Selective Liquid-Liquid Extraction of Thorium(IV) from Rare-Earth Element Mixtures.

One of the major challenges in processing rare-earth element (REE) materials arises from the large amounts of radioactive thorium (Th) that are often found within REE minerals, encouraging enhanced metal separation procedures. We report here a study aimed at developing improved systems for REE processing with the goal of efficient extraction of Th(IV) from acidic solution. A tripodal ligand, TRPN-CMPO-Ph, was prepared that utilizes carbamoylmethylphosphine oxide (CMPO) chelators tethered to a tris(3-aminopropyl)amine (TRPN) capping scaffold. The ligand and its metal complexes were characterized by using elemental analysis, NMR, Fourier transform infrared spectroscopy, mass spectrometry, and luminescence spectroscopy. Using a liquid-liquid metal extraction protocol, TRPN-CMPO-Ph selectively extracts Th(IV) at an efficiency of 79% from a mixture of Th(IV), UO22+, and all rare-earth metal cations (except promethium) dissolved in nitric acid into an organic solvent. Th(IV) extraction selectivity is maintained upon extraction from a mixture that approximates a typical monazite leach solution containing several relevant lanthanide ions, including two ions at higher concentration relative to Th(IV). Comparative studies with a tris(2-aminoethyl)amine (TREN)-capped derivative are presented and support the need for a larger TRPN capping scaffold in achieving Th(IV) extraction selectivity.

Rapid Acute Coronary Syndrome Evaluation Over One Hour With High-Sensitivity Cardiac Troponin I: A United States-Based Stepped-Wedge, Randomized Trial.

STUDY OBJECTIVE: The real-world effectiveness and safety of a 0/1-hour accelerated protocol using high-sensitivity cardiac troponin (hs-cTn) to exclude myocardial infarction (MI) compared to routine care in the United States is uncertain. The objective was to compare a 0/1-hour accelerated protocol for evaluation of MI to a 0/3-hour standard care protocol. METHODS: The RACE-IT trial was a stepped-wedge, randomized trial across 9 emergency departments (EDs) that enrolled 32,609 patients evaluated for possible MI from July 2020 through April 2021. Patients undergoing high-sensitivity cardiac troponin I testing with concentrations less than or equal to 99th percentile were included. Patients who had MI excluded by the 0/1-hour protocol could be discharged from the ED. Patients in the standard care protocol had 0- and 3-hour troponin testing and application of a modified HEART score to be eligible for discharge. The primary endpoint was the proportion of patients discharged from the ED without 30-day death or MI. RESULTS: There were 13,505 and 19,104 patients evaluated in the standard care and accelerated protocol groups, respectively, of whom 19,152 (58.7%) were discharged directly from the ED. There was no significant difference in safe discharges between standard care and the accelerated protocol (59.5% vs 57.8%; adjusted odds ratio (aOR)=1.05, 95% confidence interval [CI] 0.95 to 1.16). At 30 days, there were 90 deaths or MIs with 38 (0.4%) in the standard care group and 52 (0.4%) in the accelerated protocol group (aOR=0.84, 95% CI 0.43 to 1.68). CONCLUSION: A 0/1-hour accelerated protocol using high-sensitivity cardiac troponin I did not lead to more safe ED discharges compared with standard care.

Is rapid acute coronary syndrome evaluation with high-sensitivity cardiac troponin less costly? An economic evaluation.

Objective: Protocols to evaluate for myocardial infarction (MI) using high-sensitivity cardiac troponin (hs-cTn) have the potential to drive costs upward due to the added sensitivity. We performed an economic evaluation of an accelerated protocol (AP) to evaluate for MI using hs-cTn to identify changes in costs of treatment and length of stay compared with conventional testing. Methods: We performed a planned secondary economic analysis of a large, cluster randomized trial across nine emergency departments (EDs) from July 2020 to April 2021. Patients were included if they were 18 years or older with clinical suspicion for MI. In the AP, patients could be discharged without further testing at 0 h if they had a hs-cTnI < 4 ng/L and at 1 h if the initial value were 4 ng/L and the 1-h value ≤7 ng/L. Patients in the standard of care (SC) protocol used conventional cTn testing at 0 and 3 h. The primary outcome was the total cost of treatment, and the secondary outcome was ED length of stay. Results: Among 32,450 included patients, an AP had no significant differences in cost (+$89, CI: -$714, $893 hospital cost, +$362, CI: -$414, $1138 health system cost) or ED length of stay (+46, CI: -28, 120 min) compared with the SC protocol. In lower acuity, free-standing EDs, patients under the AP experienced shorter length of stay (-37 min, CI: -62, 12 min) and reduced health system cost (-$112, CI: -$250, $25). Conclusion: Overall, the implementation of AP using hs-cTn does not result in higher costs.

COVID-19 exacerbating ESRD induced pericardial effusion requiring pericardial window: A case report.

INTRODUCTION: Pericardial effusion can lead to cardiac tamponade requiring immediate management. Pericardial windows are an effective measure to surgically drain recurrent effusions. PRESENTATION OF CASE: We present a case of a 53-year-old male with recurrent pericardial effusion secondary to ESRD and exacerbated by COVID-19 infection, describing the successful management of an uncommon clinical scenario. A sub-xiphoid pericardial window and right sided thoracostomy was performed. DISCUSSION: There are limited case reports highlighting recurrent pericardial effusion management, secondary to ESRD and COVID-19 in a post renal transplant patient, through a subxiphoid pericardial window. CONCLUSION: COVID-19 infection can exacerbate pericardial effusion in a patient with ESRD, post renal transplant. Preventing cardiac tamponade, a sub-xiphoid pericardial window remains an effective measure in treating recurrent pericardial effusion.

Protein re-surfacing of E. coli L-Asparaginase to evade pre-existing anti-drug antibodies and hypersensitivity responses.

The optimal use of many biotherapeutics is restricted by Anti-drug antibodies (ADAs) and hypersensitivity responses which can affect potency and ability to administer a treatment. Here we demonstrate that Re-surfacing can be utilized as a generalizable approach to engineer proteins with extensive surface residue modifications in order to avoid binding by pre-existing ADAs. This technique was applied to E. coli Asparaginase (ASN) to produce functional mutants with up to 58 substitutions resulting in direct modification of 35% of surface residues. Re-surfaced ASNs exhibited significantly reduced binding to murine, rabbit and human polyclonal ADAs, with a negative correlation observed between binding and mutational distance from the native protein. Reductions in ADA binding correlated with diminished hypersensitivity responses in an in vivo mouse model. By using computational design approaches to traverse extended distances in mutational space while maintaining function, protein Re-surfacing may provide a means to generate novel or second line therapies for life-saving drugs with limited therapeutic alternatives.

Ocean acidification impacts sperm swimming performance and pHi in the New Zealand sea urchin Evechinus chloroticus.

In sea urchins, spermatozoa are stored in the gonads in hypercapnic conditions (pH<7.0). During spawning, sperm are diluted in seawater of pH>8.0, and there is an alkalinization of the sperm's internal pH (pHi) through the release of CO2 and H+. Previous research has shown that when pHi is above 7.2-7.3, the dynein ATPase flagellar motors are activated, and the sperm become motile. It has been hypothesized that ocean acidification (OA), which decreases the pH of seawater, may have a narcotic effect on sea urchin sperm by impairing the ability to regulate pHi, resulting in decreased motility and swimming speed. Here, we used data collected from the same individuals to test the relationship between pHi and sperm motility/performance in the New Zealand sea urchin Evechinus chloroticus under near-future (2100) and far-future (2150) atmospheric PCO2 conditions (RCP 8.5: pH 7.77, 7.51). Decreasing seawater pH significantly negatively impacted the proportion of motile sperm, and four of the six computer-assisted sperm analysis (CASA) sperm performance measures. In control conditions, sperm had an activated pHi of 7.52. Evechinus chloroticus sperm could not defend pHi in future OA conditions; there was a stepped decrease in the pHi at pH 7.77, with no significant difference in mean pHi between pH 7.77 and 7.51. Paired measurements in the same males showed a positive relationship between pHi and sperm motility, but with a significant difference in the response between males. Differences in motility and sperm performance in OA conditions may impact fertilization success in a future ocean.

Machine Learning to Assess for Acute Myocardial Infarction Within 30 Minutes.

Variations in high-sensitivity cardiac troponin I by age and sex along with various sampling times can make the evaluation for acute myocardial infarction (AMI) challenging. Machine learning integrates these variables to allow a more accurate evaluation for possible AMI. The goal was to test the diagnostic and prognostic utility of a machine learning algorithm in the evaluation of possible AMI. We applied a machine learning algorithm (myocardial-ischemic-injury-index [MI3]) that incorporates age, sex, and high-sensitivity cardiac troponin I levels at time 0 and 30 minutes in 529 patients evaluated for possible AMI in a single urban emergency department. MI3 generates an index value from 0 to 100 reflecting the likelihood of AMI. Patients were followed at 30-45 days for major adverse cardiac events (MACEs). There were 42 (7.9%) patients that had an AMI. Patients were divided into 3 groups by the MI3 score: low-risk (≤ 3.13), intermediate-risk (> 3.13-51.0), and high-risk (> 51.0). The sensitivity for AMI was 100% with a MI3 value ≤ 3.13 and 353 (67%) ruled-out for AMI at 30 minutes. At 30-45 days, there were 2 (0.6%) MACEs (2 noncardiac deaths) in the low-risk group, in the intermediate-risk group 4 (3.0%) MACEs (3 AMIs, 1 cardiac death), and in the high-risk group 4 (9.1%) MACEs (4 AMIs, 2 cardiac deaths). The MI3 algorithm had 100% sensitivity for AMI at 30 minutes and identified a low-risk cohort who may be considered for early discharge.

Phenology is the dominant control of methane emissions in a tropical non-forested wetland.

Tropical wetlands are a significant source of atmospheric methane (CH4), but their importance to the global CH4 budget is uncertain due to a paucity of direct observations. Net wetland emissions result from complex interactions and co-variation between microbial production and oxidation in the soil, and transport to the atmosphere. Here we show that phenology is the overarching control of net CH4 emissions to the atmosphere from a permanent, vegetated tropical swamp in the Okavango Delta, Botswana, and we find that vegetative processes modulate net CH4 emissions at sub-daily to inter-annual timescales. Without considering the role played by papyrus on regulating the efflux of CH4 to the atmosphere, the annual budget for the entire Okavango Delta, would be under- or over-estimated by a factor of two. Our measurements demonstrate the importance of including vegetative processes such as phenological cycles into wetlands emission budgets of CH4.

From sink to source: high inter-annual variability in the carbon budget of a Southern African wetland.

We report on three years of continuous monitoring of carbon dioxide (CO2) and methane (CH4) emissions in two contrasting wetland areas of the Okavango Delta, Botswana: a perennial swamp and a seasonal floodplain. The hydrographic zones of the Okavango Delta possess distinct attributes (e.g. vegetation zonation, hydrology) which dictate their respective greenhouse gas (GHG) temporal emission patterns and magnitude. The perennial swamp was a net source of carbon (expressed in CO2-eq units), while the seasonal swamp was a sink in 2018. Despite differences in vegetation types and lifecycles, the net CO2 uptake was comparable at the two sites studied in 2018/2020 (-894.2 ± 127.4 g m-2 yr-1 at the perennial swamp, average of the 2018 and 2020 budgets, and -1024.5 ± 134.7 g m-2 yr-1 at the seasonal floodplain). The annual budgets of CH4 were however a factor of three larger at the permanent swamp in 2018 compared to the seasonal floodplain. Both ecosystems were sensitive to drought, which switched these sinks of atmospheric CO2 into sources in 2019. This phenomenon was particularly strong at the seasonal floodplain (net annual loss of CO2 of 1572.4 ± 158.1 g m-2), due to a sharp decrease in gross primary productivity. Similarly, drought caused CH4 emissions at the seasonal floodplain to decrease by a factor of 4 in 2019 compared to the previous year, but emissions from the perennial swamp were unaffected. Our study demonstrates that complex and divergent processes can coexist within the same landscape, and that meteorological anomalies can significantly perturb the balance of the individual terms of the GHG budget. Seasonal floodplains are particularly sensitive to drought, which exacerbate carbon losses to the atmosphere, and it is crucial to improve our understanding of the role played by such wetlands in order to better forecast how their emissions might evolve in a changing climate. Studying such hydro-ecosystems, particularly in the data-poor tropics, and how natural stressors such as drought affect them, can also inform on the potential impacts of man-made perturbations (e.g. construction of hydro-electric dams) and how these might be mitigated. Given the contrasting effects of drought on the CO2 and CH4 flux terms, it is crucial to evaluate an ecosystem's complete carbon budget instead of treating these GHGs in isolation. This article is part of a discussion meeting issue 'Rising methane: is warming feeding warming? (part 2)'.

Ranking United States University-Based General Surgery Programs on the Academic Achievement of Surgery Department Faculty.

OBJECTIVE: Rankings of residency programs are highly influential and utilized by residency applicants. Existing ranking resources often use opaque criteria that may include bias or do not accurately represent the academic achievement of current faculty. This study aims to create an updated general surgery residency ranking list based on the academic achievements of their respective surgery department faculty members. DESIGN: One hundred and six general surgery residency programs were selected from the American Medical Association Residency & Fellowship Programs Database. The names of faculty members affiliated with the departments of surgery were manually obtained. Lifetime and five-year h-indexes, a sum of grant awards from the National Institute of Health and Veterans Affairs, and a tally of journal editorial board positions were collected for the faculty. Metrics were compared among surgical departments, and the corresponding residency programs were ranked accordingly. SETTING: The study evaluated university-based general surgery residency programs in the United States from 2017 to 2019 via assessing their respective institutions' departments of surgery. PARTICIPANTS: A total of 7568 faculty members were evaluated. Faculty were required to be full-time, clinical surgeons to meet inclusion criteria. RESULTS: Based on a composite of all measured criteria, the top overall surgery department was at the University of Michigan. Massachusetts General Hospital had the highest lifetime and five-year h-indexes. Brigham and Women's Hospital had the most National Institute of Health funding, and the University of Pittsburgh Medical Center had the most Veterans Affairs funding. Washington University in St. Louis/Barnes Jewish Hospital had the most editorial board positions in their department. CONCLUSIONS: The academic success of departments of surgery was evaluated to develop a ranking list of general surgery residency programs. Through utilizing standardized methods and several measures of academic achievement, this comprehensive general surgery residency classification system will allow residency applicants to make more informed decisions.

The complete mitogenome of the Mountain chicken frog, Leptodactylus fallax.

The mountain chicken frog (Leptodactylus fallax) is a critically endangered frog native to the Caribbean islands of Dominica and Montserrat. Over the past 25 years their populations have declined by over 85%, largely due to a chytridiomycosis outbreak that nearly wiped out the Montserratian population. Within the context of developing tools that can aid in the conservation of the mountain chicken frog, we assembled its complete mitochondrial genome, contributing the first complete mitogenome of the genus Leptodactylus (Genbank Accession number MW260634). The circular genome is 18,669 bp long and contains 37 genes. A phylogenetic analysis reveals that L. fallax forms a clade with Leptodactylus melanonotus, highlighting the close relationship of Leptodactylus spp. relative to other species from the superfamily Hyloidea included in the analysis.

The role of cardiac testing with the 0/1-hour high-sensitivity cardiac troponin algorithm evaluating for acute myocardial infarction.

BACKGROUND: The role of cardiac testing in the 3 zones (rule-out, observation, and rule-in) of the 0/1-hour algorithm to evaluate for acute myocardial infarction (AMI) has not been well studied. This study evaluated the 0/1-hour algorithm with a high-sensitivity cardiac troponin (hs-cTnI) assay and investigated cardiac testing in the 3 zones. METHODS: Patients (n = 552) at a single urban center were enrolled if they were evaluated for AMI. Blood samples were obtained at presentation, 1 hour, and 3 hours for hs-cTnI. Follow-up at 30 to 45 days for death/AMI was done. The results of echocardiograms, stress testing, and coronary angiography were recorded. RESULTS: In total, 45 (8.2%) had AMI (27 Type 1 and 18 Type 2) during the index hospitalization while at follow-up death/AMI occurred in 11 (2.0%) of patients. The rule-out algorithm had a negative predictive value for AMI of 99.6% while the rule-in zone had a positive predictive value of 56.6%. The MACE rate at follow-up was 0.4% for those in the rule-out group. There were 6/95 (6.3%) abnormal stress tests in the rule-out zone and 4 of these were false positives. CONCLUSIONS: The 0/1-hour algorithm had high diagnostic sensitivity and negative predictive value for AMI, and adverse events were very low in patients in the rule-out zone. Noninvasive testing in rule-out zone patients had low diagnostic yield.

Is Duration of Symptoms Predictive of Acute Myocardial Infarction?

Patient interviews regarding the duration of symptoms are commonly conducted when evaluating a patient with possible acute myocardial infarction (AMI) and are believed to distinguish between AMI and non-AMI symptoms. In a single center, 569 patients evaluated in the emergency department (ED) for possible AMI from May 2013 to April 2015 were prospectively studied. Patients in the ED were asked by trained research personnel about the duration of their predominant symptom. The final diagnosis of AMI was determined by an independent cardiologist and emergency medicine physician in accordance with the third universal definition of AMI. Disagreements were settled by a third physician (cardiologist) who reviewed the case. There were 44 (8%) AMIs and 484 (85%) patients had chest pain as their predominant symptom. In the 26 type 1 AMIs, the median symptom duration was 3.3 hours, while in the 18 type 2 AMIs it was 1.3 hours. AMI was not present if symptom duration was under 20 minutes and was more likely during the 20-59 minute period. In conclusion, clinical symptoms still play a prominent role in the evaluation of a patient with possible AMI in the ED. Duration of symptoms was not very helpful in distinguishing between patients with AMI and those with non-AMI, except in the time interval of 20-59 minutes.

Baseline High Sensitivity Cardiac Troponin I Level Below Limit of Quantitation Rules Out Acute Myocardial Infarction in the Emergency Department.

The objective of our study was to determine the utility of a baseline high sensitivity cardiac troponin (hs-cTnI) value below the limit of quantitation to rule-out acute myocardial infarction (AMI) in patients presenting to the emergency department (ED) with any suspicious symptoms of a cardiac etiology. We enrolled subjects presenting to the ED with symptoms suspicious for AMI. Blood specimens were collected within 1 hour after a triage electrocardiogram. Cardiac troponin I was measured using the Beckman Coulter Access hs-cTnI assay. The diagnosis of AMI was adjudicated by 2 cardiologists using the Third Universal Definition of AMI and Roche Diagnostics Troponin T Generation 5 assay with all available clinical data at 30 days after presentation. A total of 567 subjects had all data required for data analyses. AMI was diagnosed in 46 (8.1%) patients. Two hundred thirty-two (40.9%) individuals had presentation hs-cTnI results <4.0 ng/L. None of the patients with baseline hs-cTnI <4.0 ng/L had an AMI, yielding a negative predictive value of 100.0% and a sensitivity of 100%, and a good prognosis (no AMIs or cardiac-related deaths at 30 days). In this single-center ED study, a baseline presenting novel hs-cTnI value of <4.0 ng/L effectively ruled out AMI in 40.9% of all patients presenting to the ED and having any symptoms suspicious for AMI. Importantly all patients, not only those with chest pain, and those having symptoms for any duration or those with end-stage renal disease requiring dialysis were included.

Enamel thickness of maxillary canines evaluated with microcomputed tomography scans.

INTRODUCTION: Enameloplasty of maxillary canines is often needed for aesthetic substitution in patients with congenitally missing lateral incisors. The exact enamel thicknesses for the various canine surfaces are unknown because previous studies failed to employ accurate measurement tools to report and compare detailed enamel thicknesses for each surface at various crown heights. METHODS: Thirty-two extracted maxillary canines were collected and scanned in a microcomputed tomography scanner. The scans were imported into a custom-written MATLAB software (version 9.2; MathWorks, Natick, Mass) and the enamel thickness on the mesial, distal, labial, fossa, cingulum, and incisal edge of each tooth was computed, obtaining the mean value from slices at 0.1 mm intervals. The overall mean enamel thickness for each surface was also calculated, and these values were compared using paired t tests. Incisal wear stage and incisal enamel thickness that was measured were compared using Spearman rank correlation coefficient. RESULTS: The mean enamel thickness was significantly thinner at the gingival level when compared with the incisal for all surfaces that were analyzed (1-tailed, P <0.001). The mean enamel coverage at the mesial was significantly thinner than the distal when measured gingival to the widest mesiodistal area. The mean enamel coverage of the cingulum was particularly thin and therefore requires extreme care in reshaping it. Incisal edge enamel thickness was highly negatively correlated with the wear stage of the scoring system that was used (1-tailed, P <0.001). CONCLUSIONS: The enamel coverage of the maxillary canine varies depending on the tooth surface and the incisogingival measurement location.

Assessing congruence of opportunistic records and systematic surveys for predicting Hispaniolan mammal species distributions.

Comparative assessment of the relative information content of different independent spatial data types is necessary to evaluate whether they provide congruent biogeographic signals for predicting species ranges. Opportunistic occurrence records and systematically collected survey data are available from the Dominican Republic for Hispaniola's surviving endemic non-volant mammals, the Hispaniolan solenodon (Solenodon paradoxus) and Hispaniolan hutia (Plagiodontia aedium); opportunistic records (archaeological, historical and recent) exist from across the entire country, and systematic survey data have been collected from seven protected areas. Species distribution models were developed in maxent for solenodons and hutias using both data types, with species habitat suitability and potential country-level distribution predicted using seven biotic and abiotic environmental variables. Three different models were produced and compared for each species: (a) opportunistic model, with starting model incorporating abiotic-only predictors; (b) total survey model, with starting model incorporating biotic and abiotic predictors; and (c) reduced survey model, with starting model incorporating abiotic-only predictors to allow further comparison with the opportunistic model. All models predict suitable environmental conditions for both solenodons and hutias across a broadly congruent, relatively large area of the Dominican Republic, providing a spatial baseline of conservation-priority landscapes that might support native mammals. Correlation between total and reduced survey models is high for both species, indicating the substantial explanatory power of abiotic variables for predicting Hispaniolan mammal distributions. However, correlation between survey models and opportunistic models is only moderately positive. Species distribution models derived from different data types can provide different predictions about habitat suitability and conservation-priority landscapes for threatened species, likely reflecting incompleteness and bias in spatial sampling associated with both data types. Models derived using both opportunistic and systematic data must therefore be applied critically and cautiously.

Complementarity, completeness and quality of long-term faunal archives in an Asian biodiversity hotspot.

Long-term baselines on biodiversity change through time are crucial to inform conservation decision-making in biodiversity hotspots, but environmental archives remain unavailable for many regions. Extensive palaeontological, zooarchaeological and historical records and indigenous knowledge about past environmental conditions exist for China, a megadiverse country experiencing large-scale biodiversity loss, but their potential to understand past human-caused faunal turnover is not fully assessed. We investigate a series of complementary environmental archives to evaluate the quality of the Holocene-historical faunal record of Hainan Island, China's southernmost province, for establishing new baselines on postglacial mammalian diversity and extinction dynamics. Synthesis of multiple archives provides an integrated model of long-term biodiversity change, revealing that Hainan has experienced protracted and ongoing human-caused depletion of its mammal fauna from prehistory to the present, and that past baselines can inform practical conservation management. However, China's Holocene-historical archives exhibit substantial incompleteness and bias at regional and country-wide scales, with limited taxonomic representation especially for small-bodied species, and poor sampling of high-elevation landscapes facing current-day climate change risks. Establishing a clearer understanding of the quality of environmental archives in threatened ecoregions, and their ability to provide a meaningful understanding of the past, is needed to identify future conservation-relevant historical research priorities. This article is part of a discussion meeting issue 'The past is a foreign country: how much can the fossil record actually inform conservation?'

Reservoir frogs: seasonality of Batrachochytrium dendrobatidis infection in robber frogs in Dominica and Montserrat.

Emerging infectious diseases are an increasingly important threat to wildlife conservation, with amphibian chytridiomycosis, caused by Batrachochytrium dendrobatidis, the disease most commonly associated with species declines and extinctions. However, some amphibians can be infected with B. dendrobatidis in the absence of disease and can act as reservoirs of the pathogen. We surveyed robber frogs (Eleutherodactylus spp.), potential B. dendrobatidis reservoir species, at three sites on Montserrat, 2011-2013, and on Dominica in 2014, to identify seasonal patterns in B. dendrobatidis infection prevalence and load (B. dendrobatidis genomic equivalents). On Montserrat there was significant seasonality in B. dendrobatidis prevalence and B. dendrobatidis load, both of which were correlated with temperature but not rainfall. B. dendrobatidis prevalence reached 35% in the cooler, drier months but was repeatedly undetectable during the warmer, wetter months. Also, B. dendrobatidis prevalence significantly decreased from 53.2% when the pathogen emerged on Montserrat in 2009 to a maximum 34.8% by 2011, after which it remained stable. On Dominica, where B. dendrobatidis emerged seven years prior to Montserrat, the same seasonal pattern was recorded but at lower prevalence, possibly indicating long-term decline. Understanding the dynamics of disease threats such as chytridiomycosis is key to planning conservation measures. For example, reintroductions of chytridiomycosis-threatened species could be timed to coincide with periods of low B. dendrobatidis infection risk, increasing potential for reintroduction success.