Isolated abnormal diffusing capacity for carbon monoxide (iso↓DLco) is associated with increased respiratory symptom burden in people with HIV infection.

OBJECTIVES: An isolated reduction in the diffusing capacity for carbon monoxide (DLco; iso↓DLco) is one of the most common pulmonary function test (PFT) abnormalities in people living with HIV (PWH), but its clinical implications are incompletely understood. In this study, we explored whether iso↓DLco in PWH is associated with a greater respiratory symptom burden. STUDY DESIGN: Cross-sectional analysis. METHODS: We used ATS/ERS compliant PFTs from PWH with normal spirometry (post-bronchodilator FEV1/FVC ≥0.7; FEV1, FVC ≥80% predicted) from the I AM OLD cohort in San Francisco, CA and Seattle, WA, grouped by DLco categorized as normal (DLco ≥lower limit of normal, LLN), mild iso↓DLco (LLN >DLco >60% predicted), and moderate-severe iso↓DLco (DLco ≤60% predicted). We performed multivariable analyses to test for associations between DLco and validated symptom-severity and quality of life questionnaires, including the modified Medical Research Council dyspnea scale (mMRC), the COPD Assessment Test (CAT), and St. George's Respiratory Questionnaire (SGRQ), as well as between DLco and individual CAT symptoms. RESULTS: Mild iso↓DLco was associated only with a significantly higher SGRQ score. Moderate-severe iso↓DLco was associated with significantly higher odds of mMRC ≥2 and significantly higher CAT and SGRQ scores. PWH with moderate-severe iso↓DLco had increased odds of breathlessness, decreased activity, lower confidence leaving home, and less energy. CONCLUSIONS: Iso↓DLco is associated with worse respiratory symptom scores, and this association becomes stronger with worsening DLco, suggesting that impaired gas exchange alone has a significant negative impact on the quality of life in PWH. Additional studies are ongoing to understand the etiology of this finding and design appropriate interventions.

Sex modifies the risk of HIV-associated obstructive lung disease in Ugandans postpneumonia.

OBJECTIVES: Spirometric abnormalities are frequent, and obstructive lung disease (OLD) is a common comorbidity among people with HIV (PWH). HIV increases the risk of many comorbidities to a greater degree in women than in men. Few studies have evaluated whether sex modifies the HIV-associated risk of OLD. DESIGN AND METHODS: To evaluate the associations between sex and HIV with abnormal lung function, women and men with and without HIV underwent spirometric testing after completing therapy for pneumonia, including tuberculosis (TB), in Kampala, Uganda. OLD was defined as a postbronchodilator forced expiratory volume in the first second to forced vital capacity (FEV 1 /FVC) ratio less than 0.70. Associations between sex, HIV, and lung function were evaluated using multivariable regression models including sex-by-HIV interaction terms after adjusting for age, BMI, smoking status, and TB status. RESULTS: Among 348 participants, 147 (42%) were women and 135 (39%) were HIV-positive. Sixteen (11%) women and 23 men (11%) had OLD. The HIV-sex interaction was significant for obstructive lung disease ( P  = 0.04). In the adjusted stratified analysis, women with HIV had 3.44 (95% CI 1.11-12.0; P  = 0.04) increased odds of having OLD compared with men with HIV. Women without HIV did not have increased odds of having OLD compared with men without HIV. CONCLUSION: HIV appears to increase the risk of OLD to a greater degree in women than in men in an urban Ugandan setting. The mechanistic explanation for this interaction by sex remains unclear and warrants further study.

Repurposing of archived CO1 sequence data reveals unusually high genetic structure between North American and European zebra mussels (Dreissena polymorpha).

The invasion of the zebra mussel, Dreissena polymorpha in the Great Lakes of North America is regarded as one of the most catastrophic ecological events in recent history. Previous studies showed a close kinship between European zebra mussels and their invasive cohorts in the Great Lakes. In this study, we repurposed and reanalyzed archived CO1 sequence data from Lake Superior and multiple sites in Europe that were collected between 1991 and 2011 to illustrate an interesting pattern of genetic isolation that was overlooked in previous studies. The results showed extreme genetic isolation of Lake Superior zebra mussels as evident by high ϕST values and strong geographic patterning of Lake Superior haplotypes.

How Budget Issues Affect Technologists.

Departmental budgets create active issues that positively or negatively affect the technologist's everyday practice. This literature review was conducted to determine if technologists' quality of care and radiation safety were at risk and if examination productivity was affected. Midwestern State University's library database was searched for the most recent literature concerning these issues using CINAHL, Academic Search Complete, and MEDLINE databases. The literature used for this review found that a department with a minimalist budget negatively affected technologists' occupational attitude and job satisfaction because of budget cuts and lack of communication between management and employees; this adversely affected the quality of care given. Radiation protection practices were noncompliant in some facilities with a poor budget because educational programs could not be funded and adequate shielding resources were not provided, which increased the risk of unnecessary radiation exposure to personnel and patients. In contrast, a department with generous funds that had continuing education programs available showed compliance with radiation protection. Furthermore, departments with a strong budget that included purchasing a picture archiving computer system created a more simplistic workflow, increased patient throughput, and increased examination productivity. It was found that budgets should be correctly distributed in order to create optimal occupational success for a department because working under a minimalist budget ultimately affects many aspects of technologists' day-to-day practice. Because of the age of the most current articles, a need to conduct research focusing on recent changes affecting budgetary concerns has been shown.