Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america.

Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. These guidelines for its management have been built on the previous Infectious Diseases Society of America guidelines from 2000 and include new sections. There is a discussion of the management of cryptococcal meningoencephalitis in 3 risk groups: (1) human immunodeficiency virus (HIV)-infected individuals, (2) organ transplant recipients, and (3) non-HIV-infected and nontransplant hosts. There are specific recommendations for other unique risk populations, such as children, pregnant women, persons in resource-limited environments, and those with Cryptococcus gattii infection. Recommendations for management also include other sites of infection, including strategies for pulmonary cryptococcosis. Emphasis has been placed on potential complications in management of cryptococcal infection, including increased intracranial pressure, immune reconstitution inflammatory syndrome (IRIS), drug resistance, and cryptococcomas. Three key management principles have been articulated: (1) induction therapy for meningoencephalitis using fungicidal regimens, such as a polyene and flucytosine, followed by suppressive regimens using fluconazole; (2) importance of early recognition and treatment of increased intracranial pressure and/or IRIS; and (3) the use of lipid formulations of amphotericin B regimens in patients with renal impairment. Cryptococcosis remains a challenging management issue, with little new drug development or recent definitive studies. However, if the diagnosis is made early, if clinicians adhere to the basic principles of these guidelines, and if the underlying disease is controlled, then cryptococcosis can be managed successfully in the vast majority of patients.

Responses Of Mytilus-Edulis On Exposure To The Water-Accommodated Fraction Of North-Sea-Oil

Individuals of Mytilus edulis L., collected from the Erme estuary (S.W. England) in 1978, were exposed to low concentrations (7 to 68 μg l-1) of the water-accommodated fraction (WAF) of North Sea crude oil. The pattern of accumulation of petroleum hydrocarbons in the body tissues was affected by the presence of algal food cells, the period of exposure, the hydrocarbon concentration in seawater, the type of body tissue and the nature of the hydrocarbon. Many physiological responses (e.g. rates of oxygen consumption, feeding, excretion, and scope for growth), cellular responses (e.g. lysosomal latency and digestive cell size) and biochemical responses (e.g. specific activities of several enzymes) were significantly altered by short-term (4 wk) and/or long-term (5 mo) exposure to WAF. Stress indices such as scope for growth and lysosomal latency were negatively correlated with tissue aromatic hydrocarbons.

Refugial persistence and postglacial recolonization of North America by the cold-tolerant herbaceous plant Orthilia secunda

Previous phylogeographical and palaeontological studies on the biota of northern North America have revealed a complex scenario of glacial survival in multiple refugia and differing patterns of postglacial recolonization. Many putative refugial regions have been proposed both north and south of the ice sheets for species during the Last Glacial Maximum, but the locations of many of these refugia remain a topic of great debate. In this study, we used a phylogeographical approach to elucidate the refugial and recolonization history of the herbaceous plant species Orthilia secunda in North America, which is found in disjunct areas in the west and east of the continent, most of which were either glaciated or lay close to the limits of the ice sheets. Analysis of 596-bp of the chloroplast trnS-trnG intergenic spacer and five microsatellite loci in 84 populations spanning the species' range in North America suggests that O.secunda persisted through the Last Glacial Maximum (LGM) in western refugia, even though palaeodistribution modelling indicated a suitable climate envelope across the entire south of the continent. The present distribution of the species has resulted from recolonization from refugia north and south of the ice sheets, most likely in Beringia or coastal regions of Alaska and British Columbia, the Washington/Oregon region in the northwest USA, and possibly from the region associated with the putative 'ice-free corridor' between the Laurentide and Cordilleran ice sheets. Our findings also highlight the importance of the Pacific Northwest as an important centre of intraspecific genetic diversity, owing to a combination of refugial persistence in the area and recolonization from other refugia.

Meridional mixing of water masses in the Kuroshio Extension: Origins of North Pacific Intermediate Water anomalies

Senior thesis written for Oceanography 445

Molluscan carbonate geochemistry and paleoceanography of the Late Cretaceous western interior seaway of North America

North Amerlc8 W8S inundated by fJ major eplcontlnental sea during ihe C:retaceo.us Period. The sOljihw6rd transgression of th.e northern Boreal See along the ~\festern Interior Seaway resulted in a meetlng with the northward edv6nclng waters from the GUlf of Mexico (Obradovich and Cobban, 1975). Th1s link was 1n eXlstence by late Albien time and 6llowed for the comm1ngl1ng of the prol1ferous Arctic and Gulf rnar1ne faunas (F1g. 1). By early Campanlan time, there was a widening of B6ffln Bay wlth a slrnult8neous subsidence 1n the Arct1c Archlpelago and Sverdrup 6as1n (W11liam and Stelck, 1975). Williams and Burk (1964) found 6 break 1n the marines sedlmentatlon in the f1anltoba area, suggesting Bland corlnectlon from the Dlstrlct of Keewatln through eastern M6fl1toba to the lake Sl~perlor reglon, lmplying that the only dlrect connection between the Interlor Sea with Baffln Bay, was yia the Arct1c. This hiatus was also documented by Meek and Hayden (1861) ln the United states between the Niobrara and Pierre Format1ons. Jeletzky (1971) suggested that the retreat of the sea towards the east was by a serles of strong pulses resultlng in the regression of the Campanlan and M66str1chtlan seas. During ttle Cretaceous1 the r1s1ng Corl1111era caused the western shoreline of the Interlor Sea to migrate eastwards and the Cordillera'l detritus produced deltaic cornplexes from the Mackenzie Valley to Ne\N Mexlcoo The foreland basin was continually subslding and thls down\",arplng aided in the eastward m1gration of the western shorel1ne. Thls also lndicates that trle water 'tIes becom1ng deeper in the central Plains sect10n of the Seaway (Fig. 2).

Niagara Lodges of the Loyal Orange Association of British America

The Loyal Orange Association of British America is a Protestant fraternal society. The Loyal Orange Association originated in Ulster, Ireland during the late eighteenth century. Its purpose was to promote Protestant rights and privileges. The association was exclusively Protestant, fraternal, democratic, and benevolent. Orange principles were brought to Upper Canada by Protestant Irish settlers after 1815. The first Canadian Orange Lodge was formally established in Brockville, Leeds County, 1830. By the late 19th and early 20th century, the Loyal Orange Association of British North America had gained considerable popularity and political influence. Many prominent politicians, including several prime ministers, were members. Orangemen were particularly concerned with issues such as separate school funding, language rights, immigration, religious freedom and conscription. Further, they demanded the execution of Louis Riel and opposed the Jesuits Estates settlement. Administrative sketch courtesy Archives of Ontario.

Printed blank sent to Mr. B. Allen from the Clough Stone Co. of North Amherst, Ohio, Miners and Manufacturers of Grindstones and Building Stone

Printed blank sent to Mr. B. Allen from the Clough Stone Co. of North Amherst, Ohio, Miners and Manufacturers of Grindstones and Building Stone regarding shipping. This is signed by Mr. Davis, July 19, 1876.

Environmental Influences on the Frequency and Intensity of North Indian Ocean Tropical Cyclones

Tropical cyclones genesis, movement and intensification are highly dependent on its environment both oceanic and atmospheric. This thesis has made a detailed study on the environmental factors related to tropical cyclones of North Indian Ocean basin. This ocean basin has produced only 6% of the global tropical cyclones annually but it has caused maximum loss of human life associated with the strong winds, heavy rain and particularly storm surges that accompany severe cyclones as they strike the heavily populated coastal areas. Atmospheric factors studied in the thesis are the moisture content of the atmosphere, instability of the atmosphere that produces thunderstorms which are the main source of energy for the tropical cyclone, vertical wind shear to which cyclones are highly sensitive and the Sub-Tropical westerly Jetsteram and its Asian high speed center. The oceanic parameters studied are sea surface temperature and heat storage in the top layer of the ocean. A major portion of the thesis has dealt with the three temporal variabilities of tropical cyclone frequency namely intra-seasonal (mainly the influence of Madden Julian Oscillation), inter- annual (the relation with El Nino Southern Oscillation) and decadal variabilities. Regarding decadal variability, a prominent four decade oscillation in the frequency of both tropical cyclones and monsoon depressions unique to the Indian Ocean basin has been brought out. The thesis consists of 9 chapters.

The impact of global freshwater forcing on the thermohaline circulation: adjustment of North Atlantic convection sites in a CGCM

On the time scale of a century, the Atlantic thermohaline circulation (THC) is sensitive to the global surface salinity distribution. The advection of salinity toward the deep convection sites of the North Atlantic is one of the driving mechanisms for the THC. There is both a northward and a southward contributions. The northward salinity advection (Nsa) is related to the evaporation in the subtropics, and contributes to increased salinity in the convection sites. The southward salinity advection (Ssa) is related to the Arctic freshwater forcing and tends on the contrary to diminish salinity in the convection sites. The THC changes results from a delicate balance between these opposing mechanisms. In this study we evaluate these two effects using the IPSL-CM4 ocean-atmosphere-sea-ice coupled model (used for IPCC AR4). Perturbation experiments have been integrated for 100 years under modern insolation and trace gases. River runoff and evaporation minus precipitation are successively set to zero for the ocean during the coupling procedure. This allows the effect of processes Nsa and Ssa to be estimated with their specific time scales. It is shown that the convection sites in the North Atlantic exhibit various sensitivities to these processes. The Labrador Sea exhibits a dominant sensitivity to local forcing and Ssa with a typical time scale of 10 years, whereas the Irminger Sea is mostly sensitive to Nsa with a 15 year time scale. The GIN Seas respond to both effects with a time scale of 10 years for Ssa and 20 years for Nsa. It is concluded that, in the IPSL-CM4, the global freshwater forcing damps the THC on centennial time scales.

In situ degradability of dry matter and neutral-detergent fibre of thorn scrubland forage consumed by goats in the semi-arid region of north Mexico

Three goats provided with oesophageal and ruminal cannulae were used to determine variations in dry matter (DM) and neutral-detergent fibre (NDF) degradability of the forage consumed when grazing thorn scrubland in the semi-arid region of north Mexico, during two consecutive dry and wet periods. Ingesta samples were incubated intraruminally, the data were fitted to the exponential equation P = a + b (1-e(-ct)) and statistically analysed using a randomized-block design. Organic matter and crude protein (CP) contents were higher (P < 0.05) in the wet seasons. Values of NDF were similar in dry and wet season of both years whereas higher numerical values of acid-detergent fibre (ADF), lignin and cellulose were registered in the dry seasons. DM and NDF degradabilities after 24 and 48 h of ruminal incubation were higher (P < 0.05) in the wet seasons. Higher values (P < 0.05) in DM and NDF bag losses at zero time (A fraction) were registered in the two wet seasons. The insoluble but fermentable DM and NDF (B fractions) were higher (P < 0.05) in the 1999 wet season and variable in the rest of the studied period. Numerically higher values of DM and NDF c fraction were found in wet periods, whereas DM and NDF potential degradabilities were higher (P < 0.05) in the wet season in 1999 and similar across seasons in 2000. Lowest (P < 0.05) contents of CP in grazed forage, DM and NDF degradabilities after 48 h of ruminal incubation, and A, and B, and c fractions were observed in the dry seasons. Thus, these results may be related to both the lower feeding value of forage consumed by the animals and lower performance of livestock during this period. Then, the DM and NDF degradability after 48 h, together with the insoluble but fermentable matter and the c fraction permit the nutritive value of the forage consumed by grazing goats to be accurately described.