Prevalence of Batrachochytrium dendrobatidis in immature eastern hellbenders Cryptobranchus alleganiensis from North Carolina, USA.

Batrachochytrium dendrobatidis (Bd) has been detected in wild hellbender Cryptobranchus alleganiensis populations, with rare instances of chytridiomycosis and Bd-induced mortality. To date, Bd surveillance in hellbender populations has been disproportionately focused on adult age classes. A lingering question is whether Bd might contribute to hellbender declines through disproportionate negative effects on immature age classes. The objective of this study was to quantify Bd prevalence and load in immature hellbenders in western North Carolina, USA. We conducted field surveys during 2018 and 2019 and collected 88 skin swabs from 84 hellbenders spanning 3 age classes. Bd was detected on 11% of individuals, including 8 larvae and 1 juvenile. We did not detect symptoms of chytridiomycosis or a decline in body condition in Bd-positive hellbenders. Load varied from approximately 1-153 zoospore equivalents for the 9 Bd-positive hellbenders and was not associated with size class of the individual. While hellbenders appeared to be abundant in each survey reach, more work is needed to determine whether Bd may increase the vulnerability of immature hellbenders to anthropogenic stressors.

Batrachochytrium salamandrivorans (Bsal) not detected in an intensive survey of wild North American amphibians.

The salamander chytrid fungus (Batrachochytrium salamandrivorans [Bsal]) is causing massive mortality of salamanders in Europe. The potential for spread via international trade into North America and the high diversity of salamanders has catalyzed concern about Bsal in the U.S. Surveillance programs for invading pathogens must initially meet challenges that include low rates of occurrence on the landscape, low prevalence at a site, and imperfect detection of the diagnostic tests. We implemented a large-scale survey to determine if Bsal was present in North America designed to target taxa and localities where Bsal was determined highest risk to be present based on species susceptibility and geography. Our analysis included a Bayesian model to estimate the probability of occurrence of Bsal given our prior knowledge of the occurrence and prevalence of the pathogen. We failed to detect Bsal in any of 11,189 samples from 594 sites in 223 counties within 35 U.S. states and one site in Mexico. Our modeling indicates that Bsal is highly unlikely to occur within wild amphibians in the U.S. and suggests that the best proactive response is to continue mitigation efforts against the introduction and establishment of the disease and to develop plans to reduce impacts should Bsal establish.

A simple non-invasive method to detect and monitor hypercapnia: the sodium [13C]bicarbonate breath test.

Arterial partial pressure of carbon dioxide (paCO(2)) is commonly evaluated by an invasive test, the arterial blood gas analysis (ABG). The sodium [(13)C]bicarbonate breath test (SBT) can potentially estimate arterial paCO(2). We studied 55 subjects with respiratory disorders and performed the ABG and the SBT to determine if the SBT can predict hypercapnia. The percentage of (13)CO(2) recovered in exhaled breath at 30 minutes (PDR(30)) alone was able to discriminate clinically significant hypercapnia (>53 mmHg) with a sensitivity of 82 % and specificity of 93 % (p<0.001). To evaluate the clinical utility of the SBT as a non-invasive substitute to repeated ABG, we monitored the progress of seven chronic obstructive pulmonary disease (COPD) patients on therapy with both the ABG and the SBT. The PDR(30) values from the SBT were able to correctly predict improvement or worsening of paCO(2) with 100 % accuracy. In conclusion, the SBT is a simple test that can be used in clinical practice to detect clinically significant hypercapnia and monitor COPD patients before and after therapy.

Proximity to traffic, inflammation, and immune function among women in the Seattle, Washington, area.

BACKGROUND: Traffic-related air pollution has been associated with adverse health outcomes, and the immune system may be a biologic mediator of health effects. OBJECTIVES: We analyzed associations between living near major roads and immune status as measured by five immune assays. We hypothesized that living near a freeway, arterial, or truck route would be associated with increased inflammation and decreased immune function. METHODS: We used a geographic information system (GIS) to determine residential proximity to major roads among 115 postmenopausal, overweight women in the greater Seattle, Washington (USA), area whose immunity was assessed at the baseline visit of an exercise intervention trial. We evaluated three inflammatory markers (C-reactive protein, serum amyloid A, and interleukin-6) and two functional assays of cellular immunity [natural killer (NK) cell cytotoxicity and T-lymphocyte proliferation]. RESULTS: Women living within 150 m of arterial roads had 21% lower NK cytotoxicity compared with women who lived farther from an arterial [mean cytotoxicity, 19.5%; 95% confidence interval (CI), 15.6-23.5%; vs. mean cytotoxicity, 24.8%; 95% CI, 22.0-27.5%], after adjustment for both individual-level and census tract-level demographic characteristics. This association was limited to women who reported exercising near traffic. Fewer women lived near freeways and truck routes. Markers of inflammation and lymphocyte proliferation did not consistently differ according to proximity to major roads. CONCLUSIONS: If the observed association between residential proximity to traffic and decreased NK cytotoxicity is confirmed in other populations, our results may have implications for local land use policy.

Serum interleukin-6 predicts the development of multiple symptoms at nadir of allogeneic hematopoietic stem cell transplantation.

BACKGROUND: During the time of lowest white blood cell count (nadir) of allogeneic hematopoietic stem cell transplantation (allo-HSCT), cancer patients suffer from tremendous symptom burden related to therapy that requires intensive patient care. However, the mechanism underlying the development of multiple symptoms has not been established. METHODS: To explore the role of inflammatory cytokines in the development of treatment-related symptoms, we studied dynamic changes in symptoms and in serum concentrations of inflammatory cytokines (interleukin [IL]-6, IL-8, soluble tumor necrosis factor receptor 1 [sTNF-R1], IL-1 receptor antagonist, and IL-12p40p70) from pretherapy throughout the first 30 days of allo-HSCT in 30 patients with acute myelogenous leukemia or myelodysplastic syndrome. We measured multiple symptoms repeatedly using the M. D. Anderson Symptom Inventory. Mixed-effects modeling was used to analyze longitudinal data. RESULTS: In response to conditioning and stem-cell infusion, serum levels of IL-6 and the severity of multiple symptoms increased rapidly and peaked at nadir. From baseline to nadir (approximately Day 8 post-transplantation), increase in IL-6 was significantly associated with worsening of the most severe symptoms (fatigue, poor appetite, pain, drowsiness, dry mouth, and disturbed sleep; P< .01). During the first 30 days after transplantation, increases in IL-6 (P< .001) and sTNF-R1 (P< .05) significantly predicted the increasing severity of these symptoms. CONCLUSIONS: These results suggest that release of systemic inflammatory cytokines, mainly IL-6, corresponds to an increase in treatment-related multiple-symptom burden during the nadir period of allo-HSCT.

Informal caregiving dynamics with a case study in blood and marrow transplantation.

PURPOSE/OBJECTIVES: To develop a definition of informal caregiving dynamics through a selective literature review and explore the proposed definition in the context of blood and marrow transplantation using a case study. DATA SOURCES: Published articles. DATA SYNTHESIS: Informal caregiving dynamics are commitment, expectations, and negotiation that move a dyadic informal caregiving relationship along an illness trajectory. CONCLUSIONS: The proposed definition of informal caregiving dynamics is useful in explaining how an informal caregiving dyadic relationship develops and is sustained. IMPLICATIONS FOR NURSING: Understanding the dynamics underlying informal caregiving relationships enables nurses to intervene effectively to develop and sustain these vital relationships. Elements of the concept require further clarification. Research to validate the accuracy of the concept is needed.