Treatment of Primary Pulmonary Aspergillosis: An Assessment of the Evidence.

Aspergillus spp. are a group of filamentous molds that were first described due to a perceived similarity to an aspergillum, or liturgical device used to sprinkle holy water, when viewed under a microscope. Although commonly inhaled due to their ubiquitous nature within the environment, an invasive fungal infection (IFI) is a rare outcome that is often reserved for those patients who are immunocompromised. Given the potential for significant morbidity and mortality within this patient population from IFI due to Aspergillus spp., along with the rise in the use of therapies that confer immunosuppression, there is an increasing need for appropriate initial clinical suspicion leading to accurate diagnosis and effective treatment. Voriconazole remains the first line agent for therapy; however, the use of polyenes, novel triazole agents, or voriconazole in combination with an echinocandin may also be utilized. Consideration as to which particular agent and for what duration should be made in the individual context for each patient based upon underlying immunosuppression, comorbidities, and overall tolerance of therapy

Evolution of planetesimal velocities

A self-consistent set of equations for the velocity evolution of a general planetesimal population is presented. The equations are given in a form convenient for calculations of the early stages of planetary accumulation when it is necessary to model the planetesimal swarm by methods of gas dynamics, rather than follow the orbital evolution of individual bodies. Steady state velocities of a simple planetesimal population consisting of two different sizes of bodies are calculated. Dynamical friction is found to be an important mechanism for transferring kinetic energy from the larger planetesimals to the smaller ones. When the small planetesimals are relatively abundant, gas drag and inelastic collisions among the smaller bodies are of comparable importance for dissipating energy from the population

Correction: Stewart, E.R.; Thompson, G.R. Treatment of Primary Pulmonary Aspergillosis: An Assessment of the Evidence. J. Fungi 2016, 2, 25.

The authors of the published paper [1] would like to correct Table 1.[...]

Medical Care of AIDS in New England: Costs and Implications

This article presents an overview of cost issues related to AIDS. Data from the Massachusetts Cost of AIDS Study are combined with epidemiological projections to estimate the cost of treating people diagnosed with AIDS in New England. Aggregate inpatient, ambulatory, and home care costs are estimated to be $96.9 million and$524.8 million through 1987 and 1991, respectively. These estimates represent a relatively small percentage of total health care costs for all illnesses over the same time period. The authors find that the cost of treating AIDS does not affect all health care providers uniformly and therefore argue that appropriate measures must be developed to assist those impacted disproportionately. Reduction of inpatient hospital days through the creation of subacute care centers, subsidy programs for medical care providers serving large numbers of uninsured or underinsured AIDS patients and education to prevent new cases are recommended to continue the availability of medical care for people with AIDS

Coccidioidomycosis Complement Fixation Titer Trends in the Age of Antifungals.

Coccidioidomycosis is associated with a broad spectrum of illness severity, ranging from asymptomatic or self-limited pulmonary infection to life-threatening manifestations of disseminated disease. Serologic studies before the widespread availability of antifungals established current understanding of serologic kinetics and dynamics. Chart histories and complement fixation (CF) titer trends were analyzed for 434 antifungal-treated coccidioidomycosis patients, who were classified by three infectious disease physicians as having either pulmonary uncomplicated coccidioidomycosis (PUC) (n = 248), pulmonary chronic coccidioidomycosis (PCC) (n = 64), disseminated coccidioidomycosis (DC) not including meningitis (n = 86), or coccidioidal meningitis (CM) (n = 36). The median maximal CF titers were 1:4 for PUC patients, 1:24 for PCC patients, 1:128 for DC patients, and 1:32 for CM patients. Approximately 25.4% of PUC patients, 6.2% of PCC patients, 2.3% of DC patients, and 8.3% of CM patients did not develop detectable titers during the study period. Maximal titers developed a mean of 31 days (95% confidence interval [CI], 13 to 50 days) after initial serologic positivity, with no significant differences between groups. Serologic recurrence occurred in 9% of PUC patients, 36% of PCC patients, 50% of DC patients, and 52% of CM patients. Median titer improvement rates were 91 days/dilution for PUC patients, 112 days/dilution for PCC patients, 136 days/dilution for DC patients, and 146 days/dilution for CM patients. Receiver operating characteristic (ROC) analysis revealed that CF testing retains moderate classification value for disseminated infections (area under the curve [AUC], 0.82 [95% CI, 0.78 to 0.87]) and complicated infections (AUC, 0.82 [95% CI, 0.77 to 0.86]). A suitable cutoff value for complicated infections is ≥1:32. Findings update serologic parameters that are relevant for clinical assessment of coccidioidomycosis patients in the triazole era

Recovery of absolute absorption line shapes in tunable diode laser spectroscopy using external amplitude modulation with balanced detection

Accurate recovery of an absorption lineshape is important in many industrial applications for simultaneous measurement of gas concentration and pressure or temperature. Here we demonstrate a method, based on a modification to the Hobbs balanced receiver circuit, for background signal nulling when external amplitude modulation of the laser output is used. Compared with direct or non-nulled detection techniques, we demonstrate that the method significantly improves the signal to noise ratio to a level comparable to that of conventional second harmonic wavelength modulation spectroscopy. Most importantly, normalisation and recovery of the lineshape is straightforward and immune to the difficulties that afflict lineshape recovery with conventional wavelength modulation spectroscopy

RXTE monitoring observations of Markarian 3

We present Rossi X-ray Timing Explorer, monitoring observations of the Seyfert 2 galaxy Markarian 3 spanning a 200 day period during which time the source flux varied by a factor $\sim 2$ in the 4-20 keV bandpass. In broad agreement with earlier Ginga results, the average spectrum can be represented in terms of a simple spectral model consisting of a very hard power-law continuum ($\Gamma \approx 1.1$) modified below $\sim 6$ keV by a high absorbing column ($N_H\sim 6\times 10^{23}$ \cunits) together with a high equivalent width Fe-K emission feature at 6.4 keV. The abnormally flat spectral index is probably the signature of a strong reflection component and we consider two models incorporating such emission. In the first the reflected signal suffers the same absorption as the intrinsic continuum, whereas in the second the reflection is treated as an unabsorbed spectral component. In the former case, we require a very strong reflection signal ($R ~< 3$) in order to match the data; in addition variability of both the intrinsic power-law and the reflection component is required. The unabsorbed reflection model requires a somewhat higher line-of-sight column density to the nuclear source ($\sim 10^{24}$ \cunits), but in this case the reflected signal remains constant whilst the level of the intrinsic continuum varies. The latter description is consistent with the reflection originating from the illuminated far inner wall of a molecular torus, the nearside of which screens our direct view of the central continuum source.Comment: 7 pages, submitted to the MNRA

Acceptance Test for Jetstream Test Cluster — Jetstream-Arizona (JA) Dell PowerEdge Test and Development Cluster

This paper details the system description and the performance targets, methods used to perform the acceptance tests, and the achieved performance of the Jetstream test cluster.National Science Foundation Award ACI-1445604: Jetstream - A Self-Provisioned, Scalable Science and Engineering Cloud Environment, Craig A. Stewart, IU, Principal Investigator