Search

INTRODUCTION: Mediport use as a clinical option for the administration of chimeric antigen receptor T cell (CAR T cell) therapy in patients with B-cell malignancies has yet to be standardized. Concern for mediport dislodgement, cell infiltration, and ineffective therapy delivery to systemic circulation has resulted in variable practice with intravenous administration of CAR T cell therapy. With CAR T cell commercialization, it is important to establish practice standards for CAR T cell delivery. We conducted a study to establish usage patterns of mediports in the clinical setting and provide a standard of care recommendation for mediport use as an acceptable form of access for CAR T cell infusions. METHODS: In this retrospective cohort study, data on mediport use and infiltration rate was collected from a survey across 34 medical centers in the Pediatric Real-World CAR Consortium, capturing 504 CAR T cell infusion routes across 489 patients. Data represents the largest, and to our knowledge sole, report on clinical CAR T cell infusion practice patterns since FDA approval and CAR T cell commercialization in 2017. RESULTS: Across 34 sites, all reported tunneled central venous catheters, including Broviac® and Hickman® catheters, as accepted standard venous options for CAR T cell infusion. Use of mediports as a standard clinical practice was reported in 29 of 34 sites (85%). Of 489 evaluable patients with reported route of CAR T cell infusion, 184 patients were infused using mediports, with no reported incidences of CAR T cell infiltration. DISCUSSION/CONCLUSION: Based on current clinical practice, mediports are a commonly utilized form of access for CAR T cell therapy administration. These findings support the safe practice of mediport usage as an accepted standard line option for CAR T cell infusion.

We discuss select imprecise and untenable natural history information about migration, urban habitat use. and diet presented in the technical literature about Accipiter hawks in North America. We focus primarily on challenging the claim that Sharp-shinned Hawks (Accipiter striatus) are more frequent predators of House Sparrows (Passer domesticus) than are Cooper's Hawks (A. cooperii). We urge scientists to be cognizant of the ever-changing dynamics of the predatory behavior, nesting, and migration ecology of Sharp-shinned and Cooper's hawks due to anthropogenic factors, features that arc in constant flux and may not be well tracked long term or apply to the entire distributional ranges of these 2 species. Received 16 March 2021. Accepted 26 May 2022. Key words: diet, House Sparrow, migration, predation, urbanization. Discuthnos acerca de informaciones de historia natural imprecisa e insostcnible acerca dc la migracion. del uso de habitat urbano y la dieta presentada en la literatura teenies sobre gavilancs Accipiter en America del None Principalmente nos cnl'ocamos en cucstionar la afirmacion de que el gavilan americano (Accipiter striatus) es un depredador mas frecuente de gorrion conuin (Passer domesticus) que del gavilan de Cooper (A. cooperii). Exhortamos a los cicnlificos a rcconocer las dinamicas siempre cambiantes de comportamientos dc deprcdacion. anulamiento y ecologia migratoria del gavilan americano y del gavilan de Cooper debido a factorcs antropogenicos, aspectos que estan en ftujo constante y podrian no tener buen seguimiento a largo plazo o no aplicar al range de distribucion complete de esas especies. Palabras clave' deprcdacion. dieta. gorrion comun, migracion. urbanizacion., Predation of several groups of landbirds by Accipiter hawks in North America, especially the Sharp-shinned Hawk (Accipiter striatus) and the larger Cooper's Hawk (A. cooperii), has recently received much attention [...]

Social monogamy is the prevalent mating system in birds, but alternative strategies of extra‐pair paternity (EPP) and conspecific brood parasitism (CBP) occur in many species. Raptors are virtually absent in discussions of broad taxonomic reviews regarding EPP and CBP likely because these strategies are mostly absent or at low frequency; CBP is unreported in solitary nesting raptors. In contrast, we found high frequencies of EPP (16%–31%) and CBP (15%–26%) nests among three populations of Cooper's Hawks (Accipiter cooperii) across the northern breeding range of this solitary nesting, socially monogamous species. EPP and CBP combined occurred in 42%–46% of all nests among populations and hence unexpectedly were nearly equivalent to proportions of genetically monogamous nests. Select covariates failed to predict presence of EPP and CBP in part because virtually all extra‐pair adults were uncaught and likely were floaters. We found no support for the hypothesis that territorial females traded copulations for food to maximize energy intake for increased production. Our unique discoveries enhance knowledge of the extent and diversity of alternative breeding strategies among groups of avian and other animal species. [ABSTRACT FROM AUTHOR]

Reduced-intensity conditioning (RIC) regimens have the potential to decrease transplantation-related morbidity and mortality. However, engraftment failure has been prohibitively high after RIC unrelated umbilical cord blood transplantation (UCBT) in chemotherapy-naïve children with nonmalignant diseases (NMD). Twenty-two children with a median age of 2.8 years, many with severe comorbidities and prior viral infections, were enrolled in a novel RIC protocol consisting of hydroxyurea, alemtuzumab, fludarabine, melphalan, and thiotepa followed by single UCBT. Patients underwent transplantation for inherited metabolic disorders (n = 8), primary immunodeficiencies (n = 9), hemoglobinopathies (n = 4) and Diamond Blackfan anemia (n = 1). Most umbilical cord blood (UCB) units were HLA-mismatched with median infused total nucleated cell dose of 7.9 × 10(7)/kg. No serious organ toxicities were attributable to the regimen. The cumulative incidence of neutrophil engraftment was 86.4% (95% confidence interval [CI], 65% to 100%) in a median of 20 days, with the majority sustaining > 95% donor chimerism at 1 year. Cumulative incidence of acute graft-versus-host disease (GVHD) grades II to IV and III to IV by day 180 was 27.3% (95% CI, 8.7% to 45.9%) and 13.6% (95 CI, 0% to 27.6%), respectively. Cumulative incidence of extensive chronic GVHD was 9.1% (95% CI, 0% to 20.8%). The primary causes of death were viral infections (n = 3), acute GVHD (n = 1) and transfusion reaction (n = 1). One-year overall and event-free survivals were 77.3% (95% CI, 53.7% to 89.8%) and 68.2% (95% CI, 44.6% to 83.4%) with 31 months median follow-up. This is the first RIC protocol demonstrating durable UCB engraftment in children with NMD. Future risk-based modifications of this regimen could decrease the incidence of viral infections. (www.clinicaltrials.gov/NCT00744692).

Abundance of soil microbial nitrogen (N) cycling genes responsible for nitrification, denitrification, and nitrous oxide reduction may vary with tree species and N inputs, and these variables may be used to predict or mediate nitrate (NO3−) and nitrous oxide (N2O) from soil. Nitrification and denitrification rates have also been linked to tree mycorrhizal associations, as soil beneath species associated with arbuscular mycorrhiza (AM) shows greater nitrification rates than species forming ectomycorrhizal (ECM) associations. In this study, we integrated N microbial functional gene abundance in the soil influenced by six tree species in two sub-catchments receiving either high or low N inputs. The soils beneath the two ECM-associated tree species and the four AM-associated tree species were analyzed for inorganic N content and potential N2O flux and microbial gene abundance (nirK and nosZ) was quantified using qPCR techniques. Other parameters measured include soil pH, moisture, and organic matter. We determined that tree species influence NO3− and N2O production in riparian soils, particularly under high N enrichment. The soil beneath black cherry had the lowest pH, NO3− concentration, potential N2O production, and OM, though this result did not occur in the low N catchment. The strongest predictors of soil NO3− and N2O across the study sites were N enrichment and pH, respectively. These results provide a framework for species selection in managed riparian zones to minimize NO3− and N2O production and improve riparian function. [ABSTRACT FROM AUTHOR]