Difficulty in differentiating liver injury from an immune checkpoint inhibitor from chemotherapy.

This study investigated the potential of immune checkpoint inhibitors (ICIs) combined with chemotherapy as a promising treatment approach for malignancies. This report focuses on a patient with drug-induced liver injury (DILI) following the administration of chemotherapy and ICIs. A 63-year-old patient with non-small cell lung adenocarcinoma (NSCLC) initially underwent γ-knife treatment and subsequently received a combination of chemotherapy comprising bevacizumab and camrelizumab. Due to liver abnormalities, both chemotherapy and ICIs were stopped on day 21. The patient's liver function improved within a month after methylprednisolone treatment. Subsequently, the patient received carboplatin, pemetrexed, and bevacizumab without complications. This finding supported the notion that DILI was likely triggered by the ICI. This case series details a complex instance of DILI resulting from the use of ICIs and pemetrexed/carboplatin. The alignment of the pathological findings and clinical presentation strongly suggested ICI-induced DILI, which was further supported by the definitive response to steroid treatment. This information is important for clinicians, as it emphasizes the importance of closely monitoring liver function and being aware of potential adverse effects associated with ICIs. Such insights contribute to more effective patient care.

The safety concerns regarding immune checkpoint inhibitors in liver cancer patients rising mainly from CHB.

Aim: To analyze the safety of immune checkpoint inhibitors in primary liver cancer patients and to identify the risk factors for immune-related adverse events (irAEs). Methods: The study enrolled 106 patients with primary liver cancer, including 81 with hepatocellular carcinoma and 25 with intrahepatic cholangiocarcinoma. We analyzed the differences between groups in irAE occurrence, including those with and without targeted drugs and those who received interventional therapy. Results: The incidence of irAEs was 39%, with thyroid function, liver function, and skin events being the most common. There was no correlation among irAE incidence and the liver cancer type, stage, or severity; grade of Child-Pugh score; and Barcelona Clinical Liver Cancer classification. However, being overweight was a significant risk factor for irAEs, correlating with high body mass index. The combination of targeted drugs and/or transcatheter arterial chemoembolization therapy did not increase the incidence of irAEs. Conclusion: Being overweight is a potential risk factor for irAEs in primary liver cancer patients. However, there is no correlation between irAE incidence and the liver cancer type, stage, or severity or a combination of targeted drugs or transarterial chemoembolization therapy.

Settling behaviors of microplastic disks in water.

Microplastic (MP) disks have not been studied for settling behaviors in aquatic environments, which affects the transport and fate of MPs. Therefore, settling experiments were conducted on MP disks of three shapes and four common-seen materials. Lighter MP disks (with density ρs = 1.038 g/cm3 and length l ≤ 5 mm) followed rectilinear vertical trajectories, while heavier MP disks (ρs = 1.161-1.343 g/cm3 and l = 5 mm) followed zigzag trajectories with oscillations and rotations. The mean terminal settling velocities of MP disks were 19.6-48.8 mm/s. Instantaneous settling velocities of heavier MP disks fluctuated. Existing formulas could not accurately predict the settling velocity of MP disks; thus, a new model was proposed with an error of 15.5 %. Finally, the Red - I* diagram (Red is the disk Reynolds number and I* is the dimensionless moment of inertia) was extended for MP disks to predict settling trajectories.

Impact of tidally induced residual circulations on chemical oxygen demand (COD) distribution in Laizhou Bay, China.

To understand the impact of hydrodynamics on pollutant transport in Laizhou Bay, China, we conducted numerical simulations using Mike 21. The model was calibrated with good agreements to field monitoring data at various monitoring stations. The simulation results show a clockwise and an anti-clockwise tidally-induced residual circulation in the western and eastern bay, respectively. Historical COD monitoring data also indicate two rings of high COD concentration in the same regions of the bay. This suggests that the hydrodynamics of tidal and residual currents is the main cause of the ring-shaped high COD concentration field in the bay. Pollutant inputs from inland rivers are also important for the COD distribution, making the near-shore side of the COD ring higher than the offshore side. Regions with higher retention time in the bay are usually associated with higher COD concentrations. This study is useful in understanding the mechanism of pollutant spatial distribution and subsequent pollution control in a sea bay.

Probabilistic ecological risk assessment of heavy metals in western Laizhou Bay, Shandong Province, China.

Considering the serious land-based pollution and the weak water exchange ability of western Laizhou Bay, it is essential to conduct an ecological risk assessment of the pollutants in this area. In this study, the ecological risk caused by heavy metals deposited in the surface sediments and those resuspended in the seawater of western Laizhou Bay was evaluated using probabilistic approaches. First, the concentrations of seven heavy metals, namely As, Cd, Cr, Cu, Hg, Pb, and Zn, in the surface sediments and seawater of western Laizhou Bay were detected during the spring and autumn of 2016. The concentrations of As, Cd, Cr, Cu, and Pb were found to be at levels comparable to those in the other global coastal systems, while those of Hg and Zn were lower than those in other coastal areas. Next, an ecological risk assessment of heavy metals in the surface sediments was performed using a typical potential ecological risk index and refined by using a Monte Carlo simulation. The results suggested low risk for the heavy metals detected in the sediments of western Laizhou Bay, with the exception of Hg in September 2016, which showed a probability (0.03%) of moderate risk. Meanwhile, the aquatic ecological risk assessment of the heavy metals was performed by applying a combination of hazard quotient (HQ) and joint probability curve. While the ecological risk of Cd, Hg, and Pb was found to be acceptable, the HQs for Cr, Cu, and Zn were greater than 1, and the overall risk probability of their adverse effects was higher than 0.05, suggesting certain ecological risk. Specifically, in the case of As, the overall risk probability was lower than 0.05, suggesting that its ecological risk was acceptable, although its HQ was greater than 1. Thus, by applying the probabilistic approaches, the ecological risk of the heavy metals in western Laizhou Bay was better characterized in this study, avoiding both overestimation and underestimation of ecological risk.