History of wildland fires on Vandenberg Air Force Base, California

The fire history of the past 50 years for Vandenberg AFB, California was determined using aerial photography, field investigation, and historical and current written records. This constitutes a record of the vegetation age classes for the entire base. The location, cause, and fuel type for sixty fires from this time period were determined. The fires were mapped and entered into a geographic infomation system (GIS) for Vandenberg. Fire history maps derived from this GIS were printed at 1:9600 scale and are on deposit at the Vandenberg Environmental Task Force Office. Although some ecologically significant plant communities on Vandenberg are adapted to fire, no natural fire frequency could be determined, since only one fire possibly caused by lightning occurred in the area now within the base since 1937. Observations made during this study suggest that burning may encourage the invasion of exotic species into chaparral, in particular Burton Mesa or sandhill chaparral, an unusual and geographically limited form of chaparral found on the base

Vegetation studies on Vandenberg Air Force Base, California

Vandenburg Air Force Base, located in coastal central California with an area of 98,400 ac, contains resources of considerable biological significance. Available information on the vegetation and flora of Vandenburg is summarized and new data collected in this project are presented. A bibliography of 621 references dealing with vegetation and related topics related to Vanderburg was compiled from computer and manual literature searches and a review of past studies of the base. A preliminary floristic list of 642 taxa representing 311 genera and 80 families was compiled from past studies and plants identified in the vegetation sampling conducted in this project. Fifty-two special interest plant species are known to occur or were suggested to occur. Vegetation was sampled using permanent plots and transects in all major plant communities including chaparral, Bishop pine forest, tanbark oak forest, annual grassland, oak woodland, coastal sage scrub, purple sage scrub, coastal dune scrub, coastal dunes, box elder riparian woodland, will riparian woodland, freshwater marsh, salt marsh, and seasonal wetlands. Comparison of the new vegetation data to the compostie San Diego State University data does not indicate major changes in most communities since the original study. Recommendations are made for additional studies needed to maintain and extend the environmental data base and for management actions to improve resource protection

Management of coronary disease in patients with advanced kidney disease

BACKGROUND Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P=0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P=0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P=0.03). CONCLUSIONS Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction

Health status after invasive or conservative care in coronary and advanced kidney disease

BACKGROUND In the ISCHEMIA-CKD trial, the primary analysis showed no significant difference in the risk of death or myocardial infarction with initial angiography and revascularization plus guideline-based medical therapy (invasive strategy) as compared with guideline-based medical therapy alone (conservative strategy) in participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease (an estimated glomerular filtration rate of <30 ml per minute per 1.73 m2 or receipt of dialysis). A secondary objective of the trial was to assess angina-related health status. METHODS We assessed health status with the Seattle Angina Questionnaire (SAQ) before randomization and at 1.5, 3, and 6 months and every 6 months thereafter. The primary outcome of this analysis was the SAQ Summary score (ranging from 0 to 100, with higher scores indicating less frequent angina and better function and quality of life). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate the treatment effect with the invasive strategy. RESULTS Health status was assessed in 705 of 777 participants. Nearly half the participants (49%) had had no angina during the month before randomization. At 3 months, the estimated mean difference between the invasive-strategy group and the conservative-strategy group in the SAQ Summary score was 2.1 points (95% credible interval, 120.4 to 4.6), a result that favored the invasive strategy. The mean difference in score at 3 months was largest among participants with daily or weekly angina at baseline (10.1 points; 95% credible interval, 0.0 to 19.9), smaller among those with monthly angina at baseline (2.2 points; 95% credible interval, 122.0 to 6.2), and nearly absent among those without angina at baseline (0.6 points; 95% credible interval, 121.9 to 3.3). By 6 months, the between-group difference in the overall trial population was attenuated (0.5 points; 95% credible interval, 122.2 to 3.4). CONCLUSIONS Participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease did not have substantial or sustained benefits with regard to angina-related health status with an initially invasive strategy as compared with a conservative strategy