Bacterial and Archaea Community Present in the Pine Barrens Forest of Long Island, NY: Unusually High Percentage of Ammonia Oxidizing Bacteria

Of the few preserved areas in the northeast of United States, the soil in the Pine Barrens Forests presents a harsh environment for the microorganisms to grow and survive. In the current study we report the use of clustering methods to scientifically select the sampling locations that would represent the entire forest and also report the microbial diversity present in various horizons of the soil. Sixty six sampling locations were selected across the forest and soils were collected from three horizons (sampling depths). The three horizons were 0–10 cm (Horizon O); 11–25 cm (Horizon A) and 26–40 cm (Horizon B). Based on the total microbial substrate utilization pattern and K-means clustering analysis, the soil in the Pine Barrens Forest can be classified into four distinct clusters at each of the three horizons. One soil sample from each of the four clusters were selected and archaeal and bacterial populations within the soil studied using pyrosequencing method. The results show the microbial communities present in each of these clusters are different. Within the microbial communities present, microorganisms involved in nitrogen cycle occupy a major fraction of microbial community in the soil. High level of diversity was observed for nitrogen fixing bacteria. In contrast, Nitrosovibrio and Nitrosocaldus spp are the single bacterial and archaeal population respectively carrying out ammonia oxidation in the soil

Standardized Outcome Measurement for Patients With Coronary Artery Disease: Consensus From the International Consortium for Health Outcomes Measurement (ICHOM)

Background: Coronary artery disease (CAD) outcomes consistently improve when they are routinely measured and provided back to physicians and hospitals. However, few centers around the world systematically track outcomes, and no global standards exist. Furthermore, patient-centered outcomes and longitudinal outcomes are under-represented in current assessments. Methods and Results: The nonprofit International Consortium for Health Outcomes Measurement (ICHOM) convened an international Working Group to define a consensus standard set of outcome measures and risk factors for tracking, comparing, and improving the outcomes of CAD care. Members were drawn from 4 continents and 6 countries. Using a modified Delphi method, the ICHOM Working Group defined who should be tracked, what should be measured, and when such measurements should be performed. The ICHOM CAD consensus measures were designed to be relevant for all patients diagnosed with CAD, including those with acute myocardial infarction, angina, and asymptomatic CAD. Thirteen specific outcomes were chosen, including acute complications occurring within 30 days of acute myocardial infarction, coronary artery bypass grafting surgery, or percutaneous coronary intervention; and longitudinal outcomes for up to 5 years for patient-reported health status (Seattle Angina Questionnaire [SAQ-7], elements of Rose Dyspnea Score, and Patient Health Questionnaire [PHQ-2]), cardiovascular hospital admissions, cardiovascular procedures, renal failure, and mortality. Baseline demographic, cardiovascular disease, and comorbidity information is included to improve the interpretability of comparisons. Conclusions: ICHOM recommends that this set of outcomes and other patient information be measured for all patients with CAD

ProSeal laryngeal mask airway improves oxygenation when used as a conduit prior to laryngoscope guided intubation in bariatric patients

Background: The primary objective of this study was to compare the effect of ventilation using the ProSeal TM laryngeal mask airway (PLMA) with facemask and oropharyngeal airway (FM), prior to laryngoscopy, on arterial oxygenation in morbidly obese patients undergoing bariatric surgery. Methods: Forty morbidly obese patients were randomly recruited to either PLMA or FM. After pre-oxygenation (FiO 2 1.0) in the ramp position with continuous positive airway pressure of 10 cm H 2 O for 5 min, anaesthesia was induced. Following loss of jaw thrust oropharyngeal airway, the FM and PLMA were inserted. On achieving paralysis, volume control ventilation with PEEP (5 cm H 2 O) was initiated. The difficulty in mask ventilation (DMV) in FM, number of attempts at PLMA and laryngoscopy were graded (Cormack and Lehane) in all patients. Time from onset of laryngoscopy to endotracheal tube confirmation was recorded. Hypoxia was defined as mild (SpO 2 ≤95%), moderate (SpO 2 ≤90%) and severe (SpO 2 ≤85%). Results: Significant rise in pO 2 was observed within both groups ( P=0.001), and this was significantly higher in the PLMA ( P=0.0001) when compared between the groups. SpO 2 ≥ 90% ( P=0.018) was seen in 19/20 (95%) patients in PLMA and 13/20 (65%) in FM at confirmation of tracheal tube. A strong association was found between DMV and Cormack Lehane in the FM group and with number of attempts in the PLMA group. No adverse events were observed. Conclusion: ProSeal TM laryngeal mask airway as conduit prior to laryngoscopy in morbidly obese patients seems effective in increasing oxygen reserves, and can be suggested as a routine airway management technique when managing the airway in the morbidly obese