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Providing the first meta-analysis of risk factors for pressure ulcer development in adult patients.Pressure ulcers remain a serious health complication for patients and nursing staff. However, there is a lack of statistical evidence for risk factors as previous research did not include any quantitative synthesis.Meta-analysis, using PRISMA guidelines.Studies from PubMed, Embase, CINAHL Complete, Web of Science, Cochrane Library, and other reviews and sources were screened and checked against the inclusion criteria. The risk of bias was evaluated using a slightly modified QUIPS tool. Data regarding population, design, statistical analysis and risk factors were extracted. Meta-analysis with comparable studies was conducted for age, sex, and Braden scale. The sub-group analysis was used to account for heterogeneity.28 studies with 570,162 patients were entered in meta-analysis. Older age and a low total Braden scale score increased the risk for pressure ulcers. All subscales excluding 'moisture' reached significance in meta-analysis based only on few studies, however, limiting overall evidence. Male sex achieved mixed results, too.The first meta-analytic analysis shows evidence for age and Braden scale as risk factors for pressure ulcer development. Limitations regarding study quality and heterogeneity must be considered, highlighting the need for unifying certain conditions in risk factor research.Patients at risk for new pressure ulcers can be identified by their total Braden score and age, whereas the latter is also connected to deeper pressure ulcers. Nurses and health personnel should pay great attention to patients in older age and undergo specific training to utilise and evaluate the Braden scale effectively, if necessary.

To accelerate sustainability transitions, policymakers have to set clear targets for the decline and phase-out of unsustainable technologies. As such decisions are contested, many different actor groups engage in the politics and discourse around decline. This chapter compares the debates surrounding coal phase-out in three countries: the UK, Germany and Finland. Despite major differences, e.g. in the relevance of coal for energy supply and jobs, we find many similarities in discourse dynamics, key arguments and the actor groups engaged. Our findings can therefore inform debates about coal and other unsustainable technologies in places where phase-outs are still pending. Our analysis advances the repertoire of comparative studies in transitions research, and shows how the technological innovation systems framework can be mobilized to also explore processes of technology decline.

To accelerate sustainability transitions, policymakers have to set clear targets for the decline and phase-out of unsustainable technologies. As such decisions are contested, many different actor groups engage in the politics and discourse around decline. This chapter compares the debates surrounding coal phase-out in three countries: the UK, Germany and Finland. Despite major differences, e.g. in the relevance of coal for energy supply and jobs, we find many similarities in discourse dynamics, key arguments and the actor groups engaged. Our findings can therefore inform debates about coal and other unsustainable technologies in places where phase-outs are still pending. Our analysis advances the repertoire of comparative studies in transitions research, and shows how the technological innovation systems framework can be mobilized to also explore processes of technology decline.

In socio-technical transitions research, capacities relevant for transformations have primarily been assessed at systemic or niche levels, with capacities of individual actors to engage in transformative activities not yet well-conceptualized. This paper draws on theories of power in transitions, transformative social innovation and social practice theory to develop a conceptual framework for transformative capacities at the level of the individual citizen. We argue that in order to change social practices and foster successful bottom-up transitions, different forms of capacities - with regards to the elements of a social practice (meanings, competences and materials/resources) - are required. As a next step, the framework developed based on different literatures from transitions research and sociology will be tested empirically in an online-survey targeted at individuals engaged in social innovation. The objective is to better understand social processes of change and the conditions for them, in order to support the development of participatory governance models.

In socio-technical transitions research, capacities relevant for transformations have primarily been assessed at systemic or niche levels, with capacities of individual actors to engage in transformative activities not yet well-conceptualized. This paper draws on theories of power in transitions, transformative social innovation and social practice theory to develop a conceptual framework for transformative capacities at the level of the individual citizen. We argue that in order to change social practices and foster successful bottom-up transitions, different forms of capacities - with regards to the elements of a social practice (meanings, competences and materials/resources) - are required. As a next step, the framework developed based on different literatures from transitions research and sociology will be tested empirically in an online-survey targeted at individuals engaged in social innovation. The objective is to better understand social processes of change and the conditions for them, in order to support the development of participatory governance models.

International journal of environmental research and public health : IJERPH 19(2), 761 (2022). doi:10.3390/ijerph19020761 special issue: "Special Issue "New Advances in Nursing Care" / Special Issue Editor: Dr. Raúl Juárez-Vela, Guest Editor", Published by MDPI, Basel

OBJECTIVE: Risk factors for mortality in patients with subdural hematoma (SDH) include poor Glasgow Coma Scale (GCS), pupil non-reactivity, and hemodynamic instability on presentation. Little is published regarding prognosticators of SDH in the elderly. This study aims to examine risk factors for hospital mortality and withdrawal of life-sustaining measures in an octogenarian population presenting with SDH. METHODS: A prospectively collected multi-center database of 3,279 TBI admissions to 45 different U.S. trauma centers between 2017–2019 was queried to identify patients >79 years old presenting with SDH. Factors collected included baseline demographic data, past medical history, antiplatelet/anticoagulant use, and clinical presentation (GCS, pupil reactivity, injury severity scale [ISS]). Primary outcome data included hospital mortality/discharge to hospice care and withdrawal of life-sustaining measures. Multivariate logistic regression analyses were used to identify factors independently associated with primary outcome variables. RESULTS: A total of 695 patients were isolated for analysis. Of the total cohort, the rate of hospital mortality or discharge to hospice care was 22% (n=150) and the rate of withdrawal of life-sustaining measures was 10% (n=66). A multivariate logistic regression model identified GCS 80 years with SDH. Pre-existing CHF may further predict withdrawal of life-sustaining measures.

ZusammenfassungDamit im hektischen Arbeitsalltag keine wichtigen Informationen mehr verloren gehen, stellen wir Ihnen das Teaming Board vor. Es ist ein lösungsorientiertes Führungsinstrument, mit dem sich die Informationsweitergabe und Prozessgestaltung in der Patientenversorgung verbessern lassen. Dabei bringt es Leitungen und Mitarbeitende aller Qualifikationsstufen zusammen und hält Beratungsergebnisse tagesaktuell und strukturiert fest.

Discourse analysis is gaining attention in transition studies. This paper uses discourse network analysis (DNA) to study how discourse coalitions, and the storylines they mobilize, change over time. Drawing from archival data of two daily newspapers, we analyze the struggle over coal phase-out in Germany (2000–2020). We identify an anti-coal discourse coalition, which was stable and ideationally congruent over time. It used climate change as the dominant storyline to delegitimize coal. The phase-out policy decision in 2020 can be interpreted as the success of this coalition. The pro-coal coalition, in contrast, was more dispersed and less consistent in their arguments. Nonetheless, it was able to institutionalize some of its key storylines in the final policies. We argue that DNA is a powerful tool we can mobilize in sustainability transitions research for the study of politics and beyond., Environmental Innovation and Societal Transitions, 40, ISSN:2210-4224

In a seafood processing plant, refrigeration is a vital and energy intensive process. In India, NH3 is predominately used to cater to such refrigeration demands. These industrial refrigeration systems have the multi-evaporator configuration with high pressure ratios necessitating adoption of multistage compression. In recent years, owing to excellent and favorable thermo-physical properties of CO2 in low temperature, adoption of NH3-CO2 cascade refrigeration system (CRS) with NH3 in high temperature cycle is gaining worldwide acceptance. In the present work, performance of a conventional NH3 multistage industrial refrigeration system is compared with a proposed NH3-CO2 CRS system in terms of energy, exergy and economic perspectives. Investigation is focused to thermodynamically evaluate and optimize the performance of the proposed cascade configuration with respect to operating parameters. A sensitivity analysis has been performed as well to study the effects of climatic conditions on system performance. The proposed NH3-CO2 CRS showed a maximum benefit of 13.3% in COP, 14% in exergy efficiency and 9% less TEWI compared to the baseline system. The estimated payback period is 25 months.

Ethane is the second most abundant component of natural gas in addition to methane, and—similar to methane—is chemically unreactive. The biological consumption of ethane under anoxic conditions was suggested by geochemical profiles at marine hydrocarbon seeps1–3, and through ethane-dependent sulfate reduction in slurries4–7. Nevertheless, the microorganisms and reactions that catalyse this process have to date remained unknown8. Here we describe ethane-oxidizing archaea that were obtained by specific enrichment over ten years, and analyse these archaea using phylogeny-based fluorescence analyses, proteogenomics and metabolite studies. The co-culture, which oxidized ethane completely while reducing sulfate to sulfide, was dominated by an archaeon that we name ‘Candidatus Argoarchaeum ethanivorans’; other members were sulfate-reducing Deltaproteobacteria. The genome of Ca. Argoarchaeum contains all of the genes that are necessary for a functional methyl-coenzyme M reductase, and all subunits were detected in protein extracts. Accordingly, ethyl-coenzyme M (ethyl-CoM) was identified as an intermediate by liquid chromatography–tandem mass spectrometry. This indicated that Ca. Argoarchaeum initiates ethane oxidation by ethyl-CoM formation, analogous to the recently described butane activation by ‘Candidatus Syntrophoarchaeum’9. Proteogenomics further suggests that oxidation of intermediary acetyl-CoA to CO2 occurs through the oxidative Wood–Ljungdahl pathway. The identification of an archaeon that uses ethane (C2H6) fills a gap in our knowledge of microorganisms that specifically oxidize members of the homologous alkane series (CnH2n+2) without oxygen. Detection of phylogenetic and functional gene markers related to those of Ca. Argoarchaeum at deep-sea gas seeps10–12 suggests that archaea that are able to oxidize ethane through ethyl-CoM are widespread members of the local communities fostered by venting gaseous alkanes around these seeps. An archaeon, ‘Candidatus Argoarchaeum ethanivorans’, which is involved in the oxidation of ethane observed in anoxic marine habitats, is identified and metabolically characterized.

The aromatic hydrocarbon naphthalene, which occurs in coal and oil, can be degraded by aerobic or anaerobic microorganisms. A wide-spread electron acceptor for the latter is sulfate. Evidence for in situ naphthalene degradation stems in particular from the detection of 2-naphthoate and [5,6,7,8]-tetrahydro-2-naphthoate in oil field samples. Because such intermediates are usually not detected in laboratory cultures with high sulfate concentrations, one may suppose that conditions in reservoirs, such as sulfate limitation, trigger metabolite release. Indeed, if naphthalene-grown cells of marine sulfate-reducing Deltaproteobacteria (strains NaphS2, NaphS3 and NaphS6) were transferred to sulfate-free medium, they released 2-naphthoate and [5,6,7,8]-tetrahydro-2-naphthoate while still consuming naphthalene. With 2-naphthoate as initial substrate, cells produced [5,6,7,8]-tetrahydro-2-naphthoate and the hydrocarbon, naphthalene, indicating reversibility of the initial naphthalene-metabolizing reaction. The reactions in the absence of sulfate were not coupled to observable growth. Excretion of naphthalene-derived metabolites was also achieved in sulfate-rich medium upon addition of the protonophore carbonyl cyanide 4-(trifluoromethoxy)phenylhydrazone or the ATPase inhibitor N,N'-dicyclohexylcarbodiimide. In conclusion, obstruction of electron flow and energy gain by sulfate limitation offers an explanation for the occurrence of naphthalene-derived metabolites in oil reservoirs, and provides a simple experimental tool for gaining insights into the anaerobic naphthalene oxidation pathway from an energetic perspective. This article is protected by copyright. All rights reserved.

Beta blockers, a class of medications that inhibit endogenous catecholamines interaction with beta adrenergic receptors, are often administered to patients hospitalized after traumatic brain injury (TBI). We tested the hypothesis that beta blocker use after TBI is associated with lower mortality, and secondarily compared propranolol to other beta blockers.The American Association for the Surgery of Trauma Clinical Trial Group conducted a multi-institutional, prospective, observational trial in which adult TBI patients who required intensive care unit admission were compared based on beta blocker administration.From January 2015 to January 2017, 2,252 patients were analyzed from 15 trauma centers in the United States and Canada with 49.7% receiving beta blockers. Most patients (56.3%) received the first beta blocker dose by hospital day 1. Those patients who received beta blockers were older (56.7 years vs. 48.6 years, p0.001) and had higher head Abbreviated Injury Scale scores (3.6 vs. 3.4, p0.001). Similarities were noted when comparing sex, admission hypotension, mean Injury Severity Score, and mean Glasgow Coma Scale. Unadjusted mortality was lower for patients receiving beta blockers (13.8% vs. 17.7%, p = 0.013). Multivariable regression determined that beta blockers were associated with lower mortality (adjusted odds ratio, 0.35; p0.001), and propranolol was superior to other beta blockers (adjusted odds ratio, 0.51, p = 0.010). A Cox-regression model using a time-dependent variable demonstrated a survival benefit for patients receiving beta blockers (adjusted hazard ratio, 0.42, p0.001) and propranolol was superior to other beta blockers (adjusted hazard ratio, 0.50, p = 0.003).Administration of beta blockers after TBI was associated with improved survival, before and after adjusting for the more severe injuries observed in the treatment cohort. This study provides a robust evaluation of the effects of beta blockers on TBI outcomes that supports the initiation of a multi-institutional randomized control trial.Therapeutic/care management, level III.

De.sul.fo.ther' mus. L. pref. de from; L. n. sulfur sulfur; Gr. adj. thermus hot; M.L. masc. n. Desulfothermus sulfate reducer living in hot places. Proteobacteria / Deltaproteobacteria / Desulfovibrionales / Desulfohalobiaceae / Desulfothermus Rod-shaped to slightly curved cells, 0.8–1.0 × 2.0–3.5 μm. Occur singly or in pairs. May grow as individual cells or as compact clumps. Cells tend to stick to hydrophobic surfaces. Spore formation is not observed. Gram negative. Slow motility may occur. Strict anaerobe with a respiratory type of metabolism. Chemoorganotroph, using alkanes (C6–C14), and long-chain fatty acids (C4–C18) as electron donors and as carbon sources; these compounds are completely oxidized to CO2 via the anaerobic C1-pathway (carbon monoxide dehydrogenase [CO-DH] pathway, Wood pathway) as indicated by CO–DH activity. Sulfate and thiosulfate serve as terminal electron acceptors and are reduced to H2S. The optimal pH range for growth is 6.5–6.8. The optimal temperature range for growth is 60–65°C. Mesophilic species have not been described. Anoxic media containing a reductant (usually sulfide), NaCl, and MgCl2 are necessary for growth. Vitamins are not required. Occur in anoxic marine sediment rich in aliphatic hydrocarbons. The mol% G + C of the DNA is: 37.4. Type species: Desulfothermus naphthae sp. nov. Keywords: Desulfothermus gen. nov.; Desulfothermus naphthae; Desulfohalobiaceae fam. nov.

De.sul.fo.bac.ter.a.ce' ae. M.L. masc. n. Desulfobacter type genus of the family; suff. ceae denotes family; M.L. fem. pl. n. Desulfobacteraceae the family that comprises the genus Desulfobacter and other genera. Proteobacteria / Deltaproteobacteria / Desulfobacterales / Desulfobacteraceae Keywords: Desulfobacteraceae fam. nov.; Desulfobacter; Deltaproteobacteria class nov.; Desulfobacterales ord. nov

De.sul.fo.vi.bri.o.na.ce' ae. M.L. masc. n. Desulfovibrio type genus of the family; suffix -ceae denotes family; M.L. fem. pl. n. Desulfovibrionaceae the family that comprises the genus Desulfovibrio. Proteobacteria / Deltaproteobacteria / Desulfovibrionales / Desulfovibrionaceae Keywords: Desulfovibrionaceae fam. nov.; Desulfovibrio; Deltaproteobacteria class nov.; Desulfovibrionales ord. nov

The anaerobic formation and oxidation of methane involve unique enzymatic mechanisms and cofactors, all of which are believed to be specific for C-1-compounds. Here we show that an anaerobic thermophilic enrichment culture composed of dense consortia of archaea and bacteria apparently uses partly similar pathways to oxidize the C-4 hydrocarbon butane. The archaea, proposed genus Candidatus Syntrophoarchaeum', show the characteristic autofluorescence of methanogens, and contain highly expressed genes encoding enzymes similar to methyl-coenzyme M reductase. We detect butyl-coenzyme M, indicating archaeal butane activation analogous to the first step in anaerobic methane oxidation. In addition, Ca. Syntrophoarchaeum expresses the genes encoding beta-oxidation enzymes, carbon monoxide dehydrogenase and reversible C-1 methanogenesis enzymes. This allows for the complete oxidation of butane. Reducing equivalents are seemingly channelled to HotSeep-1, a thermophilic sulfate-reducing partner bacterium known from the anaerobic oxidation of methane. Genes encoding 16S rRNA and methyl-coenzyme M reductase similar to those identifying Ca. Syntrophoarchaeum were repeatedly retrieved from marine subsurface sediments, suggesting that the presented activation mechanism is naturally widespread in the anaerobic oxidation of short-chain hydrocarbons.

Emissions of methane, a potent greenhouse gas, from marine sediments are controlled by anaerobic oxidation of methane coupled primarily to sulphate reduction (AOM). Sulphate-coupled AOM is believed to be mediated by a consortium of methanotrophic archaea (ANME) and sulphate-reducing Deltaproteobacteria but the underlying mechanism has not yet been resolved. Here we show that zero-valent sulphur compounds (S0) are formed during AOM through a new pathway for dissimilatory sulphate reduction performed by the methanotrophic archaea. Hence, AOM might not be an obligate syntrophic process but may be carried out by the ANME alone. Furthermore, we show that the produced S0—in the form of disulphide—is disproportionated by the Deltaproteobacteria associated with the ANME. Our observations expand the diversity of known microbially mediated sulphur transformations and have significant implications for our understanding of the biogeochemical carbon and sulphur cycles. Methane oxidation under anaerobic conditions coupled to sulphate reduction is thought to be carried out by a consortium of methanotrophic archaea (ANME) and sulphate-reducing Deltaproteobacteria; here it is shown that ANME alone can mediate the reaction and that the associated bacteria perform disulphide disproportionation, a new microbial sulphur transformation. Anaerobic methane oxidation in marine sediments is coupled to sulphate reduction and is carried out by a consortium of methanotrophic archaea (ANME) and Deltaproteobacteria. However, the underlying biochemical pathway and electron-transfer mechanism between the two species has been difficult to determine. Jana Milucka et al. now demonstrate that this transformation involves the reduction of sulphate to elemental sulphur by ANME and disulphide disproportionation (simultaneous oxidation and reduction of a substance reacting with itself) by the Deltaproteobacterium — the latter process a previously unknown microbial sulphur transformation.

Anaerobic oxidation of methane (AOM) coupled to sulfate reduction (SR) at marine gas seeps is performed by archaeal-bacterial consortia that have so far not been cultivated in axenic binary or pure cultures. Knowledge about possible biochemical reactions in AOM consortia is based on metagenomic retrieval of genes related to those in archaeal methanogenesis and bacterial sulfate reduction, and identification of a few catabolic enzymes in protein extracts. Whereas the possible enzyme for methane activation (a variant of methyl-coenzyme M reductase, Mcr) was shown to be harboured by the archaea, enzymes for sulfate activation and reduction have not been localized so far. We adopted a novel approach of fluorescent immunolabelling on semi-thin (0.3-0.5 μm) cryosections to localize two enzymes of the SR pathway, adenylyl : sulfate transferase (Sat; ATP sulfurylase) and dissimilatory sulfite reductase (Dsr) in microbial consortia from Black Sea methane seeps. Both Sat and Dsr were exclusively found in an abundant microbial morphotype (c. 50% of all cells), which was tentatively identified as Desulfosarcina/Desulfococcus-related bacteria. These results show that ANME-2 archaea in the Black Sea AOM consortia did not express bacterial enzymes of the canonical sulfate reduction pathway and thus, in contrast to previous suggestions, most likely cannot perform canonical sulfate reduction. Moreover, our results show that fluorescent immunolabelling on semi-thin cryosections which to our knowledge has been so far only applied on cell tissues, is a powerful tool for intracellular protein detection in natural microbial associations.

Iron (Fe(0) ) corrosion in anoxic environments (e.g. inside pipelines), a process entailing considerable economic costs, is largely influenced by microorganisms, in particular sulfate-reducing bacteria (SRB). The process is characterized by formation of black crusts and metal pitting. The mechanism is usually explained by the corrosiveness of formed H(2) S, and scavenge of 'cathodic' H(2) from chemical reaction of Fe(0) with H(2) O. Here we studied peculiar marine SRB that grew lithotrophically with metallic iron as the only electron donor. They degraded up to 72% of iron coupons (10 mm × 10 mm × 1 mm) within five months, which is a technologically highly relevant corrosion rate (0.7 mm Fe(0) year(-1) ), while conventional H(2) -scavenging control strains were not corrosive. The black, hard mineral crust (FeS, FeCO(3) , Mg/CaCO(3) ) deposited on the corroding metal exhibited electrical conductivity (50 S m(-1) ). This was sufficient to explain the corrosion rate by electron flow from the metal (4Fe(0) → 4Fe(2+) + 8e(-) ) through semiconductive sulfides to the crust-colonizing cells reducing sulfate (8e(-) + SO(4) (2-) + 9H(+) → HS(-) + 4H(2) O). Hence, anaerobic microbial iron corrosion obviously bypasses H(2) rather than depends on it. SRB with such corrosive potential were revealed at naturally high numbers at a coastal marine sediment site. Iron coupons buried there were corroded and covered by the characteristic mineral crust. It is speculated that anaerobic biocorrosion is due to the promiscuous use of an ecophysiologically relevant catabolic trait for uptake of external electrons from abiotic or biotic sources in sediments.

Summary Diverse microorganisms have been described to degrade petroleum hydrocarbons anaerobically. Strains able to utilize n-alkanes do not grow with aromatic hydrocarbons, whereas strains able to utilize aromatic hydrocarbons do not grow with n-alkanes. To investigate this specificity in more detail, three anaerobic n-alkane degraders (two denitrifying, one sulfate-reducing) and eight anaerobic alkylbenzene degraders (five denitrifying, three sulfate-reducing) were incubated with mixtures of n-alkanes and toluene. Whereas the toluene degradationers formed only the characteristic toluene-derived benzylsuccinate and benzoate, but no n-alkane-derived metabolites, the n-alkane degraders formed toluene-derived benzylsuccinate, 4-phenylbutanoate, phenylacetate and benzoate besides the regular n-alkane-derived (1-methylalkyl)succinates and methyl-branched alkanoates. The co-metabolic conversion of toluene by anaerobic n-alkane degraders to the level of benzoate obviously follows the anaerobic n-alkane degradation pathway with C-skeleton rearrangement and decarboxylation rather than the β-oxidation pathway of anaerobic toluene metabolism. Hence, petroleum-derived aromatic metabolites detectable in anoxic environments may not be exclusively formed by genuine alkylbenzene degraders. In addition, the hitherto largely unexplored fate of fumarate hydrogen during the activation reactions was examined with (2,3-2H2)fumarate as co-substrate. Deuterium was completely exchanged with hydrogen at the substituted carbon atom (C-2) of the succinate adducts of n-alkanes, whereas it is retained in toluene-derived benzylsuccinate, regardless of the type of enzyme catalysing the fumarate addition reaction.

Anaerobic oxidation of methane (AOM) with sulfate is catalysed by microbial consortia of archaea and bacteria affiliating with methanogens and sulfate-reducing Deltaproteobacteria respectively. There is evidence that methane oxidation is catalysed by enzymes related to those in methanogenesis, but the enzymes for sulfate reduction coupled to AOM have not been examined. We collected microbial mats with high AOM activity from a methane seep in the Black Sea. The mats consisted mainly of archaea of the ANME-2 group and bacteria of the Desulfosarcina-Desulfococcus group. Cell-free mat extract contained activities of enzymes involved in sulfate reduction to sulfide: ATP sulfurylase (adenylyl : sulfate transferase; Sat), APS reductase (Apr) and dissimilatory sulfite reductase (Dsr). We partially purified the enzymes by anion-exchange chromatography. The amounts obtained indicated that the enzymes are abundant in the mat, with Sat accounting for 2% of the soluble mat protein. N-terminal amino acid sequences of purified proteins suggested similarities to the corresponding enzymes of known species of sulfate-reducing bacteria. The deduced amino acid sequence of PCR-amplified genes of the Apr subunits is similar to that of Apr of the Desulfosarcina/Desulfococcus group. These results indicate that the major enzymes involved in sulfate reduction in the Back Sea microbial mats are of bacterial origin, most likely originating from the bacterial partner in the consortium.

Microorganisms can degrade saturated hydrocarbons (alkanes) not only under oxic but also under anoxic conditions. Three denitrifying isolates (strains HxN1, OcN1, HdN1) able to grow under anoxic conditions by coupling alkane oxidation to CO2 with NO3− reduction to N2 were compared with respect to their alkane metabolism. Strains HxN1 and OcN1, which are both Betaproteobacteria, utilized n-alkanes from C6 to C8 and C8 to C12 respectively. Both activate alkanes anaerobically in a fumarate-dependent reaction yielding alkylsuccinates, as suggested by present and previous metabolite and gene analyses. However, strain HdN1 was unique in several respects. It belongs to the Gammaproteobacteria and was more versatile towards alkanes, utilizing the range from C6 to C30. Neither analysis of metabolites nor analysis of genes in the complete genome sequence of strain HdN1 hinted at fumarate-dependent alkane activation. Moreover, whereas strains HxN1 and OcN1 grew with alkanes and NO3−, NO2− or N2O added to the medium, strain HdN1 oxidized alkanes only with NO3− or NO2− but not with added N2O; but N2O was readily used for growth with long-chain alcohols or fatty acids. Results suggest that NO2− or a subsequently formed nitrogen compound other than N2O is needed for alkane activation in strain HdN1. From an energetic point of view, nitrogen–oxygen species are generally rather strong oxidants. They may enable enzymatic mechanisms that are not possible under conditions of sulfate reduction or methanogenesis and thus allow a special mode of alkane activation.

Object The aim of this study was to report the results of a large clinical series of patients with symptomatic Rathke cleft cysts (RCCs) who underwent resection by a single neurosurgeon using intraoperative alcohol cauterization, and to review any possible differences in recurrence rates in those treated with this chemically ablative technique. Methods The authors performed a retrospective database review of 82 patients (age range 10–74 years) with symptomatic RCCs who underwent surgery between 1993 and 2009. Results Preoperative symptoms of headaches, vision disturbances, and hormone dysfunction were observed in 68%, 35%, and 56% of patients, respectively. All 82 patients underwent treatment by a single surgeon. Surgery consisting of simple cyst drainage followed by cyst wall biopsy without vigorous cyst wall removal was performed. A subset of these patients (62) received intraoperative alcohol instillation. Perioperative complication rates were low: CSF leakage, symptomatic hyponatremia, and permanent diabetes insipidus (DI) in 2%, 5%, and 0% of patients, respectively. Headaches and vision problems improved or resolved in 71% and 83% of patients, respectively. In addition, hyperprolactinemia, hypothyroidism, panhypopituitarism, DI, and adrenal insufficiency improved or resolved in 94%, 90%, 50%, 33%, and 67% of patients, respectively. Recurrence, as defined by enlargement of the cyst as compared with its appearance on baseline 3-month postoperative MR imaging, was noted in 10.7% of the primary surgery group. There was a trend toward increased recurrence rates in the alcohol-treated (12.9%) versus no–alcohol treatment groups (0%), although not statistically significant (p = 0.20). Conclusions This large, single-surgeon/single-institution series of patients with symptomatic RCCs confirms that significant postoperative improvement in headaches, vision, and pituitary hormone dysfunction can be achieved via a conservative surgical approach, with low complication and recurrence rates. The data also demonstrate a limited role for alcohol cauterization in the treatment of symptomatic RCCs.

Glucose homeostasis depends on insulin-regulated glucose uptake in the skeletal muscles and fat tissues via glucose transporter (GLUT) 4 translocation into cellular plasma membranes. The present study sought to elucidate GLUT4 expression, GLUT1 and GLUT4 translocation and glucose uptake in the skeletal muscles of Shetland ponies. Semitendinosus muscle explants were removed by open muscle biopsy from six Shetland pony geldings under general anaesthesia. The expression of GLUT4 was analysed by measuring muscle crude membrane (CM) GLUT4 protein contents. To determine the insulin-stimulated GLUT translocation, GLUT1 and GLUT4 concentrations were measured in partially purified plasma membranes (PM) and cytoplasmic vesicles (CV). GLUT contents were determined semi-quantitatively by Western blotting. Insulin-stimulated glucose uptake was analysed using 3-O-d-methyl[(3)H]glucose uptake. Incubation of semitendinosus muscle strips with 0.1 and 20mIU/mL insulin significantly increased GLUT4 translocation (PM GLUT4 contents), but had no significant effect on GLUT4 expression (CM GLUT4 concentrations) or PM GLUT1. The uptake of myocyte 3-O-Methylglucose was not significantly increased following insulin stimulation. The sub-cellular fractionation technique proved to be an appropriate tool for determining insulin-stimulated GLUT4 translocation in equine skeletal muscle. GLUT4 translocation in equines is insulin-dependent, as has been described in rodents and farm animals, but insulin-stimulated GLUT4 activation in ponies is lower than reported for pigs and cows under the same experimental conditions. Poor insulin-activated GLUT4 translocation may account for insulin resistance in ponies in previous euglycaemic, hyperinsulinaemic clamp tests.

An anaerobic nitrate-reducing enrichment culture was established with a cyclic saturated petroleum hydrocarbon, cyclohexane, the fate of which in anoxic environments has been scarcely investigated. GC-MS showed cyclohexylsuccinate as a metabolite, in accordance with an anaerobic enzymatic activation of cyclohexane by carbon-carbon addition to fumarate. Furthermore, long-chain cyclohexyl-substituted cell fatty acids apparently derived from cyclohexane were detected. Nitrate reduction was not only associated with cyclohexane utilization but also with striking depletion of added ammonium ions. Significantly more ammonium was consumed than could be accounted for by assimilation. This indicated the occurrence of anaerobic ammonium oxidation (anammox) with nitrite from cyclohexane-dependent nitrate reduction. Indeed, nitrite depletion was stimulated upon further addition of ammonium. Analysis of 16S rRNA genes and subsequent cell hybridization with specific probes showed that approximately 75% of the bacterial cells affiliated with the Geobacteraceae and approximately 18% with Candidatus 'Brocadia anammoxidans' (member of the Planctomycetales), an anaerobic ammonium oxidizer. These results and additional quantitative growth experiments indicated that the member of the Geobacteraceae reduced nitrate with cyclohexane to nitrite and some ammonium; the latter two and ammonium added to the medium were scavenged by anammox bacteria to yield dinitrogen. A model was established to quantify the partition of each microorganism in the overall process. Such hydrocarbon oxidation by an alleged 'denitrification' ('pseudo-denitrification'), which in reality is a dissimilatory loop through anammox, can in principle also occur in other microbial systems with nitrate-dependent hydrocarbon attenuation.

Object The goal of this investigation is to describe the results of a vigorous attempt to preserve contaminated free bone flaps and avoid the problems associated with the traditional and common practice of discarding the flap, administering a course of antibiotics, and after several months, performing a cranioplasty. Methods Patients with clearly contaminated, free cranial bone flaps, including so-called high risk cases, were treated by meticulous debridement of the surgical bed, scrubbing, soaking, and then replacing the bone flap in its normal position, and administering a course of intravenous antibiotics. Results Fourteen patients with contaminated avascular cranial bone flaps were treated using this technique. All bone flaps were able to be preserved. Conclusions Patients with bacteriologically contaminated, free bone flaps can be treated successfully without discarding the flaps. Success is dependent upon aggressive surgical debridement and persistence.

The anaerobic oxidation of methane (AOM) by methanotrophic archaea and sulfate-reducing bacteria is the major sink of methane formed in marine sediments. The study of AOM as well as of methanogenesis in different habitats is essentially connected with the in situ analysis of stable isotope ((13) C/(12) C, D/H) signatures (δ-values). For their kinetic interpretation, experimental (cultivation-based) isotope fractionation factors (α-values) are richly available in the case of methanogenesis, but are scarce in the case of AOM. Here we used batch enrichment cultures with high AOM activity and without background methanogenesis from detrital remnants to determine (13) C/(12) C and D/H fractionation factors. The enrichment cultures which originated from three marine habitats (Hydrate Ridge, NE Pacific; Amon Mud Volcano, Mediterranean Sea; NW shelf, Black Sea) were dominated by archaeal phylotypes of anaerobic methanotrophs (ANME-2 clade). Isotope fractionation factors calculated from the isotope signatures as a function of the residual proportion of methane were 1.012-1.039 for (13) CH4 /(12) CH4 and 1.109-1.315 for CDH3 /CH4 . The present values from in vitro experiments were significantly higher than values previously estimated from isotope signature distributions in marine sediment porewater, in agreement with the overlap of other processes with AOM in the natural habitat.