Wyattharrell3915

Our top models indicated that host genetic clade, precipitation in the year prior to specimen collection, and the year prior to specimen collection best predicted prevalence and severity of skunk cranial worm. We suggest the positive association with precipitation is a result of local availability of gastropods, the intermediate host for skunk cranial worm. There was a negative association between prior year and prevalence, but the severity of damage increased over time for all clades. Given concerns over population declines of spotted skunks as well as observations of increasing damage over the past century, there is a need for further research on the impacts of cranial worm infection on individual-scale behavior, reproduction and survival, and on population-scale demographics.Environmental DNA (eDNA) methods provide novel options for the detection of pathogens. The amphibian pathogens Batrachochytrium dendrobatidis (Bd) and Ranavirus have been relatively understudied in Texas, USA, so we applied eDNA assays for the surveillance of these pathogens in the upper Brazos River basin near the Texas panhandle. We collected water samples from five urban playa lakes and one reservoir in and around Lubbock, Texas. Quantitative PCR detected both Bd and Ranavirus at one playa lake, representing novel detection of both pathogens in the region. Based on these results, we recommend increased monitoring for the pathogens and symptoms of amphibian disease throughout the region.BACKGROUND 5α-Reductase inhibitors (5ARI) reduced risk of prostate cancer (Pca) with 25% in two randomized trials but increased risk of Gleason 8-10 at biopsy. One explanation is that 5ARI induce morphological changes in Pca cells similar to higher Gleason grades but without its adverse biology. To assess this, we compared risk of Pca death between men on 5ARI and men not on 5ARI before Pca diagnosis, in each Gleason grade group (GGG). MATERIALS AND METHODS Prostate Cancer data Base Sweden (PCBaSe) consists of linkages between the National Prostate Cancer Register, the Prescribed Drug Registry and the Cause of Death Registry. Out of 89 227 men diagnosed with Pca between July 2007 and December 2016, 5 816 men had been on 5ARI for more than 180 days before the date of diagnosis. Follow-up ended in December 2018. A Cox proportional hazard model was used to assess hazard ratio (HR) for Pca death. Adjustments for age, comorbidity, education and curative treatment were made. Men with high-risk cancer were stratified according to GGG. RESULTS In men with high-risk cancer, risk of Pca death was similar among 5ARI-users and non-users - GGG1 HR 1.02 (95% CI 0.53-1.95), GGG2 HR 1.04 (95% CI 0.65-1.69), GGG3 HR 1.27 (95% CI 0.89-1.80), GGG4 HR 0.95 (95% CI 0.76-1.18) and GGG5 HR 0.99 (95% CI 0.83-1.19), for 5ARI users vs. non-users. CONCLUSION We found no evidence for that 5ARI affect Gleason grading since no difference in mortality was observed among 5ARI users and non-users in each Gleason group.BACKGROUND Men with biochemical recurrence (BCR) after radical prostatectomy (RP) need information on competing risks of mortality to inform prognosis and guide treatment. We sought to quantify the risk of prostate cancer metastasis and mortality (PCSM) and other-cause mortality (OCM) across key clinical predictors. METHODS We analyzed 1,225 men with BCR after RP from 2001-2017 in the VA SEARCH database. Multivariable competing risks regression was used to identify predictors and quantify cumulative incidence of metastasis, PCSM, and OCM. Recursive partitioning analysis (RPA) was used to identify optimum variable cutpoints for prediction of PCSM and OCM. RESULTS Over a median follow up of 5.6 years after BCR(IQR 2.7,9.1), 243 (20%) men died of other causes and 68 (6%) died of prostate cancer. Multivariable competing risks regression showed that high D'Amico tumor risk and PSA doubling time (PSADT) at BCR less then 9 months were associated with metastasis and PCSM(p≤0.001); 10-year PCSM was 14% and 9% for those with high-risk tumors and PSADT less then 9 mos, respectively. Advanced age and worse comorbidity were associated with OCM(p≤0.001); 10-year OCM was higher among men ≥70 years with any Charlson comorbidity (1-3+) (40-49%) compared with those with none (20%). Thiomyristoyl clinical trial RPA identified optimal variable cutpoints for prediction of PCSM and OCM, with 10-year PCSM ranging from 3-59% and 10-year OCM ranging from 17-50% across risk subgroups. CONCLUSIONS Among men with BCR after RP, there is significant heterogeneity in prognosis that can be explained by available clinical variables. Men in their 70s with any major comorbidity are 2-10 times more likely to die of other causes than prostate cancer.PURPOSE Vesicoureteral Reflux Index (VURx) is a simple, validated tool for prediction of vesicoureteral reflux (VUR) resolution. Along with likelihood of spontaneous resolution, identification of children at risk for febrile urinary tract infection (fUTI) impacts management. We evaluated the utility of VURx as a predictive factor for breakthrough fUTI compared to VUR grade and distal ureteral diameter ratio (UDR). MATERIALS AND METHODS Children with primary VUR and detailed voiding cystourethrogram (VCUG) data were identified. A 1-6 point VURx was assigned and UDR computed by measuring largest ureteral diameter within the pelvis and dividing by the distance between L1-L3 vertebral bodies. Random forest modeling and logistic multivariable regression were employed to estimate the predictability of grade, UDR and VURx with regard to breakthrough fUTI. RESULTS One hundred and thirty-nine children (94 girls, 45 boys) were analyzed with a mean age at diagnosis of 5.4 ± 4.7 months. Mean length of follow-up was 32.1 ± 24.5 months. Thirteen children (9.4%) experienced breakthrough fUTI. On univariate analysis, UDR (p = 0.01) and VURx (p = 0.0005) were associated with breakthrough UTI, while grade (p = 0.09) did not reach significance. Area under the curve was generated as a measure of accuracy for each variable and was 0.77 for VURx, 0.71 for UDR and 0.68 for grade, demonstrating superiority of VURx for predicting breakthrough fUTI. CONCLUSIONS Children with higher VURx are at increased risk for breakthrough febrile UTI independent of reflux grade. VURx provides valuable prognostic information about infection risk facilitating improved clinical decision-making.