bluuebunny/crossref_metadata_2025 huggingface dataset:
Isotopic composition of waters from Ethiopia and Kenya: Insights into moisture sources for eastern Africa
Authors: Levin Naomi E. , Zipser Edward J. , Cerling Thure E.
Published: December 2009

Oxygen and deuterium isotopic values of meteoric waters from Ethiopia are unusually high when compared to waters from other high‐elevation settings in Africa and worldwide. These high values are well documented; however, the climatic processes responsible for the isotopic anomalies in Ethiopian waters have not been thoroughly investigated. We use isotopic data from waters and remote data products to demonstrate how different moisture sources affect the distribution of stable isotopes in waters from eastern Africa. Oxygen and deuterium stable isotopic data from 349 surface and near‐surface groundwaters indicate isotopic distinctions between waters in Ethiopia and Kenya and confirm the anomalous nature of Ethiopian waters. Remote data products from the Tropical Rainfall Measuring Mission (TRMM) and National Centers for Environmental Prediction (NCEP) reanalysis project show strong westerly and southwesterly components to low‐level winds during precipitation events in western and central Ethiopia. This is in contrast to the easterly and southeasterly winds that bring rainfall to Kenya and southeastern Ethiopia. Large regions of high equivalent potential temperatures (θe) at low levels over the Sudd and the Congo Basin demonstrate the potential for these areas as sources of moisture and convective instability. The combination of wind direction data from Ethiopia and θe distribution in Africa indicates that transpired moisture from the Sudd and the Congo Basin is likely responsible for the high isotopic values of rainfall in Ethiopia.
Objective determination of monsoon season onset, withdrawal, and length
Authors: Cook Benjamin I. , Buckley Brendan M.
Published: December 2009

Using daily precipitation data from a network of weather stations across mainland Thailand, we apply a two‐phase linear regression model to objectively determine the onset, withdrawal, and length of the summer monsoon season for the years 1951–2005. Our onset metric compares favorably with an independent determination of onset. Both onset and withdrawal are associated with expected wind and geopotential height anomalies in the lower atmosphere. Comparisons between stations show no coherent spatial variability in either onset or withdrawal, and trends at each station are small and statistically insignificant at the p < 0.05 level. When averaged across all stations, onset, withdrawal, and season length all show significant correlations with sea surface temperatures (SST) in the Indian ocean, tropical Pacific, and in the North Pacific regions with relatively well understood connections to monsoon variability. Additionally, there are also significant correlations with SSTs in the South Atlantic and North Atlantic, teleconnections that have been previously suggested but remain controversial. Compared to other methods for deriving the onset and withdrawal of the monsoon, our method provides one of the most objective techniques available using data readily available from most meteorological stations.
Phoenix soil physical properties investigation
Authors: Shaw Amy , Arvidson Raymond E. , Bonitz Robert , Carsten Joseph , Keller H. U. , Lemmon Mark T. , Mellon Michael T. , Robinson Matthew , Trebi‐Ollennu Ashitey
Published: December 2009

The Phoenix Lander investigated the polygonal terrain and associated soil and icy soil deposits of a high northern latitude site on Mars. The soil physical properties component involved the analysis of force data determined from motor currents from the Robotic Arm (RA)'s trenching activity. Using this information and images of the landing site, soil cohesion and angle of internal friction were determined. Dump pile slopes were used to determine the angle of internal friction of the soil: 38° ± 5°. Additionally, an excavation model that treated walls and edges of the scoop as retaining walls was used to calculate mean soil cohesions for several trenches in the Phoenix landing site workspace. These cohesions were found to be consistent with the stability of steep trench slopes. Cohesions varied from 0.2 ± 0.4kPa to 1.2 ± 1.8 kPa, with the exception of a subsurface platy horizon unique to a shallow trough for which cohesion will have to be determined using other methods. Soil on polygon mounds had the greatest cohesion (1.2 ± 1.8 kPa). This was most likely due to the presence of adsorbed water or pore ice above the shallow icy soil surface. Further evidence for enhanced cohesion above the ice table includes lateral increase in excavation force, by over 30 N, as the RA approached ice.
A benchtop, ultrafast infrared spectroscopic imaging system for biomedical applications
Authors: Amrania Hemmel , McCrow Andrew , Phillips Chris
Published: December 2009

We discuss the potential biomedical applications for a novel infrared spectroscopic microimaging system. A tunable, table top solid-state laser has been coupled to a commercial infrared microscope, fitted with a modified high resolution infrared camera, to create a unique tool for midinfrared imaging. The system is capable of performing broadband imaging at a diffraction-limited spatial resolution, as is demonstrated here by spatially resolved spectroscopy of polymer test samples with a spectral resolution of 20 cm−1. The large pulse energies (tens of microjoules) offer previously unobtainable combinations of high signal-to-noise levels and rapid data collection times which are superior to current stand-alone laboratory instruments by many decades. Coupled with the short (100 ps) short pulse duration, these characteristics promise to make a wide range of time-resolved and reflection mode imaging experiments possible with live biological systems.
A more efficient device for preparing model-membrane liposomes by the rapid solvent exchange method
Authors: Buboltz Jeffrey T.
Published: December 2009

We modified the original design for a rapid solvent exchange (RSE) device with the intent of making the RSE method (i) more efficient and (ii) easier to adopt and implement. Our modifications improved solvent-removal kinetics by a factor of 2, while reducing sample-prep time by a factor of 3. In this paper, we develop the kinetic model that informed the device revision and we address several RSE parameters that have not yet been discussed in the literature. We also provide detailed mechanical drawings and present solvent-removal efficiency data that confirm the improved performance of our device.
Manifestation of finite temperature size effects in nanogranular magnetic graphite
Authors: Sergeenkov S. , Souza N. S. , Speglich C. , Rivera V. A. G. , Cardoso C. A. , Pardo H. , Mombrú A. W. , Araújo-Moreira F. M.
Published: December 2009

In addition to the double phase transition (with the Curie temperatures TC=300 K and TCt=144 K), a low-temperature anomaly in the dependence of the magnetization is observed in the bulk magnetic graphite (MG) (with an average granular size of L≃10 nm), which is attributed to the manifestation of the size effects below the quantum temperature TL∝ℏ2/L2 and is well fitted by the periodic function ML(T)∝sin[M(T)Λ(T)/L] with M(T) being the bulk magnetization and Λ(T)∝ℏ/T the thermal de Broglie wavelength. The best fits of the high-temperature data (using the mean-field Curie–Weiss and Bloch expressions) produced reasonable estimates for the model parameters, such as defects mediated effective spin exchange energy J≃12 meV (which defines the intragranular Curie temperature TC) and proximity mediated interactions between neighboring grains (through potential barriers U created by thin layers of nonMG) with energy Jt=exp(−d/ξ)J≃5.8 meV (which defines the intergranular Curie temperature TCt) with d≃1.5 nm and ξ∝ℏ/U≃2 nm being the intergranular distance and characteristic length, respectively.
Transfer-arm evaporator cell for rapid loading and deposition of organic thin films
Authors: Greiner M. T. , Helander M. G. , Wang Z. B. , Lu Z. H.
Published: December 2009

Described herein is a transfer-arm evaporator cell (TAE-cell), which allows for rapid loading of materials into vacuum for low-temperature sublimation deposition of thin films. This design can be incorporated with an existing analysis system for convenient in situ thin film characterization. This evaporator is especially well suited for photoemission characterization of organic semiconductor interfaces. Photoemission is one of the most important techniques for characterizing such, however, it generally requires in situ sample preparation. The ease with which materials can be loaded and evaporated with this design increases the throughput of in situ photoemission characterization, and broadens the research scope of the technique. Here, we describe the design, operation, and performance of the TAE-cell.
Defect kinetics and dopant activation in submicrosecond laser thermal processes
Authors: Huet K. , Fisicaro G. , Venturini J. , Besaucèle H. , La Magna A.
Published: December 2009

Defect evolution in ion implanted c-Si at the submicrosecond time scales during a laser thermal annealing process is investigated by means of kinetic simulations. Nonmelting, melting, and partial melting regimes are simulated. Our modeling considers irradiation, heat diffusion, and phase transition together with defect diffusion, annihilation, and clustering. The reduction in the implantation damage and its reorganization in defect aggregates are studied as a function of the process conditions. The approach is applied to double implanted Si and compared to experimental data, indicating a relationship between damage reduction and dopant activation.
Encoding and decoding nanoscale thermal barcodes for ultrahigh capacity identification systems
Authors: Ma Zeyu , Hong Yan , Zhang Minghui , Su Ming
Published: December 2009

An ultrahigh capacity coding system is created based on the solid to liquid phase changes of a variety of nanoparticles, which are designed and prepared with sharp, discrete melting peaks and encapsulated inside nonmelting shells. A mixture of such thermally-active nanoparticles at designed ratio can be embedded inside an object as a nanoscale barcode that can be decoded by differential thermal scan. The coding capacity depends on the number of melting peaks, which in turn depends on nanoparticle compositions. A coding system with 50 different compositions can generate over 1015 thermal barcodes, sufficient for many identification applications.
Bidirectional magnetic nanowire shift register
Authors: O’Brien L. , Read D. E. , Zeng H. T. , Lewis E. R. , Petit D. , Cowburn R. P.
Published: December 2009

We experimentally demonstrate a shift register based on an open-ended chain of ferromagnetic NOT gates which can support bidirectional data flow. Up to eight data bits are electrically input to the device, stored for extended periods without power, and then output either in a first in first out or last in first out scheme. Comparing to traditional transistor-based logic, this bidirectionality offers a range of devices that are reversible and not limited to only one mode of operation.
ChIP-Seq of transcription factors predicts absolute and differential gene expression in embryonic stem cells
Authors: Ouyang Zhengqing , Zhou Qing , Wong Wing Hung
Published: December 2009

Next-generation sequencing has greatly increased the scope and the resolution of transcriptional regulation study. RNA sequencing (RNA-Seq) and ChIP-Seq experiments are now generating comprehensive data on transcript abundance and on regulator–DNA interactions. We propose an approach for an integrated analysis of these data based on feature extraction of ChIP-Seq signals, principal component analysis, and regression-based component selection. Compared with traditional methods, our approach not only offers higher power in predicting gene expression from ChIP-Seq data but also provides a way to capture cooperation among regulators. In mouse embryonic stem cells (ESCs), we find that a remarkably high proportion of variation in gene expression (65%) can be explained by the binding signals of 12 transcription factors (TFs). Two groups of TFs are identified. Whereas the first group (
E2f1
,
Myc
,
Mycn
, and
Zfx
) act as activators in general, the second group (
Oct4
,
Nanog
,
Sox2
,
Smad1
,
Stat3
,
Tcfcp2l1
, and
Esrrb
) may serve as either activator or repressor depending on the target. The two groups of TFs cooperate tightly to activate genes that are differentially up-regulated in ESCs. In the absence of binding by the first group, the binding of the second group is associated with genes that are repressed in ESCs and derepressed upon early differentiation.
Inhalation exposure to ambient polycyclic aromatic hydrocarbons and lung cancer risk of Chinese population
Authors: Zhang Yanxu , Tao Shu , Shen Huizhong , Ma Jianmin
Published: December 2009

An Euler atmospheric transport model (Canadian Model for Environmental Transport of Organochlorine Pesticides, CanMETOP) was applied and validated to estimate polycyclic aromatic hydrocarbon (PAH) ambient air concentrations at ground level in China based on a high-resolution emission inventory. The results were used to evaluate lung cancer risk for the Chinese population caused by inhalation exposure to PAHs. The uncertainties of the transport model, exposure, and risk analysis were assessed by using Monte Carlo simulation, taking into consideration the variation in PAH emission, aerosol and OH radical concentrations, dry deposition, respiration rate, and genetic susceptibility. The average benzo[
a
]pyrene equivalent concentration (B[
a
]P
eq
) was 2.43 [≈1.29–4.50 as interquartile range (IR)] ng/m
3
. The population-weighted B[
a
]P
eq
was 7.64 (IR, ≈4.05–14.1) ng/m
3
because of the spatial overlap of the emissions and population density. It was estimated that 5.8% (IR, ≈2.0–11%) of China's land area, where 30% (IR, ≈17–43%) of the population lives, exceeded the national ambient B[
a
]P
eq
standard of 10 ng/m
3
. Taking into consideration the variation in exposure concentration, respiration rate, and susceptibility, the overall population attributable fraction (PAF) for lung cancer caused by inhalation exposure to PAHs was 1.6% (IR, ≈0.91–2.6%), corresponding to an excess annual lung cancer incidence rate of 0.65 × 10
−5
. Although the spatial variability was high, the lung cancer risk in eastern China was higher than in western China, and populations in major cities had a higher risk of lung cancer than rural areas. An extremely high PAF of >44% was estimated in isolated locations near small-scale coke oven operations.
The diffusion of maize to the southwestern United States and its impact
Authors: Merrill William L. , Hard Robert J. , Mabry Jonathan B. , Fritz Gayle J. , Adams Karen R. , Roney John R. , MacWilliams A. C.
Published: December 2009

Our understanding of the initial period of agriculture in the southwestern United States has been transformed by recent discoveries that establish the presence of maize there by 2100 cal. B.C. (calibrated calendrical years before the Christian era) and document the processes by which it was integrated into local foraging economies. Here we review archaeological, paleoecological, linguistic, and genetic data to evaluate the hypothesis that Proto-Uto-Aztecan (PUA) farmers migrating from a homeland in Mesoamerica introduced maize agriculture to the region. We conclude that this hypothesis is untenable and that the available data indicate instead a Great Basin homeland for the PUA, the breakup of this speech community into northern and southern divisions ≈6900 cal. B.C. and the dispersal of maize agriculture from Mesoamerica to the US Southwest via group-to-group diffusion across a Southern Uto-Aztecan linguistic continuum.
Targeted lipidomics reveals mPGES-1-PGE2 as a therapeutic target for multiple sclerosis
Authors: Kihara Yasuyuki , Matsushita Takuya , Kita Yoshihiro , Uematsu Satoshi , Akira Shizuo , Kira Jun-ichi , Ishii Satoshi , Shimizu Takao
Published: December 2009

The arachidonic acid (AA) cascade produces eicosanoids, such as prostaglandins (PGs), that regulate physiological and pathological functions. Although various nonsteroidal anti-inflammatory drugs have been developed, blocking upstream components (cyclooxygenase-1 and -2) of the AA cascade leads to severe side effects, including gastrointestinal ulcers and cardiovascular events, respectively, due to the complexity of the AA cascade. Here, using an AA cascade-targeted lipidomics approach, we report that microsomal PGE synthase 1 (mPGES-1) plays a key role in experimental autoimmune encephalomyelitis (EAE). Eicosanoids (mainly PGD
2
) are produced constitutively in the spinal cord of naive mice. However, in EAE lesions, the PGE
2
pathway is favored and the PGD
2
, PGI
2
, and 5-lipoxygenase pathways are attenuated. Furthermore, mPGES-1
−/−
mice showed less severe symptoms of EAE and lower production of IL-17 and IFN-γ than mPGES-1
+/+
mice. Expression of PGE
2
receptors (EP1, EP2, and EP4) was elevated in EAE lesions and correlated with clinical symptoms. Immunohistochemistry on central nervous systems of EAE mice and multiple sclerosis (MS) patients revealed overt expression of mPGES-1 protein in microglia/macrophages. Thus, the mPGES-1-PGE
2
-EPs axis of the AA cascade may exacerbate EAE pathology. Our findings have important implications for the design of therapies for MS.
Interplay between the Smc5/6 complex and the Mph1 helicase in recombinational repair
Authors: Chen Yu-Hung , Choi Koyi , Szakal Barnabas , Arenz Jacqueline , Duan Xinyuan , Ye Hong , Branzei Dana , Zhao Xiaolan
Published: December 2009

The evolutionarily conserved Smc5/6 complex is implicated in recombinational repair, but its function in this process has been elusive. Here we report that the budding yeast Smc5/6 complex directly binds to the DNA helicase Mph1. Mph1 and its helicase activity define a replication-associated recombination subpathway. We show that this pathway is toxic when the Smc5/6 complex is defective, because
mph1
Δ and its helicase mutations suppress multiple defects in mutants of the Smc5/6 complex, including their sensitivity to replication-blocking agents, growth defects, and inefficient chromatid separation, whereas
MPH1
overexpression exacerbates some of these defects. We further demonstrate that Mph1 and its helicase activity are largely responsible for the accumulation of potentially deleterious recombination intermediates in mutants of the Smc5/6 complex. We also present evidence that
mph1
Δ does not alleviate sensitivity to DNA damage or the accumulation of recombination intermediates in cells lacking Sgs1, which is thought to function together with the Smc5/6 complex. Thus, our results reveal a function of the Smc5/6 complex in the Mph1-dependent recombinational subpathway that is distinct from Sgs1. We suggest that the Smc5/6 complex can counteract/modulate a pro-recombinogenic function of Mph1 or facilitate the resolution of recombination structures generated by Mph1.
Adaptive strategies of the influenza virus polymerase for replication in humans
Authors: Mehle Andrew , Doudna Jennifer A.
Published: December 2009

Transmission of influenza viruses into the human population requires surmounting barriers to cross-species infection. Changes in the influenza polymerase overcome one such barrier. Viruses isolated from birds generally contain polymerases with the avian-signature glutamic acid at amino acid 627 in the PB2 subunit. These polymerases display restricted activity in human cells. An adaptive change in this residue from glutamic acid to the human-signature lysine confers high levels of polymerase activity in human cells. This mutation permits escape from a species-specific restriction factor that targets polymerases from avian viruses. A 2009 swine-origin H1N1 influenza A virus recently established a pandemic infection in humans, even though the virus encodes a PB2 with the restrictive glutamic acid at amino acid 627. We show here that the 2009 H1N1 virus has acquired second-site suppressor mutations in its PB2 polymerase subunit that convey enhanced polymerase activity in human cells. Introduction of this polymorphism into the PB2 subunit of a primary avian isolate also increased polymerase activity and viral replication in human and porcine cells. An alternate adaptive strategy has also been identified, whereby introduction of a human PA subunit into an avian polymerase overcomes restriction in human cells. These data reveal a strategy used by the 2009 H1N1 influenza A virus and identify other pathways by which avian and swine-origin viruses may evolve to enhance replication, and potentially pathogenesis, in humans.
Oil sands development contributes polycyclic aromatic compounds to the Athabasca River and its tributaries
Authors: Kelly Erin N. , Short Jeffrey W. , Schindler David W. , Hodson Peter V. , Ma Mingsheng , Kwan Alvin K. , Fortin Barbra L.
Published: December 2009

For over a decade, the contribution of oil sands mining and processing to the pollution of the Athabasca River has been controversial. We show that the oil sands development is a greater source of contamination than previously realized. In 2008, within 50 km of oil sands upgrading facilities, the loading to the snowpack of airborne particulates was 11,400 T over 4 months and included 391 kg of polycyclic aromatic compounds (PAC), equivalent to 600 T of bitumen, while 168 kg of dissolved PAC was also deposited. Dissolved PAC concentrations in tributaries to the Athabasca increased from 0.009 μg/L upstream of oil sands development to 0.023 μg/L in winter and to 0.202 μg/L in summer downstream. In the Athabasca, dissolved PAC concentrations were mostly <0.025 μg/L in winter and 0.030 μg/L in summer, except near oil sands upgrading facilities and tailings ponds in winter (0.031–0.083 μg/L) and downstream of new development in summer (0.063–0.135 μg/L). In the Athabasca and its tributaries, development within the past 2 years was related to elevated dissolved PAC concentrations that were likely toxic to fish embryos. In melted snow, dissolved PAC concentrations were up to 4.8 μg/L, thus, spring snowmelt and washout during rain events are important unknowns. These results indicate that major changes are needed to the way that environmental impacts of oil sands development are monitored and managed.
Imprint of denitrifying bacteria on the global terrestrial biosphere
Authors: Houlton Benjamin Z. , Bai Edith
Published: December 2009

Loss of nitrogen (N) from land limits the uptake and storage of atmospheric CO
2
by the biosphere, influencing Earth's climate system and myriads of the global ecological functions and services on which humans rely. Nitrogen can be lost in both dissolved and gaseous phases; however, the partitioning of these vectors remains controversial. Particularly uncertain is whether the bacterial conversion of plant available N to gaseous forms (denitrification) plays a major role in structuring global N supplies in the nonagrarian centers of Earth. Here, we use the isotope composition of N (
15
N/
14
N) to constrain the transfer of this nutrient from the land to the water and atmosphere. We report that the integrated
15
N/
14
N of the natural terrestrial biosphere is elevated with respect to that of atmospheric N inputs. This cannot be explained by preferential loss of
14
N to waterways; rather, it reflects a history of low
15
N/
14
N gaseous N emissions to the atmosphere owing to denitrifying bacteria in the soil. Parameterizing a simple model with global N isotope data, we estimate that soil denitrification (including N
2
) accounts for ≈1/3 of the total N lost from the unmanaged terrestrial biosphere. Applying this fraction to estimates of N inputs, N
2
O and NO
x
fluxes, we calculate that ≈28 Tg of N are lost annually via N
2
efflux from the natural soil. These results place isotopic constraints on the widely held belief that denitrifying bacteria account for a significant fraction of the missing N in the global N cycle.
Mortality and major morbidity in premature infants less than 31 weeks gestational age in the decade after introduction of surfactant
Authors: GENZEL‐BOROVICZÉNY ORSOLYA , MACWILLIAMS SABINE , VON POBLOTZKI MARTINA , ZOPPELLI LUCIANO
Published: December 2009

Objective. Population‐ but also center‐based mortality and major morbidity rates of premature infants are essential for prenatal counseling and quality control. Methods. Records of all infants <30 + 6 weeks (n=674) admitted (1991–2000) to a single neonatal intensive care unit were reviewed and compared to the state‐wide mortality. Results. Six hundred and ninety‐one infants were born in or transferred to the hospital and 600 infants (89%) survived. The mean (SD) birth weight was 1018 g (±314) and the mean gestational age 27 + 5 weeks (±2.0). Mortality and morbidity did not change significantly over the 10‐year period but correlated inversely with gestational age from 45% at 230/7 weeks to 5% at 306/7 weeks. Study center mortality rate for extremely low birth weight infants with birth weight <750 g was significantly lower than reported for the entire state (local 25%; Bavaria 36% p=0.0003). Thirty‐four per cent (251/600) of the survivors had one or more major complications: intracranial hemorrhage III–IV 8% (88/600), periventricular leucomalacia 6% (41/600), bronchopulmonary dysplasia with oxygen requirement at 36 weeks 20% (128/600), necrotizing enterocolitis 6% (43/600), and retinopathy of prematurity grade III–IV 9% (55/600). Survival without major morbidity increased from 32% at 23 weeks to 92% at 30 weeks. Conclusions. Despite changes in obstetric and neonatal care during the 1990s, mortality and major morbidity rates did not change significantly after the introduction of surfactant in 1991. Comparison of local, regional, national, and international mortality and morbidity rates are becoming more important in allocating resources and in decision‐making at the limits of viability.
Size of delivery unit and neonatal outcome in Sweden. A catchment area analysis
Authors: FINNSTRÖM ORVAR , BERG GÖRAN , NORMAN ANNA , OLAUSSON PETRA OTTERBLAD
Published: December 2009

Background. Quality of perinatal care was evaluated in relation to size of delivery unit and size of catchment area for deliveries. Methods. Neonatal outcome, measured as neonatal mortality, low Apgar scores at 5 min, and the occurrence of respiratory disorders and cerebral palsy was analyzed during a 15‐year period from 1985 to 1999 inclusive. Figures were derived from the Swedish Medical Birth Registry and the Hospital Discharge Registry. Odds ratios were estimated for the different outcomes in relation to size of delivery unit (actual and estimated number of births) and the provision of a pediatric department at the hospital. Seven possible confounders were considered: year of birth, maternal age, parity, smoking during pregnancy, gestational age, parental cohabitation, and maternal body mass index. Results. Neonatal mortality was significantly higher for infants in families living within the catchment area of the smallest units without a pediatric department. Small differences in the occurrence of respiratory disturbances and Apgar scores are probably due to diagnostic differences. There were no differences in the incidence of cerebral palsy. Neonatal mortality continued to decrease during the observation period. Conclusions. Differences were minor, pointing to a fairly homogeneous quality of perinatal care and an efficient referral system for risk pregnancies. Mortality continues to decrease in spite of a reduction in the number of units caring for deliveries.
Transcervical endometrial resection: Long‐term results of 390 procedures
Authors: BØE ENGELSEN INGEBORG , WOIE KATHRINE , HORDNES KNUT
Published: December 2009

Background. Hysteroscopic transcervical resection of the endometrium and submucous fibroids has been performed to treat excessive uterine bleeding as an alternative to hysterectomy. The present study aims to evaluate the treatment effect of this procedure at our department. Methods. Retrospective record review and a questionnaire 4–10 years after surgery. Patients’ characteristics, symptoms, medical treatment prior to surgery, uterine size, weight of resectate, blood loss, glycine loss, operative time, complications, procedures per surgeon, indications, frequency and time to hysterectomy, dysmenorrhea related to prior tubal ligation, the presence of adenomyosis related to later hysterectomy, and patient satisfaction. Results. In the period 1992–1998, 386 patients had 390 procedures performed by six different surgeons. 49.5% of patients had fibroids and 46.9% had a prior tubal sterilization. During operations, 6% had a hemoglobin loss of more than 2.5 g/dl, and 2.1% had a glycine loss of more than 1.5 l. Uterine perforations were encountered in 31 cases (8%), of which only 2 led to a laparotomy. During the time of follow‐up of 4–10 years, 16.6% of patients had a hysterectomy, usually because of pain or bleeding, and 50% of these were done within 2 years after the initial hysteroscopic procedure. Malignancy was found in the resectate in 6 of the patients (1.5%) despite a normal preoperative cytological or histological endometrial sample, and all these had a hysterectomy. Adenomyosis was not related to later hysterectomy and dysmenorrhea did not seem to increase after the procedure. Conclusions. For 83.4% of the patients, the problem of uterine bleeding was solved by the hysteroscopic resection, and major surgery was avoided. Long‐term results did not correlate to surgeon's experience. Patient satisfaction was high.
Obstetricians’ attitudes and opinions on sickness absence and benefits during pregnancy
Authors: LARSSON CAROLINE , SYDSJÖ ADAM , ALEXANDERSON KRISTINA , SYDSJÖ GUNILLA
Published: December 2009

Background. In Sweden, sick leave is taken more frequently by pregnant women than by nonpregnant women. This led us to ask if the taking of sick leave during pregnancy could possibly be explained by attitudes to sickness absence held among obstetricians working in antenatal care. Methods. All obstetricians (n=45) engaged in public antenatal care and at work in May 2001 in seven hospitals in South Eastern Sweden were asked to anonymously respond to questions/statements concerning their work; 87% participated. The results were presented as percent (the median value) on a visual analog scale. Results. In 60% of all contacts with pregnant women issues such as working conditions, sickness absence or benefit programs were discussed besides the actual pregnancy. In 46% the obstetricians stated that they could not exactly pinpoint a correct medical diagnosis motivating a sickness certificate asked for by the pregnant woman. As the majority of the obstetricians (74%) often did not like to conform to the pregnant women's wishes, unpleasant situations were not uncommon (56%). A conflict was experienced in the dual role that the obstetrician had as the patient's confidant on the one hand and as a representative or gatekeeper for the social security system on the other. Male and female obstetricians did not differ in their opinions on their handling of pregnant women with regard to taking sick leave but for one issue, back pain. Conclusions. The high degree of work dealing with sickness absence and social benefits at the Antenatal Care Centers seems to have a negative effect on the obstetrician's evaluation of their work environment. The obstetricians’ opinion is that pregnant women are sick‐listed too frequently, but obstetricians comply as a rule to the women's wishes in order to avoid conflict.
Fear of childbirth and history of abuse: implications for pregnancy and delivery
Authors: HEIMSTAD RUNA , DAHLOE RAIJA , LAACHE INGEBJORG , SKOGVOLL EIRIK , SCHEI BERIT
Published: December 2009

Background. The aim of this study was to assess the prevalence of fear of childbirth, and to find possible associations to selected sociodemographic factors and important life events. A secondary aim was to explore the relationship between these factors and pregnancy outcome. Methods. Questionnaire booklets were sent to 2680 women at 18 weeks of gestation, of whom 1452 women (54%) responded. The questionnaire included background factors (marital status, education, history of abuse, current pregnancy), W‐DEQ (measurement of fear of childbirth), and STAI (measurement of subjective anxiety). Pregnancy outcome information was recorded. Results. The prevalence of serious fear of childbirth (W‐DEQ > /100) was 5.5%. The W‐DEQ and STAI scores were positively correlated (r=/0.44, p</0.001). Among the anxious women, a trend towards more frequent operative vaginal delivery (12.1% versus 6.9%, p=/0.07) was noted, but not for emergency cesarean section (10.6% versus 7.6%, p=/0.34). Women who reported being exposed to physical or sexual abuse in childhood had a higher W‐DEQ score (71, SD 31 and 69, SD 27) than did the non‐abused (61, SD 23, p<0.01). Only half of women sexually or physically abused in childhood (54% and 57% respectively) had uncomplicated vaginal delivery at term versus 75% among non‐abused (p<0.001). Conclusion. The prevalence of serious fear of childbirth was 5.5%. Fear of childbirth was not associated with mode of delivery, whereas sexual or physical abuse in childhood influenced negatively mode of delivery.
Peritoneal fluid and serum levels of hepatocyte growth factor may predict the activity of endometriosis
Authors: KHAN KHALEQUE NEWAZ , MASUZAKI HIDEAKI , FUJISHITA AKIRA , KITAJIMA MICHIO , HIRAKI KOICHI , MIURA SEIYOU , SEKINE ICHIRO , ISHIMARU TADAYUKI
Published: December 2009

Background. The suitable parameter in PF as well as in serum that may predict the activity of endometriosis is not well described. Therefore, we tried to examine the peritoneal fluid (PF) and serum concentrations of hepatocyte growth factor (HGF) in different revised American Society of Reproductive Medicine (r‐ASRM) staging and morphologic appearances of endometriosis in an attempt to determine whether HGF can be clinically useful to predict the activity of pelvic endometriosis.

Methods. Peritoneal fluid was collected from 137 women with endometriosis and 57 women without endometriosis during laparoscopy and blood sampling was collected from 37 women with endometriosis and 21 women without endometriosis before laparoscopy. The concentration of HGF in PF and serum was measured by enzyme‐linked immunosorbent assay. The ability of isolated macrophages and stroma to secrete HGF in response to lipopolysaccharide (LPS) was evaluated.

Results. A significantly increased concentration of HGF in PF was found in women with endometriosis (1451.75±/90.7 pg/mL) than that in non‐endometriosis (1120.5±/77.3 pg/mL, p < /0.01) without any remarkable difference in HGF levels between women with stage I–/II endometriosis and stage III–/IV endometriosis. When we distributed serum and PF levels of HGF according to different color appearances of endometriosis, we found a significantly higher serum and PF levels of HGF in women containing dominant red peritoneal lesions in pelvic cavity (740±/109.3 pg/mL for serum; 1685±/183.4 pg/mL for PF) than those having other pigmented lesions (649±/79.5 pg/mL, p < /0.05 for serum; 1224±/67.8 pg/mL, p < /0.05 for PF) or chocolate cysts (485±/43.1 pg/mL, p < /0.05 for serum; 1118±/ 83.1 pg/mL, p < /0.01 for PF). Exogenous stimulation with LPS significantly increased the production of HGF in the culture media by macrophages and stroma derived from women with endometriosis than that in women without endometriosis.

Conclusions. These results suggest that women with early or advanced endometriosis as measured by r‐ASRM scoring system are not associated with an increase in either serum or PF concentrations of HGF. Rather HGF levels in serum and PF were significantly increased in women harboring blood‐filled red peritoneal lesions and may be clinically useful to predict the activity of pelvic endometriosis.
Effectiveness and safety of a new vaginal misoprostol product specifically labeled for cervical ripening and labor induction
Authors: Guilherme Cecatti José , Porto Tedesco Ricardo , Maria Besteti Pires Helaine , Matos Calderon Iracema , Faúndes Aníbal
Published: December 2009

Objective. The purpose of this study was to evaluate the effectiveness and safety of misoprostol in two different formulations: vaginal tablets of 25 μg and one‐eighth of a 200‐μg oral tablet, also administered intravaginally, for cervical ripening and labor induction of term pregnancies with an indication for that. Methods. A single‐blind, randomized, controlled clinical trial was carried out in 120 pregnant women who randomly received one of the two formulations. The main dependent variables were mode of delivery, need for additional oxytocin, time between beginning of induction and delivery, perinatal results, complications, and maternal side effects. Student's t, Mann–Whitney, χ2, Fisher's Exact, Wilcoxon and Kolmogorov‐Smirnoff tests, as well as survival analysis, were used in the data analysis. Results. There were no significant differences between the groups in terms of general characteristics, uterine contractility, and fetal well‐being during labor, cesarean section rates, perinatal outcomes, or maternal adverse events. The mean time between the beginning of cervical ripening and delivery was 31.3 h in the vaginal tablet group and 30.1 h in the oral tablet group, a difference that was not statistically significant. Conclusion. The results showed that the 25‐μg vaginal tablets of misoprostol were as effective and safe for cervical ripening and labor induction as the dose‐equivalent fraction of 200‐μg oral tablets.
Risk factors for bacterial vaginosis in pregnancy: a population‐based study on Danish women
Authors: Thorsen Poul , Vogel Ida , Molsted Kirsten , Jacobsson Bo , Arpi Magnus , Møller Birger R. , Jeune Bernard
Published: December 2009

Background. No larger population‐based study of bacterial vaginosis in pregnancy has previously been available. The objective of this study was to examine risk factors for bacterial vaginosis in pregnancy. Design. From a prospective population‐based cohort of 3,596 eligible pregnant women, 2,927 (81.4%) completed the study. Methods. Women were asked to participate in this study at their first prenatal visit at 17 gestational weeks (range 7 + 3–24 + 0). Samples from the genital tract were taken at enrolment. Bacterial vaginosis was determined by Amsel's clinical criteria (3 out of 4: pH > 4.5, homogenous discharge, clue cells, and positive amine test). Data were collected from three questionnaires completed during the second and third trimesters and correlated with the diagnosis of bacterial vaginosis. Crude and adjusted relative risks (reproductive, medical, behavioral, sexual, and sociodemographic factors) were computed. Results. At enrolment, bacterial vaginosis was diagnosed in 13.7% of Danish pregnant women. Significant risk factors for bacterial vaginosis were: daily coitus (adjusted relative risk 2.09 [1.43–3.04]), being single (1.76 [1.21–2.56]), smoking more than 10 cigarettes daily at conception (1.59 [1.29–1.93]), previous genital infection with Chlamydia trachomatis or Neisseria gonorrhoeae (1.39 [1.07–1.79]), and consuming 2 or more drinks per week (1.33 [1.02–1.74]) after control for confounding factors. Conclusion. In pregnancy, women who have daily coitus, are single, smokers, with a previous sexually transmitted disease, or with high alcohol consumption in pregnancy are at increased risk for bacterial vaginosis. Information on these risk factors may be important when planning preventive and treatment strategies of bacterial vaginosis in pregnancy.
Obstetric outcome in post‐term pregnancies: time for reappraisal in clinical management
Authors: Hovi Minna , Raatikainen Kaisa , Heiskanen Nonna , Heinonen Seppo
Published: December 2009

Background. The objective of this study was to determine the outcome of pregnancy in post‐term cases compared with term cases in a well defined population receiving modern obstetric care. Methods. We utilized the population‐based birth registry data of the Kuopio University Hospital (1990–2000) to investigate pregnancy outcome in 1,678 post‐term singleton pregnancies. The general obstetric population (n=22,712) was used as a reference group in logistic regression analysis. Results. The overall frequency of post‐term pregnancies was 6.9% and the incidence of post‐term pregnancies was found to be increased in obese, primiparous, and smoking women, whereas in women with chronic diseases and obstetric risks deliveries were induced earlier. The risks of macrosomia, maternal complications, and operative deliveries were increased in post‐term pregnancies. Post‐term infants experienced meconium passage (21.2% versus 12.8%) (p<0.01) and intrapartum asphyxia (3.4% versus 2.1%) (p<0.01) significantly more often than the controls. However, the stillbirth rate was low, probably due to careful monitoring of these pregnancies. Conclusions. Although high‐risk pregnancies were not allowed to come post‐term, postmaturity per se is a moderate risk state compromising fetal well‐being with regard to meconium passage and acid–base status at birth. We conclude that simple antenatal monitoring beyond 42 weeks reduces perinatal mortality but is inefficient in reducing meconium‐stained liquor seen with increasing gestation.
Detection of fetal structural abnormalities by an 11–14‐week ultrasound dating scan in an unselected Swedish population
Authors: Cedergren Marie , Selbing Anders
Published: December 2009

Background. To determine the detection rate of fetal structural abnormalities by a routine 11–14‐week ultrasound scan for dating in an unselected pregnant population. Methods. A prospective observational cohort study of 2,708 unselected pregnant women attending an abdominal ultrasound examination at 11–14 weeks gestation. The number of major fetal structural abnormalities diagnosed after birth was obtained from a computerized database at the same unit. Results. Out of 2,708 pregnant women, 89 (3.3%) were found to have a missed abortion at the time of the ultrasound scan and 33 (1.2%) were diagnosed as twins. Thirteen major structural abnormalities were detected, three cases of anencephaly (one case also had a spina bifida), one case with hydranencephaly, one fetus with Dandy‐Walker syndrome, two cases with gastroschisis, one case with a bilateral hydronephrosis, one case with a generalized hydrops, one fetus with multiple malformations, and three cystic hygromas. An additional 19 major structural defects were detected at birth. Four cases of neural tube defects and nine fetuses with congenital heart defects were diagnosed. The antenatal ultrasound detection rate was 40.6% (13/32). Nine patients had a nuchal translucency greater than 3.0 mm (excluding cystic hygromas); two of them had chromosomal abnormalities (trisomy 21 and trisomy 18). Conclusions. Fetal structural abnormalities were detected in 41% (95%CI = 24–59) of the cases in an unselected pregnant population at a routine 11–14‐week ultrasound scan for dating purpose. Two out of nine fetuses with a nuchal translucency greater than 3.0 mm had a chromosomal abnormality.
Clinical presentation and risk factors of placental abruption
Authors: Tikkanen Minna , Nuutila Mika , Hiilesmaa Vilho , Paavonen Jorma , Ylikorkala Olavi
Published: December 2009

Background. To study the risk factors of placental abruption during the index pregnancy. Methods. One hundred and ninety‐eight women with placental abruption and 396 control women were identified among 46,742 women who delivered at a tertiary referral university hospital between 1997 and 2001. Clinical variables were compared between the groups. Multivariate logistic regression analysis was applied to identify independent risk factors. The clinical manifestations of placental abruption were also studied. Results. The overall incidence of placental abruption was 0.42%. The independent risk factors were maternal (adjusted OR 1.8; 95% CI 1.1, 2.9) and paternal smoking (2.2; 1.3, 3.6), use of alcohol (2.2; 1.1, 4.4), placenta previa (5.7; 1.4, 23.1), pre‐eclampsia (2.7; 1.3, 5.6), and chorioamnionitis (3.3; 1.0, 10.0). Vaginal bleeding (70%), abdominal pain (51%), bloody amniotic fluid (50%), and fetal heart rate abnormalities (69%) were the most common manifestations. Neither bleeding nor pain was present in 19% of the cases. Overall, 59% had preterm labor (OR 12.9; 95% CI 8.3, 19.8), and 91% were delivered by cesarean section (34.7; 20.0, 60.1). Of the newborns, 25% were growth restricted. The perinatal mortality rate was 9.2% (OR 10.1; 95% CI 3.4, 30.1). Retroplacental blood clot was seen by ultrasound in 15% of the cases. Conclusions. Maternal alcohol consumption and smoking, and smoking by the partner turned out to be independent risk factors for placental abruption. Smoking by both partners multiplied the risk. The liberal use of ultrasound examination contributed little to the management of women with placental abruption.
Elevated amniotic fluid leptin levels in pregnant women who are destined to develop preeclampsia
Authors: CHAN TE‐FU , SU JINU‐HUANG , CHUNG YUEH‐FANG , HSU YU‐HSIN , YEH YAO‐TSUNG , YUAN SHYNG‐SHIOU F.
Published: December 2009

Objective. To analyze whether leptin levels of the amniotic fluid elevate during early pregnancy in women destined to develop preeclampsia and to evaluate the relationship between amniotic fluid leptin levels and gestational age, maternal body mass index, and fetal sex. Study design. Leptin levels of the amniotic fluid were compared in two groups of women, preeclamptic (n=20) and normotensive pregnant (n=40), matched for fetal sex, maternal body mass index at sampling, gravidity and fetal gestational age at sampling. Furthermore, amniotic leptin levels in 400 normotensive pregnant women were analyzed for their correlation with gestational age, maternal body mass index, and fetal sex. Results. Median leptin concentrations were significantly higher (p<0.001) in the women with preeclampsia (7.3±0.7 ng/ml) than in the normotensive pregnant women (4.1±0.3 ng/ml), independent of fetal sex. The leptin levels in the amniotic fluid decreased with advanced gestational age (r=0.24, p<0.001). Amniotic fluid leptin levels in the pregnant women carrying a female fetus (5.6±0.3 ng/ml) were significantly higher than those carrying a male fetus (4.7±0.2 ng/ml) (p = 0.004). Conclusion. Higher amniotic fluid leptin levels were observed in the preeclamptic pregnant women, and they decreased as gestational age advanced. Furthermore, the women with a female fetus were noted to have higher amniotic fluid leptin levels.
Can pelvic floor muscle training prevent and treat pelvic organ prolapse?
Authors: BØ KARI
Published: December 2009

Background and methods. Pelvic floor muscle dysfunction may cause urinary and fecal incontinence, pelvic organ prolapse (POP), pain, and sexual disturbances. The aim of the present study is to review the literature on the effectiveness of pelvic floor muscle training (PFMT) to prevent and treat POP, and the possible theories and mechanisms on how PFMT could prevent or reverse prolapse. Results. No studies were found on prevention of POP. One uncontrolled study and one low‐quality RCT were found in the treatment of prolapse. The results showed a positive effect of PFMT in severe, but not in mild prolapse. A review is presented of the main hypothesis of mechanisms on how PFMT may be effective. The two mechanisms are morphological changes occurring after strength training and use of a conscious contraction during increase in abdominal pressure in daily activities. Conclusions. In addition to the theory of functional anatomy and exercise science, one randomized controlled trial (RCT) is supportive for a positive effect of PFMT in the treatment of POP. There is an urgent need for more RCT with high methodological quality, use of valid and reproducible methods to assess degree of prolapse, and appropriate training protocols to evaluate the effect of PFMT in the prevention and treatment of POP.