In patients with suspected fungal pneumonia, an Aspergillus secondary metabolite signature in breath can identify individuals with IA. These results provide proof-of-concept that direct detection of exogenous fungal metabolites in breath can be used as a novel, noninvasive, pathogen-specific approach to identifying the precise microbial cause of pneumonia.

The clinical epidemiology of BK virus (BKV) disease after allogeneic hematopoietic stem cell transplantation (HSCT) is not well defined. We evaluated 491 patients transplanted from January 2010 to December 2011 at a single transplant center to assess incidence, severity, and risk factors for BKV disease after HSCT. BKV disease was defined as BKV detection in urine by PCR testing in association with genitourinary symptoms without other concurrent genitourinary conditions. BKV disease occurred in 78 patients (15.9%), for an incidence rate of .47/1000 patient-days (95% confidence interval [CI], .37 to .59); BKV disease was considered severe in 27 patients (5.5%). In multivariate Cox modeling, time-dependent acute graft-versus-host disease (aGVHD) grades II to IV (adjusted hazard ratio [aHR] 4.25; 95% CI, 2.51 to 7.21), cord blood HSCT (aHR 2.28; 95% CI, 1.01 to 5.15), post-transplant mycophenolate use (aHR 3.31; 95% CI, 1.83 to 5.99), and high-dose cyclophosphamide conditioning (aHR 2.34, 95% CI 1.45 to 3.77) were significant predictors of BKV disease. Time-dependent aGVHD grades III to IV (aHR 10.5; 95% CI, 4.44 to 25.0) and cord blood HSCT (aHR 5.40; 95% CI, 1.94 to 15.0) were independent risk factors for severe BKV disease. BKV disease is common and is associated with significant and prolonged morbidity after HSCT. Prospective studies are needed to better define the morbidity of post-HSCT BKV disease and inform the design of prophylaxis and treatment trials.

BACKGROUND Heart transplant (HT) recipients are at risk for invasive fungal disease (IFD), a morbid and potentially fatal complication. METHODS We performed a retrospective cohort study to evaluate the incidence and risk factors for IFD in HT recipients from 1995 to 2012 at a single center. IFD cases were classified as proven or probable IFD according to current consensus definitions of the European Organization for Research and Treatment of Cancer/Mycoses Study Group. We calculated IFD incidence rates and used Cox proportional hazards models to determine IFD risk factors. RESULTS Three hundred sixty patients underwent HT during the study period. The most common indications were dilated (39%) and ischemic (37%) cardiomyopathy. There were 23 (6.4%) cases of proven (21) or probable (2) IFD, for a cumulative incidence rate of 1.23 per 100 person-years (95% CI 0.78 to 1.84). Candida (11) and Aspergillus (5) were the most common etiologic fungi. Thirteen cases (56%) occurred within 3 months of HT, with a 3-month incidence of 3.8% (95% CI 2.2 to 6.4). Delayed chest closure (HR 3.3, 95% CI 1.4 to 7.6, p = 0.01) and the addition of OKT3, anti-thymocyte globulin or daclizumab to standard corticosteroid induction therapy (HR 2.7, 95% CI 1.1 to 6.2, p = 0.02) were independently associated with an increased risk of IFD. CONCLUSIONS IFD incidence was greatest within the first 3 months post-HT, largely reflecting early surgical-site and nosocomial Candida and Aspergillus infections. Patients receiving additional induction immunosuppression or delayed chest closure were at increased risk for IFD. Peri-transplant anti-fungal prophylaxis should be considered in this subset of HT recipients.

Broiler breeders display high levels of aggressive activity as a result of feed restriction. The objective of this study was to determine if aggressive activity in developing and mature broiler breeder males is influenced by increased dietary L-tryptophan (Trp). Broiler breeder males were raised using a skip-a-day feed restriction regimen. In Experiment 1, three levels of dietary Trp, .19 (control), .75, and 1.5%, were fed from the start of feed restriction at 4 wk of age and throughout development. All occurrences of aggressive behavior were recorded during three 20-min observation sessions per week on mornings on which feed was not delivered through Week 20. The Trp significantly decreased (P less than .05) aggressive pecking in birds fed supplemental Trp as compared to controls. No differences in threatening behavior were found. In the second part of Experiment 1, the effect of continued Trp supplementation on mature flocks of male broiler breeders and time-of-day effects on aggression were investigated. A depressing effect of supplemental Trp on pecking and threatening was observed. Maximum aggressive activity in all treatment groups occurred on mornings when feed was delivered. In Experiment 2, four levels of Trp, .19 (control), .38, .75, and 1.5%, were fed to developing birds as in Experiment 1. Birds fed supplemental Trp pecked less (P less than .05) than controls and .38% Trp was as effective in decreasing pecking as was 1.5%. It was concluded that increased levels of dietary Trp decrease aggression in both developing and mature, socially stable flocks of broiler breeder males.

Many dioecious plant species show spatial segregation of the sexes along a gradient of habitat quality. This study explores the spatial distribution and size of male and female Nyssa aquatica (water tupelo) trees along a water depth gradient. Individuals were mapped to determine the spatial distribution of male and female trees and the relationship between distribution ofmales and females and water depth. Nearest neighbor analysis indicated that males and females were randomly distributed in space. Comparisons among plots, however, indicated that there were more male trees in the shallowest plot. Height and diameter at breast height were measured for each tree. Males were significantly larger in height and basal area than females. Coring of male and female trees indicated that size differences between the sexes cannot be attributed to age differences, suggesting that male water tupelo trees allocate more resources to growth than do female trees.