Graft-Versus-Host Disease: an Update on Functional Implications and Rehabilitation Interventions.

PURPOSE OF REVIEW: Despite advances in treatment, chronic graft-versus-host disease (cGVHD) remains a highly morbid complication of allogeneic hematopoietic stem cell transplantation. Due to direct effects of the disease on specific body sites, and its treatment, patients lose function. This review summarizes the latest evidence surrounding how cGVHD affects function, and restorative interventions. RECENT FINDINGS: Different body sites of cGVHD carry a higher risk of functional decline, including pulmonary and sclerotic/fascial. Support should be comprehensive and individualized, with precautions taken to avoid worsening fibrosis, offloading painful joints and fractures, and utilizing function-directed skilled therapies. Inpatient rehabilitation improves function in hospitalized people with cGVHD. For people with cGVHD, rehabilitation addresses different aspects of impaired function across the spectrum of disease. Given the dynamic nature of the disease process, routine assessment may be warranted. Rehabilitation may also improve deleterious effects of anti-cGVHD medication including glucocorticoids and tyrosine kinase inhibitors.

Optimized low-level liquid scintillation spectroscopy of 35S for atmospheric and biogeochemical chemistry applications.

Anthropogenic activities, dominated by emissions of sulfur dioxide (SO(2)), have perturbed the global sulfur (S) cycle. Uncertainties in timescales of S transport and chemistry in the atmosphere lead to uncertainties in the predicted impact of S emissions. Measurements of cosmogenic (35)S may potentially be used to resolve existing uncertainties in the photochemical and chemical transformation of S in the environment. The lack of a simple, effective, and highly sensitive technique to measure (35)S activity in samples with low activities may explain the scarcity of published measurements. We present a set of new sample handling and measurement procedures optimized for the measurement of (35)S in natural samples with activities as low as 0.20 dpm above background (2sigma, integration time = 2 hr). We also report simultaneous measurements of aerosol (35SO4 ) and gas phase (35SO2) collected at inland and coastal locations; the range of observed activities corresponds to SO(2) residence lifetimes of 0.2 +/- 0.04 (coastal) - 22.3 d +/- 0.04 (inland). These optimized techniques offer the potential for resolving atmospheric processes that occur on 6-12-hour timescales as well as resolving transport phenomena such as stratospheric mixing into the troposphere.

Discovery and measurement of an isotopically distinct source of sulfate in Earth's atmosphere.

Sulfate (SO(4)) and its precursors are significant components of the atmosphere, with both natural and anthropogenic sources. Recently, our triple-isotope ((16)O, (17)O, (18)O) measurements of atmospheric sulfate have provided specific insights into the oxidation pathways leading to sulfate, with important implications for models of the sulfur cycle and global climate change. Using similar isotopic measurements of aerosol sulfate in a polluted marine boundary layer (MBL) and primary sulfate (p-SO(4)) sampled directly from a ship stack, we quantify the amount of p-SO(4) found in the atmosphere from ships. We find that ships contribute between 10% and 44% of the non-sea-salt sulfate found in fine [diameter (D) < 1.5 microm) particulate matter in coastal Southern California. These fractions are surprising, given that p-SO(4) constitutes approximately 2-7% of total sulfur emissions from combustion sources [Seinfed JH, Pandis SN (2006) Atmospheric Chemistry and Physics (Wiley-Interscience, New York)]. Our findings also suggest that the interaction of SO(2) from ship emissions with coarse hydrated sea salt particles may lead to the rapid removal of SO(2) in the MBL. When combined with the longer residence time of p-SO(4) emissions in the MBL, these findings suggest that the importance of p-SO(4) emissions in marine environments may be underappreciated in global chemical models. Given the expected increase of international shipping in the years to come, these findings have clear implications for public health, air quality, international maritime law, and atmospheric chemistry.