Watershed characteristics and chemical properties govern methyl mercury concentrations within headwater streams of boreal forests in Ontario, Canada.

Methyl mercury (MeHg) concentrations in boreal headwater streams are influenced by complex natural processes and disturbances such as forestry management. Understanding drivers of MeHg within boreal streams in Ontario, Canada, is of particular interest as there are legacy MeHg concerns. However, models accounting for the complexity of underlying processes have not yet been developed. We assessed how catchment characteristics and stream water chemistry influence MeHg concentrations within 19 watersheds of the Dryden - Wabigoon Forest in Ontario, Canada, using a structural equation modelling (SEM) approach. Despite the study area encompassing a large variation of boreal forest watersheds in the Canadian Shield, our SEM had substantial explanatory power across the region (χ251 = 45.37, p-value = 0.70, R2 = 0.75). Nitrate concentrations (p-value <0.001), water temperature (p-value = 0.002), and the latent watershed characteristic (p-value <0.001) had a positive influence on MeHg concentrations once variable interactions were accounted. Due to the inherent strengths of applying an SEM approach, we describe two plausible pathways driving MeHg concentrations: 1) indirect effect of forest-derived nutrients increases in-situ MeHg production in Dryden - Wabigoon Forest streams, and 2) direct supply of MeHg from inundated soils following consistent precipitation and inundation events (i.e., fill, sit, and spill).

Significant publications on infectious diseases pharmacotherapy in 2015.

PURPOSE: The most important articles on infectious diseases (ID) pharmacotherapy published in the peer-reviewed literature in 2015, as nominated and selected by panels of pharmacists and others with ID expertise, are summarized. SUMMARY: Members of the Houston Infectious Diseases Network were asked to nominate articles published in prominent peer-reviewed journals in 2015 that were thought to have a major impact in the field of ID pharmacotherapy. A list of 55 nominated articles on general ID-related topics and 10 articles specifically related to human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) was compiled. In a national online survey, members of the Society of Infectious Diseases Pharmacists (SIDP) were asked to select from the list 10 general ID articles believed to have made a significant contribution to the field of ID pharmacotherapy and 1 article contributing to HIV/AIDS pharmacotherapy. Of the 361 SIDP members surveyed, 153 (42%) and 76 (21%) participated in the selection of general ID-related articles and HIV/AIDS-related articles, respectively. The 11 highest-ranked publications (10 general ID-related articles and 1 HIV/AIDS-related article) are summarized here. CONCLUSION: With the growing number of significant ID-related publications each year, it can be challenging to stay current with the literature. This review of important ID pharmacotherapy publications in 2015 may be helpful in identifying key articles and lessening this burden.

Predicting the risk of nephrotoxicity in patients receiving colistimethate sodium: a multicentre, retrospective, cohort study.

OBJECTIVES: With increasing rates of infections caused by MDR Gram-negative organisms, clinicians resort to older agents such as colistimethate sodium (CMS) despite a significant risk of nephrotoxicity. Several risk factors for CMS-associated nephrotoxicity have been reported, but they have yet to be validated. We compared the performance of published mathematical models in predicting the risk of CMS-associated nephrotoxicity. METHODS: In a multicentre, retrospective, cohort study, adult patients (≥18 years of age) were evaluated from five large academic medical centres in the USA. Patients with normal renal function (baseline serum creatinine ≤1.5 mg/dL) who received intravenous CMS for ≥72 h were followed for up to 30 days. The development of nephrotoxicity was as defined by the RIFLE criteria. Each published model was conditioned using patient-specific variables to predict the risk of nephrotoxicity. The predictive performance of the models was evaluated using the observed-to-expected (O/E) ratio. The most significant cut-off threshold for stratifying patients into high and low risk of nephrotoxicity was identified using classification and regression tree analysis. RESULTS: A total of 106 patients were examined (mean age 53.3 ±â€Š14.9 years, 66% male); the overall observed nephrotoxicity rate was 52.8%. We identified a simple model demonstrating reasonable overall nephrotoxicity risk assessment [O/E ratio of 1.07 (95% CI = 0.81-1.39)] and high sensitivity (92.9%) in predicting nephrotoxicity development in patients on CMS therapy. CONCLUSIONS: We identified a model that could be incorporated into patient management strategies to reduce the risk of nephrotoxicity in patients requiring CMS therapy.