Breakthrough Research Articles

Recovery of carboxylic acids from actual effluent by using sequential cationic-anionic adsorption steps at semi pilot scale

This work presents for the first time an exhaustive experimental assessment at semi-pilot scale for the sequential use of cationic-anionic adsorption columns for recovering carboxylic acids (CAs) from a real fermentation broth. The consecutive steps were dedicated to i) remove cations limiting the CAs interaction with the functional group of the anionic resin, and ii) adsorb CAs onto the anionic resin, respectively. The experimental broth was obtained from anaerobic co-fermentation of urban biowaste (UBW-broth). Breakthrough (BT) tests were firstly performed with the cationic column containing the strong-acid resin Lewatit® S2568H. This allowed both to assess the single process and to prepare 60 L of decationised UBW-broth to be used in the BT-tests with the anionic column (containing the weak-basic resin Lewatit® A365). Both columns were assessed (at 25°C) under packed and expanded bed modes, by feeding at different rates the actual UBW-broth or synthetic solutions. Main study innovative outputs were: 1) 100 % of the CAs occurring in UBW-broth were recovered with the proposed system; 2) best performances were obtained under expanded bed mode of operation, allowing to use 100 % of the installed capacity; 3) the affinity of other organic matter else than CAs resulted weaker than Na+/NH4+ and CAs/PO4x-/Cl- in both cationic and anionic columns, respectively (i.e. low adsorption performances generally reported are due to inorganic cations/anions presence); 4) a very preliminary economic analysis carried out on the basis of the obtained data indicates overall costs ranging 0.58–1.49 EUR/kg of CAs (depending on the process configuration).

Exploration of the adsorption and desorption performance of volatile organic compounds by activated carbon with different shapes based on fixed-bed experiments

Activated carbon (AC) has been widely used in volatile organic compounds (VOCs) treatment of industrial exhaust gases. Rather than modifying specific pore size distributions and surface properties, altering the shape of AC offers a more feasible approach to enhance its adsorption performance. This study investigates the adsorption-desorption performance of two different shaped ACs with highly similar properties for the removal of VOCs. The clover-shaped AC (CSAC) has a 27.46% lower internal void fraction and a 39.10% higher external void fraction compared to cylindrical AC (CAC), resulting in denser packing and longer contact time with VOCs. Adsorption experiments showed the CSAC has 40% longer adsorption breakthrough (BT) times for ethanol, ethyl acetate, and n-hexane on average, and 20% higher saturation adsorption capacity per unit volume. CSAC also has higher partition coefficients, with the highest values for ethanol, ethyl acetate, and n-hexane being 0.0187, 0.0382, and 0.0527 mol kg−1·Pa−1, respectively. The desorption process for selected VOCs is non-spontaneous and endothermic. Optimal desorption conditions were identified as an inlet space velocity of 3535 h−1, a desorption temperature of 150 °C, and a pulsed inlet method. To investigate the possibility of the application of CSAC in real-world scenarios, xylene was chosen as a representative industrial VOC. Results showed CSAC has 20% higher BT time and saturation adsorption capacity for xylene compared to CAC under different bed heights. The desorption efficiency for xylene on both ACs is below 40%. With increasing xylene inlet concentration, the mass transfer zone (MTZ) height initially increases but stabilizes beyond 1704 mg m−3. At identical bed heights, the MTZ height of CSAC is 29% shorter than CAC, indicating a higher bed utilization efficiency.

COVID-19 vaccine breakthrough infection among health care workers at MODHS hospitals in Saudi Arabia: A multicenter study

BackgroundWe investigated the clinical manifestation and severity of COVID-19 infection represented as a composite outcome (hospital or ICU admission, or in-hospital death) among infected fully vaccinated HCWs, the RT-PCR test Ct value (Cycle Threshold) of positive fully vaccinated HCWs, and we measure the interval from the second vaccine to acquiring the infection. MethodsA multicenter retrospective cohort study was conducted in different regions at (16) Ministry of Defense Health Services (MODHS) hospitals. Data were restricted to fully vaccinated (minimum of 2 doses) HCWs who had a confirmed positive PCR test and employed in MODHS hospitals from August 2021 to March 2022. ResultsA total of 45862 HCWs were vaccinated as of Aug 2021. Of these 1253 participants met the selection criteria and were included in the study. The average age of infected HCWs was 35.27 years (SD = ± 8.10) of which 57% were females. The HCWs were employed as doctors (24%), nurses (33%), and other (43%). The most administered vaccine type was mRNA (44%) followed by Adenovirus Viral Vector (39%) and mixed vaccine (17%). The incidence of COVID-19 vaccine breakthrough (BT) infection among HCWs was observed at 2.73% (m-RNA 3.19%, Viral Vector 2.83% and mixed 1.87%). Conclusionthe overall COVID-19 (BT) infection incidence proportion was (2.73%), with the Mixed vaccine group showing the lowest (BT) incidence proportion (1.87%). The most commonly reported symptoms among (BT) infections were cough (51%), sore throat (51%), fever (47%), headache (31%), and runny nose (23%), with overall (6%) asymptomatic (BT) infections. We had (1%) hospital admissions, Zero ICU admission, and Zero deaths. our finding may indicate that infection affecting fully vaccinated patients were less severe and mostly affected the upper respiratory tract.

Switching from combination therapy with entecavir hydrate plus tenofovir alafenamide fumarate to tenofovir alafenamide fumarate monotherapy in patients with chronic hepatitisB based on nucleotide sequences of hepatitisB virus pregenome RNA.

Patients with chronic hepatitisB virus (HBV) infection experiencing viral breakthrough (BTH) or partial response (PR) during lamivudine (LAM) or entecavir hydrate (ETV) administration often took ETV plus tenofovir alafenamide fumarate (TAF) due to the emergence of a drug-resistance mutation. However, in patients lacking drug-resistance mutation against TAF, sufficient antiviral effects may be achievable with TAF monotherapy. We assessed the drug-resistance profile through nucleotide sequences of HBV pregenome RNA, and subsequently changed to TAF monotherapy from ETV plus TAF. This prospective study included 25 patients with serum HBV-DNA below 20IU/mL under ETV plus TAF administration. Pregenome RNA nucleotide sequences of HBV in the sera were analyzed using direct sequencing and deep sequencing. ETV was discontinued in patients without rtA194T and rtS106C+rtH126Y +rtD134E +rtL269I quadruple mutations in direct sequencing. LAM-PR, LAM-BTH, ETV-PR, and ETV-BTH were observed in 1, 16, 7, and 1 patient(s), respectively. Pregenome RNA nucleotide sequences were analyzable in 20 patients. Among the 12 patients classified as LAM-BTH, six patients showed rtL180M+rtM204V/I in direct sequencing, and one patient showed minor clones containing rtL180M+rtM204V+A194T in deep sequencing at a frequency of 0.3%. In the six patients classified as ETV-PR, one patient harbored rtM204I. No clones showing rtS106C+rtH126Y+rtD134E+rtL269I quadruple mutation were detected in deep sequencing. Subsequently, ETV was discontinued, and serum HBV-DNA remained undetectable up to 48weeks in all patients. Patients receiving ETV plus TAF due to partial response or BTH during initial LAM or ETV administration were able to safely transition to TAF monotherapy based on nucleotide sequences of HBV pregenome RNA in the sera.

Enhanced copper removal by magnesium modified biochar derived from Alternanthera philoxeroides

Adsorption processes are being widely used by various researchers for the removal of heavy metals from waste streams and biochar has been frequently used as an adsorbent. In this study, a MgO-loaded biochar derived from Alternanthera philoxeroides (MAPB) was synthesized for the removal of Cu(II). Compared with other biochar absorbents, MAPB showed a relatively slow adsorption kinetics, but an effective removal of Cu(II) with a maximum sorption capacity of 1, 238 mg/g. The adsorption mechanism of Cu(II) by MAPB was mainly controlled by chemical precipitation as Cu2(OH)3NO3, complexation and ion replacement. Fixed bed column with MAPB packed in same dosage (1, 000 mg) and different bed depth (1.3, 2.6 and 3.9 cm) showed that the increased of bed depth by mixing MAPB with quartz sand could increase the removal of Cu(II). The fitted breakthrough (BT) models showed that mixing MAPB with support media could reduce the mass transfer rate, increase the dynamic adsorption capacity and BT time. Therefore, MAPB adsorbent act as a highly efficient long-term adsorbent for Cu(II) contaminated water treatment may have great ecological and environmental significance.

Scheduled and Breakthrough Opioid Use for Cancer Pain in an Inpatient Setting at a Tertiary Cancer Hospital.

Background: Our aim was to examine the frequency and prescription pattern of breakthrough (BTO) and scheduled (SCH) opioids and their ratio (BTO/SCH ratio) of use, prior to and after referral to an inpatient supportive care consult (SCC) for cancer pain management (CPM). Methods and Materials: Patients admitted at the MD Anderson Cancer Center and referred to a SCC were retrospectively reviewed. Cancer patients receiving SCH and BTO opioids for ≥24 h were eligible for inclusion. Patient demographics and clinical characteristics, including the type and route of SCH and BTO opioids, daily opioid doses (MEDDs) of SCH and BTO, and BTO/SCH ratios were reviewed in patients seen prior to a SCC (pre-SCC) and during a SCC. A normal BTO ratio was defined as 0.5-0.2. Results: A total of 665/728 (91%) patients were evaluable. Median pain scores (p < 0.001), BTO MEDDs (p < 0.001), scheduled opioid MEDDs (p < 0.0001), and total MEDDs (p < 0.0001) were higher, but the median number of BTO doses was fewer (2 vs. 4, p < 0.001), among patients seen at SCC compared to pre-SCC. A BTO/SCH ratio over the recommended ratio (>0.2) was seen in 37.5% of patients. The BTO/SCH ratios in the pre-SCC and SCC groups were 0.10 (0.04, 0.21) and 0.17 (0.10, 0.30), respectively, p < 0.001. Hydromorphone and Morphine were the most common BTO and SCH opioids prescribed, respectively. Patients in the early supportive care group had higher pain scores and MEDDs. Conclusions: BTO/SCH ratios are frequently prescribed higher than the recommended dose. Daily pain scores, BTO MEDDs, scheduled opioid MEDDs, and total MEDDs were higher among the SCC group than the pre-SCC group, but the number of BTO doses/day was lower.

Comparison of Omicron breakthrough infection versus monovalent SARS-CoV-2 intramuscular booster reveals differences in mucosal and systemic humoral immunity

Our understanding of the quality of cellular and humoral immunity conferred by coronavirus disease 2019 (COVID-19) vaccination alone versus vaccination plus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough (BT) infection remains incomplete. While the current (2023) SARS-CoV-2 immune landscape of Canadians is complex, in late 2021 most Canadians had either just received a third dose of COVID-19 vaccine, or had received their two dose primary series and then experienced an Omicron BT. Herein we took advantage of this coincident timing to contrast cellular and humoral immunity conferred by three doses of vaccine versus two doses plus BT. Our results show that mild BT infection induces cell-mediated immune responses to variants comparable to an intramuscular vaccine booster dose. In contrast, BT subjects had higher salivary IgG and IgA levels against the Omicron spike and enhanced reactivity to the ancestral spike for the IgA isotype, which also reacted with SARS-CoV-1. Serum neutralizing antibody levels against the ancestral strain and the variants were also higher after BT infection. Our results support the need for vaccines that emulate the enhanced mucosal and humoral immunity induced by Omicron BT without exposing individuals to the risks associated with SARS-CoV-2 infection.One Sentence SummaryOmicron breakthrough elicits cross-reactive systemic and mucosal immune responses in vaccinated adults.

In silico approaches for the prediction of the breakthrough of organic contaminants in wastewater treatment plants.

The removal efficiency (RE) of organic contaminants in wastewater treatment plants (WWTPs) is a major determinant of the environmental impact of chemicals which are discharged to wastewater. In a recent study, non-target screening analysis was applied to quantify the percentage removal efficiency (RE%) of more than 300 polar contaminants, by analyzing influent and effluent samples from a Swedish WWTP with direct injection UHPLC-Orbitrap-MS/MS. Based on subsets extracted from these data, we developed quantitative structure-property relationships (QSPRs) for the prediction of WWTP breakthrough (BT) to the effluent water. QSPRs were developed by means of multiple linear regression (MLR) and were selected after checking for overfitting and chance relationships by means of bootstrap and randomization procedures. A first model provided good fitting performance, showing that the proposed approach for the development of QSPRs for the prediction of BT is reasonable. By further populating the dataset with similar chemicals using a Tanimoto index approach based on substructure count fingerprints, a second QSPR indicated that the prediction of BT is also applicable to new chemicals sufficiently similar to the training set. Finally, a class-specific QSPR for PEGs and PPGs showed BT prediction trends consistent with known degradation pathways.

Uncharacteristic Adsorption Breakthrough Behavior of a Core–Shell Copper Hydroxysulfate Metal–Organic Framework Against Gaseous Formaldehyde

AbstractCore–Shell structured microspheres with a packed nano‐platelet copper hydroxysulfate (CHS) core and an octahedral crystalized metal–organic framework‐199 (CHS@M199) shell are synthesized and tested as adsorbent for gaseous formaldehyde (FA). CHS@M199 outperforms reference materials (e.g., activated carbon (AC), CHS, and M199) with adsorption capacity (Q) of 8.13 mg g−1 and partition coefficient (PC) of 0.263 mol kg−1 Pa−1 against 10 Pa FA at 10% breakthrough (BT) level with the aid of large surface area and copper sites for coordinating with carbonyl group. Contrary to general expectations, CHS@M199 exhibits a unique adsorption behavior in that BT volume increases systematically with the rise in FA inlet partial pressure (e.g., 5–10 Pa). The 10% BT capacity of CHS@M199 decreases noticeably (8.13 to 2.08 mg g−1) with increasing relative humidity (0.016 to 10%), reflecting water‐FA competition for hydrophilic adsorption sites. Although FA adsorption on CHS@M199 diminishes with elevated RH levels, such reduction intensifies when simulating ambient conditions (through stepwise addition of competing components: O2, CO2, and H2O). The FA adsorption on CHS@M199 is well described by both pseudo‐first‐order (PFO) and pseudo‐second‐order (PSO) kinetics. Polymerization may play a pivotal role in the adsorption of FA on CHS@M199, as Qi‐LeVan isotherm best fits the experimental data.

Neutralization against Omicron sublineages (BA.2/BA.5/BQ.1.1/XBB/XBB.1.5) in bivalent BNT162b2-vaccinated HCWs with or without risk factors, or following BT infection with Omicron

SARS-CoV-2-BA.4/5-adapted-bivalent-BNT162b2-vaccine (bvBNT), developed in response to the recent emergence of immune-evasive Omicron-variants, has been given to individuals who completed at least 2-doses of the monovalent-BNT162b2-vaccine (mvBNT). In the present cohort study, we evaluated neutralization-titers (NT50s) against Wuhan-strain (SCoV2Wuhan) and Omicron-sublineages including BA.2/BA.5/BQ.1.1/XBB/XBB.1.5, and vaccine-elicited S1-binding-IgG in sera from participants-vaccinated with 5th-bvBNT following 4th-mvBNT. The 5th-bvBNT-dose elicited good protective-activity against SCoV2Wuhan with geometric-mean (gMean)-NT50 of 1966–2091, higher than the peak-values post-4th-mvBNT with no statistical significance, and favorable neutralization-activity against not only BA.5 but also BA.2, with ~ 3.2-/~ 2.2-fold greater gMean-NT50 compared to the peak-values post-4th-mvBNT-dose, in participants with or without risk factors. However, neutralization-activity of sera post-5th-bvBNT-dose was low against BQ.1.1/XBB/XBB.1.5. Interestingly, participants receiving bvBNT following breakthrough (BT) infection during Omicron-wave had significantly enhanced neutralization-activity against SCoV2Wuhan/BA.2/BA.5 with ~ 4.6-/~ 6.3-/~ 8.1-fold greater gMean-NT50, respectively, compared to uninfected participants receiving bvBNT. Sera from BT-infected-participants receiving bvBNT had enhanced neutralization-activity against BQ.1.1/XBB/XBB.1.5 by ~ 3.8-fold compared to those from the same participants post-4th-mvBNT-dose, and had enhanced gMean-NT50 ~ 5.4-fold greater compared to those of uninfected-participants’ sera post-bvBNT. These results suggest that repeated stimulation brought about by exposure to BA.5’s-Spike elicit favorable cross-neutralization-activity against various SARS-CoV-2-variants.

Gas breaktrough behavior of the Spanish reference bentonite

&#x0D; The Spanish concept for the geological disposal of radioactive waste implies the use of pre-compacted bentonite, as a main component of the engineering barrier system. The reference bentonite, called FEBEX bentonite, is composed mainly of montmorillonite, has a maximum grain size of 5 mm and a hygroscopic water content of ~14.5%. The aim of this work was to determine the gas breakthrough (BT) pressure on saturated samples of this buffer material.&#x0D; Samples (20 mm length, 38/50 mm diameter) were uniaxially compacted at 1.5 and 1.6 g·cm-3 dry densities (DD), directly in the test cell. Their water content were from hygroscopic to around 26% (full saturation at 1.6 DD), most of them on the wet side of optimum. Compaction pressures ranged between 7 and 1.4 MPa, depending on target DD, water content and granulometry of the bentonite. To check the effect of the as-compacted macrostructure, we tested three grain size distributions (full &lt;5 mm, 1.18&lt;x&lt;2.0 mm, and 2.83&lt;x&lt;4.7 mm) with similar water content (hygroscopic); and the full grain size distribution with different water contents (around 18, 22 and 26%). Mercury intrusion porosimetry (MIP) on small compacted samples (for different DD and granulometric fractions) showed that the main differences between them were macrostructural, with minor effect on mesostructure.&#x0D; A series of long-term gas injection tests were carried out to determine, by constant pressure steps, the BT pressure. Some improvements were introduced in the experimental gas breaktrough (BT) setup and the testing protocol described in [1], including different configurations of gas up and downstream volumes (~150, 75 and 50 cm3), where actual pressure (inlet or outlet) is measured (Fig. 1a). A measurement of gas permeability (on the as-compacted sample) and two injection phases (on the fully saturated sample) configure the BT protocol. Each injection phase consists of a water permeability measurement and a long-term gas injection at increasing/decreasing pressures. The gas injection is intended to elicit at least two BT events (Fig 1b). The cells kept the samples in isochoric conditions during the test: after the saturation phase, the swelling pressure is expected to prevent preferential gas flows between the sample and the cell body. Once the gas injection starts no more water was supplied.&#x0D; Gas permeability was measured on as-compacted samples with the high-pressure steady-state setup described in [2, 3]. The measurements of gas outflow and other variables, including RH/Temperature, permit to calculate the gas permeability and to estimate the sample drying induced by gas flow during the test. In these samples, there was a linear relationship of gas flow with the difference of square pressures for all dry densities tested. From these measurements, intrinsic permeability ranged from 10-14 m2 to 10-17 m2 (for 1.5 DD and 1.6 DD).&#x0D; The water permeability measurement before the first gas injection phase allows to obtain a base-line value; the one after gas injection allows to determine if the sealing capacity was compromised by the previous BT events. Average values were in the range (0.7 – 2.0)·10-18 m2.&#x0D; After [1], the air entry pressure for the FEBEX compacted bentonite is around 25 MPa (for DD 1.6). BT pressures determined in this work were much lower than this value and close to the upper range of the expected swelling pressure, that controls the gas entry and the breakthrough events. Local variations in the swelling pressure due to several factors (material heterogeneity, change in suction, temperature, stress) can direct the high-pressure gas through preferential local paths.&#x0D; The BT events on pressure-time curves showed a consistent and systematic repetition of BT values (Fig 1b); they had different shapes depending on whether the injection pressure was greater than, close to or just less than the actual BT pressure; and changes in the slope of the curves could indicate different types of flow and the underlying physical concept (from microfracturing, in the case of the instantaneous episodes, to microscopic pathway dilation for the gradual ones).&#x0D; BT pressures increased with increasing dry density and water content (initial saturation degree) at compaction (considered as initial microstructural state); and the geometry of the sample (decreasing L/D ratio). The BT behavior is considered as a characteristic of a given liquid-solid system (sample): related to the initial state after compaction and the preservation of their structure during the test, at a specified temperature. Changes affecting the structure will affect the BT pressure.&#x0D; Gas migration in saturated FEBEX bentonite at DD&lt;1.6 was interpreted to occur by the formation and propagation of dilatant pathways.&#x0D;

Seed Transmission of Wheat Streak Mosaic Virus and Triticum Mosaic Virus in Differentially Resistant Wheat Cultivars.

Wheat streak mosaic virus (WSMV) and Triticum mosaic virus (TriMV) are important viral pathogens of wheat in the Great Plains. These viruses individually or in mixed infections with High Plains wheat mosaic virus cause a devastating wheat streak mosaic (WSM) disease. Although seed transmission of WSMV has been studied, no information is currently available on that of TriMV. Furthermore, no study has explored the implications of mixed infections of WSMV and TriMV on seed transmission of one or both viruses. To study both aspects, seeds from differentially resistant field-grown wheat plants (cv. TAM 304 (susceptible), Joe (WSMV resistant, Wsm2 gene), and Breakthrough (BT) (WSMV and TriMV resistant, Wsm1 gene)) showing characteristic WSM symptoms were collected and analyzed to quantify both viruses using qRT-PCR. The percentage of seeds tested positive for WSMV or TriMV individually and in mixed infection varied with cultivar and virus combinations; 13% of TAM 304 seeds tested positive for WSMV, followed by 8% of BT and 4% of Joe seeds. Similarly, TriMV was detected in 12% of BT seeds, followed by 11% of TAM 304 and 8% of Joe seeds. Lastly, mixed infection was detected in 7% of TAM 304 seeds, followed by 4% in BT, and 2% in Joe. Dissection of field-collected seeds into three parts, embryo, endosperm, and seed coat, revealed both WSMV and TriMV accumulated only in the seed coat. Consistent with seeds, percent infection of WSMV or TriMV in the plants that emerged from infected seeds in each treatment varied with cultivar and virus combinations (WSMV: BT 3%; Joe 2%; TAM 304 9%; TriMV: BT 7%; Joe 8%; and TAM 304 10%). Plants infected with mixed viruses showed more pronounced WSM symptoms compared to individual infections. However, both viruses were present only in a few plants (BT: 2%, Joe: 1%, and TAM 304: 4%). Taken together, this study showed that TriMV was transmitted vertically at a higher frequency than WSMV in resistant cultivars, and the seed transmission of TriMV with WSMV increased the virulence of both pathogens (measured via WSM symptom severity) in the emerged plants. Furthermore, Wsm1 and Wsm2 genes considerably reduced WSMV transmission via infected seeds. However, no such effects were observed on TriMV, especially in progeny plants. These results reiterated the importance of planting clean seeds and highlighted the immediate need to identify/develop new sources of TriMV resistance to effectively manage the recurring WSM epidemic.

Atrial contractile and electrical remodeling is associated with more complex conduction patterns in patients without history of atrial fibrillation: a high-density epicardial mapping study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This work was supported by the Netherlands Heart Foundation (CVON2014-09, RACE V Reappraisal of Atrial Fibrillation: Interaction between hyperCoagulability, Electrical remodelling, and Vascular Destabilisation in the Progression of AF), the European Union (ITN Network Personalized Therapies for Atrial Fibrillation: a translational network: PersonalizeAF, grant 860974, CATCH ME: Characterizing Atrial fibrillation by Translating its Causes into Health Modifiers in the Elderly, No. 633196). Background Early atrial remodeling refers to a concept where atrial structural, functional, and electrophysiological changes may be present without clinical manifestation of atrial arrhythmias. (1) However, it is currently unknown how electrophysiological and functional atrial properties are related, especially in the early stages of atrial remodeling. Purpose To investigate the relationship between electrophysiological properties of the atria, determined by intraoperative high-density epicardial mapping after AF-induction, and echocardiographic and electrocardiographic parameters in patients without a history of AF undergoing cardiac surgery. Methods All patients underwent functional and electrophysiological analysis of both atria using preoperative transthoracic echocardiography, electrocardiography, and intraoperative biatrial high-density epicardial mapping. Postoperatively, all patients were continuously monitored for occurrence of new-onset postoperative AF (POAF). In addition to univariable and multivariable analysis, cluster analysis was performed to identify distinct clusters of subjects for epicardial mapping parameters. Results The study population consisted of 38 patients undergoing coronary artery bypass grafting, isolated aortic valve replacement, or the combination of both. All patients completed 1-year continuous rhythm monitoring and 19 patients (50%) developed POAF. There was a greater number of waves/cycle (4.57±1.55 vs. 3.98±1.63, p=0.04) and breakthrough (BT) waves/cycle (1.16±0.58 vs. 0.88±0.60, p=0.01) in the RA compared to the LA (Figure 1). Also, there was a lower conduction velocity (CV) in the RA than in the LA (0.71±0.10m/s vs 1.19±0.36m/s, p&amp;lt;0.01) (Figure 1). Average waves/cycle were significantly correlated with reduced P-wave duration and P-wave amplitude (Spearman’s rho=-0.32, p=0.04, and Spearman’s rho=-0.32, p=0.04, respectively). Also, there was significant negative correlation between LA booster function and LA waves/cycle (Spearman’s rho=-0.55, p&amp;lt;0.01). Survival analysis revealed that older age, lower P-wave amplitude, reduced LA booster function, and increased RA waves/cycle were associated with increased occurrence of POAF (Figure 2). Cluster analysis was performed for RA and LA epicardial mapping parameters, which identified 2 distinct clusters: cluster 1 consisted of patients with more complex atrial electrical conduction patterns, and cluster 2 less complex atrial electrical conduction patterns. Multivariable analysis showed that reduced LA booster function was independently associated with a cluster representing more complex atrial electrical conduction patterns in the LA (OR=1.13, 95% CI: 1.02-1.25, p=0.02). Conclusion In patients without a history of AF, reduced LA contractile function and lower P-wave amplitude are associated with more complex electrical conduction patterns in acutely induced AF, potentially representing an early step in the atrial remodeling process.

Predictors of discharge disposition and mortality following hospitalization with SARS-CoV-2 infection.

The SARS-CoV-2 pandemic has overwhelmed hospital capacity, prioritizing the need to understand factors associated with type of discharge disposition. Characterization of disposition associated factors following SARS-CoV-2. Retrospective study of SARS-CoV-2 positive patients from March 7th, 2020, to May 4th, 2022, requiring hospitalization. Midwest academic health-system. Patients above the age 18 years admitted with PCR + SARS-CoV-2. None. Discharge to home versus PAC (inpatient rehabilitation facility (IRF), skilled-nursing facility (SNF), long-term acute care (LTACH)), or died/hospice while hospitalized (DH). We identified 62,279 SARS-CoV-2 PCR+ patients; 6,248 required hospitalizations, of whom 4611(73.8%) were discharged home, 985 (15.8%) to PAC and 652 (10.4%) died in hospital (DH). Patients discharged to PAC had a higher median age (75.7 years, IQR: 65.6-85.1) compared to those discharged home (57.0 years, IQR: 38.2-69.9), and had longer mean length of stay (LOS) 14.7 days, SD: 14.0) compared to discharge home (5.8 days, SD: 5.9). Older age (RRR:1.04, 95% CI:1.041-1.055), and higher Elixhauser comorbidity index [EI] (RRR:1.19, 95% CI:1.168-1.218) were associated with higher rate of discharge to PAC versus home. Older age (RRR:1.069, 95% CI:1.060-1.077) and higher EI (RRR:1.09, 95% CI:1.071-1.126) were associated with more frequent DH versus home. Blacks, Asians, and Hispanics were less likely to be discharged to PAC (RRR, 0.64 CI 0.47-0.88), (RRR 0.48 CI 0.34-0.67) and (RRR 0.586 CI 0.352-0.975). Having alpha variant was associated with less frequent PAC discharge versus home (RRR 0.589 CI 0.444-780). The relative risks for DH were lower with a higher platelet count 0.998 (CI 0.99-0.99) and albumin levels 0.342 (CI 0.26-0.45), and higher with increased CRP (RRR 1.006 CI 1.004-1.007) and D-Dimer (RRR 1.070 CI 1.039-1.101). Increased albumin had lower risk to PAC discharge (RRR 0.630 CI 0.497-0.798. An increase in D-Dimer (RRR1.033 CI 1.002-1.064) and CRP (RRR1.002 CI1.001-1.004) was associated with higher risk of PAC discharge. A breakthrough (BT) infection was associated with lower likelihood of DH and PAC. Older age, higher EI, CRP and D-Dimer are associated with PAC and DH discharges following hospitalization with COVID-19 infection. BT infection reduces the likelihood of being discharged to PAC and DH.

Zinc-doped titanium oxynitride as a high-performance adsorbent for formaldehyde in air

The potential utility of titanium oxynitride doped with 5% zinc (ZnTON) has been investigated as an adsorbent for the treatment of gaseous formaldehyde (FA) using a fixed-bed adsorption system. The adsorption capacity of ZnTON, when estimated at 10%/100% breakthrough (BT) levels from a dry feed gas consisting of 10 Pa FA, was far superior to two reference materials (i.e., commercial P25-TiO2 and activated carbon (AC)) by factors of 1.7/1.3 and 10/2.5, respectively. The adsorption capacity of ZnTON increased with the increase in the initial feeding concentration of FA (5–12.5 Pa), while decreasing with the rising temperature (25–100 oC). An increase in moisture level (0–100% relative humidity) also led to 5.4- and 2.5-fold reductions in adsorption capacity of ZnTON at 10% and 100% BT levels, respectively. Thermodynamically, the adsorption of FA onto ZnTON is an exothermic (ΔHo = - 9.69 kJ.mol-1) to be feasible in nature based on physisorption mechanism. Further, the adsorption of FA onto ZnTON was governed by surface interactions and monolayer surface coverage (Van der Waal's force/electrostatic attraction), as it obeyed the Langmuir isotherm and pseudo-second-order kinetic models. Regeneration tests indicated a positive effect of moisture on FA desorption and durability of ZnTON (i.e., over three adsorption-desorption cycles). This study offers valuable mechanistic insights into the synthesis of an advanced adsorbent for the efficient removal of hazardous volatile organic compounds under near-ambient conditions.

635. Is Azole Prophylaxis in Liver Transplant Recipients Effective in Preventing Invasive Candidiasis in the Era of Emerging Resistance?

Abstract Background Antifungal prophylaxis (px) in liver transplant (LT) recipients reduces invasive candidiasis (IC) and its associated mortality. Studies from our institution (UPMC) and others have shown that targeted px was as effective as universal px. Antifungal resistance has emerged among Candida spp., with ∼7% of the bloodstream isolates tested at CDC resistant to fluconazole. We sought to determine if our targeted antifungal px in LT recipients remained effective in the era of rising azole resistance. Methods We performed a retrospective study of patients undergoing LT at UPMC between 11/2010 and 06/2021. IC episodes were included if they occurred within 6 months of transplant. IC was defined using EORTC/MSGERC criteria, 2020. CLSI’s M60 2nd edition was used for antifungal susceptibility interpretation. Px was with fluconazole or voriconazole, based on risk factors for yeast or mold infection, respectively (Fig. 1). Results 1065 patients (pts) underwent LT over the study period. The most common indications for LT were HCC and NASH cirrhosis. Thirty-four pts (3%) developed IC within six months. 74% and 65% of these pts had risk factors for yeast or mold infection at some point, respectively (Table 1). Twenty-five of 34 (73.5%) pts received antifungal px, with voriconazole most commonly. Sixteen pts with IC (47%) had living donor transplant, and 11 (32%) had Roux-en-Y anastomosis. Types of IC were intra-abdominal candidiasis in 19 (56%), fungemia in 11 (32%), and intra-abdominal IC with secondary fungemia in 4 (12%). Seventeen (50%) episodes were breakthrough (BT) IC (most BT occurred in the voriconazole group), eight (24%) developed after stopping px, and nine (26%) occurred in those without px (Table 2). C. albicans and C. glabrata were the most common species (Fig. 2). Sixteen isolates underwent susceptibility testing: 12% and 44% were resistant and S-DD to fluconazole (Fig. 2); none were resistant to voriconazole. Attributable mortality of IC was 8%. Conclusion Targeted antifungal px in LT recipients with fluconazole or voriconazole effectively prevented IC, even in the era of rising azole resistance among Candida spp. We recommend antifungal susceptibility testing for Candida spp. obtained from infected sites to guide antifungal therapy. Disclosures Fernanda P. Silveira, MD, Ansun: Grant/Research Support|Janssen: Honoraria|Merck: Grant/Research Support|Novartis: Grant/Research Support|Regeneron: Grant/Research Support|Takeda: Advisor/Consultant|Takeda: Grant/Research Support.

Mechanistic investigation of using optimum saline water in carbonate reservoirs low asphaltenic crude oil with high resin content: A carbonate-coated microfluidic study

Many mature reservoirs around the world have entered the second period of their life and their production rates are going to decline. In addition, after producing from the reservoir at the primary and secondary stages more than 50 percent of hydrocarbons would remain in place. Therefore, it is essential to find a suitable method to increase oil recovery in the tertiary stage. In recent two decades, smart water or low saline water (LSW) flooding has been introduced as a dominant method, especially on wettability alteration from oil-wet to water-wet or neutral wet conditions, which is leading to more oil production. On the contrary, there are an inadequate number of researches on low asphaltenic crude oil with high resin content in water flooding. In this type of crude oil, the role of asphaltene in changing the wettability and reducing the interfacial tension (IFT) is not as great as the other surface active agents of crude oil. Hence, the role of each ion and its synergism with the surface active agents of crude oil may be different from previous studies. The fluid–fluid and rock-fluid interactions between diluted seawater and a low asphaltenic crude oil were investigated by performing different types of experiments, such as pendant drop IFT measurement tests, sessile drop contact angle (CA) measurement experiments, zeta potential analysis, and pH determination. In the next step, the impact of ten different salts on reducing the interfacial tension, and wettability alteration was determined to show the underlying mechanisms of optimum brine based on the same ionic strength (IS). Finally, some microfluidic tests were utilized in a carbonate-coated micromodel to show the confirmation of previous results in porous media visually and determine the fluid–fluid and rock-fluid interactions on the recovery factor (RF). Based on IFT and CA results, the optimum brine was seawater (SW) that could reduce the IFT from 21.13 to 16.21 mN/m and change the CA from 137° to 46° (Δϴ = 91°). Due to the lower asphaltene content in such crude oil, the presence of Na+ with SO42-, and Mg2+ with Cl- plays a significant role in IFT reduction by creating a synergistic effect between these ions with a high fraction of resin. Na2SO4 and MgSO4 reduce the IFT from 21.13 to 6.21 and 8.46 mN/m, respectively due to the existence of the high amount of Mg and SO4 in aqueous solution which has a considerable effect on fluid–fluid interaction. Also, Mg2+ and SO42- can obtain 89° wettability alteration (Δϴ) and provide a water-wet condition (ϴ = 48°) because of the synergistic of the presence of divalent anions and cations through the solution and the presence of high resin content that leads to excellent wettability change. Additionally, Na2SO4 can change the contact angle from 137° to 67° (Δϴ = 70°). Although the greatest impact of single salts on IFT reduction and wettability alteration was obtained by Na2CO3 and NaHCO3 because of saponification and pH elevation; however, the concentration of these salts in SW was negligible. Thus, the main salts for fluid–fluid and rock-fluid interactions in SW/low asphaltenic crude oil/calcite systems were Na2SO4, MgSO4, and MgCl2. Moreover, due to the presence of Na+, Mg2+, and SO42- in SW, the wettability of the pore surface was altered from oil-wet to water-wet during SW flooding in the micromodel. Furthermore, reducing the IFT and changing the wettability lead to decreasing the capillary number and delay in breakthrough (BT) time, which consequently improved the oil recovery from 25.42 % (DIW flooding) to 46.59 %. The findings of this study can help for a better understanding of the effect of low asphaltenic with high resin crude oil and ions on the fluid–fluid and rock-fluid interaction through porous media at static and dynamic conditions in order to increase the final oil recovery.

Adsorptive degradation of dimethyl methylphosphonate over Zr-based metal–organic framework built from 3,3′,5,5′-azobenzenetetracarboxylic acid

Chemical warfare agents (CWAs) pose a significant threat to humans because of their high toxicity. Zirconium-based metal–organic frameworks (Zr-MOFs) are promising candidates for the purification and detoxification of CWAs. In this study, we prepared a Zr6O4(OH)8(H2O)4(abtc)2 denoted to Zr-abtc (abtc = 3,3′,5,5′-azobenzene-tetracarboxylate) under eco-friendly hydrothermal reflux conditions and investigated its detoxification performance. Dimethyl methylphosphonate (DMMP) was used as a simulant of a nerve agent to evaluate the adsorption performance of Zr–abtc. The Zr–abtc MOF was constructed from an 8-connected Zr6 cluster [Zr6(µ3-O)4(µ3-OH)4] with abtc as a linker, resulting in the generation of abundant surface hydroxyl groups, high porosity, and remarkable structural robustness under high moisture and high temperature conditions. The results of the breakthrough (BT) test of DMMP under dry and humid conditions reveal that Zr–abtc displays high DMMP adsorption performance with the adsorption capacity of 1.74 and 1.60 mmol/g under dry and humid condition, respectively. The high performance of Zr–abtc can be attributed to not only the strong interaction between the surface hydroxyl group of Zr–abtc MOF and DMMP but also the catalytic activity of the surface hydroxyl group to form the decomposed product of DMMP, as demonstrated using Fourier transform infrared spectroscopy (FTIR).

COVID-19 vaccine breakthrough infection among fully vaccinated healthcare workers in Duhok governorate, Iraqi Kurdistan:Aretrospective cohort study.

The aims of this study were: to determine the incidence of Severe Acute Respiratory Syndrome Coronavirus‐2 (SARS‐CoV‐2) infection among vaccinated healthcare workers (HCWs), assess risk factors associated with the vaccine breakthrough (BT), and compare the effectiveness of vaccine manufacturers against SARS‐CoV‐2 variant of concern among HCWs in Duhok governorate. It is a multicenter retrospective cohort study, which enrolled 944 HCWs through March 2022. COVID‐19 vaccinated HCWs aging 18 and above were included. A random sampling process was performed by asking the participants to fill out a standardized questionnaire by means of interviews or participant‐completed surveys. Fully vaccinated HCWs with positive polymerase chain reaction tests were considered to have vaccine BT infection. Two hundred and eighty‐four (30.1%) out of 944 vaccinated HCWs had SARS‐CoV‐2 infection postvaccination, of whom 241 (84.9%) were fully vaccinated, concluding that the incidence of BT infection is 25.5%. There were 422 (44.7%) males and 522 (55.3%) females. Most vaccine BT infections had developed in SARS‐CoV‐2 Omicron variant (53.5%). The majority of BT infections were mild to moderate (95.5%). Occupation, namely dentist was a significant risk factor, with a p value of 0.001. HCWs with a history of SARS‐CoV‐2 infection prevaccination were more prone to a vaccine BT infection (p value =0.002). Pfizer vaccine manufacturers revealed the highest effectiveness against BT infection (p value =0.0001). Paramedics showed a significant association with the disease severity (p value =0.02). The three available vaccine manufacturers in the Duhok governorate are effective against COVID‐19 BT infections. Dentists and paramedics were significantly associated with poor COVID‐19 outcomes.

Degradation Effect of Gas Diffusion Layer on Water Transport in Polymer Electrolyte Membrane Fuel Cell

Hydrogen is converted to electric power by proton exchange membrane fuel cells (PEMFCs), which have received significant attention for transportation applications because of their high energy efficiency. In order to ensure the long-term stability, understanding about their long-term durability is essential because the operating performance deteriorates over time. Gas diffusion layers (GDLs) manage the transport of water generated from the CL during chemical reactions, and the degradation of the GDL significantly deteriorate the fuel cell performance. Compared to the fresh GDL, the water transport characteristics of GDL aged by inserting hydrogen peroxide solutions are investigated. The dynamic movement of the water meniscus inside the GDL is visualized using synchrotron X-ray imaging. Unlike the pristine GDL having snap-off patterns, water continuously transports through the degraded GDL representing the piston-like movement, and pressure fluctuations are not observed. This difference shows the change of the dominant local transport mechanisms due to GDL degradation. The temporal pressure variations are simultaneously measured, and the pressure and time at breakthrough (BT) are compared. The aged GDL exhibits a larger BT pressure and requires a longer time to achieve the first BT. Longer BT time in the degraded GDL can reflect a higher water saturation level. GDL degradation leads to the loss of polytetrafluoroethylene (PTFE) which is commonly treated to ensure efficient mass transport by restraining water clogging in the GDL pores due to the increase of hydrophobicity. Despite the reduction in hydrophobicity, The PTFE loss can increase BT pressure by reducing the pore size and the actual path length of the water flow. The increase in the BT time and BT pressure, as well as continuous transport, can disrupt fuel supply to chemical reaction sites, thereby deteriorating the PEMFC performance. This study provides a comprehensive understanding of the effect of GDL degradation on mass transport in PEMFCs. Figure 1