Time to Pregnancy: A Computational Method for Using the Duration of Non-Conception for Predicting Conception

An important problem in reproductive medicine is deciding when people who have failed to become pregnant without medical assistance should begin investigation and treatment. This study describes a computational approach to determining what can be deduced about a couple''s future chances of pregnancy from the number of menstrual cycles over which they have been trying to conceive. The starting point is that a couple''s fertility is inherently uncertain. This uncertainty is modelled as a probability distribution for the chance of conceiving in each menstrual cycle. We have developed a general numerical computational method, which uses Bayes'' theorem to generate a posterior distribution for a couple''s chance of conceiving in each cycle, conditional on the number of previous cycles of attempted conception. When various metrics of a couple''s expected chances of pregnancy were computed as a function of the number of cycles over which they had been trying to conceive, we found good fits to observed data on time to pregnancy for different populations. The commonly-used standard of 12 cycles of non-conception as an indicator of subfertility was found to be reasonably robust, though a larger or smaller number of cycles may be more appropriate depending on the population from which a couple is drawn and the precise subfertility metric which is most relevant, for example the probability of conception in the next cycle or the next 12 cycles. We have also applied our computational method to model the impact of female reproductive ageing. Results indicate that, for women over the age of 35, it may be appropriate to start investigation and treatment more quickly than for younger women. Ignoring reproductive decline during the period of attempted conception added up to two cycles to the computed number of cycles before reaching a metric of subfertility.     

The metabolism of leukotrienes in blood plasma studied by high-performance liquid chromatography

The metabolism of leukotrienes (B4, C4, D4, and E4) within human plasma was studied and a simple sample preparation is presented. It was demonstrated that leukotriene E4 and leukotriene B4 were stable during incubation at 37 degrees C using the in vitro system. In contrast, leukotriene C4 was metabolized by gamma-glutamyl transpeptidase activities into leukotriene D4 which was further metabolized by dipeptidase activities of plasma into leukotriene E4. The transition state inhibitor of gamma-glutamyl transpeptidase L-serine-borate decreased the metabolism of leukotriene C4 in plasma. Dilution of plasma demonstrated that the dipeptidase was more active compared to the gamma-glutamyl transpeptidase. The metabolizing activities of plasma were functionally characterized by fractionating the plasma proteins.     

Effects of stream-crossing by a pipeline on the benthic macroinvertebrate communities of a small mountain stream

Aquatic environmental impact associated with stream-crossing by a pipeline was monitored at Archibald Creek, B.C. for two years. Water chemistry and benthic macroinvertebrates were used as monitoring tools. Results indicated that impacts arising from stream-crossing were short-term and non-residual.Funded by a contract from Canadian Arctic Gas Study Limited, calgary, to Aquatic Environments Limited, Calgary.Aquatic Environments Limited, Calgary.Aquatic Environments Limited, Calgary.     

Über das Invertierungsvermögen der Speicheldrüsen und des Mitteldarmes von Bienen verschiedenen Alters

Zusammenfassung Die gewonnenen Ergebnisse zeigen mit völliger Klarheit, daß die Schlunddrüse ein stark ausgesprochenes Invertierungsvermögen besitzt, das sich jedoch in hohem Grade, je nach dem Alter der Bienen ändert. Im Gegensatz zum Mitteldarm, der Invertase auszuscheiden beginnt von dem Augenblicke des Ausschlüpfens der jungen Biene, bedarf die Schlunddrüse eines gewissen Zeitraumes zu ihrer Entwicklung. Die von uns angestellten Versuche können indessen die Frage noch nicht endgültig entscheiden, in welchem Moment die Schlunddrüse zu funktionieren beginnt. Wir haben die Sekretionstätigkeit der Drüse an verhältnismäßig alten Bienen — von 10 Tagen an — beobachtet und die maximalen Ziffern der Zuckerinversion bei 30tägigen Bienen ermittelt. Hieraus lassen sich noch keine verallgemeinernden Schlüsse ziehen. Unsere Versuche begannen im August und dauerten bis Mitte September, fanden also am Ende der Saison statt. Das Versuchsvolk war schwach und die Zahl der jungen Bienen und der Brut gering (auf einem Rahmen). Als Beleg dazu genügt der Hinweis, daß die Bienen ihre Orientierungsausflüge im Alter von 18 Tagen unternahmen. Alle diese Faktoren könnten zweifellos das Tempo der Entwicklung des Organismus der Biene — und der Sehlunddrüse im besonderen — beeinflussen. Es ist sehr wahrscheinlich, daß eine Untersuchung über die Veränderung des Invertierungsvermögens der Schiunddrüsen von Bienen, die zu verschiedenen Zeiten der Frühlings- und Sommersaison ausgeschlüpft waren, auch eine verschiedene Schnelligkeit der Entwicklung der Drüse ergeben würde.Was die Brustdrüse anbetrifft, so geben unsere Versuche kein genügendes Material zur Beurteilung, welche Rolle sie im Kohlehydratstoffwechsel der Biene spielt. Nur eines steht fest, daß sie an der Invertierung des Zuckers in keinem Falle beteiligt ist.Der Mitteldarm scheint auch mit dem Alter der Biene sein Invertierungsvermögen zu steigern, wenn auch nicht in solchem Umfange als die Schlunddrüse.Die von uns gewonnenen Resultate erlauben, einige Schlüsse über mehrere Fragen der Bienenbiologie zu ziehen, wie z. B. die Frage über den Anteil der Schlunddrüse an der Futtersaftbereitung usw. Doch müssen solche spezielle Fragen an einer anderen Stelle ausführlich besprochen werden.Zum Schlusse sprechen wir Dr. Resnitschenko sowie Dr. Alpatov für die freundliche Hilfe bei der Ausführung der Arbeit unseren Dank aus.     

Staff Nurses’ Perceptions and Experiences about Structural Empowerment: A Qualitative Phenomenological Study

The aim of the study reported in this article was to investigate staff nurses’ perceptions and experiences about structural empowerment and perceptions regarding the extent to which structural empowerment supports safe quality patient care. To address the complex needs of patients, staff nurse involvement in clinical and organizational decision-making processes within interdisciplinary care settings is crucial. A qualitative study was conducted using individual semi-structured interviews of 11 staff nurses assigned to medical or surgical units in a 600-bed university hospital in Belgium. During the study period, the hospital was going through an organizational transformation process to move from a classic hierarchical and departmental organizational structure to one that was flat and interdisciplinary. Staff nurses reported experiencing structural empowerment and they were willing to be involved in decision-making processes primarily about patient care within the context of their practice unit. However, participants were not always fully aware of the challenges and the effect of empowerment on their daily practice, the quality of care and patient safety. Ongoing hospital change initiatives supported staff nurses’ involvement in decision-making processes for certain matters but for some decisions, a classic hierarchical and departmental process still remained. Nurses perceived relatively high work demands and at times viewed empowerment as presenting additional. Staff nurses recognized the opportunities structural empowerment provided within their daily practice. Nurse managers and unit climate were seen as crucial for success while lack of time and perceived work demands were viewed as barriers to empowerment.