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This thesis includes a review of scientific studies of tree injuries following mechanized thinning. Interviews have been made with drivers of single grip harvesters and forwarders in forest thinning and a number of essential factors have been identified as the most important to take into account in order to minimize and/orprevent injuries to stems and roots of remaining trees.

University of Macau / Faculty of Social Sciences. / Department of Communication

Wild-type transthyretin amyloidosis (ATTRwt) is a rare, sporadic protein misfolding disorder with no validated biomarkers or specific treatments. The disease is characterized by deposition of amyloid fibrils composed of wild-type transthyretin (TTR) in cardiac tissue, which leads to cardiomyopathy, heart failure, and death within 5 years. The hypothesis for the studies detailed in this dissertation was non-coding variants in the TTR gene regulatory regions impact expression and serum levels of the protein, thereby contributing to ATTRwt pathogenesis. Investigations included examination of 2 enhancer regions and the proximal promoter of the TTR gene for risk factors which could contribute to pathogenesis of ATTRwt amyloidosis. In total, 11 common and 20 rare variants were identified. The analyses demonstrated significant associations of 3 variants with increased disease risk and 4 variants with age at disease onset and/or survival. Functional studies using GFP and luciferase reporter assays in HepG2 cells were performed to examine the impact of nucleotide alterations in the TTR proximal promoter on reporter expression. Three ATTRwt-risk factors (rs3764479, rs72922940, rs3794885), caused significantly decreased reporter expression in both GFP and luciferase assays (p < 0.02). Moreover, serum TTR levels, measured by immunoturbidity and analyzed along with ATTRwt clinical data, demonstrated that lower serum TTR concentrations were associated with worse survival (hazard ratio = 0.89, p = 0.003). Follow-up analysis of an ATTRwt subset treated with diflunisal, a TTR stabilizer, showed increased serum TTR (p = 0.002) and organ improvement as assessed by cardiac biomarkers (p = 0.043). Unexpectedly, our genetic sequencing data suggested that the TTR G6S variant was disease-protective. Analysis of the TTR G6S protein using circular dichroism and aggregation assay corroborated these findings by demonstrating a higher structural stability and a lower aggregation propensity compared to L55P and V122I, two unstable amyloidogenic TTR variants. In summary, the major findings of this work were: 1) identification of genetic variants that confer risk for ATTRwt amyloidosis through changes in expression, 2) evidence in support of serum TTR as a candidate for monitoring disease progression and response to treatment, and 3) evidence suggesting that TTR G6S may confer protection from ATTRwt by slowing the amyloid cascade. / 2017-09-08T00:00:00Z

In the United States, hysterectomy is one of the most commonly performed operations for women that is not related with pregnancy. However, not enough attention has been paid to how women's exposure to the surgery differs according to their social characteristics as well attitudinal/behavioral factors. Using cohort data from the National Longitudinal Surveys of Mature Women, this study investigated two aspects: (1) the association between socioeconomic status and hysterectomy and (2) the impact of women's attitudinal/behavioral characteristics on hysterectomy. With Cox proportional hazards analyses, this study found that women's exposure to hysterectomy significantly differs according to their social and attitudinal standings. Social characteristics that were found to be statistically significant risk factors of hysterectomy include women's eduction, employment status, and marital status. Among additional and behavioral factors, women's locus of control and number of children were identified as statistically significant risk factors. These findings may be used to enhance consumer awareness of hysterectomy and aid in policy reconstruction.

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Background: Many risk factors for venous thromboembolism have been identified, but two particular exposures - the use of combined oral contraceptives and long-distance air travel - have generated considerable concern in recent years. In contrast, a possible link between venous thromboembolism and a third exposure - the use of psychotropic drugs - was first raised in the 1950s, but has received surprisingly little attention. Information about all three exposures and the risk of fatal events is limited. These risks were examined in three inter-related national population-based studies. Methods: The underlying study population included all men and women aged 15 - 59 years who died in New Zealand between 1990 and 2000, for whom the underlying cause of death was pulmonary embolism. The potential associations between fatal pulmonary embolism and the use of oral contraceptives and psychotropic drugs were explored in a general practice records-based case-control study. Non-users were the reference category for all analyses. Contraceptive supply data were used to estimate the absolute risk of death from pulmonary embolism in users of oral contraceptives. A second case-control study, in which computer-assisted telephone interviews were undertaken with the next of kin of cases who had been resident in New Zealand, and with sex and age-matched controls randomly selected from the electoral roll, investigated the possible association between long-distance air travel and fatal pulmonary embolism. Finally, the absolute risk of dying from pulmonary embolism following a long-distance flight was estimated in a descriptive study based on official migration data and deaths in recent air travellers. Results: The adjusted odds ratio for use of any oral contraceptive in the three months before the index date (the onset of the fatal episode) was 13.1 (95% CI 4.4 - 39.0). The odds ratio for formulations containing desogestrel and gestodene was about three times higher than the point estimate for levonorgestrel products; preparations containing cyproterone acetate appeared to carry the highest risk. The estimated absolute risk of fatal pulmonary embolism in current users of oral contraceptives was 10.5 (95% CI 6.2 - 16.6) per million woman-years. The adjusted odds ratio for current use of any antipsychotic was 13.3 (95% CI 2.3 - 76.3). Low-potency antipsychotics carried a 20-fold increase in risk; thioridazine was the main drug involved. Antidepressant use was also associated with a significantly increased risk (adjusted odds ratio 4.9 [95% CI 1.1 - 22.5]). Compared with non-travellers, people who had undertaken a flight of more than eight hours� duration in the preceding four weeks were eight times more likely to die from pulmonary embolism (odds ratio 7.9 [95% CI 1.1 - 55.1]). The absolute risk of fatal pulmonary embolism following air travel of more than eight hours was 1.3 (95% CI 0.4 - 3.0) per million arrivals. Conclusions: The present research was the first to have estimated the relative risks of fatal pulmonary embolism in relation to three exposures: oral contraceptive use in a population in which preparations containing desogestrel and gestodene preparations were widely used, conventional antipsychotics, and long-distance air travel. The findings were consistent with previous, and subsequent, studies of non-fatal events. Increased risks of fatal pulmonary embolism in users of antidepressants, and in people with an intellectual disability, have not been described previously and warrant further investigation. Referral and diagnostic biases are very unlikely in these studies of fatal events, and other types of bias and possible confounding are considered unlikely explanations for the findings.

Background: As a multifactorial disease glaucoma may be associated with pressure-dependent and -independent factors. Ocular hypertension (OHT) may develop into primary open angle glaucoma (POAG) for many patients. We compared groups with OHT and POAG for pressure-dependent and -independent risk factors. A high prevalence of any factor(s) could indicate a contribution to progression from OHT to POAG. Method: A sample of patients with POAG (n 438) and with OHT (n 301) were selected from those attending a tertiary referral private glaucoma practice, and data were collected regarding age and intraocular pressure at the time of diagnosis, gender, family history of glaucoma, systemic hypertension, diabetes, Raynaud's phenomenon, migraine and myopia. Results: After multivariate analysis, older age at time of diagnosis (P<0.001), myopia (odds ratio (O.R) 1.5, 95percent confidence interval (C.I)1.0-2.2; P 0.05), a family history of glaucoma (O.R 1.6, 95 percent C.I 1.1-2.3; P 0.01) and a high intraocular pressure (P 0.002) were associated with POAG. No other significant differences were found between the two groups. Conclusion: Patients who have OHT may be at higher risk of developing POAG if they also have myopia, a family history of glaucoma or are of older age.