Metagenomics reveals sediment microbial community response to Deepwater Horizon oil spill

The Deepwater Horizon (DWH) oil spill in the spring of 2010 resulted in an input of ∼4.1 million barrels of oil to the Gulf of Mexico; >22% of this oil is unaccounted for, with unknown environmental consequences. Here we investigated the impact of oil deposition on microbial communities in surface sediments collected at 64 sites by targeted sequencing of 16S rRNA genes, shotgun metagenomic sequencing of 14 of these samples and mineralization experiments using (14)C-labeled model substrates. The 16S rRNA gene data indicated that the most heavily oil-impacted sediments were enriched in an uncultured Gammaproteobacterium and a Colwellia species, both of which were highly similar to sequences in the DWH deep-sea hydrocarbon plume. The primary drivers in structuring the microbial community were nitrogen and hydrocarbons. Annotation of unassembled metagenomic data revealed the most abundant hydrocarbon degradation pathway encoded genes involved in degrading aliphatic and simple aromatics via butane monooxygenase. The activity of key hydrocarbon degradation pathways by sediment microbes was confirmed by determining the mineralization of (14)C-labeled model substrates in the following order: propylene glycol, dodecane, toluene and phenanthrene. Further, analysis of metagenomic sequence data revealed an increase in abundance of genes involved in denitrification pathways in samples that exceeded the Environmental Protection Agency (EPA)'s benchmarks for polycyclic aromatic hydrocarbons (PAHs) compared with those that did not. Importantly, these data demonstrate that the indigenous sediment microbiota contributed an important ecosystem service for remediation of oil in the Gulf. However, PAHs were more recalcitrant to degradation, and their persistence could have deleterious impacts on the sediment ecosystem

Relation of Change in Weight Status to the Development of Hypertension in Children and Adolescents

Background/Aims: This study examined the association of body mass index (BMI) percentile and change in BMI percentile to change in blood pressure (BP) percentile and development of hypertension in children and adolescents. Methods: This retrospective cohort included 101,725 subjects aged 3–17 years from three health systems across the United States. Height, weight, age, sex and BP measures were extracted from electronic health records, and then age/sex/height-adjusted BP percentiles and BMI percentiles were computed. Mixed linear regression estimated change in systolic BP percentile, and proportional hazards regression was used to estimate risk of incident hypertension associated with BMI percentile and change in BMI percentile. Results: The largest increases in BP percentile were observed among children and adolescents who became obese or maintained obesity. Over a median 3.1-year follow-up, 0.4% of subjects developed hypertension. Obese children aged 3–11 had 3.5-fold increased risk of developing hypertension compared with normal weight. Obese adolescents aged 12–17 had 3.2-fold increased risk of developing hypertension compared with normal weight. Children and adolescents who stayed obese had 5.4- and 4.8-fold increased risk of developing hypertension, respectively, compared with those who maintained a normal weight. Children who became obese and adolescents who became overweight had 2.6- and 2.3-fold increased risk of developing hypertension, respectively. Conclusion: We observed a strong, statistically significant association between increasing BMI percentile and increases in BP percentile, with risk of incident hypertension primarily associated with obesity. The adverse impact of weight gain and obesity in this young cohort over a short period of time underscores the need for effective strategies for prevention of overweight and obesity in youth to slow progression toward diabetes and cardiovascular disease later in life

Qualitative Data from a Trial of Home Blood Pressure Telemonitoring and Pharmacist Management (Hyperlink)

Background/Aims: Hyperlink was a cluster-randomized intervention trial in HealthPartners clinics from 2009 to 2013 with nonintervention follow-up through 2015 (60 months). Participants had uncontrolled hypertension. Telemonitoring intervention patients had improved blood pressure control at 6 months compared with usual care patients (72% vs. 45%, P \u3c 0.001). Intervention effects narrowed at 12 (72% vs. 53%, P = 0.005) and 18 months (72% vs. 57%, P = 0.003); 60-month blood pressure data will be complete in October 2015. We conducted a mixed-methods analysis combining our quantitative results with patient, clinical and other organizational stakeholder perspectives to learn how to optimize the intervention for the most patients and implement this intervention in our care setting. Methods: We collected three sources of qualitative data: seven patient focus groups stratified by 6–18-month blood pressure outcomes, four structured interviews with intervention pharmacists, and interviews (currently being collected) with key organizational stakeholders. Focus group and structured interview data were analyzed by a team of five using grounded theory. Initial themes were identified and coded in NVivo10. Results: Qualitative data revealed several initial themes. First, patients valued trust in the patient-provider relationship and good communication between providers. Second, patients have varying goals with medications and successfully initiating/adhering to treatment is better when provider understands and respects the patient’s perspective on medications. Finally, intervention patients benefited from seeing their own blood pressure data (reinforcement) and a trusted provider seeing their data (accountability). Pharmacist interviews agreed with these themes, revealing key insights about intervention design including: length of intervention, addressing relapse, and meeting individual patient’s needs with effective use of data and lifestyle counseling. Results of 60-month blood pressure outcomes will be analyzed in the context of these initial findings, and qualitative findings will be further refined. Stakeholder interview results about implementation are forthcoming. Conclusion: Findings suggest the need for several adaptations to the intervention before implementation in practice: provision of blood pressure monitors for ongoing use, a shorter duration with ability to re-engage if blood pressure becomes uncontrolled, more tailoring of the intervention to individual needs, and better communication and handoffs between pharmacists and physicians