Tigers are globally endangered and continue to decline due to poaching, prey depletion and habitat loss. In Nepal, tiger populations are fragmented and found mainly in four protected areas (PAs). To establish the use of standard methods, to assess the importance of prey availability and human disturbance on tiger presence and to assess tiger occupancy both inside and outside PAs, we conducted a tiger occupancy survey throughout the Terai Arc Landscape of Nepal. Our model‐average estimate of the probability of tiger site occupancy was 0.366 [standard error (se) = 0.02, a 7% increase from the naive estimate] and the probability of detection estimate was 0.65 (se = 0.08) per 1 km searched. Modeled tiger site occupancy ranged from 0.04 (se = 0.05) in areas with a relatively lower prey base and higher human disturbance to 1 (se = 0 and 0.14) in areas with a higher prey base and lower human disturbance. We estimated tigers occupied just 5049 (se = 3) km2 (36%) of 13 915 km2 potential tiger habitat (forests and grasslands), and we detected sign in four of five key corridors linking PAs across Nepal and India, respectively indicating significant unoccupied areas likely suitable for tigers and substantial potential for tiger dispersal. To increase tiger populations and to promote long‐term persistence in Nepal, otherwise suitable areas should be managed to increase prey and minimize human disturbance especially in critical corridors linking core tiger populations.

Information on the abundance of tigers Panthera tigris is essential for effective conservation of the species. The main aim of this study was to determine the status of tigers in Chitwan National Park, Nepal, including the Churia hills, using a camera-trap based mark-recapture abundance estimate. Camera traps (n 5 310) were placed in an area of 1,261 km 2 from 20 January to 22 March 2010. The study area was divided into three blocks and each block was trapped for 19-21 days, with a total effort of 3,582 man-days, 170 elephant-days and 4,793 camera-trap nights. The effectively camera-trapped area was 2,596 km 2 . Camera stations were located 1.5-2 km apart. Sixty-two tigers (age > 1.5 years), comprising 15 males, 41 females and six of unidentified sex, were identified from 344 photographs. The heterogeneity model Mh (jackknife) was the best fit for the capture history data. A capture probability (P) of 0.05 was obtained, generating a population estimate (N) of 125 ± SE 21.8 tigers. The density of tigers in the area, including Churia and Barandabhar (buffer zone forest linked with mid hill forest), was estimated to be 4.5 ± SE 0.35 tigers per 100 km 2 , using a Bayesian spatially explicit capture-recapture model in SPACECAP. Our study showed the use of Churia by tigers and we therefore conclude that the Chitwan tiger population serves as a source to maintain tiger occupancy of the larger landscape that comprises Chitwan National Park, Parsa Wildlife Reserve, Barandabhar buffer zone, Someswor forest in Nepal and Valmiki Tiger Reserve in India.

We estimated leopard (Panthera pardus fusca) abundance and density in the Bhabhar physiographic region in Parsa Wildlife Reserve, Nepal. The camera trap grid, covering sampling area of 289 km2 with 88 locations, accumulated 1,342 trap nights in 64 days in the winter season of 2008-2009 and photographed 19 individual leopards. Using models incorporating heterogeneity, we estimated 28 (±SE 6.07) and 29.58 (±SE 10.44) leopards in Programs CAPTURE and MARK. Density estimates via 1/2 MMDM methods were 5.61 (±SE 1.30) and 5.93 (±SE 2.15) leopards per 100 km2 using abundance estimates from CAPTURE and MARK, respectively. Spatially explicit capture recapture (SECR) models resulted in lower density estimates, 3.78 (±SE 0.85) and 3.48 (±SE 0.83) leopards per 100 km2, in likelihood based program DENSITY and Bayesian based program SPACECAP, respectively. The 1/2 MMDM methods have been known to provide much higher density estimates than SECR modelling techniques. However, our SECR models resulted in high leopard density comparable to areas considered better habitat in Nepal indicating a potentially dense population compared to other sites. We provide the first density estimates for leopards in the Bhabhar and a baseline for long term population monitoring of leopards in Parsa Wildlife Reserve and across the Terai Arc.

Background Clostridium difficile infection (CDI) is the leading cause of hospital-associated gastrointestinal illness. Previous studies reported that patients with active malignancy are at high risk for CDIs, and yet they are still classified as nonsevere CDI and initially treated with metronidazole. Our aim is to investigate the need for the escalation of antibiotic therapy in patients with CDI and active cancer treated with oral metronidazole versus oral vancomycin. Methods This is a retrospective study of adult patients admitted with CDI and any underlying active malignancy at Beaumont Hospital, Royal Oak, Michigan, from January 2008 to December 2014. Inclusion criteria included age > 18 years old, polymerase chain reaction- (PCR-) proven CDI, and active malignancy. Results 197 patients were included in the final analysis. 44.8% of the metronidazole group required escalation of therapy compared to 15.2% in the vancomycin group (p value = 0.001). 29.8% of the combination group (metronidazole and vancomycin) underwent deescalation of antibiotics, which was significantly higher compared to 2.2% of patients in the vancomycin group (p value < 0.001). Discussion Our results support the initial use of vancomycin or a combination (metronidazole and vancomycin) versus metronidazole in patients with CDI and active malignancy.

Clinical data regarding mucosa-associated lymphoid tissue lymphoma (MALToma) solely involving the duodenum are sparse because of the relative rarity of the disease. A comprehensive literature review revealed only 17 cases reported until 2004, and only a moderate number of cases have been reported since. MALToma can be asymptomatic in its very early stages but frequently produces localized or nonspecific symptoms, including early satiety, abdominal pain, vomiting, and involuntary weight loss in later stages. While gastric MALToma is strongly associated with gastric Helicobactor pylori infection, duodenal MALToma is often unassociated with H. pylori infection. A 74-year-old female presented with only dysphagia (without symptoms referable to a duodenal lesion), without systemic ‘B’ symptoms, and with no evident duodenal lesions at esophagogastroduodenoscopy; however, she was diagnosed with duodenal MALToma by pathologic examination of random duodenal biopsies performed to exclude celiac disease. An important clinical feature of this case is that duodenal MALToma was diagnosed by pathologic analysis of duodenal biopsies despite (1) no endoscopically apparent duodenal lesions; (2) duodenal involvement without gastric involvement; (3) lack of symptoms attributable to duodenal MALToma, and (4) absence of evident H. pylori infection. This work shows that early duodenal MALToma can be difficult to diagnose because of absent symptoms, absence of gastric involvement, absence of endoscopic abnormalities, and absence of H. pylori infection; it may require random duodenal biopsies for diagnosis.