Microbial biogeography along a 2578 km transect on the East Antarctic Plateau.

Microorganisms are present in snow/ice of the Antarctic Plateau, but their biogeography and metabolic state under extreme local conditions are poorly understood. Here, we show the diversity and distribution of microorganisms in air (1.5 m height) and snow/ice down to 4 m depth at three distant latitudes along a 2578 km transect on the East Antarctic Plateau on board an environmentally friendly, mobile platform.

Snoring and aortic dimension in Marfan syndrome.

Recent reports suggest that self-reported snoring, which is a feature of obstructive sleep apnea, is associated with aortic enlargement in Marfan syndrome (MFS). Objective assessment of snoring although lacking, could provide a rational for OSA screening in MFS patients. Our goal in this study was to examine the association between objective measurements of snoring with OSA and aortic size in persons with MFS.

Contralateral noise effects on otoacoustic emissions and electrophysiologic responses in normal-hearing adults.

Contralateral noise inhibits the amplitudes of cochlear and neural responses. These measures may hold potential diagnostic utility. The medial olivocochlear (MOC) reflex underlies the inhibition of cochlear responses but the extent to which it contributes to inhibition of neural responses remains unclear.

Assessment of pleural pressure during sleep in Marfan syndrome.

Study Objectives: Patients with Marfan syndrome (MFS) have a high risk for aortic aneurysms. They are also susceptible to sleep-disordered breathing that may expose them to highly negative intrathoracic pressures known to increase aortic transmural pressure, which may accelerate aortic dilatation. Our objective was to quantify overnight intrathoracic pressure changes during sleep in snoring patients with MFS and the therapeutic effect of continuous positive airway pressure (CPAP).

A case study using 2019 pre-monsoon snow and stream chemistry in the Khumbu region, Nepal.

This case study provides a framework for future monitoring and evidence for human source pollution in the Khumbu region, Nepal. We analyzed the chemical composition (major ions, major/trace elements, black carbon, and stable water isotopes) of pre-monsoon stream water (4300-5250 m) and snow (5200-6665 m) samples collected from Mt. Everest, Mt.

A Perspective of the Cumulative Risks from Climate Change on Mt. Everest: Findings from the 2019 Expedition.

In 2019, the National Geographic and Rolex Perpetual Planet Everest expedition successfully retrieved the greatest diversity of scientific data ever from the mountain. The confluence of geologic, hydrologic, chemical and microbial hazards emergent as climate change increases glacier melt is significant. We review the findings of increased opportunity for landslides, water pollution, human waste contamination and earthquake events.

Into Thick(er) Air? Oxygen Availability at Humans' Physiological Frontier on Mount Everest.

Global audiences are captivated by climbers pushing themselves to the limits in the hypoxic environment of Mount Everest. However, air pressure sets oxygen abundance, meaning it varies with the weather and climate warming. This presents safety issues for mountaineers but also an opportunity for public engagement around climate change.

Deposition of PFAS 'forever chemicals' on Mt. Everest.

Mt. Everest, one of the most coveted climbing mountains on earth, also contains the highest altitude chemical contamination on land. For the first time, meltwater and snow samples from Mt.

Organic Compounds in a Sub-Antarctic Ice Core: A Potential Suite of Sea Ice Markers.

Investigation of organic compounds in ice cores can potentially unlock a wealth of new information in these climate archives. We present results from the first ever ice core drilled on sub-Antarctic island Bouvet, representing a climatologically important but understudied region. We analyze a suite of novel and more familiar organic compounds in the ice core, alongside commonly measured ions.

Plastic pollution affects American lobsters, Homarus americanus.

This paper provides the first record of ingestion of plastic debris by American lobster, Homarus americanus. Plastics particles, identified as rubber pieces, were found in the stomachs of 3 from 17 individuals of lobsters kept in laboratory conditions. Debris had evidence of cuts, what suggest they were actively consumed.

Consideration of high-sensitivity troponin values below the 99th percentile at presentation: does it improve diagnostic accuracy?

Background: The introduction of high-sensitivity cardiac troponin (hs-cTn) assays allows the assessment of clinical decision values below the 99th percentile.

Methods: Final diagnosis and one-year mortality were adjudicated in a multicenter, prospective cohort of 1181 patients presenting with acute chest pain to the emergency department. Hs-cTnT (Roche) and cTnI-ultra (Siemens) were measured in a blinded fashion.

Incremental value of biomarkers to clinical variables for mortality prediction in acutely decompensated heart failure: the Multinational Observational Cohort on Acute Heart Failure (MOCA) study.

Aim: This study aims to evaluate the incremental value of plasma biomarkers to traditional clinical variables for risk stratification of 30-day and one-year mortality in acutely decompensated heart failure (ADHF).

Methods And Results: Through an international collaborative network, individual patient data on 5306 patients hospitalized for ADHF were collected. The all-cause mortality rate was 11.

One-hour rule-out and rule-in of acute myocardial infarction using high-sensitivity cardiac troponin T.

Background: High-sensitivity cardiac troponin (hs-cTn) assays seem to improve the early diagnosis of acute myocardial infarction (AMI), but it is unknown how to best use them in clinical practice. Our objective was to develop and validate an algorithm for rapid rule-out and rule-in of AMI.

Methods: A prospective multicenter study enrolling 872 unselected patients with acute chest pain presenting to the emergency department.

Direct comparison of mid-regional pro-atrial natriuretic peptide with N-terminal pro B-type natriuretic peptide in the diagnosis of patients with atrial fibrillation and dyspnoea.

Objectives: Due to different release mechanisms, mid-regional pro-atrial natriuretic peptide (MR proANP) may be superior to N-terminal pro-B-type natriuretic peptide (NT proBNP) in the diagnosis of acute heart failure (AHF) in patients with atrial fibrillation (AF). We compared MR proANP and NT proBNP for their diagnostic value in patients with AF and sinus rhythm (SR).

Design: Prospective cohort study.

Mid-regional pro-adrenomedullin in acute heart failure: a better biomarker or just another biomarker?

Circulating biomarkers have become increasingly important in diagnosing and risk-stratifying patients with heart failure (HF). While the natriuretic peptides have received much focus in the past decade, there is increasing interest in the role of other circulating biomarkers such as mid-regional proadrenomedullin (MR-proADM), a stable peptide of the precursor of adrenomedullin (ADM), responsible for volume regulation and electrolyte homeostasis. Increased levels of MR-proADM are associated with an increased risk of mortality and morbidity in patients with HF, independent of natriuretic peptides.

The novel marker LTBP2 predicts all-cause and pulmonary death in patients with acute dyspnoea.

The risk stratification in patients presenting with acute dyspnoea remains a challenge. We therefore conducted a prospective, observational cohort study enrolling 292 patients presenting to the emergency department with acute dyspnoea. A proteomic approach for antibody-free targeted protein quantification based on high-end MS was used to measure LTBP2 [latent TGF (transforming growth factor)-binding protein 2] levels.

B-type natriuretic peptide in the evaluation and management of dyspnoea in primary care.

Objectives: The rapid and accurate diagnosis of heart failure in primary care is a major unmet clinical need. We evaluated the additional use of B-type natriuretic peptide (BNP) levels.

Design: A randomized controlled trial.

Diagnostic and prognostic impact of copeptin and high-sensitivity cardiac troponin T in patients with pre-existing coronary artery disease and suspected acute myocardial infarction.

Objective: The early diagnosis of acute myocardial infarction (AMI) can be particularly challenging in patients with known coronary artery disease (CAD) due to pre-existing ECG changes and chronic increases in cardiac troponin (cTn) levels.

Design: Of 1170 consecutive patients presenting with symptoms suggestive of AMI, 433 (37%) with pre-existing CAD were analysed in a prospective multicentre study and the diagnostic and prognostic impact of copeptin in combination with either fourth generation cardiac troponin T (cTnT) or high-sensitivity cTnT (hs-cTnT) was evaluated.

Results: AMI was the final diagnosis in 78 patients with pre-existing CAD (18%).

Use of procalcitonin for the diagnosis of pneumonia in patients presenting with a chief complaint of dyspnoea: results from the BACH (Biomarkers in Acute Heart Failure) trial.

Aims: Biomarkers have proven their ability in the evaluation of cardiopulmonary diseases. We investigated the utility of concentrations of the biomarker procalcitonin (PCT) alone and with clinical variables for the diagnosis of pneumonia in patients presenting to emergency departments (EDs) with a chief complaint of shortness of breath.

Methods And Results: The BACH trial was a prospective, international, study of 1641 patients presenting to EDs with dyspnoea.

Plasma neutrophil gelatinase-associated lipocalin for the prediction of acute kidney injury in acute heart failure.

Introduction: The accurate prediction of acute kidney injury (AKI) in patients with acute heart failure (AHF) is an unmet clinical need. Neutrophil gelatinase-associated lipocalin (NGAL) is a novel sensitive and specific marker of AKI.

Methods: A total of 207 consecutive patients presenting to the emergency department with AHF were enrolled.

Influence of age, race, sex, and body mass index on interpretation of midregional pro atrial natriuretic peptide for the diagnosis of acute heart failure: results from the BACH multinational study.

Aims: Midregional pro atrial natriuretic peptide (MR-proANP) is useful for diagnosing acute heart failure (HF) in patients presenting to the Emergency Department with dyspnoea. Optimal interpretation of MR-proANP requires understanding of how various demographic variables influence its levels and performance as a diagnostic marker. We sought to determine how age, race, sex, and body mass index (BMI) affect the levels and interpretation of MR-proANP for the diagnosis of acute HF.