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For example diabetes symptoms with alcohol discount glycomet 500mg with visa, digital acoustic recording tags provide sophisticated metrics to estimate the energy cost of diving, which can be incorporated with energy models to investigate the implications of disrupted feeding behavior. A feeding whale needs to take in more energy than it expends, allowing a reserve for growth and reproduction. Tyack observed that controlled exposure experiments are proving highly informative for characterizing and quantifying whale responses to sound. Apart from overt behavior, effects that are less readily observed and measured might also be biologically significant. For example, male blue whales produce low-frequency calls for reproductive advertisement. Tyack pointed out that because blue (and fin) whale calls might be heard at distances of up to 1,000 km, their mating system(s) could have evolved to depend on breeding advertisement over vast geographical distances, and the increased ambient noise from ship traffic and other sources may have reduced their potential range of communication by an order of magnitude. It is possible that the whales are managing to compensate for such degradation of their acoustic environment, but in any event, this relatively subtle effect would be exceedingly difficult to detect and measure. Cumulative and synergistic impacts further complicate matters, as repeated or multiple exposures to sound, in combination with other factors such as fisheries bycatch or chemical pollution, may lead to more serious effects. The overall impacts of sound on marine ecosystems (of which marine mammals are a part) also merit consideration. Topic 2: Introduction to National and International Legal and Regulatory Frameworks for Marine Mammals and Human Generated Sound the central topic addressed in this section of the workshop was the range of national and international laws and regulatory mechanisms governing acoustic impacts on marine mammals. The session was organized around a series of short presentations, abstracts of which are provided in Appendix 3. A number of posters also addressed aspects of this topic (Appendix 4, note especially posters 4, 15, 23, 26, and 27). Tasker gave a brief summary of the various frameworks and instruments in Europe under which anthropogenic sound in the marine environment could be managed, including international regional seas conventions, international conservation agreements, international economic integration organizations, and national laws. The regional seas conventions generally define pollution as substances or energy that cause harm to living resources. Therefore, they arguably have the potential to be used as frameworks for providing protection to marine mammals from the adverse effects of human-generated sound. Most regional seas conventions have a framework under which more detailed agreements or resolutions may be set; as yet, however, none has 3 See. The resolution would call for more research on the effects of sound on cetaceans and the development of guidelines (with the use of sound prohibited until these are in place). Specific resolutions for whale-watching and the use of 10 acoustic harassment devices are also likely. The major international economic integration organization in the region is the European Union (E. The Habitats Directive calls for the creation of protected areas (for seals, bottlenose dolphins, and harbor porpoises), with strict protection of designated species, including prohibitions on indiscriminate killing or deliberate disturbance of cetaceans. Both Directives allow for public participation, encourage relevant research, and require measures to reduce the effects of harmful activities. Member States are individually responsible for implementation of the Directives; the timing and mode of compliance varies significantly from one country to another. Tasker provided a brief overview of relevant national legislation in the United Kingdom, which has sought to implement and apply the E. Their implementation, with respect to human-generated sound, has varied across sectors. For shipping, fisheries, and aggregate extraction sectors, no requirements currently exist. Those efforts began after Frantzis (1998) called world attention to the 1996 strandings of Cuviers beaked whales in Greece coincident in space and time with the deployment of military sonar. According to Carron, about half of the known mass strandings of Cuviers beaked whales have been associated with nearby military operations. Except in a few of these cases, no direct link has been established between the military operations and the strandings. Scientists must adhere to instructions and protocols for human and marine mammal risk mitigation. Following Carrons presentation, attention was called to the fact that Australias naval forces are engaged in extensive efforts to mitigate the potential effects of their sound-producing activities on marine mammals (see Appendix 4, poster 25). The 15 System was initiated under a 1959 framework agreement (the Antarctic Treaty), which includes 45 sovereign States as Contracting Parties, 28 of which are Consultative. The Antarctic continent is a demilitarized natural reserve where peace and science are supposed to prevail. Member States have the right to make inspections of any installations in the System area at any time and the right to conduct scientific investigations anywhere. Under the 1991 Protocol, all activities are subject to environmental impact assessment and monitoring. Agreements within the System are reached by consensus, and implementation depends on national compliance. Walton noted that consensus is often more easily achieved on guidelines than on legal changes, and that overlapping jurisdictions can cause problems. National legislation by Member States may establish more stringent requirements than those of the Treaty System, and in fact, the permitting of activities may involve multiple agencies and governments. His presentation, together with the background documents, provided (a) a review of available information on anthropogenic marine sound and its implications in the Antarctic, (b) suggested mitigation measures, (c) a proposed approach to risk analysis for use in impact assessments prior to issuance of permits for sound-generating activities, and (d) an attempt to establish background levels of underwater sound against which to assess further inputs from human activities. Although no military exercises or oil and gas industry seismic exploration occurs in Antarctic waters, anthropogenic sound is of some concern in the region. According to Walton, ship traffic, seismic research, and ice breaking are the principal sources of anthropogenic sound in the Antarctic at present. There is some controversy over the extent to which these activities may affect the regions marine mammals. In discussion, Wolfgang Dinter of Germanys Federal Agency for Nature Conservation, which advises the German Federal Ministry for the Environment, Nature Conservation and Nuclear 15 See. These were summarized in a document circulated at the workshop in response to Waltons background documents and presentation (Federal Agency for Nature Conservation/BfN [Germany] 2004). The features include inter alia (a) the Systems dedication to comprehensive ecosystem protection and (b) a prohibition on taking, or harmfully interfering with, any mammal except under permit. Walton responded that (a) environmental protection is a relatively new aspect of Antarctic Treaty goals. In his view, a risk assessment approach needs to be used more often to evaluate proposed activities in the Antarctic. Thus, if the potential impacts of a sound-producing activity were interpreted to constitute taking under either law, the activity would be subject to regulation. The specific regulations and permitting requirements that apply depend on the type of activity. These Measures address species protection and protected area designation within the Treaty System. Latin America Monica Borobia (Brazil) indicated that policies and regulatory frameworks concerning marine mammals and sound are either in early developmental stages or have yet to be addressed in most Latin American countries (broadly defined as those in South and Central America, the Caribbean, and Mexico). She cited three main mechanisms available in Latin America to address marine mammal protection and anthropogenic sound production at the national level: (a) general environmental regulations (including directives, licensing guidelines, and action plans), (b) designation of protected areas, and (c) special protection for endemic or threatened species. Some nations also participate in regional agreements 31 such as the United Nations Environment Programmes Regional Seas Conventions and Associated Protocols on Specially Protected Areas and Wildlife, notably in the Wider Caribbean and South-East Pacific regions where attention to marine mammals, nationally and regionally through action plans and other initiatives or instruments, has been longstanding. As is generally the case with multilateral and regional agreements, implementation is left to the member states and varies widely. Borobia offered more specific information related to Brazils licensing regulations for seismic operations by the oil and gas industry. Under a recent presidential decree, the Venezuelan Ministry of Environment and Natural Resources has been developing terms of reference for environmental impact assessments and various related studies in the oil and gas sector, with an explicit focus on evaluation and regulation of the effects of anthropogenic sound. Moreover, independent and governmental observers working onboard active seismic survey vessels in Venezuelan waters have reported changes in behavior and avoidance reactions by baleen whales. Asia/Pacific Rim John Wang (FormosaCetus Research and Conservation Group, Taiwan) presented a paper (authored by himself and eight co-authors) that focused on policies and legislation in 13 Southeast Asian countries: China (including Hong Kong), Taiwan, Philippines, Vietnam, Laos, Cambodia, Thailand, Malaysia, Singapore, Brunei, Indonesia, East Timor, and Australia. Although most of those countries confer full legal protection to marine mammals, implementation and enforcement of existing laws are generally lacking, and little effort has been made to assess or manage the potential impacts of human-generated underwater sound in the region. The only one of these classes of potentially harmful activities that is likely to decline in the immediate future is blast fishing; all others are almost certain to increase.

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Secondary septicemia is common diabetes medications for elderly buy discount glycomet 500mg on line, as greater than 80 percent of blood cultures are positive for the organism in patients with bubonic plague. In humans, the mortality of untreated bubonic plague is approximately 60 percent, but this is reduced to less than 5 percent with prompt, effective therapy. Plague septicemia can produce thromboses in the acral vessels (presumably assisted by a low-temperature-activated coagulase protein produced by the organism), possibly leading to necrosis and gangrene, and disseminated intravascular coagulation; thus, black necrotic appendages may be accompanied by more proximal, purpuric lesions due to endotoxemia in advanced disease. Organisms can spread via the bloodstream to the lungs and, less commonly, to the central nervous system and elsewhere. Pneumonic plague is an infection of the lungs due to either inhalation of the organisms (primary pneumonic plague), or spread to the lungs from septicemia (secondary pneumonic plague). Secondary pneumonic plague has been a complication in 12% of bubonic cases in the U. Although bloody sputum is characteristic, it can sometimes be watery or, less commonly, purulent. The chest X-ray findings are variable, but most commonly reveal bilateral infiltrates, which may be patchy or consolidated. Pneumonic plague is the only form of plague disease which readily spreads from person to person. Meningitis is a rare complication of plague (up to 6 % of patients with septicemia, more common in children), most often occurring in bubonic or septicemic plague patients a week or more into illness. The blood urea nitrogen, creatinine, transaminases, and bilirubin may also be elevated, consistent with multiorgan failure. A patient with a painful bubo accompanied by fever, severe malaise and possible rodent exposure in an endemic area should raise suspicion of bubonic plague. Bubo aspirates can be obtained by inserting a 20 gauge needle on a 10ml syringe containing 1ml of sterile saline; saline is injected and withdrawn until blood tinged. Any patient with suspected plague should have blood cultures performed; as bacteremia can be intermittent, multiple cultures should be obtained, preferably prior to receipt of antibiotics (clinical severity permitting). Confirmative culture-based diagnosis is conducted via specific bacteriophage lysis of the organism, which is available at reference laboratories. A single anti-F1 titer of >1:10 by agglutination testing is suggestive of plague, while a single titer of >1:128 in a patient who has not previous been exposed to plague or received a plague vaccine is more specific; a fourfold rise in acute vs. Patients with uncomplicated bubonic plague often demonstrate resolution of fever and other systemic symptoms within 3-5 days, while more complicated bubonic disease, septicemic, and pneumonic plague often result in extended hospital courses. It is imperative that antibiotics are adjusted for demonstrated susceptibility patterns for the infecting strain; naturally-occurring strains have been reported which are resistant to streptomycin, tetracyclines, and chloramphenocol, and it is anticipated that weaponized plague could be intentionally rendered antibiotic resistant. Despite typically good in vitro susceptibilities to penicillins and cephalosporins, these antibiotics are generally felt to be ineffective in treating plague; in fact, animal studies suggest that beta lactam antibiotics may accelerate mortality in bacteremic mice. Pneumonic plague patients being transported should wear a surgical mask when feasible. It protected mice for a year against an inhalational challenge, and is now being tested in primates. Postexposure prophylaxis: Face-to-face contacts (within 2 meters) of patients with pneumonic plague or persons possibly exposed to a plague aerosol. Trimethoprim sulfamethoxazole may represent a second-line alternative, should susceptibilities allow. Chemoprophylaxis is generally not recommended after contact with bubonic or septicemic plague patients; however, individuals making such contacts, especially if sharing the same environment in which the patient received a natural exposure, should be observed for symptoms for a week. Chronic Q fever should be treated with combination therapy, either doxycycline plus quinolones for 4 years, or doxycycline plus hydroxychloroquine for 1 to 3 years. Prophylaxis: Chemoprophylaxis begun too early during the incubation period may delay but not prevent the onset of symptoms. Patients exposed to Q fever by aerosol do not present a risk for secondary contamination or re aerosolization of the organism. Its natural reservoirs are sheep, cattle, goats, cats, some wild animals (including rodents), and ticks. The organism localizes in the gravid uterus and mammary glands of infected animals and is shed in high numbers at parturition, whether at or before term. Transmission to humans is typically via aerosolization of infectious particles such as from premises contaminated with fetal membranes, birth fluids, aborted fetuses, and excreta from infected animals in locations where infected animals and their by-products are processed, and at necropsy sites. Infection in livestock occasionally results in abortion, stillbirth, and dystocia, but is often asymptomatic. Transmission also occurs by ingesting contaminated raw milk and cheese, through blood product transfusions, vertically (mother to offspring), and by tick vectors. Exposure to infected animals at parturition is an important risk factor for endemic disease. Humans acquire the disease primarily by inhaling aerosols contaminated with the organism. Coxiella burnetii is also a significant hazard in laboratory personnel who are working with the organism. Of those who develop clinically apparent disease, less than 5 percent will be ill enough to require hospitalization. Fever typically increases to a plateau over 2-4 days then ends abruptly after 1-2 weeks; untreated, fever duration ranges from 5-57 days. While a febrile syndrome with headache is probably the most common clinical presentation, atypical pneumonia or acute hepatitis syndromes are common as well, and tend to follow a geographical distribution; for example, pneumonia predominates in Nova Scotia, while hepatitis predominates in France. Rounded or nodular focal opacities, hilar adenopathy, or effusions have less frequently been described. Pleuritic chest pain occurs in about one-fourth of patients with Q fever pneumonia. Mortality rate is <3 percent and most patients recover within several months even without treatment. Acute Q fever hepatitis, seen in 30-60 percent of reported cases, typically manifests itself only as elevated liver associated enzymes in conjunction with the nonspecific febrile syndrome described already. This mild hepatitis may occur in conjunction with atypical pneumonia or in the absence of a febrile syndrome as well. While hepatomegaly is common, abdominal pain, anorexia, nausea, vomiting, and diarrhea are less so, and jaundice is rare. Other findings associated with acute Q fever include pericarditis (present in approximately 1 percent), myocarditis (0. The primary complication of acute Q fever is the development of chronic disease, which develops in less than 5 percent of acute cases and most commonly presents as endocarditis; but it may also present as osteoarticular disease, vascular infection, or granulomatous hepatitis. Endocarditis accounts for 60-70 percent of all chronic Q fever cases; 90 percent of all cases of endocarditis develop in patients with underlying cardiac valvular defects (congenital, rheumatic, degenerative, or infectious). Endocarditis patients usually present with heart failure or valvular dysfunction, often after a remittent febrile illness with malaise, fatigue, weight loss, and sweats. Findings that accompany endocarditis include vegetative lesions on valves (seen on echocardiography in less than 25 percent of patients, predominantly aortic and prosthetic), clubbing of digits, hepatomegaly and splenomegaly (half of patients), arterial emboli (1/3 of patients), and purpura (20 percent of patients). Acute Q fever during pregnancy (especially in the first 2 trimesters) is associated with an increased incidence of fetal death, premature delivery, and low birth weights; the majority of these pregnant women will develop chronic Q fever. More rapidly progressive forms of Q fever pneumonia may look like bacterial pneumonias such as tularemia or plague. If significant numbers of soldiers from the same geographic area are presenting over 1 to 2 weeks with a nonspecific febrile illness with associated pulmonary symptoms in about 25 percent of cases, attack with aerosolized C. Laboratory Diagnosis: A complete blood count is usually unremarkable excepting leukocytosis and/or thrombocytopenia in up to one third of patients in the acute phase. Hepatitis patients and those with chronic Q fever frequently have circulating autoantibodies, including anti-smooth muscle, anti-cardiolipin, anti-phospholipid, anti-clotting factor (thus liver biopsy may risk hemorrhage), and antinuclear antibodies. Mild 50 lymphocytic pleocytosis is common in the cerebrospinal fluid of patients with meningoencephalitis. Liver biopsy in hepatitis patients or bone biopsy in patients with osteomyelitis may reveal granulomas. Combined detection of IgM, IgA, and IgG antibodies improves assay specificity and provides accuracy in diagnosis. Antibodies generally present during acute and chronic Q Fever infection Imaging Studies: Chest radiography may reveal atypical pneumonia; pleural effusions are rare. Transesophageal echocardiography is more sensitive in finding the typically small and subendothelial lesions of endocarditis.

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Species Conservation Assessment and Strategy for Townsends Big-eared Bat (Corynorhinus townsendii townsendii and Corynorhinus townsendii pallescens) diabetes symptoms type 1 diabetes glycomet 500 mg amex. Arizona Game and Fish Department Arizona Bat Conservation Strategic Plan Implementation. One element of the program is to monitor site occupancy for 4 bat species at 10 sites (site list and access were provided by Pima County based on data collected by previous field efforts) within the Pima County Preserve System, and to monitor site condition. All 4 species are subterranean-obligates, which means they require caves or mines to survive. Pima County has not yet finalized selection of the 10 caves/mines; staff is inventorying and evaluating potential sites for use by the 4 targeted species as well as other bat species. We (Bat Research and Consulting) were contracted to assist with the monitoring effort. Survey 10 sites 2 times (approximately) between 15 April and 31 December, 2018 for bat use and site condition. Identify species of bat, number of individuals, and observed threats to the site. Methods included internal surveys, video-recording evening bat emergences, capturing bats, and deploying guano sheets to collect guano for analysis to determine species. Monitoring protocols for each survey method are discussed in detail in the Protocols for Field Methods for Inventorying and Monitoring Bats in Caves and Mines included in this report. Methods were selected and implemented so that disturbance to bats, when present, was minimized while obtaining necessary data. All methods are standard practices and discussed in the American Society of Mammalogists guidelines (Sikes et al. We notified the appropriate Pima County, Colossal Cave Mountain Park, Border Patrol, and Bureau of Land Management personnel as necessary before going out to each site. We cleaned gear after each field trip, following the most recent decontamination protocols for white-nose syndrome from the U. Collected guano was sent to the Bat Ecology and Genetics Lab at Northern Arizona University for analysis. We observed 3 of the 4 targeted species: Townsends big-eared bats at 2 sites (Colossal Cave and Mine Site #1), California leaf-nosed bats at 2 sites (Mine Sites #2 and 5), and Mexican long-tongued bats at 2 sites (Arkenstone and Karens Caves). We did not observe or find evidence of use by lesser long-nosed bats at any of the sites. We observed cave myotis (Myotis velifer) at Colossal Cave, and what were most likely cave myotis at 4 additional sites (Mine Sites # 3, 4, 5, 6). Analysis of this guano confirmed use by cave myotis at Mine Site #1 and 6, and use by big brown bats at Mine Site #1. We were unable to survey 3 features: Mine Site #7 and two additional adits near Mine Site #5. There were bee hives at the portals of Mine Site #7 and one of the adits near Mine Site #5, and one adit near Mine Site #5 was closed with cable netting. We observed and recorded the condition of each sites physical structure and evidence of human visitation or vandalism. All abandoned mines are subject to natural deterioration and some showed more signs of instability than others. We saw very little evidence of recent human visitation in the form of trash or tire tracks. One of the most vulnerable is Mine Site #2, which is near to houses; the gate installed in 2007 was breached and needs repair. Another is Mine Site #6 in the Rancho Seco area, where there was evidence of rock-hounding. Prior field efforts by Pima County staff have also encountered people exploring the interior of this feature (Ian Murray, personal communication). Mine Site #2 and Colossal Cave have been occupied by California leaf-nosed bats and Townsends big-eared bats, respectively, for many years, and therefore are stable colonies. Mexican long-tongued bats have been observed from 1997 to the present, including 2018. Arkenstone Cave, Mine Site #5, Mine Site #6, and Mine Site #7 need additional inventory work on bats using these sites to determine whether they are suitable as long-term monitoring sites. Mine Site #4, though a biologically valuable site given its status as a large cave myotis maternity site, is not a good choice for monitoring any of the 4 targeted species because of its physical characteristics and its use by large numbers of cave myotis spring through fall. Townsends bats have been captured on the bench below the shafts (Pima County data), but although the bats were likely roosting in the mine, mist-netting is not a valid method to determine abundance; it can only confirm presence of a species. Mist-netting should be avoided when bats are pregnant or newly lactating (mid-May through early August) and is not likely to be successful in cool months when bats are torpid, so the time period for using mist-netting to document presence is narrow. In addition, failure to capture a targeted species cannot be interpreted as absence of that species in the mine or area. Acoustic data can document presence, but may miss Townsends bats because of their call characteristics or placement of equipment. Mine Site #3 is also not a good choice for monitoring targeted species, for similar reasons as those given for Mine Site #4. It seems to be primarily, or solely, a cave myotis summer roost (use by a maternity or bachelor colony is unknown), and is a deep shaft not safe to rappel (collar has loose material). Although it may be difficult to distinguish lesser long-nosed bats from cave myotis either acoustically or by video-recording depending on the proportion of lesser long-nosed bats to cave myotis and total abundance, the site should be surveyed in mid-late September for lesser long-nosed bats (see section on Targeted Species). More inventory work on caves and mines in the Pima County Preserve system will identify additional sites that are occupied by bats and potential sites that are suitable as permanent, long-term monitoring sites. Multiple potential sites in each geographic area of interest should be surveyed in all seasons and over multiple years to determine how each site is used, when, and in what numbers, by a particular species. A particular site may be important one year and not the next because of changes in temperature and rainfall patterns that affect roost microclimates and prey availability, human disturbance, and the availability of alternate nearby sites. Although such intensive work can be costly and labor intensive, it is crucial that how, when, and in what numbers bats use a particular site is understood in relation to other nearby roosts before a site is selected for long-term monitoring. It is of no value to monitor a site that is used as an ephemeral, transitory, or auxiliary roost by a small number of bats when large numbers of the same species are roosting nearby, or in the same site at a different time of year. It is much easier to determine abundance accurately, and therefore determine long-term trends, at a single species roost, so such a roost is preferable to a multi-species roost for permanent long-term monitoring sites. Monitoring multi-species roosts adds to the difficulty of determining abundance, or even presence, of each species. It may be impossible if the cameras field of view must be wide to cover a large entrance and species cannot be distinguished. For a single-species roost, such as Arkenstone Cave, an Anabat Roost Logger acoustic detector can be used to find the time of year when activity is greatest. Abundance can then be obtained through evening bat emergences during that period of time in the future. Deploying a roost logger inside the entrance of a mine or cave for a couple years minimizes personnel time otherwise spent on many survey trips that may not be at optimal times. Batteries can last at A-5 least 2 months; several quick trips to change the batteries will result in long-term data on relative activity throughout the year, and in the long run, will be more cost-effective in determining the best time for a survey. Females migrate from Mexico in the spring to form small maternity colonies, often only a few bats (<20), and up to ~50 bats (OShea et al. They frequently roost in the twilight/entrance area, and often fly out of the roost if it is approached by humans, rather than fly farther back into the roost. They are able to use a wide variety of shelters spring through fall, from shallow to deep caves or mines. Some may also overwinter in the Tucson area if they can find sufficiently warm roosts and food resources. To determine population size over an area and through time, many roosts would need to be identified and monitored as simultaneously as possible (bats may move from one site to another nearby from day to day or within short periods of time). Even if all 10 of Pima Countys chosen monitoring sites were occupied by this species, they would need to be in the same area, such as Cienega Creek Natural Preserve, for interpretation of trends to be valid. In late September, there were 5 bats in Arkenstone and 2 in Karens Cave, possibly the same adults plus young-of-the-year. Although both sites would work as permanent monitoring sites, interpreting data from surveys at isolated sites every 2-3 years would be impossible. They were unable to conclude whether the population throughout this area had decreased or increased (OShea et al. These examples illustrate the difficulty of determining real trends in population with both frequent, repeated visits to one site and over time at many sites over a large geographic area. We suggest that multiple sites in a relatively small area be considered a single long-term monitoring site.

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While acute exposure to some of these chemicals may not be immediately dangerous diabetes symptoms mouth cheap generic glycomet canada, these compounds may have extremely serious effects on an individuals health after multiple low-level exposures. Although they are not as lethal as the highly toxic nerve agents, their ability to make a significant impact on the populace is assumed to be more related to the amount of chemical a terrorist can employ on the target(s) and less related to their lethality. For instance, sulfuric acid is not as lethal as the nerve agents, but it is easier to acquire and disseminate large quantities of sulfuric acid because large amounts of it are manufactured and transported everyday. It is assumed that a balance is struck between the lethality of a material and the amount of materials produced worldwide. In addition, blood and choking agents are noted by single or double asterisks, respectively. The term "blood agent" is a misnomer, however, because these agents do not actually affect the blood in any way. Rather, they exert their toxic effect at the cellular level by interrupting the electron transport chain in the inner membranes of mitochondria. During starvation conditions, some types of bacteria can transform into spores that are more resistant to cold, heat, drying, chemicals, and radiation than the bacterium itself. Most bacteria do not cause disease in human beings, but those that do cause disease act by two differing mechanisms, i. Rickettsiae are bacteria that are obligate intracellular parasites associated with arthropods vectors including insects (fleas and lice) and arachnids (ticks and mites). They are intermediate in size, between most bacteria and viruses, and possess certain characteristics common to both bacteria and viruses. Like bacteria, they have metabolic enzymes and cell membranes, use oxygen, and are susceptible to broad-spectrum antibiotics; like viruses, they grow only in living cells. Most rickettsiae are spread by the bites of arthropod vectors and are not spread through human contact. Table 35 lists some of the common bacterial agents along with possible methods of dissemination, incubation period, symptoms, and treatment. Rickettsiae Biological Coxiella burnetii Rickettsia Agent or Rickettsia typhus (Rickettsia Rickettsia rickettsii prowazekii Source burnetti) Disease Endemic Typhus Epidemic Typhus Q Fever Rocky Mountain Spotted Fever Likely Method of Aerosol Aerosol 1. Because viruses lack a system for their own metabolism, they require living hosts (cells of an infected organism) for replication and cannot be cultivated in synthetic nutritive solutions. However, host cells can be cultivated in synthetic nutrient solutions and then infected with a virus specific to the host cells. Table 37 lists the viral agents of greatest concern, along with possible methods of dissemination, incubation period, symptoms, and treatment. As a result, they are highly appealing as weapons of bioterrorism not only for their lethality, but also because of their ability to incapacitate humans. Table 38 lists the common biological toxins along with possible methods of dissemination, incubation period, symptoms, and treatment. Nuclear materials are the key ingredients in nuclear weapons and include fissile, fussionable, and source material. Nuclear weapons include the atomic bomb (nuclear fission), the hydrogen bomb (nuclear fusion), boosted fission weapons, and the neutron bomb. The atomic bomb is a fission reactor designed to release as much energy as possible in the shortest time possible, causing an explosion and stopping the chain reaction. The uncontrolled fission chain reaction has a thousand times more energy than any chemical explosive such as dynamite. The radiological materials used most often in nuclear weapons are concentrated forms of uranium-235 (the isotope of uranium with an atomic mass of 235) and plutonium-239. In the process of change, the unstable nucleus emits radiation in order to become more stable. Half-lives of radioactive materials differ from one to another and range from a fraction of a second to millions of years. Electromagnetic waves of radiation include x-rays and gamma rays, and particulate radiation includes alpha, beta, and neutron radiation. Gamma rays and neutrons can penetrate the skin and reach internal organs and tissues. Alpha particles and all but extremely high-energy beta particles are not considered penetrating radiation. Alpha particles, beta particles, and gamma rays are considered ionizing radiation because they interact with nearby atoms as they travel through matter. Radio waves, microwaves, visible light, and infrared rays from a heat lamp are sources of nonionizing radiation. Nonionizating radiation has lower energy and longer wavelengths than ionizing radiation. Although nonionizating radiation is not strong enough to affect the structure of atoms it contacts, it is strong enough to heat tissue and cause harmful biological effects. Alpha particles, beta particles, gamma/x-rays, and neutrons are discussed in the following sections. They are relatively large and very heavy consisting of two protons and two neutron, identical to the nucleus of a helium atom. Because of this strong positive charge and large mass, an alpha particle cannot penetrate far into any material and can be stopped by a sheet of paper or an inch of air, or by the dead layers of the skin or by a uniform. Inhalation of radioactive dust is a serious risk since particles may remain in the lung for a long time and are in close contact with living cells. Ingestion is also a serious threat, but the residence time in the body is usually shorter. Alpha particles are a negligible external hazard, but when emitted from an internalized radionuclide source, can cause significant cellular damage in the region immediately adjacent to their physical location. Because of their light mass and single charge, beta particles can penetrate more deeply than alpha particles. Although beta particles only travel short distances into tissue, in large quantities they can produce damage to the basal stratum of the skin. The lesion produced by the beta particle, or beta burn appears similar to a thermal burn. Beta emitters are also more serious threats when inhaled or ingested due to longer potential exposure time and proximity to tissue. The light nuclei may be produced in reactors from fission fragments or by neutron or particle beam irradiation of stable nuclei. Being electromagnetic (or photons), gamma/x-rays travel at the speed of light and have extremely high penetrating power. They can penetrate skin, paper, and thin metals but can be stopped by lead, concrete, or steel. Both gamma ray and x-ray radiation are considered an external hazard; they both have the ability to cause internal tissue damage whether the source is internal or external. Neutron particles come from splitting, or fissioning of certain atoms inside a nuclear reactor, or can be produced spontaneously from select radionuclides (uranium 235 and plutonium-239; or the man made radionuclide californium-252, the most commonly used source for spontaneous fission). Moderate to low-energy neutron radiation can be shielded by materials with a high hydrogen content, such as water (H2O) or plastics with neutron absorbers; high-energy neutrons can be shielded by more dense materials, such as steel or lead. Like gamma radiation, neutrons are an external, whole-body hazard because of their high penetrating ability; however, compared to gamma rays, neutrons cause 20 times more damage to tissue. Gamma rays and/or subatomic particles are emitted as the radionuclide undergoes radioactive decay. The biggest contributor to background radiation is radon, which accounts for roughly 54 % of annual exposure.

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Africas current major negative role in the global carbon cycle can be attributed to the substantial releases of carbon associated with land use conversion from forest or woodlands to agriculture (Smith metabolic disease conference 2012 purchase 500 mg glycomet with amex, 2008). In the 1990s, these releases accounted for approximately 15 percent of the global net fux of carbon from land use changes (Hooper et al. Soils often continue to lose carbon over time following land conversion (W oomer, Toure and Sall, 2004; Tschakert, Khouma and Sene, 2004; Liu et al. However, these carbon stocks can be replenished with combinations of residue retention, manuring, nitrogen (N) fertilization, agroforestry, and conservation practices (Lal, 2006). In most sub-humid and semi-arid areas, much of the grazing land is burned annually during the dry season to remove the old and coarse vegetation and to encourage the growth of young and more nutritious grasses. Status of the Worlds Soil Resources | Main Report Regional Assessment of Soil Changes 248248 in Africa South of the Sahara It exposes the soil to the erosive forces of the wind during the dry season and of the rain during the rainy season. Furthermore, the annual burn of the vegetation severely reduces the return of organic matter to the soil. This results in loss of the benefts of soil organic matter, including fertility, structure, water retention and biodiversity. Land degradation further leads to a release of carbon to the atmosphere through the oxidation of soil organic matter which results from soil disturbance and from the consequent exposure of new soil surfaces to the weather. In agricultural land, the challenge has been to produce increasing quantities of food in an economic and institutional context where the means to improve productivity in a sustainable fashion are generally not available. Pressures to increase output in the absence of these supporting factors has led to: (i) the rapid expansion of agricultural land (over 65 percent in the last three decades); and (ii) the shortening of the fallow periods in traditional, extensive land use systems, which reduced the rehabilitation of soil fertility through natural processes. The increased use of fre as a clearing tool has led to the further loss of nutrients in many systems. Fertilizer consumption has not increased to compensate for the loss of soil nutrients resulting from the intensifcation of land use. On degraded soils with low organic matter, inorganic fertilizers are also easily leached, which is likely to have negative long-term efects on agricultural productivity and on the quality of downstream water resources. Because of the increasing pressure on land, natural replenishment of nutrients during fallow periods is now insufcient to maintain soil productivity over the long-term. Insufcient nutrient replacement in agricultural systems on land with poor to moderate potential results in soil degradation. Already soil moisture stress inherently constrains land productivity on 85 percent of soils in Africa (Eswaran, Reich and Beinroth, 1997). Now soil fertility degradation places an additional serious human-induced limitation on productivity. Approximately 25 percent of soils in Africa are acidic, and therefore defcient in phosphorus (P), calcium and magnesium with often toxic levels of aluminium (McCann, 2005). Use of fertilizer in the region involves average applications of less than 9 kg of nitrogen and 6 kg of phosphorus per ha, compared with typical crop requirements of 60 kg of nitrogen and 30 kg of phosphorus per ha. Although many farmers have developed soil management strategies to cope with the poor quality of their soil, low inputs of nutrients, including of organic matter, contribute to poor crop growth and to the depletion of soil nutrients. Stoorvogel, Smaling and Janssen (1993) calculated nutrient balances for arable soils in 38 sub-Saharan countries and for 35 crops for 1982-1983 and made forecasts for 2000. Status of the Worlds Soil Resources | Main Report Regional Assessment of Soil Changes 249249 in Africa South of the Sahara Sub-national studies of nutrient depletion found annual losses of 112 kg per ha of N, 2. Signifcantly lower losses were, however, recorded in southern Mali (Smaling, 1993; Smaling, Nandwa and Janssen, 1997). Farm monitoring and modelling of nutrient cycles for the western highlands of Kenya found that more nitrogen (63 kg per ha) was being lost through leaching, nitrifcation, and volatilization than through removal of crop harvests (43 kg per ha). Depending on the type of farm management practice, net nitrogen balances on cropped land varied between 39 and 110 kg per ha peryear, and net phosphorus balances between 7 and 31 kg per ha per year (Shepherd and Soule, 1998). Biodiversity loss occurs in a number of ways including destruction of habitat, land use change, introduction of new species, and harvesting and hunting of individual wild species. For instance, the once great equatorial forest that stretched from western Africa into eastern Africa is now fragmented into pockets represented by Lamto forest in Ivory Coast, Mbalmayo forest in Cameroun, Congo forest in Democratic Republic Congo, Kabale, Budongo and Mabira forests in Uganda and Kakamega forest in Kenya. The surrounding communities still rely heavily on these forests for basic needs such as fuelwood, charcoal, timber, poles, and other building materials. Due to human encroachments, the forests are subject to a mosaic of diferent land uses. There are patches of secondary forest, fallow and arable felds amidst signifcant remnants of primary vegetation. In the process of conversion and change in land use, soil biota have not been spared. In a study conducted across diferent ecosystems of Eastern (Kenya), W estern (Nigeria, Burkina Faso, Ghana, Niger) and Southern Africa (Malawi), Ayuke et al. Continuous cultivation also exacerbates soil biodiversity loss because of loss of soil organic matter and hence of food resources for the soil organisms (Ayuke et al. Sub-Saharan Africa sufers the worlds highest annual deforestation rate because of overexploitation of forest resources and conversion of forested land to agriculture. Mulugeta (2004) reported that in Ethiopia deforestation and subsequent cultivation of the tropical dry Afromontane forest soils endangered the native forest biodiversity not only through the outright loss of habitat but also by impairing the soil seed banks. The results showed that the contribution of woody species to the soil seed bank declined from 5. However, soil quality and native fora degradation are reversible through reforestation. In fact, reforestation of abandoned farm felds with fast-growing tree species was shown to restore soil quality. Tree plantations established on degraded sites also fostered the recolonization of diverse native forest fora under their canopies. An important result from studying the efects of reforestation is that good silviculture, particularly selection of appropriate tree species, can signifcantly afect the rate and magnitude of restoration processes for both soil quality and biodiversity. Status of the Worlds Soil Resources | Main Report Regional Assessment of Soil Changes 250250 in Africa South of the Sahara In many African cultures, harvesting of soil fauna groups such as the termite alates and queens, chafer grubs for food, and the use of earthworms as bait by fshermen can also be a threat to soil biodiversity, and may in the long run contribute to substantial loss of many species of soil fauna. For example, a more than average numbers of earthworm and termite taxa are found under relatively warmer, drier conditions (Ayuke et al. This is contrary to the observation that earthworm and termite diversity increases with increases in rainfall or soil moisture, as generally found in temperate climates (Bohlen et al. However, seasonality of rainfall in the tropical regions means rainfall amounts per season may be more important than the annual total. Lower taxonomic richness among sites in Eastern Africa may be attributable to less favourable conditions arising from high rainfall and low temperatures at higher altitudes (Ayuke et al. Intense management practices that include application of pesticides and frequent cultivation afect soil organisms, often altering community composition of soil fauna. Changes in these soil properties may be refected in the distribution and diversity of soil meso fauna. Organisms adapted to high levels of physical disturbance become dominant within agricultural communities, thereby reducing the richness and diversity of soil fauna (Paoletti, Foissner and Coleman, 1993). However, it is clear that unsustainable soil management practices have depleted soil organic matter, promoted soil degradation and may have caused soil fauna and fora imbalances. The report acknowledged that, even if all its recommendations were implemented, recovery might take 30 years. Change of land use, particularly urbanization, is another factor in soil contamination. National data from South Africa indicate that areas under urban, forestry and mining land uses have all increased over the last decade, whereas the cultivated area has decreased. The increase in the urban and mining areas is a major concern in terms of soil conservation and future use. Urban development involves soil sealing which irreversibly removes soils from other land uses.

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Pharmacokinetics of oral antihyperglycaemic agents in patients with renal insufficiency diabetes mellitus type 2 deutsch discount glycomet 500mg amex. Water retention after oral chlorpropamide is associated with an increase in renal papillary arginine vasopressin receptors. Interindividual differences in chlorthalidone concentration in plasma and red cells of man after single and multiple doses. Pharmacokinetics of chlorthalidone in the elderly after single and multiple doses [letter]. Comparative studies on spironolactone (Aldactone) and chlorthalidone (Hygroton) in the treatment of arterial hypertension. Pharmacokinetics of chlorthalidone: dependence of biological half life on blood carbonic anhydrase levels. Pharmacokinetics of cidofovir n renal insufficiency and in continuous ambulatory peritoneal dialysis or high-ux dialysis. Clinical pharmacokinetics of the antiviral nucleotide analogues cidofovir and adefovir. Clinical pharmacokinetics of cidofovir in human immunodeciency virus-infected patients. Cytotoxicity of antiviral nucleotides adefovir and cidofovir is induced by the expression of human renal organic anion transporter 1. Severe irreversible proximal renal tubular acidosis and azotaemia secondary to cidofovir [letter]. Cidofovir for adenovirus infections after allogeneic hematopoietic stem cell trans plantation: a survey by the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Nucleoside phosphonate interactions with multiple organic anion transporters in renal proximal tubule. Cidofovir for treating adenoviral hemorrhagic cystitis in hematopoietic stem cell transplant recipients. Disseminated adenovirus infection in renal transplant recipients: the role of cidofovir and intravenous immunoglobulin. Polyomavirus-associated nephropathy: update of clinical management in kidney transplant patients. The effect of low-dose cidofovir on the long-term outcome of polyomavirus-associated nephropathy in renal transplant recipients. Acute renal failure in a lung transplant patient after therapy with cidofovir [letter]. Hemodialysis Preferably avoid unless no suitable alternative exists; if indeed necessary, 0. The hemodynamic effects of intravenous cimetidine in intensive care unit patients: a double-blind, prospective study. Cimetidine-procainamide pharmacokinetic interaction in man: evidence of competition for tubular secretion of basic drugs. Elimination of ciprooxacin and three major metabolites and consequences of reduced renal function. Pharmacokinetics of ciprooxacin and vancomycin in patients with acute renal failure treated by continuous haemodialysis. Pharmacokinetics of intravenously administered ciprooxacin in patients with various degrees of renal function. New quinolones: pharmacology, pharmacokinetics, and dosing in patients with renal insufficiency. Ciprooxacin in plasma and peritoneal dialysate after oral therapy in patients on continuous ambulatory peritoneal dialysis. Oral ciprooxacin in the treatment of peritonitis in patients on continuous ambulatory peritoneal dialysis. Ciprooxacin pharmacokinetics in patients with normal and impaired renal function. The administration of ciprooxacin during continuous renal replacement therapy: pilot study. Steady-state pharmacokinetics of intravenous and oral ciprooxacin in elderly patients. Acute renal failure secondary to oral ciprooxacin therapy: a presentation of three cases and a review of the literature. Pharmacokinetics of ciprooxacin tablets in renal failure: inuence of haemodialysis. The renal fractional clearance of platinum antitumour compounds in relation to nephrotoxicity. Differential effects of cisplatin in proximal and distal renal tubule epithelial cell lines. Cisplatin nephrotoxicity: a multivariate analysis of potential predisposing factors. Inuence of platinum-induced renal toxicity on bleomycin induced pulmonary toxicity in patients with disseminated testicular carcinoma. Cladribine: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in haematological malignancies. Pharmacokinetics of 2-chlorodeoxyadenosine in a child undergoing hemoltration and hemodialysis. Chlorodeoxyadenosine and arabinosylcytosine in patients with acute myelogenous leukemia: pharmacokinetic, pharmacodynamic, and molecular interactions. Subcutaneous injections of 2-chlorodeoxyadenosine for symptomatic hairy cell leukemia. A phase I study of intermittent infusion cladribine in patients with solid tumors. A limited sampling strategy for estimation of the cladribine plasma area under the concentration versus time curve after intermittent iv infusion, sc injection, and oral administration. Pharmacokinetic study of oral and bolus intravenous 2-chlorodeoxyadenosine in patients with malignancy. 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There is a growing and long-standing recognition among both policy-makers and soil specialists that soil degradation is one of the root causes of declining agricultural productivity in sub-Saharan Africa and that diabetes medications while breastfeeding buy discount glycomet 500 mg line, unless the process of degradation is controlled, many parts of the continent will sufer increasingly from food insecurity. Soil degradation is the decline in soil quality caused its improper use by humans, usually for agricultural, pastoral, industrial or urban purposes. Soil degradation may be exacerbated by climate change and encompasses physical, chemical and biological deterioration. Examples of soil degradation cited by Charman and Murphy (2005) are: loss of organic matter; decline in soil fertility; decline in structural condition; topsoil loss and erosion; adverse changes in salinity, acidity or alkalinity; and the efects of toxic chemicals, pollutants and excessive fooding. The recent publication of the frst Soil Atlas of Africa has provided a frst comprehensive overview of the soil resources of Africa (Jones et al. Four continental-scale studies have assessed the extent of soil degradation in Africa. A literature review by Dregne (1990) of 33 countries found compelling evidence of serious land degradation in sub-regions of 13 countries: Algeria, Ethiopia, Ghana, Kenya, Lesotho, Mali, Morocco, Nigeria, Swaziland, Tanzania, Tunisia, Uganda, and Zimbabwe. In another literature review, focused on drylands only, Dregne and Chou (1992) estimated that 73 percent of drylands were degraded and 51 percent severely degraded. The most widespread cause of degradation was water erosion, followed by wind erosion, chemical degradation (three-quarters from nutrient loss, the rest from salinization), and physical degradation. In terms of causes of degradation, overgrazing was responsible for half of all degradation, followed by agricultural activities, deforestation, and overexploitation. Lal (1995) calculated continent-wide soil erosion rates from water using data from the mid to late 1980s, and then used these rates to compute cumulative soil erosion for 1970-90. The highest erosion rates occurred in the Maghreb region of Northwest Africa, the East African highlands, eastern Madagascar, and parts of Southern Africa. Soils host the majority of the worlds biodiversity and healthy soils are essential to securing food and fbre production. Soils assure an adequate and clean water supply over the long term, as well as providing cultural functions. Major increases in agricultural production have been associated with diferent kinds of soil degradation, especially since the agricultural growth came in part from extensive clearing of new agricultural lands. Yet, even with this expansion, arable land per capita in Africa declined from just under 0. During this time period, yield increases on land already in production thus contributed far more to the total production. For example, more than 90 percent of the growth in developing country cereal production between 1961 and 1990 came from yield growth (W orld Bank, 1992). Agricultural expansion and yield growth at such a scale is inevitably associated with some degradation of soil resources. The annual rainfall of less than 500 mm, combined with high temperatures and consequent high rates of evapotranspiration, make this zone capable of sustaining plant life for less than 90 plant growth days (or length of growing season). Status of the Worlds Soil Resources | Main Report Regional Assessment of Soil Changes 244244 in Africa South of the Sahara Figure 9. Status of the Worlds Soil Resources | Main Report Regional Assessment of Soil Changes 245245 in Africa South of the Sahara the arid zone is mostly associated with sandy soils (Arenosols, Psamments) which are weakly diferentiated and are often of aeolian origin. The accompanying vegetation consists of short annual grasses, legumes, scattered shrubs and trees. Mobile herds of sheep, goats, cattle and camels browse the herbage and shrubs, while farmers use most of the trees and shrubs for fuel. The low rainfall and its erratic distribution make cropping uncertain in most years. Owing to this unreliability, arable farming is mostly restricted to opportunistic cultivation of short-season millets, except in topographically favourable sites such as oases or irrigated areas. Opportunities for livestock development are limited but existing techniques could be improved upon, if not to increase productivity, then at least to sustain it. The low rainfall and the long dry season make the semi-arid zone a relatively healthy environment for humans and livestock. Arenosols (Psamments) and Cambisols (Inceptisols) are widespread and include coarse sandy soils, fne sands, and loamy sandy soils. W ater retention is poor and nutrient contents, including N, P and S levels, are generally low. The permeability of the undisturbed soil is good, but algal skins contribute to the formation of surface crusts. The natural vegetation is an open low-tree grassland but this has been severely modifed in many regions. The zone receives 1 000 to 1 500 mm of rain annually which can sustain plants for 180 to 270 plant growing days. W ithin the climatic defnition, this is a very varied zone in terms of climate, soils and land use. Luvisols (Alfsols) and Cambisols (Inceptisols) occur widely, parent material is often strongly weathered, and the levels of mineral nutrients as well as the clay fraction are low. Cambisols (Inceptisols) have fewer constraints to plant production than the older, more weathered soils, since their high base status provides adequate Ca and eliminates constraints related to low pH levels. In addition, structural stability in these soils can be poor, with crusting and hardening occurring when soils are dry. The natural vegetation is typically medium height or low woodland with understory shrubs and a ground cover of medium to tall, mainly perennial, grasses; Hyparrhenia spp. Food and cash crops are grown, including cassava, yams, maize, fruits, vegetables, rice, millet, groundnut, cowpeas and cotton. From these crops, products such as cottonseed cakes and the residues of the crops are available as feed for livestock. The zone receives more than 1 500 mm of rainfall annually which can sustain plants for 270 to 365 plant growing days. Soils in this zone include Ferralsols (Oxisols), Acrisols (Ultisols) and Luvisols (Alfsols), the last of which are commonly encountered at the forest-savannah boundary. Vegetation consists of rain forest and derived savannahs with natural vegetation dominated by tall, closed forest which may be evergreen or semi-deciduous and which is often foristically rich. Status of the Worlds Soil Resources | Main Report Regional Assessment of Soil Changes 246246 in Africa South of the Sahara the soils are strongly weathered and hence have high levels of iron and aluminium oxides and low levels of phosphorous. The organic matter content is therefore generally low and the soils are fragile and easily degraded when the vegetative cover is lost. This zone has limited potential for livestock development, particularly because of the threat of the trypanosomiasis-transmitting tsetse fy. This zone occupies areas above 1 500 m altitude that have a mean daily temperature of less than 20 C. There are also many other areas above the 1500 m contour and some of these aford tsetse-free grazing. Topography varies from gently rolling hills to deeply incised valleys and steep slopes. Soils are sometimes deep and fertile Vertisols and Nitosols, but shallow soils of inherently low fertility are widespread. In many mountain grassland areas, soils only have a very shallow surface horizon that is fertile. Undisturbed upland areas are normally stable, although some soils exhibit slumping even where undisturbed. Cultivating the so called duplex soils5 and soils that form a surface crust on slopes results in high run-of. Unless soil conservation measures are taken and soils are sufciently covered with vegetation, overland fow removes large amounts of soil. The zone receives bimodal rainfall (>1000 mm annually) and there are two growing seasons. Livestock rearing is widespread: farmers grow fodder, and animal traction is of increasing importance. Of this, 227 million ha (46 percent) is by water erosion, 187 million ha (38 percent) by wind erosion, 62 million ha (12 percent) by chemical degradation and 18 million ha (4 percent) by physical degradation. W ater erosion increases on slopes where vegetation cover is reduced due to deforestation, overgrazing or cultivation that leaves the soil surface bare. It is further aggravated where there has been a loss of soil structure or infltration rates have been reduced.