Trends and outcomes of mechanically ventilated cirrhotic patients in the United States from 2005-2014.

Purpose: Cirrhotic patients in organ failure are frequently admitted to intensive care units (ICUs) to receive invasive mechanical ventilation (IMV). We evaluated the trends of hospitalizations, in-hospital mortality, hospital costs, and hospital length of stay (LOS) of IMV patients with cirrhosis. Methods: We analyzed the United States National Inpatient Sample from 2005-2014. We selected discharges of IMV adult (≥18 years) patients with cirrhosis using the International Classification of Diseases, 9th Edition, Clinical Modification codes. Trends were assessed using linear regression and joinpoint regression. Results: Between 2005 and 2014, there were approximately 9,441,605 hospitalizations of IMV adult patients, of which 4.7% had cirrhosis. There was an increasing trend in the total number of IMV cirrhotic patient hospitalizations (annual percent change [APC] 7.0%, 95% confidence interval [CI] 6.4%; 7.6%, Ptrend < 0.001). The in-hospital case-fatality ratio declined between 2005-2011 (APC -2.9%, 95% CI, -3.4%; -2.4%, Ptrend < 0.001); however, it remained similar between 2011-2014 (Ptrend = 0.58). The total annual hospital costs of all IMV cirrhotic patients increased from approximately $1.2 billion USD in 2005 to $2.7 billion USD in 2014 (Ptrend < 0.001). The mean hospital costs per patient and mean LOS declined between 2005 and 2014 (Ptrend < 0.001 and Ptrend = 0.01 respectively). Conclusions: The total number of hospitalizations and total annual costs of IMV patients with cirrhosis have been increasing over time. However, past hesitancy around admitting cirrhotic patients to the ICU may need to be tempered by the improving mortality trends in this patient population.

Brain gray matter differences among forensic psychiatric patients with psychosis and incarcerated individuals without psychosis: A source-based morphometry study.

BACKGROUND: While psychosis is a risk factor for violence, the majority of individuals who perpetrate aggression do not present psychotic symptoms. Pathological aggressive behavior is associated with brain gray matter differences, which, in turn, has shown a relationship with increased psychopathic traits. However, no study, to our knowledge, has ever investigated gray matter differences in forensic psychiatric patients with psychosis compared with incarcerated individuals without psychosis matched on levels of psychopathic traits. Here, we employed source-based morphometry (SBM) to investigate gray matter differences in these two populations. METHODS: We scanned 137 participants comprising two offender subgroups: 69, non-psychotic incarcerated offenders and 68, psychotic, forensic psychiatric patients. Groups showed no difference in age, race, ethnicity, handedness, and Hare Psychopathy Checklist-Revised scores. Source-based morphometry was utilized to identify spatially distinct sets of brain regions where gray matter volumes covaried between groups. SBM is a data-driven, multivariate technique that uses independent components analysis to categorize groups of voxels that display similar variance patterns (e.g., components) that are compared across groups. RESULTS: SBM identified four components that differed between groups. These findings indicated greater loading weights in the superior, transverse, and middle temporal gyrus and anterior cingulate in the non-psychotic versus psychotic group; greater loading weights in the basal ganglia in the psychotic versus non-psychotic group; greater loading weights in the frontal pole, precuneus, and visual cortex among psychotic versus non-psychotic offenders; and greater loading weights in the thalamus and parahippocampal gyrus in psychotic versus non-psychotic groups. CONCLUSIONS: Two different offender groups that perpetrate violence and show comparable levels of psychopathic traits evidenced different gray matter volumes. We suggest that future studies of violent offenders with psychosis take psychopathic traits into account to refine neural phenotypes.

A retrospective analysis of postrehabilitation outcomes following total knee arthroplasty.

BACKGROUND AND PURPOSE: Total knee arthroplasty (TKA) is one of the most frequently performed orthopaedic procedures in Canada. Despite the frequency at which TKAs are performed, few studies have examined the association between postoperative outcomes and long-term functional outcomes following group-based rehabilitation in Canada. The primary objective of the present study was to examine changes in flexion and extension from intake to discharge from rehabilitation in patients in Saskatchewan, Canada. A secondary objective was to explore the demographic and medical predictors of range of motion in TKA patients, and treatment duration. METHODS: A retrospective chart review from an outpatient rehabilitation clinical database was conducted between September 2014 and December 2016, and assessed demographic and medical variables. RESULTS: A total of 672 patient charts were included in the study. Significant improvements (p < 0.001) were noted from intake to discharge from rehabilitation for flexion and extension. Right-side TKA, flexion at intake and the length of treatment predicted flexion at discharge from rehabilitation (R2  = 0.23). Gender, right side TKA, extension at intake and the length of treatment predicted extension at discharge from rehabilitation (R2  = 0.23). Lastly, age, flexion at intake and extension at intake predicted length of treatment in the rehabilitation programme (R2  = 0.21). CONCLUSIONS: Patients who participated in rehabilitation following TKA experienced improvements in flexion and extension. Those with decreased flexion and extension after TKA may be less likely to experience a desirable range of motion, indicating a need for more intensive targeted rehabilitation in this group, and adjustments in hospital and community care.

Long-term pharmacodynamic effects of Ticagrelor versus Clopidogrel in fibrinolytic-treated STEMI patients undergoing early PCI.

The long-term pharmacodynamic effects of Ticagrelor versus Clopidogrel in patients undergoing early percutaneous coronary intervention (PCI) after fibrinolytic therapy is unknown. From May 2014 to August 2016, 212 patients undergoing PCI within 24 h of Tenecteplase (TNK), Aspirin, and Clopidogrel for ST-elevated myocardial infarction (STEMI) were randomized at four Canadian sites to receive additional Clopidogrel or Ticagrelor initiated prior to PCI. The platelet reactivity units (PRU) were measured with the VerifyNow Assay before study drug administration (baseline), at 4 and 24 h post PCI, and follow-up appointment. A mixed-model analysis with time as the repeated measure and drug as the between-subjects factor was calculated using 2 separate 1 × 4 ANOVAs, with students t-tests used to compare drugs within each time point. Complete clinical follow-up data (median 115.0 days; IQR 80.3-168.8) was available in 50 patients (23.6%) randomized to either Clopidogrel (n = 23) or Ticagrelor (n = 27). Analyses revealed significant decreases in PRU from baseline to 4 h (261.4 vs. 71.7; Mdiff = - 189.7; p < 0.001) to 24 h (71.7 vs. 27.7; Mdiff = - 44.0; p < 0.001) to end of follow-up (27.7 vs.17.9; Mdiff = - 9.9. p = 0.016) for those randomized to Ticagrelor and significant decreases in PRU only from baseline to 4 h (271.3 vs. 200.8; Mdiff = - 70.5, p = < 0.001) in patients receiving Clopidogrel, and a significantly greater proportion of patients with adequate platelet inhibition (PRU < 208) on long-term follow-up (Clopidogrel, 82.6% vs. Ticagrelor, 100.0%; p = 0.038). Our results demonstrate that in patients undergoing PCI within 24 h of fibrinolysis for STEMI, Ticagrelor provides prolonged platelet inhibition compared with Clopidogrel.

Effects of ticagrelor versus clopidogrel on platelet function in fibrinolytic-treated STEMI patients undergoing early PCI.

OBJECTIVES: Patients undergoing PCI early after fibrinolytic therapy are at high risk for both thrombotic and bleeding complications. We sought to assess the pharmacodynamic effects of ticagrelor versus clopidogrel in the fibrinolytic-treated STEMI patients undergoing early PCI. METHODS AND RESULTS: Patients undergoing PCI within 24 hours of tenecteplase (TNK), aspirin, and clopidogrel for STEMI were randomized to receive additional clopidogrel 300 mg followed by 75 mg daily or ticagrelor 180 mg followed by 90 mg twice daily. The platelet reactivity units (PRU) were measured with the VerifyNow Assay before study drug administration (baseline) at 4 and 24 hours post-PCI. The primary end point was PRU ≤208 at 4 hours. A total of 140 patients (74 in ticagrelor and 66 in clopidogrel group) were enrolled. The mean PRU values at baseline were similar for the 2 groups (257.8±52.9 vs 259.5±56.7, P=.85, respectively). Post-PCI, patients on ticagrelor, compared to those on clopidogrel, had significantly lower PRU at 4 hours (78.7±88 vs 193.6±86.5, respectively, P<.001) and at 24 hours (34.5±35.0 and 153.5±75.5, respectively, P<.001). The primary end point was observed in 87.8% (n=65) in the ticagrelor-treated patients compared to 57.6% (n=38) of clopidogrel-treated patients, P<.001. CONCLUSION: Fibrinolysis-treated STEMI patients who received clopidogrel and aspirin at the time of fibrinolysis and were undergoing early PCI frequently had PRU >208. In this high-risk population, ticagrelor provides more prompt and potent platelet inhibition compared with clopidogrel (Funded by Astra Zeneca; NCT01930591, https://clinicaltrials.gov/ct2/show/NCT01930591).

A Pilot Randomized, Controlled Trial of a Wall Climbing Intervention for Gynecologic Cancer Survivors.

PURPOSE/OBJECTIVES: To examine the feasibility and preliminary efficacy of an eight-week supervised climbing intervention for gynecologic cancer survivors (GCSs).
. DESIGN: A pilot randomized, controlled trial.
. SETTING: The Wilson Climbing Center in Edmonton, Alberta, Canada.
. SAMPLE: 35 GCSs who had completed cancer therapy.
. METHODS: GCSs were randomized to an eight-week (16 session) supervised wall climbing intervention (WCI) (n = 24) or usual care (UC) (n = 11).
. MAIN RESEARCH VARIABLES: Feasibility outcomes included recruitment rate, adherence rate, skill performance, and safety. Preliminary efficacy outcomes were objective health-related and functional fitness assessed before and after the eight-week intervention using the Senior Fitness Test.
. FINDINGS: Median adherence to the WCI was 13.5 of 16 sessions. Most GCSs were proficient on 16 of 24 skill assessment items. No serious adverse events were reported. Based on intention-to-treat analyses, the WCI group was superior to the UC group for the 6-minute walk, 30-second chair stand, 30-second arm curls, sit and reach, 8-foot up-and-go, grip strength-right, and grip strength-left assessments.
. CONCLUSIONS: The Gynecologic Cancer Survivors Wall Climbing for Total Health (GROWTH) Trial demonstrated that an eight-week supervised WCI was safe, feasible, and improved functional fitness in GCSs. Phase II and III trials are warranted to further establish the safety, feasibility, and efficacy of WCIs in cancer survivors.
. IMPLICATIONS FOR NURSING: Oncology nurses may consider a climbing wall as an alternative type of physical activity for improving functional fitness in GCSs.

Effects of a Structured Exercise Program on Physical Activity and Fitness in Colon Cancer Survivors: One Year Feasibility Results from the CHALLENGE Trial.

BACKGROUND: There is strong interest in testing lifestyle interventions to improve cancer outcomes; however, the optimal methods for achieving behavior change in large-scale pragmatic trials are unknown. Here, we report the 1-year feasibility results for exercise behavior change in the Canadian Cancer Trials Group CO.21 (CHALLENGE) Trial. METHODS: Between 2009 and 2014, 273 high-risk stage II and III colon cancer survivors from 42 centers in Canada and Australia were randomized to a structured exercise program (SEP; n = 136) or health education materials (HEM; n = 137). The primary feasibility outcome in a prespecified interim analysis was a difference between randomized groups of ≥5 metabolic equivalent task (MET)-hours/week in self-reported recreational physical activity (PA) after at least 250 participants reached the 1-year follow-up. Secondary outcomes included health-related fitness. RESULTS: The SEP group reported an increase in recreational PA of 15.6 MET-hours/week compared with 5.1 MET-hours/week in the HEM group [mean difference = +10.5; 95% confidence interval (CI) = +3.1-+17.9; P = 0.002]. The SEP group also improved relative to the HEM group in predicted VO2max (P = 0.068), 6-minute walk (P < 0.001), 30-second chair stand (P < 0.001), 8-foot up-and-go (P = 0.004), and sit-and-reach (P = 0.08). CONCLUSIONS: The behavior change intervention in the CHALLENGE Trial produced a substantial increase in self-reported recreational PA that met the feasibility criterion for trial continuation, resulted in objective fitness improvements, and is consistent with the amount of PA associated with improved colon cancer outcomes in observational studies. IMPACT: The CHALLENGE Trial is poised to determine the causal effects of PA on colon cancer outcomes. Cancer Epidemiol Biomarkers Prev; 25(6); 969-77. ©2016 AACR.

A new paradigm for examining the correlates of aerobic, strength, and combined exercise: an application to gynecologic cancer survivors.

PURPOSE: Almost all exercise guidelines recommend both aerobic and strength exercise, however, few studies have simultaneously examined the correlates of meeting both exercise guidelines. Here, we propose a new paradigm that calls on researchers to examine not only the correlates of meeting the various exercise guidelines versus no guideline but also the correlates of meeting the combined guidelines versus one guideline and meeting one guideline versus the other guideline. METHODS: A random sample of 621 gynecologic cancer survivors located in Alberta, Canada, completed a mailed questionnaire. RESULTS: A multivariate multinomial logistic regression analysis indicated that (a) meeting only the aerobic exercise guideline compared to neither guideline was associated with younger age, social drinking, healthy weight, better general health, and no comorbidities; (b) meeting only the strength exercise guideline compared to neither guideline was associated with social drinking and being healthy weight; (c) meeting the combined exercise guideline compared to neither guideline was associated with social drinking, being healthy weight, and better general health; (d) meeting the aerobic guideline only compared to the strength guideline only was associated with younger age and better general health; and (e) few correlates distinguished between meeting the combined guidelines compared to a single guideline. CONCLUSIONS: Demographic and health variables are associated with meeting the various exercise guidelines versus no guideline but they are not associated with meeting the combined exercise guidelines versus a single guideline or meeting one guideline versus the other guideline. Application of this new paradigm to cancer survivors is encouraged.

Extreme Sport/Adventure Activity Correlates in Gynecologic Cancer Survivors.

OBJECTIVE: We examined the demographic, medical and behavioral correlates of participation and interest in extreme sport/adventure activities (ESAA) in gynecologic cancer survivors. METHODS: A random sample of 621 gynecologic cancer survivors in Alberta, Canada, completed a mailed self-report questionnaire assessing medical, demographic, and behavioral variables and participation and interest in ESAA. RESULTS: Multivariate analyses revealed that gynecologic cancer survivors were more likely to participate in ESAA if they met aerobic exercise guidelines (OR=1.75 [95%CI:1.02-2.99]), had better general health (OR=1.71 [95%CI: 1.01-2.90]), had cervical or ovarian cancer (OR=1.95 [95%CI:0.97-3.93]), were employed (OR=1.71 [95%CI:0.95-3.08]), and were of healthy weight (OR=1.58 [95%CI:0.93-2.68]). Moreover, gynecologic cancer survivors were more likely to be interested in trying an ESAA if they had cervical or ovarian cancer (OR=1.76 [95%CI:0.94-3.27]) and were meeting the strength exercise guidelines (OR=1.68 [95%CI:0.95-2.98]). CONCLUSIONS: Medical, demographic, and behavioral variables correlate with participation and interest in ESAA in gynecologic cancer survivors. The pattern of correlates suggests that gynecologic cancer survivors are more likely to participate in ESSA if they have the physical capability and financial resources. Interventions to promote ESAA in gynecologic cancer survivors need to address these 2 key barriers.

Motivation for Different Types and Doses of Exercise During Breast Cancer Chemotherapy: a Randomized Controlled Trial.

BACKGROUND: Exercise is beneficial for breast cancer patients during chemotherapy, but their motivation to perform different types and doses of exercise is unknown. PURPOSE: The purpose of this study was to examine the anticipated and experienced motivation of breast cancer patients before and after three different exercise programs during chemotherapy. METHODS: Breast cancer patients initiating chemotherapy (N = 301) were randomized to a standard dose of 25-30 min of aerobic exercise, a higher dose of 50-60 min of aerobic exercise, or a combined dose of 50-60 min of aerobic and resistance exercise. Patient preference and motivational outcomes from the theory of planned behavior (i.e., perceived benefit, enjoyment, support, difficulty, and motivation) were assessed before and after the interventions. RESULTS: At pre-randomization, breast cancer patients were significantly (p < 0.001) more likely to prefer the combined program (80.1 %); however, after the interventions there was a significant (p < 0.001) increase in the number of patients preferring the high volume program and having no preference. At pre-randomization, breast cancer patients anticipated more favorable motivational outcomes for the combined program and less favorable motivational outcomes for the high volume program (all p < 0.001). After the interventions, the motivational outcomes experienced exceeded the anticipated motivational outcomes significantly more in the high volume group than the standard or combined groups. CONCLUSIONS: Anticipated motivational outcomes for different types and doses of exercise during chemotherapy varied considerably at pre-randomization, but the motivational outcomes experienced after the three interventions were similar. Clinicians can recommend any of the three exercise interventions to breast cancer patients knowing that positive motivational outcomes will result. Clinicaltrials.gov identifier: NCT00249015 .

Associations between exercise and posttraumatic growth in gynecologic cancer survivors.

PURPOSE: Exercise improves numerous psychosocial outcomes in cancer survivors; however, few studies have examined posttraumatic growth. The primary objective of this study was to examine the association between exercise and posttraumatic growth in gynecologic cancer survivors (GCS). METHODS: Using the Alberta Cancer Registry, a random sample of endometrial, ovarian, and cervical cancer survivors were mailed a self-report survey that assessed demographic and medical variables, aerobic and strength exercise, and posttraumatic growth using the posttraumatic growth inventory, impact of cancer scale, and benefit finding scale. RESULTS: Completed surveys were received from 621 (38 %) of the 1,626 eligible survivors. One-third (32.9 %) of GCS were meeting aerobic exercise guidelines and 19.0 % were meeting strength exercise guidelines. Multivariate analyses of covariance showed significant differences in the posttraumatic growth scales for aerobic exercise guidelines (p < 0.001) and combined (strength and aerobic) exercise guidelines (p < 0.001). Analyses of covariance indicated significant differences favoring those meeting the aerobic exercise guidelines for the negative impact of cancer scale (p < 0.001) and several of its subscales. Moreover, those meeting the combined exercise guidelines reported higher scores for the posttraumatic growth inventory (p = 0.014), the negative impact of cancer scale (p < 0.001), and several of their subscales compared to those meeting only one or neither guideline. Marital status moderated the association between exercise and posttraumatic growth with only unmarried GCS demonstrating the associations. CONCLUSION: Exercise is a modifiable lifestyle factor that is associated with posttraumatic growth in GCS. Randomized controlled trials testing the effects of exercise interventions on posttraumatic growth in this population are warranted.

Effects of supervised exercise on progression-free survival in lymphoma patients: an exploratory follow-up of the HELP Trial.

PURPOSE: Few randomized controlled trials in exercise oncology have examined survival outcomes. Here, we report an exploratory follow-up of progression-free survival (PFS) from the Healthy Exercise for Lymphoma Patients (HELP) Trial. METHODS: The HELP Trial randomized 122 lymphoma patients between 2005 and 2008 to either control (n = 62) or 12 weeks of supervised aerobic exercise (n = 60). PFS events were abstracted from medical records in 2013. In addition to the randomized comparison, we explored the effects of exercise adherence (<80 % vs. ≥80 %) and control group crossover (no vs. yes). RESULTS: After a median follow-up of 61 months (interquartile range 36-67), the adjusted 5-year PFS was 64.8 % for the exercise group compared with 65.0 % for the control group (Hazard ratio [HR] 1.01, 95 % CI 0.51-2.01, p = 0.98). In the secondary analysis, the adjusted 5-year PFS was 59.0 % in the control group without crossover compared with 69.2 % for the control group with crossover (HR 0.68, 95 % CI 0.22-2.06, p = 0.49), 67.7 % for the exercise group with <80 % adherence (HR 0.72, 95 % CI 0.28-1.85, p = 0.50), and 68.4 % for the exercise group with ≥80 % adherence (HR 0.70, 95 % CI 0.32-1.56, p = 0.39). In a post hoc analysis combining the three groups that received supervised exercise, the adjusted 5-year PFS for the supervised exercise groups was 68.5 % compared with 59.0 % for the group that received no supervised exercise (HR 0.70, 95 % CI 0.35-1.39, p = 0.31). CONCLUSIONS: This exploratory follow-up of the HELP Trial suggests that supervised aerobic exercise may be associated with improved PFS in lymphoma patients. Larger trials designed to answer this question are needed.

Effects of supervised exercise on motivational outcomes in breast cancer survivors at 5-year follow-up.

PURPOSE: Short-term physical activity (PA) has beneficial effects on symptom management and quality of life, however, longer-term adherence is likely needed for improved disease outcomes in breast cancer survivors (BCS). This study examined the effects of a supervised group exercise program on motivational outcomes and PA among BCS at 5-year follow-up. METHODS: The original study was a two-armed, randomized controlled trial comparing a 12-week supervised group exercise program to usual care among 203 BCS. BCS for this follow-up study were contacted at 60 months postintervention and asked to complete assessments of motivational outcomes from the Theory of Planned Behavior and PA behavior using the Scottish Physical Activity Questionnaire. RESULTS: Overall, 87 participants provided 5-year follow-up data with no differences in participation by group. Analyses of covariance (ANCOVAs) revealed that supervised exercise had a significant positive effect on descriptive norm at 5-year follow-up (mean = +0.6; 95% CI = +0.1 to +1.1; d = +0.48; p = 0.021). Small positive effects were also noted for perceived behavioral control (d = +0.18), instrumental attitude (d = +0.26), and injunctive norm (d = +0.35), although they were not statistically significant. Moreover, BCS who were more active at 5-year follow-up also reported more favorable perceived behavioral control (d = +0.16), instrumental attitude (d = +0.28), injunctive norm (d = +0.24), and descriptive norm (d = +0.31), although these differences were not statistically significant. CONCLUSIONS: This trial provides suggestive evidence that a supervised exercise program has positive effects on motivational outcomes even after 5 years. Additional intervention strategies during follow-up may further improve long-term adherence and health outcomes in BCS.

Effects of exercise during adjuvant chemotherapy on breast cancer outcomes.

UNLABELLED: Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes; however, no randomized data are available. Here, we report an exploratory follow-up of cancer outcomes from the Supervised Trial of Aerobic versus Resistance Training (START). METHODS: The START was a Canadian multicenter trial that randomized 242 breast cancer patients between 2003 and 2005 to usual care (n = 82), supervised aerobic (n = 78), or resistance (n = 82) exercise during chemotherapy. The primary end point for this exploratory analysis was disease-free survival (DFS). Secondary end points were overall survival, distant DFS, and recurrence-free interval. The two exercise arms were combined for analysis (n = 160), and selected subgroups were explored. RESULTS: After a median follow-up of 89 months, there were 25/160 (15.6%) DFS events in the exercise groups and 18/82 (22.0%) in the control group. Eight-year DFS was 82.7% for the exercise groups compared with 75.6% for the control group (HR, 0.68; 95% confidence interval (CI), 0.37-1.24; log-rank, P = 0.21). Slightly stronger effects were observed for overall survival (HR, 0.60; 95% CI, 0.27-1.33; log-rank, P = 0.21), distant DFS (HR, 0.62; 95% CI, 0.32-1.19; log-rank, P = 0.15), and recurrence-free interval (HR, 0.58; 95% CI, 0.30-1.11; Gray test, P = 0.095). Subgroup analyses suggested potentially stronger exercise effects on DFS for women who were overweight/obese (HR, 0.59; 95% CI, 0.27-1.27), had stage II/III cancer (HR, 0.61; 95% CI, 0.31-1.20), estrogen receptor-positive tumors (HR, 0.58; 95% CI, 0.26-1.29), human epidermal growth factor receptor 2-positive tumors (HR, 0.21; 95% CI, 0.04-1.02), received taxane-based chemotherapies (HR, 0.46; 95% CI, 0.19-1.15), and ≥85% of their planned chemotherapy (HR, 0.50; 95% CI, 0.25-1.01). CONCLUSIONS: This exploratory follow-up of the START provides the first randomized data to suggest that adding exercise to standard chemotherapy may improve breast cancer outcomes. A definitive phase III trial is warranted.

Dissipation of the herbicide [14C]dimethenamid under anaerobic conditions in flooded soil microcosms.

The objective of this research was to investigate the dissipation of the herbicide dimethenamid under anaerobic redox conditions that may develop in the soil environment. Soil-water biometers were prepared with a saturated soil and made anaerobic by either glucose pretreatment (according to the Environmental Protection Agency registration study for anaerobic fate) or N2 sparging. Treatments included glucose pretreatment, NO3- + SO42- amendment, unamended, and autoclaved. Volatile, aqueous, extractable, and bound (unextractable) 14C-residues were quantified and characterized. The redox potential decreased over time, and evidence of denitrifying, iron-reducing, sulfate-reducing, and methanogenic conditions was observed, depending on the amendments. Anaerobic degradation of 14C-dimethenamid occurred in all treatments, and the time observed for 50% disappearance (DT50) was 13-14 days for nonautoclaved treatments. 14C-metabolites accumulated to up to 20% of applied 14C. At least two major metabolites were observed in nonautoclaved treatments, whereas only one was observed in autoclaved microcosms. More than 50% of the applied 14C was eventually incorporated into soil-bound residue.