Treatment of Aspergillosis.

Infections caused by Aspergillus spp. remain associated with high morbidity and mortality. While mold-active antifungal prophylaxis has led to a decrease of occurrence of invasive aspergillosis (IA) in those patients most at risk for infection, breakthrough IA does occur and remains difficult to diagnose due to low sensitivities of mycological tests for IA. IA is also increasingly observed in other non-neutropenic patient groups, where clinical presentation is atypical and diagnosis remains challenging. Early and targeted systemic antifungal treatment remains the most important predictive factor for a successful outcome in immunocompromised individuals. Recent guidelines recommend voriconazole and/or isavuconazole for the primary treatment of IA, with liposomal amphotericin B being the first alternative, and posaconazole, as well as echinocandins, primarily recommended for salvage treatment. Few studies have evaluated treatment options for chronic pulmonary aspergillosis (CPA), where long-term oral itraconazole or voriconazole remain the treatment of choice

Dispersal Movements of Subadult Cougars From the Black Hills: The Notions of Range Expansion and Recolonization

Dispersal plays a vital role in cougar (Puma concolor) population ecology, creating genetic viability and maintaining gene flow between populations. The naturally recolonized cougar population in the Black Hills is at the edge of the species’ range in North America and completely surrounded by the grasslands of the Northern Great Plains. Our objective was to document dispersal movements and possible range expansion of subadult cougars captured within the Black Hills ecosystem of southwestern South Dakota and eastern Wyoming. Twenty-four (n ¼ 14 males, n ¼ 10 females) subadult cougars were captured in the Black Hills. Independence of cougars from females averaged 13.5 months (range ¼ 10–16 months) from parturition; dispersal occurred 1–3 months post independence. Males dispersed (mean ¼ 274.7 km SE 88.3) farther than females (mean ¼ 48.0 km SE 10.9), with females exhibiting 40% philopatry. We documented several (n ¼ 6) long-distance dispersal movements (.250 km) of male cougars and hypothesize that males making long-distance movements were in search of available mates. The long distance cougar dispersal movements documented by our study indicate that range expansion and habitat recolonization are occurring and further suggest proactive efforts to increase public knowledge of cougar ecology in areas where cougars are recolonizing previously occupied range

An Exploration of International Students’ Institutional Experiences at Cedarville University

The purpose of this study was to understand the institutional experience of international students on the campus of Cedarville University. The study utilized a phenomenological qualitative method with a sample of 18 students who represented 14 nations. Semi-structured interviews were conducted and transcribed, and the following themes were found: perception of academic challenges, programs that have been helpful/unhelpful in their adjustment to life at the University, and changes they would make that would be helpful to them. Our findings suggested that international students found the academics of Cedarville University to be more challenging than they expected, but the professors were approachable. Programs such as Orientation for international students/missionary kids/third culture kids, the international student organization, and the campus academic enrichment center were helpful for them because they provided introductions to both international and American communities and one-on-one help with academics. Students suggested that help with applying to the university and for a visa along with help integrating into work life once they are here would be helpful changes for them. Students also suggested that it would be helpful for them if the university took action in promoting cultural awareness on campus

Misdiagnosis, Mistreatment, and Harm - When Medical Care Ignores Social Forces.

The Case Studies in Social Medicine demonstrate that when physicians use only biologic or individual behavioral interventions to treat diseases that stem from or are exacerbated by social factors, we risk harming the patients we seek to serve

Dietery Response of Sympatric Deer to Fire Using Stable ISotope Analysis of Liver Tissue

Carbon (δ13C) and nitrogen (δ15N) isotopes in biological samples from large herbivores identify photosynthetic pathways (C3 vs. C4 ) of plants they consumed and can elucidate potential nutritional characteristics of dietary selection. Because large herbivores consume a diversity of forage types, δ13C and δ15N in their tissue can index ingested and assimilated diets through time. We assessed δ13C and δ15N in metabolically active liver tissue of sympatric mule deer (Odocoileus hemionus) and white-tailed deer (O. virginianus) to identify dietary disparity resulting from use of burned and unburned areas in a largely forested landscape. Interspecific variation in dietary disparity of deer was documented 2–3 years post-fire in response to lag-time effects of vegetative response to burning and seasonal (i.e., summer, winter) differences in forage type. Liver δ13C for mule deer were lower during winter and higher during summer 2 years post-fire on burned habitat compared to unburned habitat suggesting different forages were consumed by mule deer in response to fire. Liver δ15N for both species were higher on burned than unburned habitat during winter and summer suggesting deer consumed more nutritious forage on burned habitat during both seasons 2 and 3 years post-fire. Unlike traditional methods of dietary assessment that do not measure uptake of carbon and nitrogen from dietary components, analyses of stable isotopes in liver or similar tissue elucidated δ13C and δ15N assimilation from seasonal dietary components and resulting differences in the foraging ecology of sympatric species in response to fire

Incidental Captures of Plains Spotted Skunks in Central South Dakota

The plains spotted skunk (Spilogale putorius interrupta) had a historically broad distribution in the central United States, extending from the Mississippi River west to the Rocky Mountains. This subspecies of the eastern spotted skunk (S. putorius) has experienced population declines in recent decades possibly due to habitat loss and reduction of prey through conversion of grasslands and forests to croplands, as well as reductions in abandoned buildings, fence rows, creek bottoms, and wood piles throughout the region (Crabb 1948, Kaplan and Mead 1991, Gompper and Hackett 2005, Sasse 2017). Woody debris provides access to prey, and a dense understory and overhead cover provide camouflage and protection from avian predators (Lesmeister et al. 2013, Eng et al. 2018). Overharvest, disease, pesticide use, and expanding or increasing predator populations might also have contributed to population declines (Gompper and Hackett 2005, Gompper 2017). Because the plains spotted skunk is currently under consideration for federal protection under the Endangered Species Act (U.S. Fish and Wildlife Service 2012), it is important to communicate new information on abundance, distribution and ecology of the subspecies. Furthermore, limited data exist on incidental captures of plains spotted skunks by researchers and state agencies (Diggins et al. 2015, Sasse 2018). Data collected through live-capture and non-invasive techniques are needed to improve the effectiveness of management and the understanding of this subspecies (Hackett et al. 2007)

Incidental Captures of Plains Spotted Skunks in Central South Dakota

The plains spotted skunk (Spilogale putorius interrupta) had a historically broad distribution in the central United States, extending from the Mississippi River west to the Rocky Mountains. This subspecies of the eastern spotted skunk (S. putorius) has experienced population declines in recent decades possibly due to habitat loss and reduction of prey through conversion of grasslands and forests to croplands, as well as reductions in abandoned buildings, fence rows, creek bottoms, and wood piles throughout the region (Crabb 1948, Kaplan and Mead 1991, Gompper and Hackett 2005, Sasse 2017). Woody debris provides access to prey, and a dense understory and overhead cover provide camouflage and protection from avian predators (Lesmeister et al. 2013, Eng et al. 2018). Overharvest, disease, pesticide use, and expanding or increasing predator populations might also have contributed to population declines (Gompper and Hackett 2005, Gompper 2017). Because the plains spotted skunk is currently under consideration for federal protection under the Endangered Species Act (U.S. Fish and Wildlife Service 2012), it is important to communicate new information on abundance, distribution and ecology of the subspecies. Furthermore, limited data exist on incidental captures of plains spotted skunks by researchers and state agencies (Diggins et al. 2015, Sasse 2018). Data collected through live-capture and non-invasive techniques are needed to improve the effectiveness of management and the understanding of this subspecies (Hackett et al. 2007)

Dietary Response of Sympatric Deer to Fire Using Stable Isotope Analysis of Liver Tissue

Carbon (δ13C) and nitrogen (δ15N) isotopes in biological samples from large herbivores identify photosynthetic pathways (C3 vs. C4 ) of plants they consumed and can elucidate potential nutritional characteristics of dietary selection. Because large herbivores consume a diversity of forage types, δ13C and δ15N in their tissue can index ingested and assimilated diets through time. We assessed δ13C and δ15N in metabolically active liver tissue of sympatric mule deer (Odocoileus hemionus) and white-tailed deer (O. virginianus) to identify dietary disparity resulting from use of burned and unburned areas in a largely forested landscape. Interspecific variation in dietary disparity of deer was documented 2–3 years post-fire in response to lag-time effects of vegetative response to burning and seasonal (i.e., summer, winter) differences in forage type. Liver δ13C for mule deer were lower during winter and higher during summer 2 years post-fire on burned habitat compared to unburned habitat suggesting different forages were consumed by mule deer in response to fire. Liver δ15N for both species were higher on burned than unburned habitat during winter and summer suggesting deer consumed more nutritious forage on burned habitat during both seasons 2 and 3 years post-fire. Unlike traditional methods of dietary assessment that do not measure uptake of carbon and nitrogen from dietary components, analyses of stable isotopes in liver or similar tissue elucidated δ13C and δ15N assimilation from seasonal dietary components and resulting differences in the foraging ecology of sympatric species in response to fire

Vegetative Characteristics of Pronghorn Bed Sites in Wind Cave National Park, South Dakota

Much of the previous literature on pronghorn (Antilocapra americana) fawns has focused on fawn mortality (Beale 1978, Barrett 1984, Gregg et al. 2001) and social behavior (Kitchen 1974, Autenrieth and Fichter 1975, Bromley 1977). Selection of bed sites by pronghorn fawns is a major factor affecting fawn survival (Bromley 1978, Barrett 1981, O\u27Gara et al. 1986, VanSchmus 1990) because adequate cover is a crucial component of fawn bed site selection (Autenrieth 1984). Alldredge et al. (1991) reported that fawns selected dense shrub cover but avoided the most-dense cover in sagebrush-steppe communities in southcentral Wyoming while Tucker and Gamer (1983) noted that height and density of vegetation provided concealment cover to hiding fawns. Canon and Bryant (1997) also found density and height of vegetation to be factors affecting survival of fawns and suggested that increased grass and forb production provided necessary hiding cover for fawns. Bromley (1978) and Smith and Beale (1980) noted that fawns selected bed sites that offered the greatest opportunity for visual detection of predators rather than concealment The pronghorn was reintroduced into Wind Cave National Park, South Dakota, i 1914 and thus, has been maintained within its boundaries for nearly a century However, no information is available on fawning habitat within Wind Cave National Park. The objective of our study was to quantity vegetative characteris tics of fawn bed sites throughout Wind Cave National Park

Vegetative Characteristics of Pronghorn Bed Sites in Wind Cave National Park, South Dakota

Much of the previous literature on pronghorn (Antilocapra americana) fawns has focused on fawn mortality (Beale 1978, Barrett 1984, Gregg et al. 2001) and social behavior (Kitchen 1974, Autenrieth and Fichter 1975, Bromley 1977). Selection of bed sites by pronghorn fawns is a major factor affecting fawn survival (Bromley 1978, Barrett 1981, O\u27Gara et al. 1986, VanSchmus 1990) because adequate cover is a crucial component of fawn bed site selection (Autenrieth 1984). Alldredge et al. (1991) reported that fawns selected dense shrub cover but avoided the most-dense cover in sagebrush-steppe communities in southcentral Wyoming while Tucker and Gamer (1983) noted that height and density of vegetation provided concealment cover to hiding fawns. Canon and Bryant (1997) also found density and height of vegetation to be factors affecting survival of fawns and suggested that increased grass and forb production provided necessary hiding cover for fawns. Bromley (1978) and Smith and Beale (1980) noted that fawns selected bed sites that offered the greatest opportunity for visual detection of predators rather than concealment The pronghorn was reintroduced into Wind Cave National Park, South Dakota, i 1914 and thus, has been maintained within its boundaries for nearly a century However, no information is available on fawning habitat within Wind Cave National Park. The objective of our study was to quantity vegetative characteris tics of fawn bed sites throughout Wind Cave National Park