Strontium and Oxygen Isotope Profiles of Sequentially Sampled Modern Bison (Bison bison bison) Teeth from Interior Alaska as Proxies of Seasonal Mobility

Studies addressing prehistoric mobility in animals typically use isotopic analyses of sequentially formed tissues, such as the growth layers in teeth, to infer physical movement on the landscape. Strontium isotope ratios (87Sr/86Sr values), which vary geographically, are particularly useful for this purpose, especially when paired with stable oxygen isotope ratios (δ18O), which vary seasonally. Together, these two isotope systems can provide information about past animal movement patterns on a seasonal scale. However, while many studies have used 87Sr/86Sr and δ18O values from analyses of sequentially formed tissues for this purpose, there have been limited analyses on modern animals of known movement patterns across high-latitude regions. In this pilot study, we sequentially sampled and analyzed one second molar (M2) and two third molars (M3) from two bison (Bison bison bison) from the Delta bison herd, which resides in interior Alaska and has known and documented seasonal mobility patterns. The resulting 87Sr/86Sr values from the teeth were compared to a high-resolution 87Sr/86Sr isoscape for the region and were paired with δ18O analyses to determine whether the seasonal 87Sr/86Sr values matched the predicted values for each of the seasonal bison habitat areas. The results indicate that the 87Sr/86Sr and δ18O values reliably reflected the known seasonal mobility patterns of bison and suggest that this approach could be used to investigate the mobility patterns of prehistoric bison in Alaska and surrounding high-latitude regions.En général, les études qui portent sur la mobilité des animaux préhistoriques se servent d’analyses isotopiques des tissus séquentiellement formés, y compris les couches de développement des dents, afin d’en déduire les mouvements physiques dans l’environnement. Les rapports isotopiques du strontium (87Sr/86Sr) sont particulièrement utiles à cette fin, car ils varient géographiquement, surtout lorsqu’ils sont jumelés avec les rapports isotopiques stables de l’oxygène (δ18O), dont la variabilité est saisonnière. Ensemble, ces deux isotopes peuvent fournir des informations sur les habitudes de déplacement des animaux dans un paysage en fonction des saisons. Cependant, même si plusieurs études ont utilisé les valeurs 87Sr/86Sr et δ18O découlant des analyses des tissus séquentiellement formés à cette fin, peu d’analyses ont été effectuées chez les animaux modernes dont les habitudes de déplacement sont connues dans les régions de haute latitude. Dans cette étude pilote, nous avons séquentiellement échantillonné et analysé une deuxième molaire (M2) et deux troisièmes molaires (M3) de deux bisons (Bison bison bison) du troupeau de bisons du delta, troupeau qui réside dans l’intérieur de l’Alaska et dont les modèles de mobilité saisonnière sont connus et documentés. Les valeurs 87Sr/86Sr obtenues à partir des dents ont été comparées à un paysage isotopique de haute résolution 87Sr/86Sr pour la région et ont été jumelées aux analyses δ18O pour déterminer si les valeurs 87Sr/86Sr saisonnières correspondaient aux valeurs prévues pour les zones d’habitat saisonnières du bison. Les résultats indiquent que les valeurs 87Sr/86Sr et δ18O reflètent fidèlement les modèles connus de mobilité saisonnière du bison, et suggèrent que cette méthode pourrait servir à étudier les modèles de mobilité des bisons préhistoriques en Alaska et dans les régions de haute latitude environnantes

Communication tools and strategies for interprofessional teamwork in a comprehensive pain assessment clinic in primary care

The Comprehensive Pain Assessment Clinic (CoPAC) is a grant-funded clinic embedded in a family medicine residency center providing care to an under-resourced urban population. This interprofessional clinic brings together 10 professions, including healthcare professionals, university faculty, and learners to assess patients with chronic pain. The focus of the clinic is to develop a functional and dynamic model of teamwork including communication strategies to facilitate assessment. The communication/teamwork tools and strategies include pre-visit preparation sheets, pre-visit team huddles, “teamlet” visits, handoff communication tools, care plan development, patient education, follow-up care coordination, and post-clinic debriefs, which are used for continuous quality improvement. The process model for the clinic, communication tools, and qualitative comments from learners are described. Lessons learned are discussed, including time management, intentional mentoring, interprofessional education and collaborative practice (IPECP) coordination, and implementation of best practices

Strontium and Oxygen Isotope Profiles of Sequentially Sampled Modern Bison (<i>Bison bison bison</i>) Teeth from Interior Alaska as Proxies of Seasonal Mobility

Studies addressing prehistoric mobility in animals typically use isotopic analyses of sequentially formed tissues, such as the growth layers in teeth, to infer physical movement on the landscape. Strontium isotope ratios (87Sr/86Sr values), which vary geographically, are particularly useful for this purpose, especially when paired with stable oxygen isotope ratios (δ18O), which vary seasonally. Together, these two isotope systems can provide information about past animal movement patterns on a seasonal scale. However, while many studies have used 87Sr/86Sr and δ18O values from analyses of sequentially formed tissues for this purpose, there have been limited analyses on modern animals of known movement patterns across high-latitude regions. In this pilot study, we sequentially sampled and analyzed one second molar (M2) and two third molars (M3) from two bison (Bison bison bison) from the Delta bison herd, which resides in interior Alaska and has known and documented seasonal mobility patterns. The resulting 87Sr/86Sr values from the teeth were compared to a high-resolution 87Sr/86Sr isoscape for the region and were paired with δ18O analyses to determine whether the seasonal 87Sr/86Sr values matched the predicted values for each of the seasonal bison habitat areas. The results indicate that the 87Sr/86Sr and δ18O values reliably reflected the known seasonal mobility patterns of bison and suggest that this approach could be used to investigate the mobility patterns of prehistoric bison in Alaska and surrounding high-latitude regions.</jats:p

Ten-year survival in 290 patients with endometrial cancer: prognostic factors and therapeutic approach

Between 1970 and 1976, 290 patients with endometrial cancer were treated at the 1st Obstetrics and Gynecology Clinic of the University of Milan. The median age was 62 years. Surgery was completed in 262 (90.3%) patients. Abdominal hysterectomy was used in 158 (70.9%) stage I and 40 (71.4%) stage II/III) patients; vaginal hysterectomy in 55 (24.7%) stage I and nine (16.1%) stage II/III patients. Resection of the upper vagina was performed in 168 patients. Postoperative external beam radiotherapy was used in stage II/III patients and in 44 (19.7%) stage I high-risk patients. Ten-year survival, determined by the life-table method, was 84.8% in stage I (223 patients), 53.4% in stage II (37 patients), 64.4% in stage III (19 patients), and 9.1% in stage IV (11 patients). Factors associated with poorer prognosis were: late age at diagnosis (P less than 0.001); deep myometrial invasion (P less than 0.001); poorly differentiated histological grade (P = 0.11); lack of resection of the upper vagina (P = 0.13). The role and importance of surgery is discussed, with special emphasis on the selective use of the vaginal route in aged, obese and medically high-risk patients