The Association Between Distances Traveled for Care and Treatment Choices for Pelvic Floor Disorders in a Rural Southwestern Population

OBJECTIVES: To determine if distance traveled for care influenced patient choice for conservative vs. surgical treatment for pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI). METHODS: Retrospective chart review of all new patients seen in the Urogynecology clinic at the University of New Mexico Hospital (UNMH) from January 2007 through September 2011. Data collected included medical history, Pelvic Organ Prolapse Quantification (POPQ) examination, and validated quality of life questionnaires. RESULTS: 1384 women were identified with POP and/or SUI. Women traveled an average of 50 miles to receive care at UNMH. After multivariable analysis, greater distance traveled was associated with increased likelihood of choosing surgery, OR 1.45 [1.18-1.76]. More advanced disease as measured by higher stage of prolapse, OR 3.43 [2.30-5.11], and positive leak with empty supine cough test, OR 1.94 [1.45-2.59] were also associated with choosing surgical management. CONCLUSIONS: Women who travel further for care and women with more advanced pelvic organ prolapse and/or stress urinary incontinence are more likely to choose surgical management for pelvic floor disorders

Managing Woodland Caribou in West-Central British Columbia

Initial long term planning for logging on the Tweedsmuir-Entiako caribou winter range began in the early 1980s. Because little information was available on which to base winter range management, the British Columbia Fish and Wildlife Branch began studies on radio-collared caribou in 1983, and an intensive study on caribou winter habitat requirements was conducted from 1985 to 1988. Terrestrial lichens were identified as the primary winter food source for the caribou, and in 1987, caribou winter range ecosystem maps, which emphasized abundance of terrestrial lichens, were produced. The ecosystem maps and information from the caribou study, including potential direct and indirect effects of timber harvesting on the caribou population, were used to develop a management strategy for the winter range. The management strategy comprised two levels of management: a landscape level (Caribou Management Zones); and a site-specific level (caribou habitat/timber values). Timber information associated with BC Ministry of Forests forest cover maps was integrated using a Geographic Information System. Six winter range management options were proposed ranging from harvesting low value caribou habitats only throughout the winter range to total protection of the entire winter range. Impacts of those options on both the caribou population and on the timber supply were evaluated. The options were reviewed through a public planning process, the Entiako Local Resource Use Plan, and recommendations from that process were forwarded to the British Columbia Protected Areas Strategy

Mountain pine beetles and emerging issues in the management of woodland caribou in Westcentral British Columbia

The Tweedsmuir—Entiako caribou (Rangifer tarandus caribou) herd summers in mountainous terrain in the North Tweedsmuir Park area and winters mainly in low elevation forests in the Entiako area of Westcentral British Columbia. During winter, caribou select mature lodgepole pine (Pinus contorta) forests on poor sites and forage primarily by cratering through snow to obtain terrestrial lichens. These forests are subject to frequent large-scale natural disturbance by fire and forest insects. Fire suppression has been effective in reducing large-scale fires in the Entiako area for the last 40—50 years, resulting in a landscape consisting primarily of older lodgepole pine forests, which are susceptible to mountain pine beetle (Dendroctonus ponderosae) attack. In 1994, mountain pine beetles were detected in northern Tweedsmuir Park and adjacent managed forests. To date, mountain pine beetles have attacked several hundred thousand hectares of caribou summer and winter range in the vicinity of Tweedsmuir Park, and Entiako Park and Protected Area. Because an attack of this scale is unprecedented on woodland caribou ranges, there is no information available on the effects of mountain pine beetles on caribou movements, habitat use or terrestrial forage lichen abundance. Implications of the mountain pine beetle epidemic to the Tweedsmuir—Entiako woodland caribou population include effects on terrestrial lichen abundance, effects on caribou movement (reduced snow interception, blowdown), and increased forest harvesting outside protected areas for mountain pine beetle salvage. In 2001 we initiated a study to investigate the effects of mountain pine beetles and forest harvesting on terrestrial caribou forage lichens. Preliminary results suggest that the abundance of Cladina spp. has decreased with a corresponding increase in kinnikinnick (Arctostaphylos uva-ursi) and other herbaceous plants. Additional studies are required to determine caribou movement and habitat use responses to the mountain pine beetle epidemic

Population Ecology of Caribou in British Columbia

The abundance and geographic range of woodland caribou (Rangifer tarandus caribou) decreased in many areas of British Columbia during the 1900's. Recent studies have found that predation during the summer is the major cause of mortality and current population declines. Increased moose {Alecs alces) populations may be related to past and current caribou declines by sustaining greater numbers of wolves (Canis lupus). Mortality rates were greater in areas where caribou calved in forested habitats, in close proximity to predators and moose. Caribou populations which had calving sites in alpine areas, islands, and rugged mountains experienced lower mortality and were generally stable or increasing. A predator-induced population decline in one area appeared to stabilize at low caribou densities, suggesting that the wolf predation rate may be density dependent

Real estate management against state policy regarding the development of the fiber optic network

Motivation: Contemporary social and economic development is undoubtedly based on access to various types of information. This access is conditioned by the existence and availability of a proper telecommunications infrastructure. In order to provide adequate infrastructure, it is necessary to have proper legal regulations on this subject matter. According to the authors, the issue of providing access to the real estate, and in particular the obligations resulting from it, deserves a special discussion.Aim: The purpose of this article is to discuss the obligations that property managers have in the field of providing the property to telecommunications undertakings in order to provide telecommunications network. In addition, the purpose of the article is also to draw attention to the specific administrative procedure that may be initiated in the event of failure to fulfill these obligations by the administrators.Results: Based on the analysis of legal regulations and literature, the responsibilities of property managers, as well as administrative proceedings conducted by the President of UKE were discussed. Attention was also paid to a number of differences that occur in this procedure in relation to the general administrative procedure, including primarily the appeal procedure against the decision issued in the case. Moreover, the article presents statistical data on the number of initiated proceedings and decisions issued by the President of UKE. Summary of the article are conclusions regarding the impact of the fiber network development on property management

Software Metrics in Boa Large-Scale Software Mining Infrastructure: Challenges and Solutions

In this paper, we describe our experience implementing some of classic software engineering metrics using Boa - a large-scale software repository mining platform - and its dedicated language. We also aim to take an advantage of the Boa infrastructure to propose new software metrics and to characterize open source projects by software metrics to provide reference values of software metrics based on large number of open source projects. Presented software metrics, well known and proposed in this paper, can be used to build large-scale software defect prediction models. Additionally, we present the obstacles we met while developing metrics, and our analysis can be used to improve Boa in its future releases. The implemented metrics can also be used as a foundation for more complex explorations of open source projects and serve as a guide how to implement software metrics using Boa as the source code of the metrics is freely available to support reproducible research.Comment: Chapter 8 of the book "Software Engineering: Improving Practice through Research" (B. Hnatkowska and M. \'Smia{\l}ek, eds.), pp. 131-146, 201

Identification of clinical risk factors of atrial fibrillation in congestive heart failure

Background: Factors associated with the development of atrial fibrillation (AF) in generalpopulation have been described, but it is still unknown whether the same risk factors applyto heart failure (HF) patients. The aim of this study was to identify clinical factors related tovarious forms of AF in HF patients.Methods: The clinical and echocardiographic characteristics were assessed in 155 HF patients:50 with sinus rhythm, 52 with non-permanent AF, and 53 with permanent AF.Results: Multivariate logistic regression analysis showed that the increase in the NYHAclass was an independent risk factor for both forms of AF. The occurrence of permanent AF incomparison to sinus rhythm group was independently associated with hs-C-reactive protein(CRP) elevation above 1 mg/dL (OR 1.87, 95% CI 1.05–3.35), left atrial dimension above4 cm (OR 3.78, 95% CI 1.29–11.06) and tricuspid maximal pressure gradient elevation above35 mm Hg (OR 5.01, 95% CI 1.38–18.27). The presence of coronary disease was independentlyassociated with less frequent occurrence of permanent AF in comparison to sinus rhythm group(OR 0.21, 95% CI 0.06–0.67).Conclusions: More advanced congestive HF was associated with presence of both types of AF.Non-ischemic etiology of HF and elevated CRP are independently associated with permanentAF compared to sinus rhythm. Left ventricular diastolic dysfunction indicators (increasedtricuspid maximal pressure gradient and left artial dimension) are independently associatedwith permanent AF

PAR1 activation initiates integrin engagement and outside-in signalling in megakaryoblastic CHRF-288 cells

AbstractTo better understand the means by which cells such as human platelets regulate the binding of the integrin αIIbβ3 to fibrinogen, we have examined agonist-initiated inside-out and outside-in signalling in CHRF-288 cells, a megakaryoblastic cell line that expresses αIIbβ3 and the human thrombin receptor, PAR1. The results show several notable similarities and differences. (1) Activation of PAR1 caused CHRF-288 cells to adhere and spread on immobilized fibrinogen in an αIIbβ3-dependent manner, but did not support the binding of soluble fibrinogen or PAC-1, an antibody specific for activated αIIbβ3. (2) Direct activation of protein kinase C with PMA or disruption of the actin cytoskeleton with low concentrations of cytochalasin D also caused CHRF-288 cells to adhere to fibrinogen. (3) Despite the failure to bind soluble fibrinogen, activation of PAR1 in CHRF-288 cells caused phosphoinositide hydrolysis, arachidonate mobilization and the phosphorylation of p42MAPK, phospholipase A2 and the Rac exchange protein, Vav, all of which occur in platelets. PAR1 activation also caused an increase in cytosolic Ca2+, which, when prevented, blocked adhesion to fibrinogen. (4) Finally, as in platelets, adhesion of CHRF-288 cells to fibrinogen was followed by a burst of integrin-dependent (‘outside-in’) signalling, marked by FAK phosphorylation and a more prolonged phosphorylation of p42MAPK. However, in contrast to platelets, adhesion to fibrinogen had no effect on Vav phosphorylation. Collectively, these observations show that signalling initiated through PAR1 in CHRF-288 cells can support αIIbβ3 binding to immobilized ligand, but not the full integrin activation needed to bind soluble ligand. This would suggest that there has been an increase in integrin avidity without an accompanying increase in affinity. Such increases in avidity are thought to be due to integrin clustering, which would also explain the results obtained with cytochalasin D. The failure of αIIbβ3 to achieve the high affinity state in CHRF-288 cells was not due to the failure of PAR1 activation to initiate a number of signalling events that normally accompany platelet activation nor did it prevent at least some forms of outside-in signalling. However, at least one marker of outside-in signalling, the augmentation of Vav phosphorylation seen during platelet aggregation, did not occur in CHRF-288 cells

Summer Activity Patterns of Three Rodents in the Southwestern Yukon

The small mammal communities of boreal forest in the SW Yukon are diverse and little is known about the underlying reasons for this species richness. Niche differentiation through staggered periods of activity is one way in which similar species may avoid potential interference competition. In this study we describe the activity pattern of three rodents (the deer mouse, the northern red-backed vole, and the singing vole) from the summer solstice to the autumnal equinox. Activity was measured on two white spruce plots by checking live-traps at 2 h intervals over a 24 h period. We did this at monthly intervals between June and September 1984. The deer mouse was strongly nocturnal throughout the summer, while the northern red-backed vole and the singing vole were active both day and night. During the nocturnal period of deer mouse activity, approximately 80% of the red-backed vole population was active, and we conclude that there is no evidence of temporal niche differentiation between these two species. Only deer mice showed a seasonal change in activity pattern. As the days became shorter, deer mice became active earlier, so that by September they were active 4 h earlier than they were in June.Key words: deer mice, Peromyscus maniculatus, northern red-backed vole, Clethrionomys rutilus, singing vole, Microtus miurus, activity time, Yukon, competitionMots clés: souris sylvestre, Peromyscus maniculatus, campagnol à dos roux boréal, Clethrionomys rutilus, campagnol chanteur, Microtus miurus, période d'activité, Yukon, compétitio