Overall, this baseline study demonstrated that the air could be an ideal isolation source for ureolytic bacteria and laid a new pathway for MICP applications. More investigations on the performance of airborne bacteria under changeable environments may be required to further examine their survivability and adaptability.

Functional modification of mussel adhesive protein to control solubility and adhesion property

Marine mussels produce strong underwater adhesives called mussel adhesive proteins (MAPs) that can adhere to a variety of surfaces under physiological conditions. Thus, MAPs have been investigated as a potentially sustainable alternative to conventional petrochemical-based adhesives. Recombinant MAPs would be promising for large-scale production and commercialization; however, MAPs are intrinsically adhesive, aggregative, and insoluble in water. In this study, we have developed a solubilization method for the control of MAP adhesion by fusion protein technique. Foot protein 1 (Fp1), a kind of MAP, was fused with the highly water-soluble protein, which is the C-terminal domain of ice-nucleation protein K (InaKC), separated by a protease cleaving site. The fusion protein exhibited low adhesion but high solubility and stability. Notably, Fp1 recovered its adhesive property after removal from the InaKC moiety by protease cleaving, which was evaluated and confirmed by the agglomeration of magnetite particles in water. The ability to control adhesion and agglomeration makes MAPs favorable prospects for bio-based adhesives.

Interfacial biosilica coating of chitosan gel using fusion silicatein to fabricate robust hybrid material for biomolecular applications

An enzyme-encapsulated silica-based hybrid material was developed using a chitosan gel. Fusion silicatein (InaKC-ChBD-Sil), silicatein fused with a soluble tag and chitin-binding domain, was employed as an interfacial catalyst to form silica on a chitosan gel matrix under physiological conditions, and horseradish peroxidase was immobilised on the hybrid material. Silica formation on the gel was verified via fluorescence microscopy using a designed fusion protein called TBP-mCherry, a fluorescent protein fused with a silica-binding peptide. We report a chitosan gel-silica hybrid material capable of encapsulating enzymes for biomedical and environmental applications.

Influence of humic acid on microbial induced carbonate precipitation for organic soil improvement

Microbial induced carbonate precipitation (MICP) is one of the most commonly researched topics on biocementation, which achieves cementation of soil particles by carbonate from urea hydrolysis catalyzed by microbial urease. Although most MICP studies are limited to stabilizing sandy soils, more researchers are now turning their interest to other weak soils, particularly organic soils. To stabilize organic soils, the influence of humic substances should be investigated since it has been reported to inhibit urease activity and disrupt the formation of calcium carbonate. This study investigates the effect of humic acid (HA), one fraction of humic substances, on MICP. For this purpose, the effects of HA content on CaCO₃ precipitation using three strains and on CaCO₃ morphology were examined. The results showed that native species in organic soils were less adversely affected by HA addition than the exogenous one. Another interesting finding is that bacteria seem to have strategies to cope with harsh conditions with HA. Observation of CaCO₃ morphology revealed that the crystallization process was hindered by HA to some extent, producing lots of fine amorphous precipitates and large aggregated CaCO₃. Overall, this study could provide an insightful understanding of possible obstacles when using MICP to stabilize organic soils.

Naturally Derived Cements Learned from the Wisdom of Ancestors: A Literature Review Based on the Experiences of Ancient China, India and Rome

For over a thousand years, many ancient cements have remained durable despite long-term exposure to atmospheric or humid agents. This review paper summarizes technologies of worldwide ancient architectures which have shown remarkable durability that has preserved them over thousands of years of constant erosion. We aim to identify the influence of organic and inorganic additions in altering cement properties and take these lost and forgotten technologies to the production frontline. The types of additions were usually decided based on the local environment and purpose of the structure. The ancient Romans built magnificent structures by making hydraulic cement using volcanic ash. The ancient Chinese introduced sticky rice and other local materials to improve the properties of pure lime cement. A variety of organic and inorganic additions used in traditional lime cement not only changes its properties but also improves its durability for centuries. The benefits they bring to cement may also be useful in enzyme-induced carbonate precipitation (EICP) and microbially induced carbonate precipitation (MICP) fields. For instance, sticky rice has been confirmed to play a crucial role in regulating calcite crystal growth and providing interior hydrophobic conditions, which contribute to improving the strength and durability of EICP- and MICP-treated samples in a sustainable way.

Diastolic heart failure is a new clinical entity of trastuzumab-induced cardiotoxicity: a case report

Background

Cancer therapy-related cardiac dysfunction (CTRCD) is defined as a decrease in the left ventricular ejection fraction (LVEF) of >10% to a value below the lower limit of normal or relative reduction in global longitudinal strain (GLS) >15% from baseline after cancer treatment. However, the possibility of the development of isolated diastolic dysfunction has never been considered in the clinical presentation of CTRCD.

Case summary

An 81-year-old woman was admitted to our institution presenting with prominent bilateral leg oedema, orthopnoea, and 8 kg of weight gain after administration of the anti-human epidermal growth factor receptor 2 (HER-2) antibody, trastuzumab, for HER-2-positive breast cancer. Transthoracic echocardiography showed a preserved LVEF of 62% without a significant reduction in GLS compared with results obtained before anti-HER-2 targeted therapy. Doppler echocardiography distinctly revealed a newly developed significant left ventricular diastolic dysfunction with evidence of elevated filling pressure. After successful achievement of volume reduction, the patient underwent cardiac catheter examination, revealing an elevated pulmonary artery wedge pressure of 18 mmHg. Subsequently, trastuzumab was discontinued and the patient was treated with diuretics, arteriodilators, and venodilators, until the signs and symptoms of heart failure completely disappeared.

Discussion

In the management of CTRCD, including pretreatment screening, cardiotoxicity monitoring, follow-up after anti-cancer agents, and evaluation of the effectiveness of the therapy, too much emphasis has been paid exclusively to the development of systolic dysfunction; however, perspectives for diastolic dysfunction may be needed. A comprehensive multidisciplinary team approach composed of breast surgeons, oncologists, onco-cardiologists, and echocardiography specialists is required.

State-of-the-Art Review on Engineering Uses of Calcium Phosphate Compounds: An Eco-Friendly Approach for Soil Improvement

Greenhouse gas emissions are a critical problem nowadays. The cement manufacturing sector alone accounts for 8% of all human-generated emissions, and as the world's population grows and globalization intensifies, this sector will require significantly more resources. In order to fulfill the need of geomaterials for construction and to reduce carbon dioxide emissions into the atmosphere, conventional approaches to soil reinforcement need to be reconsidered. Calcium phosphate compounds (CPCs) are new materials that have only recently found their place in the soil reinforcement field. Its eco-friendly, non-toxic, reaction pathway is highly dependent on the pH of the medium and the concentration of components inside the solution. CPCs has advantages over the two most common environmental methods of soil reinforcement, microbial-induced carbonate precipitation (MICP) and enzyme induced carbonate precipitation (EICP); with CPCs, the ammonium problem can be neutralized and thus allowed to be applied in the field. In this review paper, the advantages and disadvantages of the engineering uses of CPCs for soil improvement have been discussed. Additionally, the process of how CPCs perform has been studied and an analysis of existing studies related to soil reinforcement by CPC implementation was conducted.

A Ruptured Left Gastric Artery Aneurysm That Neoplasticized during the Course of Coronavirus Disease 2019: A Case Report

Coronavirus disease 2019 (COVID-19) is an acute respiratory syndrome caused by SARS-CoV-2 and is known to cause respiratory and systemic symptoms. A SARS-CoV-2 infection is involved in aneurysm formation, enlargement, and rupture in medium-sized vessels, such as the cerebral and coronary arteries and the aorta. In contrast, its involvement in forming aneurysms in medium-sized vessels other than the cerebral and coronary arteries has not been reported. An 84-year-old Japanese man with COVID-19 was admitted to our hospital. The treatment course was favorable, and the COVID-19 treatment was completed by the 10th day. On day 14, pancreatic enzymes increased mildly. An abdominal computed tomography revealed a ruptured left gastric aneurysm after spontaneous hemostasis. Arterial embolization was performed. In this patient, a new left gastric aneurysm was suspected of having formed and ruptured during the course of the COVID-19 treatment. To the best of our knowledge, this is the first report of abdominal visceral aneurysm formation caused by COVID-19 in a medium-sized vessel, and it is necessary to remember that aneurysms can be formed at any site when treating this syndrome.

Collaborative health systems ECHO: The use of a tele-education platform to facilitate communication and collaboration with recipients of state targeted response funds in Pennsylvania

Background: The opioid epidemic continues to erode communities across Pennsylvania (PA). Federal and PA state programs developed grants to establish Hub and Spoke programs for the expansion of medications for opioid use disorders (MOUD). Employing the telementoring platform Project ECHO (Extension for Community Health Outcomes), Penn State Health engaged the other seven grant awardees in a Collaborative Health Systems (CHS) ECHO. We conducted key informant interviews to better understand impact of the CHS ECHO on health systems collaboration and opioid crisis efforts. Methods: For eight one-hour sessions, each awardee presented their unique strategies, challenges, and opportunities. Using REDCap, program characteristics, such as number of waivered prescribers and number of patients served were collected at baseline. After completion of the sessions, key informant interviews were conducted to assess the impact of CHS ECHO on awardee's programs. Results: Analysis of key informant interviews revealed important themes to address opioid crisis efforts, including the need for strategic and proactive program reevaluation and the convenience of collaborative peer learning networks. Participants expressed benefits of the CHS ECHO including allowing space for discussion of challenges and best practices and facilitating conversation on collaborative targeted advocacy and systems-level improvements. Participants further reported bolstered motivation and confidence. Conclusions: Utilizing Project ECHO provided a bidirectional platform of learning and support that created important connections between institutions working to combat the opioid epidemic. CHS ECHO was a unique opportunity for productive and convenient peer learning across external partners. Open dialogue developed during CHS ECHO can continue to direct systems-levels improvements that benefit individual and population outcomes.

Solubilization and aggregation control of silica-polymerizing enzyme fused with a removable soluble protein

Silicatein, a silica-polymerizing enzyme, is an attractive and promising biocatalyst in many applications such as the synthesis of bio-functionalized inorganic materials under mild conditions. However, its unfavorable aggregation in aqueous media due to its intermolecular hydrophobic interactions causes difficulties in handling and applications. This study aimed to enhance the solubility of silicatein via fusion with a small soluble protein, ProS2. ProS2-Sil showed high solubility and stability in aqueous media for more than 24 h. The aggregation property of ProS2-silicatein fusion protein (ProS2-Sil) was investigated with and without cleavage of ProS2 tag by site-specific protease. When ProS2 tag was removed, silicatein became aggregated, which was analyzed by transmission electron microscope and fluorescence microscope. ProS2-Sil and mature silicatein showed similar activities in silica polymerization. The present approach allows the utilization of silicatein in the fabrication of novel and functional inorganic biohybrid materials.

Experimental Study on Sand Stabilization Using Bio-Cementation with Wastepaper Fiber Integration

Recently, green materials and technologies have received considerable attention in geotechnical engineering. One of such techniques is microbially-induced carbonate precipitation (MICP). In the MICP process, CaCO₃ is achieved bio-chemically within the soil, thus enhancing the strength and stiffness. The purpose of this study is to introduce the wastepaper fiber (WPF) onto the MICP (i) to study the mechanical properties of MICP-treated sand with varying WPF content (0–8%) and (ii) to assess the freeze–thaw (FT) durability of the treated samples. Findings revealed that the ductility of the treated samples increases with the increase in WPF addition, while the highest UCS is found with a small fiber addition. The results of CaCO₃ content suggest that the WPF addition enhances the immobilization of the bacteria cells, thus yielding the precipitation content. However, shear wave velocity analysis indicates that a higher addition of WPF results in rapid deterioration of the samples when subjected to freeze–thaw cycles. Microscale analysis illuminates that fiber clusters replace the solid bonding at particle contacts, leading to reduced resistance to freeze–thaw damage. Overall, the study demonstrates that as a waste material, WPF could be sustainably reused in the bio-cementation.

Infective Endocarditis Caused by Extended-Spectrum Beta-Lactamase-Producing Escherichia coli: A Case Report

Introduction

Extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) reportedly accounts for >20% of E. coli infections and 2.0% of infective endocarditis cases. Nonetheless, there is a global paucity of reports on infective endocarditis caused by ESBL-EC.

Case

An 83-year-old Japanese man who underwent mitral annuloplasty for mitral valve prolapse 5 years ago developed a fever of 38.5°C. The patient was hospitalized the first time for pyelonephritis and bacteremia due to ESBL-EC and treated successfully with the antimicrobial meropenem for 14 days. Two days after discharge, however, the patient was re-admitted with bacteremia due to ESBL-EC. He was treated successfully with the antimicrobial cefmetazole for 14 days. The patient was admitted to our institution for a third time due to bacteremia again, a day after discharge following meropenem antibiotic therapy. Transesophageal echocardiography showed vegetation in the anterior mitral valve annulus. Magnetic resonance imaging of the head showed septic cerebral embolism. The patient was diagnosed with infective endocarditis due to ESBL-EC and underwent mitral valve replacement. After 6 weeks of antibiotic therapy with meropenem and tobramycin, the patient recovered completely. The causative E. coli strain MS6396 was identified as the E. coli clone ST131 by multilocus sequence typing and confirmed the presence of bla_CTX-M-27 ESBL gene.

Conclusion

Only six cases of infective endocarditis associated with ESBL-EC have been reported in the past. Moreover, this is the first report of a patient with infective endocarditis bacteriologically or genetically analyzed for ESBL-EC. In future, factors that may cause infective endocarditis in ESBL-EC infections may be clarified through more thorough bacteriological/genetic analyses of ESBL-EC.

Derivation of uncertainty propagation for clearance measurement

Clearance measurements are performed to calculate the sum of the ratios of the measured activity concentration to the limit for all nuclides to be considered. In the derivation of the uncertainty, the modeling of the measurement is essential. By using formula for the modeling, the uncertainty and upper limits of the coverage interval can be calculated by uncertainty propagation. The treatment of the ratio of the activity concentration of difficult-to-measure-nuclides to that of the key nuclide is also described.

Biosorption of Pb (II) and Zn (II) from aqueous solution by Oceanobacillus profundus isolated from an abandoned mine

The present study investigated biosorption of Pb (II) and Zn (II) using a heavy metal tolerant bacterium Oceanobacillus profundus KBZ 3-2 isolated from a contaminated site. The effects of process parameters such as effect on bacterial growth, pH and initial lead ion concentration were studied. The results showed that the maximum removal percentage for Pb (II) was 97% at an initial concentration of 50 mg/L whereas maximum removal percentage for Zn (II) was at 54% at an initial concentration of 2 mg/L obtained at pH 6 and 30 °C. The isolated bacteria were found to sequester both Pb (II) and Zn (II) in the extracellular polymeric substance (EPS). The EPS facilitates ion exchange and metal chelation-complexation by virtue of the existence of ionizable functional groups such as carboxyl, sulfate, and phosphate present in the protein and polysaccharides. Therefore, the use of indigenous bacteria in the remediation of contaminated water is an eco-friendly way of solving anthropogenic contamination.

Impact of door-to-deployment time of venoarterial extracorporeal membrane oxygenation for out-of-hospital refractory cardiac arrest patients secondary to cardiovascular causes

Background

Door-to-balloon time in patients with ST-elevation myocardial infarction is reported to be an independent predictor of the prognostic implication. However, the effect of door-to-deployment time (DTDT) of venoarterial extracorporeal membrane oxygenation (VA-ECMO) on patients with out-of-hospital cardiac arrest (OHCA) is unclear.

Purpose

This single-center, retrospective, observational study aimed to evaluate the effect of DTDT of VA-ECMO for mortality or neurological outcome of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiogenic OHCA.

Method

This single-center, retrospective, observational study was conducted from January 2008 to April 2019. The primary endpoint was 1-month overall survival measured after ECMO initiation. Moreover, the secondary endpoint was 1-month survival with favorable neurological functions defined as having a cerebral performance category score of 1 or 2.

Result

A total of 3082 patients with OHCA were brought to our institution and 84 received ECPR. Of these, 51 consecutive adult patients with cardiogenic OHCA without sustained return of spontaneous circulation during transport were included in this analysis. Approximately 18 patients (18/51, 35.3%) survived after 1 month and were discharged. Among the survivors, 15 (15/18, 83.3%) were discharged with a favorable neurological outcome. The baseline characteristics between the survivors and non-survivors were not significantly different, except for the initial shockable rhythm [18/18 (100%) versus 28/33 (84.9%), P=0.03]. There were no significant differences between the median time from collapse to hospital arrival [31.0 min (IQR 25.0–31.0) versus 29.0 min (IQR 25.0–39.5), P=0.53] and from call to hospital arrival [28.0 min (IQR 22.0–32.5) versus 27.0 min (IQR 23.3–34.5), P=0.56]. The median DTDT of VA-ECMO was significantly shorter in survivors [13.0 min (IQR 11.5–18.3) versus 21.0 minutes (IQR 15.5–32.0), P=0.01]. The Kaplan–Meier survival analysis showed that the group with a DTDT ≤20 min had a significantly higher 1-month overall survival rate (P<0.01) and survival rate with a favorable neurological outcome (P=0.01) than that with a DTDT >20 minutes. Using the Cox proportional hazards analysis, DTDT ≤20 minutes and bystander-witnessed significantly affected the overall survival rate at 1 month [adjusted hazard ratio (HR), 0.44; 95% confidence interval (CI), 0.20–0.95; P=0.03 and adjusted HR, 0.31; 95% CI, 0.13–0.74; P<0.01, respectively]. Regarding survival rate with a favorable neurological outcome, the result was relatively similar [adjusted HR, 0.46; 95% CI, 0.22–0.96; P=0.04 and adjusted HR, 0.37; 95% CI, 0.16–0.85; P=0.02, respectively].

Conclusion

This study revealed that the DTDT of VA-ECMO is significantly associated with the 1-month mortality and neurological prognosis of patients with cardiogenic OHCA. However, further studies will be required to confirm these findings.

Kaplan-Meier survival curve

Funding Acknowledgement

Type of funding source: None

The Influence of the Addition of Plant-Based Natural Fibers (Jute) on Biocemented Sand Using MICP Method

The microbial-induced carbonate precipitation (MICP) method has gained intense attention in recent years as a safe and sustainable alternative for soil improvement and for use in construction materials. In this study, the effects of the addition of plant-based natural jute fibers to MICP-treated sand and the corresponding microstructures were measured to investigate their subsequent impacts on the MICP-treated biocemented sand. The fibers used were at 0%, 0.5%, 1.5%, 3%, 5%, 10%, and 20% by weight of the sand, while the fiber lengths were 5, 15, and 25 mm. The microbial interactions with the fibers, the CaCO₃ precipitation trend, and the biocemented specimen (microstructure) were also evaluated based on the unconfined compressive strength (UCS) values, scanning electron microscopy (SEM), and fluorescence microscopy. The results of this study showed that the added jute fibers improved the engineering properties (ductility, toughness, and brittleness behavior) of the biocemented sand using MICP method. Furthermore, the fiber content more significantly affected the engineering properties of the MICP-treated sand than the fiber length. In this study, the optimal fiber content was 3%, whereas the optimal fiber length was s 15 mm. The SEM results indicated that the fiber facilitated the MICP process by bridging the pores in the calcareous sand, reduced the brittleness of the treated samples, and increased the mechanical properties of the biocemented sand. The results of this study could significantly contribute to further improvement of fiber-reinforced biocemented sand in geotechnical engineering field applications.

Current status of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus isolated from patients with skin and soft tissue infections in Japan

The USA300 clone, which produces Panton-Valentine leukocidin (PVL), is a major pathogenic community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clone that causes intractable skin infections. Recently, PVL-positive CA-MRSA, including USA300 clones, have emerged in both communities and hospitals in Japan. To prevent an outbreak of PVL-positive MRSA, infected patients should be treated with effective antimicrobial agents at community clinics. Herein, we investigate molecular epidemiological characteristics of PVL-positive MRSA isolated from outpatients with skin and soft tissue infections (SSTI), which are common community-onset infectious diseases. The detection rate of MRSA was 24.9% (362 strains) out of 1455 S. aureus strains isolated between 2013 and 2017. Among the MRSA strains, 15.5% (56 strains) were PVL-positive strains and associated with deep-seated skin infections. Molecular epidemiological analyses of PVL-positive MRSA showed that USA300 was the predominant clone (53.6%, 30 strains) and was identified in Kanto (18 strains), Kagawa (nine strains), Tohoku (two strains) and Hokkaido (one strain). Notably, minocycline and fusidic acid were effective against all PVL-positive MRSA strains. Hence, our data reveals the current status of PVL-positive MRSA isolated from patients with SSTI in Japan. Continuous surveillance of CA-MRSA is necessary to monitor latest prevalence rates and identify effective antimicrobial agents for PVL-positive MRSA strains.

Biological Route to Fabricate Silica on Cellulose Using Immobilized Silicatein Fused with a Carbohydrate-Binding Module

Silicatein is an enzyme capable of catalyzing silica formation under mild conditions and is a promising catalyst for the fabrication of biohybrid materials. However, unfavorable aggregation of silicatein makes it unsuitable for use in material fabrication. In this study, a soluble protein tag (ProS2) and a carbohydrate-binding module (CBM) were used to develop a soluble and cellulose-binding fusion silicatein, ProS2-Sil-CBM, which can be efficiently immobilized on cellulose to form silica on it. ProS2-Sil-CBM was soluble in aqueous media and strongly bound to cellulose. ProS2-Sil-CBM bound on cellulose catalyzed the formation of a silica layer on the cellulose in the presence of tetraethyl orthosilicate as the substrate. Scanning electron microscopy (SEM) and surface elemental analysis confirmed the formation of silica on cellulose. This technique can be used to fabricate inorganic-organic hybrid materials to immobilize biomolecules and can be applied to develop novel biocatalytic systems, biosensors, and tissue culture scaffolds.

Humidifier Use and Prone Positioning in a Patient with Severe COVID-19 Pneumonia and Endotracheal Tube Impaction Due to Highly Viscous Sputum

COVID-19 can lead to severe pneumonia, requiring mechanical ventilation. While increased sputum secretion could cause airway obstruction during mechanical ventilation, there are few reported cases in the literature. We report a case of a 65-year-old man with diabetes and severe COVID-19 pneumonia requiring mechanical ventilation and treated with hydroxychloroquine, azithromycin, nafamostat, and prone positioning. Initially, mechanical ventilation consisted of a heat moisture exchanger, endotracheal tube aspiration, and subglottic secretion drainage using a closed suction system. However, endotracheal tube impaction by highly viscous sputum occurred during this mechanical ventilation system. Replacing the endotracheal tube, the use of a humidifier instead of a heat moisture exchanger, and prone positioning contributed to the patient being weaned off mechanical ventilation. Although anti-aerosol measures are important for severe COVID-19 pneumonia, attention should be given to potential endotracheal tube impaction during mechanical ventilation.

Cellulose-metallothionein biosorbent for removal of Pb(II) and Zn(II) from polluted water

Intake of toxic trace elements in drinking water can lead to adverse health effects. To remove toxic trace elements from water, we developed a novel biosorbent composed of cellulose and a fusion protein. The fusion protein was constructed from metallothionein (MT) and a carbohydrate-binding module (CBM), where CBM can bind to cellulose while MT can capture heavy metal ions in solution. In a batch experiment, the biosorbent had maximum biosorption capacities for Pb(II) and Zn(II) ions of 39.02 mg/g and 29.28 mg/g, respectively. Furthermore, the biosorbent could be used in a semi-continuous system and showed good regeneration and recyclability. Both cellulose and the MT-CBM are environmentally friendly and renewable materials, and this biosorbent has great potential for efficient removal of toxic trace elements from polluted water.

P1357 Left atrial function decreases with age in patients with repaired tetralogy of Fallot decrease

BACKGROUND

Left ventricular function has been shown to be an important prognostic indicator in patients with repaired tetralogy of Fallot (rTOF) and tends to decrease with age. In recent years, left atrial (LA) function was reported to be a useful prognostic indicator more than or equal to left ventricular function in acquired heart diseases. However, atrial function in rTOF has not yet been sufficiently examined.

PURPOSE

The aim of this study was to investigate the relationship between LA dysfunction and age in rTOF using strain analysis.

METHODS

In order to assess the relationship between LA function and age, we recruited 59 patients with rTOF ranging in age from 5-40 years. We stratified the patients into 3 groups (T1: 5-10 years, T2: 11-20 years, T3: 21-40 years) and divided 54 controls of similar age into 3 corresponding groups (N1, N2, and N3). Two-dimensional speckle tracking images (2D-STI) obtained from four- and two-chamber views were used to assess LA functions by measuring reservoir, conduit, and pump strain. Additionally, we measured the strain rate (SR) in the systole, early diastole, and late diastole.

RESULTS

LA reservoir strain (37.4 ± 2.2% vs. 47.9 ± 1.7%, P= 0.004), LA pump strain (8.3 ± 1.4% vs. 14.1 ± 2.7%, p <.001), atrial systolic LA-SR (1.5 ± 0.4% vs. 2.4 ± 0.6%, p <.001), and systolic LA-SR (1.5 ± 0.3% vs. 2.1 ± 0.4%, p = 0.003) were significantly decreased in T3 compared with N3. Although only LA conduit strain decreased with aging (r = -0.3204, p = 0011) in controls, all of the LA reservoir (r = -0.325, p = 0.020), conduit (r = -0.314, p = 0.025), and pump strain (r = -0.481, p < 0.001) in rTOF decreased with aging.

Early diastole SR was significantly decreased in the T1 and T3 groups compared with the N1 and N3 groups (T1 vs N1, 3.00 ± 0.63% vs. 4.03 ± 0.0.80%, p <.0.001, T3 vs N3, 2.31 ± 0.57% vs.3.31 ± 0.47%, p < 0.001). Both systolic SR and late diastole SR decreased in T3 group compared with the N3 (1.54 ± 0.32% vs. 2.08 ± 0.42%, p = 0.003, 1.42 ± 0.32% vs.2.42 ± 0.61%, p < 0.001), respectively. Although only early diastole SR decreased with aging (r = -0.415, p < 0.001) in controls, all of the systole (r = -0.287, p = 0.041), early diastole (r = -0.337, p = 0.019), and late diastole SR (r = -0.407, p = 0.003) in rTOF decreased with aging.

CONCLUSIONS

In rTOF, most of the LA functions assessed by strain analysis decreased compared to normal controls in over 20 years old age. Furthermore, all measured functions decreased with age in rTOF while only two parameters decreased with age in normal controls. These results suggest that LA function may be an important indicator in long-term rTOF follow-up. These are new insights into LA function in patients with rTOF.

A Novel Metal Adsorbent Composed of a Hexa-histidine Tag and a Carbohydrate-binding Module on Cellulose

We developed a novel metal adsorbent composed of bio-based materials, cellulose and a protein. The approach involved the immobilization of a hexa-histidine tag (His₆), which shows an affinity for an intermediate acid (metal ion) in Hard and Soft Acids and Bases (HSAB) theory, on cellulose by fusing with a carbohydrate-binding module (CBM). The results show that CBM-His₆-bound cellulose has adsorption selectivity reflecting the original properties of His₆. Additionally, we prepared three configurations of CBM-His₆ proteins, which were subsequently immobilized on filter paper for Ni²⁺ ion adsorption. Of these configurations, we found that the protein containing two His₆ tags at each terminus (N- and C-) of CBM exhibited the highest metal adsorption ability. Furthermore, XPS analysis confirmed the binding of Ni²⁺ ions on the cellulose.

Solidification of sand by Pb(II)-tolerant bacteria for capping mine waste to control metallic dust: Case of the abandoned Kabwe Mine, Zambia

Environmental impacts resulting from historic lead and zinc mining in Kabwe, Zambia affect human health due to the dust generated from the mine waste that contains lead, a known hazardous pollutant. We employed microbially induced calcium carbonate precipitation (MICP), an alternative capping method, to prevent dust generation and reduce the mobility of contaminants. Pb-resistant Oceanobacillus profundus KBZ 1-3 and O. profundus KBZ 2-5 isolated from Kabwe were used to biocement the sand that would act as a cover to prevent dust and water infiltration. Sand biocemented by KBZ 1-3 and KBZ 2-5 had maximum unconfined compressive strength values of 3.2 MPa and 5.5 MPa, respectively. Additionally, biocemented sand exhibited reduced water permeability values of 9.6 × 10-8 m/s and 8.9 × 10-8 m/s for O. profundus KBZ 1-3 and KBZ 2-5, respectively, which could potentially limit the entrance of water and oxygen into the dump, hence reducing the leaching of heavy metals. We propose that these isolates represent an option for bioremediating contaminated waste by preventing both metallic dust from becoming airborne and rainwater from infiltrating into the waste. O. profundus KBZ 1-3 and O. profundus KBZ 2-5 isolated form Kabwe represent a novel species that has, for the first time, been applied in a bioremediation study.

Chitosan enhances calcium carbonate precipitation and solidification mediated by bacteria

Formation of the biominerals in living organisms is mainly associated with organic macromolecules. These organic materials play an important role in the nucleation, growth, and morphology controls of the biominerals. Current study mimics this concept of organic matrix- mediated biomineralization by using microbial induced carbonate precipitation (MICP) method in combination with the cationic polysaccharide chitosan. CaCO₃ precipitation was performed by the hydrolysis of urea by the ureolytic bacteria Pararhodobacter sp. SO1 in the presence of CaCl₂, with and without chitosan. The crystal polymorphism and morphology of oven-dried samples were analyzed by X-ray diffraction and scanning electron microscopy. The amount of precipitate obtained was higher in the presence of chitosan. The precipitate included both of the CaCO₃ and the chitosan hydrogel. Rhombohedral crystals were dominant in the precipitate without chitosan and distorted crystal agglomerations were found with chitosan. Sand solidification experiments were conducted in the presence of chitosan under different experimental conditions. By adding chitosan, more strongly cemented sand specimens could be obtained than those from conventional method. All of these results confirm the positive effect of chitosan for the CaCO₃ precipitation and sand solidification.

Efficacy of biocementation of lead mine waste from the Kabwe Mine site evaluated using Pararhodobacter sp

Biocementation of hazardous waste is used in reducing the mobility of contaminants, but studies on evaluating its efficacy have not been well documented. Therefore, to evaluate the efficacy of this method, physicochemical factors affecting stabilized hazardous products of in situ microbially induced calcium carbonate precipitation (MICP) were determined. The strength and leach resistance were investigated using the bacterium Pararhodobacter sp. Pb-contaminated kiln slag (KS) and leach plant residue (LPR) collected from Kabwe, Zambia, were investigated. Biocemented KS and KS/LPR had leachate Pb concentrations below the detection limit of < 0.001 mg/L, resisted slaking, and had maximum unconfined compressive strengths of 8 MPa for KS and 4 MPa for KS/LPR. Furthermore, biocemented KS and KS/LPR exhibited lower water absorption coefficient values, which could potentially reduce the water transportation of Pb²⁺. The results of this study show that MICP can reduce Pb²⁺ mobility in mine wastes. The improved physicochemical properties of the biocemented materials, therefore, indicates that this technique is an effective tool in stabilizing hazardous mine wastes and, consequently, preventing water and soil contamination.

Electricity Generation from Rice Bran by a Microbial Fuel Cell and the Influence of Hydrodynamic Cavitation Pretreatment

Single-chamber microbial fuel cells (MFCs) were constructed using rice bran (carbon source) and pond bottom mud (microbial source). The total electric charge obtained in the MFC combining rice bran with pond bottom mud was four times higher than that in MFC using only rice bran. Phylogenetic analyses revealed dominant growth of fermentative bacteria such as Bacteroides and Clostridium species, and exoelectrogenic Geobacter species in the anode biofilms, suggesting that mutualism of these bacteria is a key factor for effective electricity generation in the MFC. Furthermore, rice bran, consisting of persistent polysaccharide, was pretreated by the hydrodynamic cavitation system to improve the digestibility and enhance the efficiency in MFC, resulting in 26% increase in the total production of electricity.

Comparative analysis of methicillin-resistant Staphylococcus aureus isolated from outpatients of dermatology unit in hospitals and clinics

Community-onset methicillin-resistant Staphylococcus aureus (CO-MRSA) is a causative agent of intractable skin infections. In general, clinical symptoms of hospital outpatients with skin infections are severer than those of clinic patients. Hence, molecular epidemiological features of the CO-MRSA strains from hospital outpatients are predicted to be different from those of clinic patients. Here, we conducted a comparative analysis for CO-MRSA isolates from outpatients with impetigo in hospitals and clinics located in the same district of Tokyo, Japan. Incidence of MRSA infection was higher in hospital outpatients (21.5%, 20/93 isolates) than in clinic patients (14.5%, 121/845 isolates). The resistance rate to clindamycin, which is a common topical antimicrobial agent in dermatology, in the isolates from hospital outpatients (60.0%) was higher than those from clinic patients (31.4%). Proportion of the staphylococcal cassette chromosome (SCC) mec type II, which is a representative type of hospital-acquired MRSA in Japan, in the isolates from hospital outpatients (65.0%) was significantly higher than those from clinic patients (30.6%) (P < 0.01). Multilocus sequence typing showed that the clonal complex 89-SCCmec type II (CC89-II) clone, which exhibits clindamycin resistance, was the most predominant (55.0%) in the isolates from hospital outpatients. On the other hand, all CC8-IV, CC121-V, and CC89-V clones accounted for 60% in clinic patients were susceptible to clindamycin. Our findings suggested that the clindamycin-resistant CC89-II CO-MRSA clone might be more related to skin infections in hospital outpatients than clinic patients.

Adhesion and friction between glass and rubber in the dry state and in water: role of contact hydrophobicity

We study the contact mechanics between 3 different tire tread compounds and a smooth glass surface in water. We study both adhesion and sliding friction at low-sliding speeds. For 2 of the compounds the rubber-glass contact in water is hydrophobic and we observe adhesion, and slip-stick sliding friction dynamics. For one compound the contact is hydrophilic, resulting in vanishing adhesion, and steady-state (or smooth) sliding dynamics. We also show the importance of dynamical scrape, both on the macroscopic level and at the asperity level, which reduces the water film thickness between the solids during slip. The experiments show that the fluid is removed much faster from the rubber-glass asperity contact regions for a hydrophobic contact than for a hydrophilic contact. We also study friction on sandblasted glass in water. In this case all the compounds behave similarly and we conclude that no dewetting occur in the asperity contact regions. We propose that this is due to the increased surface roughness which reduces the rubber-glass binding energy.

A case report of myocarditis combined with hepatitis caused by herpes simplex virus

BACKGROUND

Viral myocarditis presents with various symptoms, including fatal arrhythmia and cardiogenic shock, and may develop into chronic myocarditis and dilated cardiomyopathy in some patients. We report a case of viral myocarditis and hepatitis caused by herpes simplex virus.

CASE PRESENTATION

A 20-year-old woman was admitted to our hospital with fever, fatigue, and anorexia. The initial investigation showed elevated liver enzyme levels and elevated creatine phosphokinase, and computed tomography showed diffuse swelling and internal heterogeneous image in the liver. These findings were consistent with acute hepatitis; therefore, we performed a liver biopsy, which showed parenchymal necrosis and lymphocytic infiltration. The night that the liver biopsy was performed, blood pressure gradually decreased and revealed cardiogenic shock. Electrocardiography showed diffuse ST-segment elevation, and echocardiography showed a dilated, spherical ventricle with reduced systolic function and pericardial effusion. An endomyocardial biopsy revealed lymphocyte infiltration of the myocardium, confirming acute myocarditis. After a few days, tests for immunoglobin M and immunoglobin G antibodies against herpes simplex virus were positive.

CONCLUSIONS

We presented a rare case of myocarditis combined with hepatitis that was caused by herpes simplex virus. Acute myocarditis can occur concurrently with hepatitis, pancreatitis, nephritis, and encephalitis; thus, determining the presence of other infectious lesions is necessary to provide appropriate treatment for the patient.

A State-of-the-Art Review on Soil Reinforcement Technology Using Natural Plant Fiber Materials: Past Findings, Present Trends and Future Directions

Incorporating sustainable materials into geotechnical applications increases day by day due to the consideration of impacts on healthy geo-environment and future generations. The environmental issues associated with conventional synthetic materials such as cement, plastic-composites, steel and ashes necessitate alternative approaches in geotechnical engineering. Recently, natural fiber materials in place of synthetic material have gained momentum as an emulating soil-reinforcement technique in sustainable geotechnics. However, the natural fibers are innately different from such synthetic material whereas behavior of fiber-reinforced soil is influenced not only by physical-mechanical properties but also by biochemical properties. In the present review, the applicability of natural plant fibers as oriented distributed fiber-reinforced soil (ODFS) and randomly distributed fiber-reinforced soil (RDFS) are extensively discussed and emphasized the inspiration of RDFS based on the emerging trend. Review also attempts to explore the importance of biochemical composition of natural-fibers on the performance in subsoil reinforced conditions. The treatment methods which enhances the behavior and lifetime of fibers, are also presented. While outlining the current potential of fiber reinforcement technology, some key research gaps have been highlighted at their importance. Finally, the review briefly documents the future direction of the fiber reinforcement technology by associating bio-mediated technological line.

Fly ash incorporated with biocement to improve strength of expansive soil

Microbially induced calcium carbonate precipitation (MICP) results in the formation of biocement (BC). This process, also known as biocementation, is recently widely used to improve the strength and durability of building materials including soils. In the present study, effectiveness of biocement as admixture with fly ash (FA) was investigated as first few studies to improve geotechnical properties of expansive soils. Biocement precipitated by Bacillus megaterium was blend with four formulations of fly ash at concentrations of 0, 10, 25 and 50%, namely 0% FABC, 10% FABC, 25% FABC, and 50% FABC, respectively. These formulations were separately added to expansive soils. Specimens with 25% FABC resulted in significant improvement in unconfined compressive strength of expansive soil that was more than two-times higher than control. Further, scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDX), Fourier-transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD) analyses characterized microstructures of soil specimens, and depicted the process of MICP in improving strength of expansive soils. This research indicates that incorporation of biocement in fly ash is an effective means of increasing the strength of expansive soils.

Charge-density-wave order takes over antiferromagnetism in Bi2Sr2-x La x CuO6 superconductors

Superconductivity appears in the cuprates when a spin order is destroyed, while the role of charge is less known. Recently, charge density wave (CDW) was found below the superconducting dome in YBa₂Cu₃O_y when a high magnetic field is applied perpendicular to the CuO₂ plane, which was suggested to arise from incipient CDW in the vortex cores that becomes overlapped. Here by ⁶³Cu-nuclear magnetic resonance, we report the discovery of CDW induced by an in-plane field, setting in above the dome in single-layered Bi₂Sr_2−xLa_xCuO₆. The onset temperature T_CDW takes over the antiferromagnetic order temperature T_N beyond a critical doping level at which superconductivity starts to emerge, and scales with the pseudogap temperature T*. These results provide important insights into the relationship between spin order, CDW and the pseudogap, and their connections to high-temperature superconductivity.

Whilst superconductivity usually appears when magnetic order is suppressed, the role of charge is less known. Here, Kawasaki et al. report a charge density wave (CDW) above the superconducting transition induced by an in-plane magnetic field in Bi₂Sr_2-xLa_xCuO₆, with the CDW onset temperature scaling with the pseudogap temperature.