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

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

Factors influencing wetland use by Canada geese

Seasonal and semi-permanent wetlands in eastern South Dakota were surveyed in 1995 and 1996 to identify habitat characteristics influencing wetland use by Canada geese (Branta canadensis maxima). Position of a wetland within the landscape and its area were important landscape-scale features influencing wetland use by geese. Our delineation of potential Canada goose habitat using a wetland geographic information system indicated that distribution and area of semi-permanent wetlands likely limit Canada goose occurrence in regions outside the Prairie Coteau. Periodicity in hydrologic cycles within landscapes also may influence goose use of wetlands in eastern South Dakota

Using Interleukin 6 and 8 in Blood and Bronchoalveolar Lavage Fluid to Predict Survival in Hematological Malignancy Patients With Suspected Pulmonary Mold Infection.

Background: Molds and other pathogens induce elevated levels of several cytokines, including interleukin (IL)-6 and IL-8. The objective of this study was to investigate the prognostic value of IL-6 and IL-8 as well as fungal biomarkers in blood and bronchoalveolar lavage fluid (BAL) for overall survival in patients with underlying hematological malignancies and suspected mold infection. Methods: This cohort study included 106 prospectively enrolled adult cases undergoing bronchoscopy. Blood samples were collected within 24 h of BAL sampling and, in a subset of 62 patients, serial blood samples were collected up until 4 days after bronchoscopy. IL-6, IL-8, and other cytokines as well as galactomannan (GM) and β-D-glucan (BDG) were assayed in blood and BAL fluid and associations with overall mortality were assessed at the end of the study using receiver operating characteristic (ROC) curve analysis. Results: Both blood IL-8 (AUC 0.731) and blood IL-6 (AUC 0.699) as well as BAL IL-6 (AUC 0.763) and BAL IL-8 (AUC 0.700) levels at the time of bronchoscopy were predictors of 30-day all-cause mortality. Increasing blood IL-6 levels between bronchoscopy and day four after bronchoscopy were significantly associated with higher 90-day mortality, with similar findings for increasing IL-8 levels. In ROC analysis the difference of blood IL-8 levels between 4 days after bronchoscopy and the day of bronchoscopy had an AUC of 0.829 (95%CI 0.71-0.95; p < 0.001) for predicting 90-day mortality. Conclusions: Elevated levels of IL-6 and IL-8 in blood or BAL fluid at the time of bronchoscopy, and rising levels in blood 4 days following bronchoscopy were predictive of mortality in these patients with underlying hematological malignancy who underwent bronchoscopy for suspected mold infection

Harvest Demographics of Temperate-breeding Canada Geese in South Dakota, 1967–1995

In South Dakota, breeding giant Canada geese (Branta canadensis maxima) have increased substantially, and harvest management strategies have been implemented to maximize hunting opportunity (e.g., special early-September seasons) on local, as well as molt-migrant giant Canada geese (B. c. interior) while still protecting lesser abundant Arcticbreeding Canada geese and cackling geese (e.g., B. hutchinsii, B. minima). Information on important parameters, such as survival and recovery rates, are generally lacking for giant Canada geese in the northern Great Plains. Patterns in Canada goose band recoveries can provide insight into the distribution, chronology, and harvest pressures to which a given goose population segment is exposed. We studied spatial and temporal recovery patterns of molting Canada geese during annual banding efforts in South Dakota between 1967 and 1995. Recovery rates (% ± SE) for Canada geese increased over time in both western South Dakota (0.034 ± 0.005 [1967 to 1976], 0.056 ± 0.009 [1977 to 1986]) and eastern (0.026 ± 0.002 [1967 to 1978], 0.058 ± 0.003 [1987 to 1995]) South Dakota. Although recovery rates for Canada geese west of the Missouri River (WR) and east of the Missouri River (ER) were relatively similar, recovery distribution and harvest chronology indicate spatial and temporal differences for geese banded in these 2 geographic regions. Overall, Canada geese banded in South Dakota were recovered in 23 states and 5 Canadian provinces, and recovery distribution varied relative to banding region. Distribution of recoveries suggests a south-southwesterly movement for WR-banded geese compared to a south-southeasterly movement for ERbanded geese. For WR-banded geese, 40 to 52% and 30 to 34% of direct and indirect recoveries, respectively, occurred in December. In contrast, for ER-banded geese, 19 to 38% and 15 to 19% of direct and indirect recoveries, respectively, occurred in December. Waterfowl managers need to consider that recovery rates and harvest chronology of banded giant Canada geese may vary geographically within a state or province. Refinement of harvest management strategies at multiple spatial scales may be required