Emborgmcgowan1153

[This corrects the article DOI 10.1371/journal.pone.0235500.].The microbial oxidation of metal sulfides plays a major role in the formation of acid rock drainage (ARD). We aimed to broadly characterize the ARD at Ely Brook, which drains the Ely Copper Mine Superfund site in Vermont, USA, using metagenomics and metatranscriptomics to assess the metabolic potential and seasonal ecological roles of microorganisms in water and sediment. Using Centrifuge against the NCBI "nt" database, ~25% of reads in sediment and water samples were classified as acid-tolerant Proteobacteria (61 ± 4%) belonging to the genera Pseudomonas (2.6-3.3%), Bradyrhizobium (1.7-4.1%), and Streptomyces (2.9-5.0%). Numerous genes (12%) were differentially expressed between seasons and played significant roles in iron, sulfur, carbon, and nitrogen cycling. The most abundant RNA transcript encoded the multidrug resistance protein Stp, and most expressed KEGG-annotated transcripts were involved in amino acid metabolism. Biosynthetic gene clusters involved in secondary metabolism (BGCs, 449) as well as metal- (133) and antibiotic-resistance (8501) genes were identified across the entire dataset. Several antibiotic and metal resistance genes were colocalized and coexpressed with putative BGCs, providing insight into the protective roles of the molecules BGCs produce. Our study shows that ecological stimuli, such as metal concentrations and seasonal variations, can drive ARD taxa to produce novel bioactive metabolites.

An accurate and precise surgical procedure is crucial for patient safety and treatment efficacy of deep brain stimulation (DBS).

To investigate the characteristics of intracranial lead bending phenomenon after DBS, and to suggest the methods to avoid bending-related complications.

A retrospective review of brain computed tomography scans after DBS was performed. Using 3-dimensional reconstruction, the maximal distance between the planned trajectory and actual lead location was measured. When the distance exceeded the lead body diameter, the lead was considered bent. The distance between the bending point and planned trajectory, and the relative direction between the bending point and lead securing site were analyzed. Changes over time in the range of lead bending and depth were analyzed when possible.

A total of 190 implanted leads in 102 patients were analyzed; 104 leads (54.7%) were bent. The average deviation of bent leads was 2.3 mm (range, 1.3-7.1 mm). Thirty-five (18.4%) and seven leads (3.7%) had deviations exceeding twice and three times the lead body diameter, respectively. Angles between the deviation point and securing site at the skull ranged from 135-180° in 83 leads (53.2%), 45-135° in 58 (37.2%), and 0-45° in 15 (9.6%). Among 17 leads that were initially bent, 16 had less deviation compared to baseline. The lead depth increased in 35 (92.1%) of 38 leads by 1.2 mm (range, 0.1-4.7 mm).

The extent of lead bending should be considered during the planning and procedural phases of intracranial lead implantation for DBS.

The extent of lead bending should be considered during the planning and procedural phases of intracranial lead implantation for DBS.

The Covid-19 pandemic threatens to overwhelm scarce clinical resources. Risk factors for severe illness must be identified to make efficient resource allocations.

To evaluate risk factors for severe illness.

Retrospective, observational case series.

Single-institution.

First 117 consecutive patients hospitalized for Covid-19 from March 1 to April 12, 2020.

None.

Intensive care unit admission or death.

In-hospital mortality was 24.8% and average total length of stay was 11.82 days (95% CI 10.01 to 13.63 days). 30.8% of patients required intensive care unit admission and 29.1% required mechanical ventilation. Multivariate regression identified the amount of supplemental oxygen required at admission (OR 1.208, 95% CI 1.011-1.443, p = .037), sputum production (OR 6.734, 95% CI 1.630-27.812, p = .008), insulin dependent diabetes mellitus (OR 11.873, 95% CI 2.218-63.555, p = .004) and chronic kidney disease (OR 4.793, 95% CI 1.528-15.037, p = .007) as significant risk factors for intensive care unithad a 25% mortality rate. Patients with increased sputum production and higher supplemental oxygen requirements at admission, and insulin dependent diabetes or chronic kidney disease may be at increased risk for severe illness. A model for predicting intensive care unit admission or death with excellent discrimination was created that may aid in treatment decisions and resource allocation. Early identification of patients at increased risk for severe illness may lead to improved outcomes in patients hospitalized with Covid-19.Travelers' diarrhea (TD) is the most prevalent illness encountered by deployed military personnel and has a major impact on military operations, from reduced job performance to lost duty days. Frequently, the etiology of TD is unknown and, with underreporting of cases, it is difficult to accurately assess its impact. An increasing number of ailments include an altered or aberrant gut microbiome. To better understand the relationships between long-term deployments and TD, we studied military personnel during two nine-month deployment cycles in 2015-2016 to Honduras. To collect data on the prevalence of diarrhea and impact on duty, a total of 1173 personnel completed questionnaires at the end of their deployment. 56.7% reported reduced performance and 21.1% reported lost duty days. We conducted a passive surveillance study of all cases of diarrhea reporting to the medical unit with 152 total cases and a similar pattern of etiology. Enteroaggregative E. coli (EAEC, 52/152), enterotoxigenic E. coli (ETEC, 50/152), and enteropathogenic E. coli (EPEC, 35/152) were the most prevalent pathogens detected. An active longitudinal surveillance of 67 subjects also identified diarrheagenic E. SB-297006 coli as the primary etiology (7/16 EPEC, 7/16 EAEC, and 6/16 ETEC). Eleven subjects were recruited into a nested longitudinal substudy to examine gut microbiome changes associated with deployment. A 16S rRNA amplicon survey of fecal samples showed differentially abundant baseline taxa for subjects who contracted TD versus those who did not, as well as detection of taxa positively associated with self-reported gastrointestinal distress. Disrupted microbiota was also qualitatively observable for weeks preceding and following the incidents of TD. These findings illustrate the complex etiology of diarrhea amongst military personnel in deployed settings and its impacts on job performance. Potential factors of resistance or susceptibility can provide a foundation for future clinical trials to evaluate prevention and treatment strategies.