Soil biogeochemical characteristics influenced by alum application in a municipal wastewater treatment wetland

Constructed treatment wetlands are a relatively low-cost alternative used for tertiary treatment of wastewater. Phosphorus (P) removal capacity of these wetlands may decline, however, as P is released from the accrued organic soils. Little research has been done on methods to restore the treatment capacity of aging constructed wetlands. One possibility is the seasonal addition of alum during periods of low productivity and nutrient removal. Our 3-mo mesocosm study investigated the effectiveness of alum in immobilizing P during periods of reduced treatment efficiency, as well as the effects on soil biogeochemistry. Eighteen mesocosms were established, triplicate experimental and control units for Typha sp., Schoenoplectus californicus, and submerged aquatic vegetation (SAV) (Najas guadalupensis dominated). Alum was slowly dripped to the water column of the experimental units at a rate of 0.91 g Al m(-2) d(-1) and water quality parameters were monitored. Soil cores were collected at experiment initiation and completion and sectioned into 0- to 5- and 5- to 10-cm intervals for characterization. The alum floc remained in the 0- to 5-cm surface soil, however, soil pH and microbial parameters were impacted throughout the upper 10 cm with the lowest pH found in the Typha treatment. Plant type did not impact most biogeochemical parameters; however, data were more variable in the SAV mesocosms. Amorphous Al was greater in the surface soil of alum-treated mesocosms, inversely correlated with soil pH and microbial biomass P in both soil layers. Microbial activity was also suppressed in the surface soil of alum-treated mesocosms. This research suggests alum may significantly affect the biogeochemistry of treatment wetlands and needs further investigation.

Cost-effectiveness of suppressing hepatitis B virus DNA in immune tolerant patients to prevent hepatocellular carcinoma and cirrhosis

BACKGROUND

For patients with hepatitis B virus (HBV) infection in the immune tolerant phase, the current standard of care is to not offer treatment. However, the recent Risk Evaluation of the Viral Load Elevation and Associated Liver Disease/Cancer-In study results show a striking relationship between high HBV DNA levels and risk for hepatocellular carcinoma and cirrhosis.

AIM

In a cost effectiveness analysis, to assess whether immune tolerant patients with high HBV DNA levels should undergo treatment.

METHODS

We created a lifetime Markov model to evaluate the cost-effectiveness of two strategies for immune tolerant hepatitis B: (i) HBV DNA suppression with lamivudine, (ii) no treatment. Patients cycled between the following health states: viral suppression, ongoing viremia, seroconversion, hepatocellular carcinoma, cirrhosis and death.

RESULTS

Compared with the no treatment strategy, lamivudine therapy was more expensive but more cost-effective with an additional cost of $5784 and $12 584 per quality adjusted life year gained in males and females, respectively. Treatment resulted in a gain in life expectancy and a decrease in lifetime risk of hepatocellular carcinoma and cirrhosis.

CONCLUSIONS

Suppressing HBV DNA to prevent hepatocellular carcinoma and cirrhosis in immune tolerant patients is very cost-effective, and treatment of these patients may be considered. Future prospective clinical trials will need to be undertaken to confirm our findings.

Simultaneous liver-kidney transplantation: evaluation to decision making

Questions about appropriate allocation of simultaneous liver and kidney transplants (SLK) are being asked because kidney dysfunction in the context of liver failure enhances access to deceased donor organs. There is specific concern that some patients who undergo combined liver and kidney transplantation may have reversible renal failure. There is also concern that liver transplants are placed prematurely in those with end-stage renal disease. Thus to assure allocation of transplants only to those truly in need, the transplant community met in March 2006 to review post-MELD (model for end-stage liver disease) data on the impact of renal function on liver waitlist and transplant outcomes and the results of SLK.

Recent changes in soil total phosphorus in the Everglades: Water Conservation Area 3

We assessed recent changes in the distribution of soil total phosphorus (TP) in Water Conservation Area 3 (WCA-3) of the Everglades. Soil cores were collected in 1992 and 2003 at 176 sites. To reflect hydrologic boundaries within the system, WCA-3 was divided into three zones (3AN, 3AS, and 3B). Total P was mapped on both a mass (TPm) and a volumetric basis (TPv) to determine if spatial distributions varied depending on the choice of units. Interpolated maps for both years showed that the highest levels of TPm were located in 3AN and in boundary areas of all zones that received surface water inputs of P from canals. Increases in TPm were greatest in central 3AN in an area adjacent to the Miami Canal that received inputs from a water control structure. Interpolated maps for TPv illustrated that a hotspot present in 1992 had disappeared by 2003. The highest levels of TPv in 2003 were located in northwestern 3AN, a region of WCA-3 that has been chronically overdrained and burned in 1999. From 1992 to 2003, increases in TPm were observed for 53% of the area of WCA-3, while only 16% of WCA-3 exhibited increases in TPv. In 1992, approximately 21% of WCA-3 had TPm concentrations in the 0-10 cm layer >500 mg kg(-1), indicating P enrichment beyond historic levels. Eleven years later, 30% of the area of WCA-3 had TPm >500 mg kg(-1). This indicated that during this period, the area of WCA-3 with enriched TPm concentrations increased about one % year(-1).

Increased soil stable nitrogen isotopic ratio following phosphorus enrichment: historical patterns and tests of two hypotheses in a phosphorus-limited wetland

We used a P enrichment gradient in the Everglades to investigate patterns of the stable N isotopic ratio (delta(15)N) in peat profiles as an indicator of historic eutrophication of this wetland. We also tested two hypotheses to explain the effects of P on increased delta(15)N of organic matter including: (1) increased N mineralization/N loss, and (2) reduced isotopic discrimination during macrophyte N uptake. Spatial patterns of delta(15)N in surface litter and soil (0-10 cm) mimic those of the aboveground macrophytes (Typha domingensis Pers. and Cladium jamaicense Crantz). Peat profiles also show increased delta(15)N in the peat accumulated in areas near the historic P discharges since the early 1960s. The increased delta(15)N of bulk peat correlated well with both measured increases in soil total P and the historical beginning of nutrient discharges into this wetland. In 15-day bottle incubations of soil, added P had no effect on the delta(15)N of NH (4) (+) and significantly increased the delta(15)N of water-extractable organic N. Measurements of surface soils collected during a field mesocosm experiment also revealed no significant effect of P on delta(15)N even after 5 years of P addition. In contrast, delta(15)N of leaf and root tissues of hydroponically grown Typha and Cladium were shown to increase up to 12 per thousand when grown at elevated levels of P and fixed levels of N (as NH (4) (+) ). The magnitude of changes in delta(15)N resulting from altered discrimination during N uptake is significant compared with other mechanisms affecting plant delta(15)N, and suggests that this may be the dominant mechanism affecting delta(15)N of organic matter following P enrichment. The results of this study have implications for the interpretation of delta(15)N as an indicator of shifts in relative N limitation in wetland ecosystems, and also stress the importance of experimental validation in interpreting delta(15)N patterns.

The anaesthetist and the cardiac catheterisation laboratory

Interventional cardiology is an innovative and expanding field. Anaesthetists are increasingly involved in managing complex congenital and acquired heart lesions in the cardiac catheterisation laboratory. This article provides an overview of common lesions encountered in the cardiac catheterisation laboratory, the anaesthetic management of patients with congenital and acquired heart lesions, the procedures performed and the complications encountered during such procedures.

Syntrophic-archaeal associations in a nutrient-impacted freshwater marsh

AIMS

Evaluation of the composition, distribution and activities of syntrophic bacteria and methanogens in soils from eutrophic and low nutrient regions of a freshwater marsh, and to compare these results with those obtained from a similar study in the Florida Everglades.

METHODS AND RESULTS

Culture dependent and independent approaches were employed to study consortia of syntrophs and methanogens in a freshwater marsh. Methanogenesis from butyrate oxidation was fourfold higher in microcosms containing soil from eutrophic regions of the marsh than from low nutrient regions. Propionate was oxidized in eutrophic microcosms at lower rates than butyrate and with lower yields of methane. Sequence analysis of 16S rRNA gene clone libraries from DNA extracted from microcosms and soils revealed differences such that the dominant restriction fragment length polymorphism (RFLP) phylotypes (representing 82-88% of clone libraries) from eutrophic soils clustered with fatty acid oxidizing Syntrophomonas spp. The four dominant RFLP phylotypes (representing 11-24%) from microcosms containing soils from low nutrient regions were sequenced, and clustered with micro-organisms having the potential for fermentative and syntrophic metabolism. Archaeal 16S rRNA sequence analysis showed that methanogens from eutrophic regions were from diverse families, including Methanomicrobiaceae, Methanosarcinaceae, and Methanocorpusculaceae, but clone libraries from low nutrient soils revealed only members of Methanosarcinaceae.

CONCLUSIONS

These findings indicate that syntroph-methanogen consortia differed with nutrient levels in a freshwater marsh.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is one of few studies addressing the distribution of fatty acid consuming-hydrogen producing bacteria (syntrophs) and their methanogenic partners in wetland soils, and the effects of eutrophication on the ecology these groups.

Peginterferon alfa-2a and ribavirin for chronic hepatitis C genotype 1 infections in black patients: safety, tolerability and impact on sustained virologic response

HCV infections are two-times more prevalent in black Americans than in whites. We previously reported that treatment with peginterferon alfa-2a plus ribavirin produced a sustained virologic response (SVR) rate of 26% in blacks, a lower efficacy compared with the SVR in whites. Here we detail the safety profile of peginterferon alfa-2a plus ribavirin and the relationship between treatment adherence, defined by cumulative drug exposure, and SVR in 78 black patients infected with HCV genotype 1. Sixty-two (79%) patients completed 48 weeks of combination treatment. Peginterferon alfa-2a dose was modified for neutropenia in 36 patients (46%), whereas ribavirin dose was modified due to anemia in 31 patients (40%). The SVR rate was related to medication exposure, based on the percentage of the planned doses of peginterferon and ribavirin that the patients received. The SVR rates were 33, 25 and 0% in patients who received >80, 61-80 and <or=60% of the planned peginterferon, respectively. The SVR rates were 28, 33 and 18% in patients who received >80, 61-80 and <or=60% of the planned ribavirin. The SVR rate was 29% (11 of 38) in patients who received >80% of the total planned doses of both peginterferon and ribavirin and 7% (1 of 14) in patients who received <or=80% of both medicines. The SVR was 30% in patients who received >60% exposure to both, and 0% in patients with <or=60% exposure. In conclusion, peginterferon alfa-2a plus ribavirin demonstrated good safety and tolerability profiles in blacks infected with HCV genotype 1. Adherence to at least >60% of the planned peginterferon alfa-2a and ribavirin doses for 48 weeks was associated with a greater SVR in black patients with HCV genotype 1 infections.

Assessment of the spatial distribution of soil properties in a northern Everglades marsh

Florida Everglades restoration plans are aimed at maintaining and restoring characteristic landscape features such as soil, vegetation, and hydrologic patterns. This study presents the results from an exhaustive spatial sampling of key soil properties in Water Conservation Area 1 (WCA 1), which is part of the northern Everglades. Three soil strata were sampled: floc, upper 0- to 10-cm soil layer, and 10- to 20-cm soil layer. A variety of properties were measured including bulk density (BD), loss on ignition (LOI), total phosphorus (TP), total inorganic phosphorus (TIP), total nitrogen (TN), total carbon (TC), total iron (TFe), total magnesium (TMg), total aluminum (TAl), and total calcium (TCa). Interpolated maps and model prediction uncertainties of properties were generated using geostatistical methods. We found that the uncertainty associated with spatial predictions of floc, particularly floc BD, was highest, whereas spatial predictions of soil chemical properties such as soil Ca were more accurate. The resultant spatial patterns for these soil properties identified three predominant features in WCA 1: (i) a north to south gradient in soil properties associated with the predominant hydrological gradient, (ii) areas of considerable soil nutrient enrichment along the western canal of WCA 1, and (iii) areas of considerable Fe enrichment along the eastern canal. By using geostatistical techniques we were able to describe the spatial dynamics of soil variables and express these predictions with an acceptable level of uncertainty.

Spatial patterns of labile forms of phosphorus in a subtropical wetland

Phosphorus (P) has been identified as the key constituent defining wetland productivity, structure, and function. Our goal was to investigate the spatial patterns of total P and three labile forms of P (labile organic, inorganic, and microbial biomass P) across a subtropical wetland located in east-central Florida, the Blue Cypress Marsh Conservation Area (BCMCA), and link spatial patterns to ecosystem processes. The wetland received a continual input of nutrients primarily from the south and intermittently from the west and east, respectively, which ceased in the mid-1990s. Since then the marsh system has been undergoing natural succession. We used (i) ordinary kriging to characterize the spatial patterns of total P and labile P forms across the wetland, (ii) local, moving spatial correlations to investigate relationships between total P and labile P forms, and (iii) a clustering technique to link the identified spatial patterns to biogeochemical processes. The spatially explicit analyses revealed patterns of total P and labile P forms as well as changing relationships between variables across the marsh. We were able to distinguish P-enriched areas from unaffected ("natural") areas and intermediate zones that are currently undergoing change as P is mobilized and translocated. We also identified areas that are at risk, showing a shift toward a more P-enriched status. Our results improve our understanding of P and its labile components within a spatially explicit context.

Bilateral gluteal compartment syndrome after total hip arthroplasty under epidural anesthesia

The gluteal compartment syndrome is uncommon and is discussed in only a few published case reports. The simultaneous bilateral gluteal compartment syndrome is exceptionally rare and is tackled in only 4 case reports to date. We report a case of bilateral gluteal compartment syndrome after total hip arthroplasty under epidural anesthesia and discuss its management.

Differences in in vitro pollen germination and pollen tube growth of cotton cultivars in response to high temperature

BACKGROUND AND AIMS

High-temperature environments with >30 degrees C during flowering reduce boll retention and yield in cotton. Therefore, identification of cotton cultivars with high-temperature tolerance would be beneficial in both current and future climates. *

METHODS

Response to temperature (10-45 degrees C at 5 degrees C intervals) of pollen germination and pollen tube growth was quantified, and their relationship to cell membrane thermostability was studied in 12 cultivars. A principal component analysis was carried out to classify the genotypes for temperature tolerance. *

KEY RESULTS

Pollen germination and pollen tube length of the cultivars ranged from 20 to 60 % and 411 to 903 microm, respectively. A modified bilinear model best described the response to temperature of pollen germination and pollen tube length. Cultivar variation existed for cardinal temperatures (T(min), T(opt) and T(max)) of pollen germination percentage and pollen tube growth. Mean cardinal temperatures calculated from the bilinear model for the 12 cultivars were 15.0, 31.8 and 43.3 degrees C for pollen germination and 11.9, 28.6 and 42.9 degrees C for pollen tube length. No significant correlations were found between pollen parameters and leaf membrane thermostability. Cultivars were classified into four groups based on principal component analysis. *

CONCLUSIONS

Based on principal component analysis, it is concluded that higher pollen germination percentages and longer pollen tubes under optimum conditions and with optimum temperatures above 32 degrees C for pollen germination would indicate tolerance to high temperature.