bluuebunny/crossref_metadata_2025 huggingface dataset:
Induction policy and missed post‐term pregnancies: a mathematical model
Authors: Mongelli Max , Wong Yee Chee , Venkat Annapoorna , Chua Tsei Meng
Published: February 2008

The aim of this study was to compare the clinical performance of ultrasound dates and ultrasound dates combined with menstrual dates for the detection of post‐maturity.

A computer model was designed which uses the statistical distributions of the duration of normal pregnancy, day of ovulation in relation to the menstrual cycle and ultrasound error for estimating gestational age. The clinical performance of the different dating methods was then analysed from these variables, on simulations of 30,000 cases. The efficacy of different dating methods for detecting post‐maturity was determined by generating receiver‐operator characteristics (ROC) curves.

The proportion of post‐term pregnancies (294 days and over) predicted by the model (3.5%) agrees with published values. There is a steep rise in missed cases if induction is delayed beyond 10 days from the expected date of delivery, reaching 20% on day 294. Elective delivery on day 290 will detect 98.9% of cases destined to deliver post‐term, with an induction rate of 10%; the respective figures for induction on day 294 are 79% and 3.8%. The ROC curves for the detection of post‐maturity suggest that use of the mid‐trimester biparietal diameter (BPD) is better than a 7‐day or 10‐day rule.

Timing of elective delivery is the most important variable affecting the detection rate for post maturity. There is no advantage in using menstrual dates when ultrasound biometry is available.
A review of 165 cases of transvaginal sacrospinous colpopexy performed by the Endo Stitch technique
Authors: Rogers Anna , Barker Glen , Viggers John , Mason Terry , Swan James , Mayall Peter
Published: February 2008

The Endo Stitch technique has been in use in Geelong since 1994 as the method of performing transvaginal sacrospinous colpopexy (TSC). This article looks at the outcome of 165 of these procedures as assessed by a questionnaire. As the operation is technically easy, has a low complication rate and a high level of patient satisfaction we suggest that the Endo Stitch technique may be the method of choice for TSC.
Whole blood mercury concentrations in sub‐fertile men in Hong Kong
Authors: Leung Tak Yeung , Choy Christine Ming Yan , Yim So‐Fan , Lam Christopher Wai Kei , Haines Christopher John
Published: February 2008

We aimed to investigate the association between whole blood mercury concentrations and semen quality in sub‐fertile men. Fifty‐nine male partners of infertile couples attending the Assisted Reproduction Unit of the Chinese University of Hong Kong between 1997 and 1998 were recruited into our study. Blood was taken from each subject for whole blood mercury concentration and hormone profile. Semen samples were obtained for computer assisted semen analysis using the Hobson sperm tracker. The semen parameters and hormone profile were compared between subjects with normal and those with elevated mercury concentrations.

Twenty‐one subjects (35.6%) had a whole blood mercury concentration higher than the normal range (0–50 nmol/1). All parameters of the semen analysis including the concentration of sperm, percentage of morphologically normal sperm, percentage of motile sperm, curvilinear velocity, straight‐line velocity, average path velocity, and amplitude of lateral head displacement, were reduced in those with elevated blood mercury concentrations, although the difference was not statistically significant.

We failed to demonstrate a statistically significant effect on the measurement of semen quality, but other adverse effects cannot be excluded. From a public heath perspective, these findings confirm that mercury toxicity is a potentially serious problem affecting the local community.
Primary Bartholin gland carcinoma: a report of seven cases
Authors: Obermalr Andreas , Roller Susanne , Crandon Alexander J , Perrin Lewis , Nicklin James L
Published: February 2008

This study reviews our experience with 7 patients with primary Bartholin gland cancer (BGC) treated at the Queensland Gynaecological Cancer Centre (QCGC) and compares this with previously published data.

A retrospective clinicopathologic review of all patients with primary BGC treated at QCGC from 1988 to 2000 was performed. Of the 7 patients treated, all underwent primary surgery and 5 of the 7 patients received radiotherapy postoperatively.

All patients presented with a local swelling or a lump. Two had associated discharge and 2 had associated pain. Of the 7 patients, 2,3 and 2 respectively were classified as having Stage IB, II or III disease. Five of the 7 patients had squamous cell carcinoma (SCC), one had adenoid‐cystic carcinoma and 1 had a small‐cell neuroendocrine cancer of the Bartholingland. None of the patients with SCC developed recurrent disease. The patient with adenoid‐cystic carcinoma experienced local recurrences at 4 years and again at 5 years and 3 months. Nine years after primary treatment she was diagnosed with pulmonary metastases. The patient with small‐cell neuroendocrine cancer of the Bartholin gland was considered tumour‐free after operation. Thorough imaging, including a CT scan of her chest, abdomen and pelvis showed no evidence of disease. She died 1 year and three months after diagnosis from disseminated pulmonary disease.

We present the first report of small cell neuroendocrine cancer of the Bartholin gland. Therapeutic principles in the management of vulval cancer at other sites appear to be appropriate for management of BGC.
Attitudes of patients towards the involvement of medical students in their intrapartum obstetric care
Authors: Grasby Devlka , Quinlivan Julie A
Published: February 2008

Data investigating patients' attitudes towards and expectations of medical students in an obstetric setting are limited. We have examined the attitudes of pregnant women towards the involvement of medical students in their intrapartum care. Ethics committee approval and informed patient consent were obtained. A survey of 203 antenatal patients was performed. Chi‐squared tests were applied to discrete and Student's t‐test to continuous data.

Only 62% of antenatal patients were prepared to accept medical student participation in their intrapartum care, although 84% agreed that participation was important for student education. Of note, only 43% of patients were prepared to have a male medical student involved in their care. Only 54% of patients correctly identified that the description medical student referred to a doctor in training, others defining it to include nurses, midwives and other hospital staff in training.

If increasing numbers of patients decline medical student participation in their intrapartum care, then alternative teaching strategies may be required. Medical educators need to ensure that patients are aware of the role of medical students in order to gain informed consent from patients for student participation in their care.
Vaginal adenosis with adenocarcinoma in situ in a woman with no recognised antecedent factors
Authors: Charlton A , Kirker JA , Robertson AK , Jones RW
Published: February 2008

We present a case of vaginal adenosis with adenocarcinoma in situ in a woman with no recognised antecedent factors. This case demonstrates the importance of continuing thorough colposcopic assessment of the entire lower genital tract with repeated biopsies of all abnormal epithelium in women with persistent or recurrent cervical cytology abnormalities. Successful management requires accurate definition of the vaginal lesion.
The safety and effectiveness of a new hysteroscopic method for permanent birth control: results of the first EssureTM pbc clinical study
Authors: Kerin JF , Carignan CS , Cher D
Published: February 2008

Background: Current methods of female surgical sterilisation require incisional surgery, general anaesthesia and a prolonged recovery time. We studied the safety and effectiveness of Essure pbc, a minimally invasive, transcervically placed micro‐insert that occludes the Fallopian tubes, resulting in permanent female contraception.

Device under study: The Essure pbc implant is a dynamically expanding micro‐insert which is placed in the proximal section of the Fallopian tube using a modified minimal access technology for cannulating the tube.

Study population: Women aged 21–43 seeking permanent birth control.

Methodology: Essure pbc micro‐inserts were inserted into the proximal portion of the Fallopian tubes under hysteroscopic visualisation with intravenous sedation or paracervical block.

Results: Bilateral device placement was achieved in 111 of 130 (85%) women who underwent device placement attempts. Women found the device placement procedure to be highly acceptable. Of women wearing the device for up to two years rate. 97% rated it to be very good to excellent. There have been no pregnancies reported in 1894 woman‐months of effectiveness. Adverse events preventing women from relying on Essure pbc were < 5%.

Discussion: This first clinical trial showed the Essure pbc method of permanent contraception to be safe and highly acceptable to women. Experience and improvements to the delivery system should increase overall micro‐insert placement rates.

Conclusion: The Essure pbc method of permanent contraception is an exciting alternative to vasectomy or laparoscopic sterilisation that does not require general anaesthesia or incisions.
A systematic review of pregnancy outcome following preterm premature rupture of membranes at a previable gestational age
Authors: Dewan Holy , Morris Jonathan M
Published: February 2008

Our objective was to identify the maternal and fetal outcome following preterm premature rupture of membranes at a previable gestational age (less than 23 weeks).

We conducted a systematic review to identify articles that assessed perinatal and maternal outcome of pregnancies complicated by preterm premature rupture of membranes in early weeks of gestation.

Articles available in the electronic database (MEDLINE and EMBASE) from the year 1980 to 1999 were included in the review.

The subjects were patients with rupture of membranes less than 23 weeks of gestation.

Two reviewers independently reviewed the abstracts and finally 11 articles were eligible. Data were extracted separately from available sources within the articles. Data on individual subjects were extracted in eight studies whereas in three studies it was only possible to extract the data on divided gestational age groups.

We found a live birth rate of 67% (95% CI: 60–73) in these groups of patients. The perinatal survival was 18% (95% CI: 11–28) and 17% (95% CI: 16–27) in less than 20 weeks and 20–23 weeks groups respectively Very little information could be extracted regarding perinatal morbidity. Respiratory distress syndrome was diagnosed to be the major morbidity among the surviving infants.

The review illustrates how little good quality information is available for pregnancy outcome following PPROM at less than 23 weeks gestation. Although the survival prognosis of this group of patients is poor, the perinatal survival is approximately 21%.
Introducing external cephalic version to clinical practice
Authors: Karantanis Emmanuel , Alcock Deborah , Phelan Lorna K , Homer Caroline SE , Davis Gregory K
Published: February 2008

A service offering external cephalic version to all women with breech presentations at 36–38 weeks' gestation was introduced at St George Hospital in July 1997.

This paper describes how this service was established and reports the clinical outcomes over the first three years; 116 external cephalic versions (ECV) were attempted on 114 women and success was achieved in 58 women (51%). Of the 58 women, 43 (74%) subsequently had vaginal deliveries. There were no fetal deaths, immediate Caesarean sections, or placental abruptions as a result of the ECV procedure. There were two (2%) episodes of transient fetal bradycardia following ECV, both of which returned to normal with a subsequent normal neonatal outcome. Pre‐ and post‐ECV Kleihauer levels were collected with no increase in levels as a result of the ECV ECV is a procedure that can, and should, be provided as part of a public hospital service.
A protocol of selective antibiotic prophylaxis for Caesarean section based on risk factors
Authors: To William WK , Lau Winnie NT
Published: February 2008

The aim of the study was to identify risk factors associated with increased risks of post Caesarean febrile morbidity from a retrospective epidemiological analysis, and to prospectively evaluate a protocol of selective antibiotic prophylaxis based on these risk factors. Caesarean section births over a three‐year period ‐ during which no antibiotic prophylaxis protocol was practised ‐ were reviewed. Risk factors for febrile morbidity were identified using both univariate and multivariate analysis. A protocol of selective antibiotic prophylaxis, incorporating the significant risk factors identified, was then evaluated prospectively over a nine‐month period. The incidence of febrile morbidity from the retrospective study was 16.9%. A logistic regression model, with febrile morbidity as the dependent variable, identified only the duration of labour over 10 hours as a significant factor. A protocol of antibiotic prophylaxis using intravenous ampicillin was then practised in the presence of these two factors. Evaluation of this protocol after nine months showed that the incidence of febrile morbidity was reduced significantly from 20% in those not given antibiotics to around 9.6% in those eligible for and given antibiotics. However, the overall incidence of febrile morbidity remained at around 16–18%.
The profile of substance‐using pregnant mothers and their newborns at a regional rural hospital in New South Wales
Authors: Richardson Rebecca , Bolisetty Srinivas , Ingall Christopher
Published: February 2008

We conducted an audit study of identified substance‐using mothers and their neonates at Lismore Base Hospital in the Northern Rivers region of New South Wales between January 1995 and December 1999. Women using marijuana and/or alcohol only were excluded. The average number of total births during the study period was 1363 per year. Forty‐nine mothers were identified as substance users with an incidence of seven per 1000 total births. Twenty‐three (47%) were methadone users, 14 (29%) methadone and intravenous heroin users, 11 (22%) heroin users, and one (2%) used amphetamines. Twenty‐seven (55%) had irregular antenatal visits. Forty‐one (89%) were hepatitis C positive.

Forty‐seven neonates were live‐born and there were two stillbirths. Thirty‐seven (79%) required admission to the special care nursery, 40% of them for withdrawal alone. Twenty‐seven (55%) babies had neonatal withdrawal and 23 (49%) required medication for withdrawal. The incidence of substance abuse among the pregnant women in this region is ten times higher than the previously quoted figures in metropolitan areas of Australia.
Petrol sniffing in a pregnant Aboriginal population: a review of maternal and neonatal outcomes
Authors: Dodd Jodie
Published: February 2008

The study's aim was to determine if petrol sniffing during pregnancy is associated with adverse maternal and neonatal outcomes at the Alice Springs Hospital. The study design was a retrospective case note review.

The subjects were Aboriginal women who delivered at the Alice Springs Hospital between July 1991 and September 1999 where petrol sniffing was identified on the discharge coding; 14 women with 21 pregnancies were identified.

One hundred and eleven nulliparous Aboriginal women who delivered at hospital between July 1998 and June 1999, with singleton gestation in cephalic presentation, were identified from the birth register and used as the control group.

We found that women identified as petrol sniffers during pregnancy presented later for antenatal care, had fewer antenatal visits, lower booking haemoglobin and weighed less at booking when compared with non‐petrol‐sniffing women.

Women who sniffed petrol during pregnancy were more likely to have one or more sexually transmitted diseases identified during the pregnancy; to use other substances during pregnancy; to be colonised with group B Streptococcus; to have meconium stained liquor prior to delivery; and to have a stillbirth.

Infants born to petrol‐sniffing mothers were more likely to have birthweight less than 2500 g; to have Apgar scores of less than 7 at 5 minutes; to require admission to the neonatal unit; and to be placed in foster care or for adoption.

We concluded that the pregnancy complicated by petrol sniffing should be recognised as one at increased risk of adverse outcome, necessitating increased antenatal surveillance. However, as with other substances abused, it is extremely difficult to determine the role played by the substance per se. and that of the lifestyle associated with the abuse behaviour.
Saline infusion sonohysterogram as initial investigation of the endometrium and uterine cavity
Authors: Kraus PA , Boston RJ
Published: February 2008

The results of 54 consecutive saline infusion sono‐hysterograms (SIS) are presented. Sonohysterogram, in conjunction with Pipelle endometrial sampling, was found to be a reliable and accurate method of initial investigation of the endometrium and uterine cavity with good correlation with other methods of investigation. It was well tolerated in an outpatient setting, saved two out of three of the women from needing a hysteroscopy and curettage, and yielded information beyond that available from hysteroscopy and curettage.
Trends in the incidence of ectopic pregnancy in New South Wales between 1990–1998
Authors: Boufous Soufiane , Quartararo Maria , Mohsin Mohammed , Parker Jim
Published: February 2008

During the last three decades, ectopic pregnancy rates have increased considerably in different parts of the world including Australia. Recent reports, however, suggest that the incidence is decreasing or at least stabilising. An analysis of the New South Wales Inpatient Statistics Data collected during the period between 1990 and 1998 has shown a decline in the rate of ectopic pregnancy after 1993. Overall the rate decreased from 17.4 per 1000 births in 1990–1991 to 16.2 per 1000 births in 1997–1998. The decline was greater for women aged 35–44 years than for younger women. The findings are consistent with recent studies in other countries, which indicate slowing or the end of the previous upward trend in the incidence of ectopic pregnancy.
Transfusion rate associated with hysterectomy for benign disease
Authors: Otton GR , Mandapati S , Streatfeild KA , Hewson AD
Published: February 2008

The transfusion rate associated with hysterectomy for benign disease is an indirect indicator of haemorrhage. It is used in quality assurance activities and is one measure of standard of care. This retrospective study was conducted to determine the transfusion rate for these operations in a tertiary referral hospital. In addition, it was considered that the information could be used in deciding the need for a routine preoperative group and save policy (G and S). The Blood Bank records of all women undergoing hysterectomy for benign disease from 1993–1998 were examined and the number of women transfused was recorded. A total of 1220 hysterectomies were performed. Of women having vaginal hysterectomies only 0.38% required transfusion compared with 2.18% for abdominal hysterectomies. These data suggest that there is no need for a strict policy of preoperative G and S for all patients. In addition, this information can be used as a benchmark when reviewing morbidity associated with hysterectomy and in particular when various methods of hysterectomy are compared.
Continuous versus cyclical transdermal oestrogen replacement therapy in postmenopausal women: effects on lipoprotein(a) and nitric oxide levels
Authors: Serin Ibrahim Serdar , Aygen Ercan M , Basbug Mustafa , Saraymen Recep , Narin Figen , Tayyar Mehmet
Published: February 2008

The purpose of our study was to compare the effects of cyclical versus continuous transdermal oestrogen replacement therapy on lipoprotein (a) (Lp(a)) and nitric oxide levels.

The patients were randomly assigned into two groups. The first group received transdermal 17‐ß oestradiol 50 μg/day for 21 days and the second group the same treatment on a continuous basis. Medroxyprogesterone acetate (10 mg/day orally) was added between the 14th and 25th days to each group. Lipoprotein (a) and nitric oxide levels were measured before the study and after six months. These values were compared using the Wilcoxon rank test within the groups and the unpaired t‐test between the groups.

Lipoprotein (a) levels decreased significantly in each group at the sixth month (p < 0.05). When compared between the groups, the decrease of lipoprotein (a) levels in the second group was more prominent at the sixth month (p < 0.05). Nitric oxide levels increased in each group after six months (p < 0.05). No difference in nitric oxide levels was observed between the groups before and after the therapy (p > 0.05).

Continuous transdermal estradiol had a better effect on lipoprotein (a) levels than cyclical therapy. The seven day pause in the 21‐day administration did not affect nitric oxide levels negatively after six months.
The young ‘elderly’ primipara revisited
Authors: Kraus PA , Hassan S
Published: February 2008

A 1970 analysis of labour ward data to determine whether primiparas in the 30 to 34 year age group should be considered ‘at risk’ due to age was repeated in 1997. Control groups were primiparas aged 20 to 23 and multiparas 2 and 3. Incidence of operative delivery, several other obstetric outcomes j and the condition of the infant at birth were compared in various age groups. Both studies showed that the 30 to 34 age group was at increased risk of operative delivery.
An uncommon cause of a destructive vulval lesion
Authors: van der Griend Benjamin , Rane Ajay , Green Eric
Published: February 2008

We present a case of a 39‐year‐old woman with a vulval lesion, which macroscopically looked consistent with a (ungating squamous cell carcinoma of the vulva. However, further investigations demonstrated a less common cause for this presentation.
Does pigment composition reflect phytoplankton community structure in differing temperature and light conditions in a deep alpine lake? An approach using HPLC and delayed fluorescence techniques1
Authors: Greisberger Sonja , Teubner Katrin
Published: February 2008

In vivo delayed fluorescence (DF) and HPLC/CHEMTAX pigment analyses were used to investigate seasonal and depth distributions of phytoplankton in a deep alpine mesotrophic lake, Mondsee (Austria). Using chl a equivalents, we determined significant relationships with both approaches. Community structure derived from pigment ratios of homogenous samples was compared with microscopic estimations using biovolume conversion factors. An advantage of the HPLC/CHEMTAX method was that it gave good discrimination among phytoplankton groups when based on a pigment ratio matrix derived from multiple regression analysis. When a single algal group was dominant, such as epilimnetic diatoms or hypolimnetic cyanobacteria in the deep chl maxima, HPLC/CHEMTAX results were significantly correlated with microscopic estimations (diatoms: r = 0.93; cyanobacteria: r = 0.94). Changes in the composition of photosynthetically active pigments were investigated with DF and benefited from excitation spectra that considered all light‐harvesting pigments, which made it possible to assess the enhancement of accessory photosynthetically active pigments relative to active chl a (chl aDF672). Changes in similarity index, based on normalized DF spectra, confirmed compositional shifts observed by microscopy. At chosen wavelengths of DF spectra, 534 and 586 nm, we generally observed a significantly inverse relationship between normalized DF intensities and temperature and light along both seasonal and depth gradients. The relative increase in photosynthetically active pigments other than chl aDF672 under low light and temperature was caused by an increasing dominance of diatoms and/or phycobilin‐rich cyanobacteria and Cryptophyta. DF spectra provided a more accurate picture of community pigments acclimated to light and temperature conditions than the β‐carotene:chl a ratio derived from HPLC.
Regulation of phosphoribulokinase and glyceraldehyde 3‐phosphate dehydrogenase in a freshwater diatom, Asterionella formosa1
Authors: Boggetto Nicole , Gontero Brigitte , Maberly Stephen C.
Published: February 2008

The regulation of phosphoribulokinase (PRK) and glyceraldehyde 3‐phosphate dehydrogenase (GAPDH) was investigated in a freshwater pennate diatom, Asterionella formosa Hassall, and compared to the well‐studied chlorophyte Chlamydomonas reinhardtii P. A. Dang. As has been reported for a marine centric diatom, in A. formosa, PRK was not regulated by reduction with dithiothreitol (DTT) apart from a weak induction in the presence of NADPH and DTT. However, NADPH‐GAPDH was strongly activated when reduced, in contrast to a previous report on a diatom. Surprisingly, it was inhibited by NADPH, unlike in C. reinhardtii, while NADH‐GAPDH was not affected. NADH‐GAPDH was also strongly activated by DTT in contrast to most other photosynthetic cells. In A. formosa, unlike C. reinhardtii, 1,3‐bisphosphoglycerate, the substrate of GAPDH, activated this enzyme, even in the absence of DTT, when using both NADH and NADPH as cofactors. Some of these kinetic behaviors are consistent with regulation by protein–protein interactions involving CP12, a small protein that links PRK and GAPDH in cyanobacteria, green algae, and higher plants. This conclusion was supported by immunodetection of CP12 in crude extracts of A. formosa, using antibodies raised against CP12 from C. reinhardtii. This is the first report of the existence of CP12 in a diatom, but CP12 may be a common feature of diatoms since a bioinformatic search suggested that it was also present in the Thalassiosira pseudonana Hasle et Heimdal genome v3.0. Despite the presence of CP12, this work provides further support for the differential regulation of Calvin cycle enzymes in diatoms compared to green algae.
Molecular and morphologically distinct Scytosiphon species (Scytosiphonales, Phaeophyceae) display similar antioxidant capacities1
Authors: Contreras Loretto , Dennett Geraldine , Moenne Alejandra , Palma R. Eduardo , Correa Juan A.
Published: February 2008

The taxonomic status of an alga with complanate thalli, occurring in central Chile and belonging to the genus Scytosiphon, was elucidated. Morphological and molecular features demonstrated that, in addition to the known and widespread constricted S. lomentaria (Lyngb.) Link that occurs along the Chilean coast, there is a Scytosiphon with complanate thalli that occurs only in central Chile—S. gracilis Kogame. Morphological analyses of this previously unreported complanate Scytosiphon showed thalli without constrictions, coherent plurilocular sporangia without ascocysts, and phaeophycean hairs arising from cortical cells. Furthermore, sequences of the internal transcribed spacer (ITS1 and ITS2) regions of the complanate Scytosiphon were 99.8% and 100% identical to those detected in S. gracilis from Korea. ITS‐based comparative analyses showed that complanate Scytosiphon grouped in a different clade than S. lomentaria and S. tenellus Kogame from various parts of the world, including Chilean species. Moreover, molecular analyses suggest the occurrence of two distinct ITS types of S. lomentaria in northern Chile, corresponding to the Korean and Greek types. On the other hand, biochemical analyses of copper‐induced antioxidant responses in S. gracilis and S. lomentaria showed an identical increase in antioxidant enzyme activities. These results suggest that copper tolerance might be a constitutive trait in these species of Scytosiphon.
Modulation of polyunsaturated fatty acids in mixotrophic Karlodinium veneficum (Dinophyceae) and its prey, Storeatula major (Cryptophyceae)1
Authors: Adolf Jason E. , Place Allen R. , Stoecker Diane K. , Harding Lawrence W.
Published: February 2008

We examined whether fatty acid (FA) composition changed when Karlodinium veneficum (D. Ballantine) J. Larsen (Dinophyceae) was grown phototrophically or mixotrophically on Storeatula major Butcher ex D. R. A. Hill (Cryptophyceae). We hypothesized that the FA composition of mixotrophic K. veneficum would not change relative to the FA composition of phototrophic K. veneficum. As in other phototrophic dinoflagellates, octadecapentaenoic acid (18:5n3) represented 9% to 20% of total FA in K. veneficum and was enriched within chloroplast‐associated galactolipid classes. The 18:5n3 content showed a highly significant positive correlation (r2 = 0.95) with chl a content and a highly significant negative correlation with growth rate (r2 = 0.88). A previously undescribed chloroplast galactolipid molecular species, digalactosyldiacylglycerol (DGDG; 18:5n3/18:5n3), was a dominant structural lipid in K. veneficum. Docosahexaenoic acid (22:6n3) represented 14% to 19% of total K. veneficum FA and was enriched within phospholipids. In the prey S. major, 18:5n3 was not present, but octadecatetraenoic acid (18:4n3) and α‐linolenic acid (18:3n3) represented approximately 50% of total FA and were enriched within chloroplast‐associated galactolipid classes. Eicosapentaenoic acid (20:5n3) and 22:6n3 represented approximately 18% of total FA in S. major and were enriched within phospholipids. The FA profile of mixotrophic K. veneficum, compared to phototrophic K. veneficum, showed elevated levels of 18:3n3, 18:4n3, and 20:5n3, and lower but persistent levels of 18:5n3. Production to ingestion (P:I) ratios >1 for major polyunsaturated fatty acids (PUFAs) indicated that direct assimilation from prey under balanced growth could not support rates of PUFA production in mixotrophic K. veneficum. These data suggest that the plastid plays a continuing and essential role in lipid metabolism during mixotrophic growth.
Is the tetrasporophyte of Asparagopsis armata (Bonnemaisoniales) limited by inorganic carbon in integrated aquaculture?1
Authors: Mata Leonardo , Silva João , Schuenhoff Andreas , Santos Rui
Published: February 2008

Seaweeds cultivated in traditional land‐based tank systems usually grow under carbon‐limited conditions and consequently have low production rates, if no costly artificial source of inorganic carbon is supplied. In integrated aquaculture, the fish effluents provide an extra source of dissolved inorganic carbon (DIC) to seaweeds due to fish respiration. To evaluate if the tetrasporophyte of Asparagopsis armata (Harv.) F. Schmitz (the Falkenbergia stage) is carbon limited when cultivated with effluents of a fish (Sparus aurata) farm in southern Portugal, we characterized the DIC forms in the water, assessed the species photosynthetic response to the different DIC concentrations and pH values, and inferred for the presence of a carbonic anhydrase (CA)–mediated mechanism. Results showed that A. armata relies mainly on CO2 to meet photosynthetic needs. Nevertheless, from pH 7.5 upward, the CO2 supply to RUBISCO seems to derive also from the external dehydration of HCO3– mediated by CA. The contribution of this mechanism was essential for A. armata to attain fully saturated O2‐evolution rates at the natural seawater DIC concentration (2–2.2 mM) and pH values (∼8.0). We revealed in this study that seaweeds cultivated in fish‐farm effluents benefit not only from a rich source of ammonia but also from an important and free source of DIC for their photosynthesis. If supplied at relatively high turnover rates (∼100 vol · d−1), fish‐farm effluents provide enough carbon to maximize the photosynthesis and growth even for species with low affinity for HCO3–, avoiding the artificial and costly supply of inorganic carbon to seaweed cultures.
Factors Associated with Oral Health–Related Quality of Life in Community‐Dwelling Elderly Persons with Disabilities
Authors: Jensen Peter M. , Saunders Ralph L. , Thierer Todd , Friedman Bruce
Published: February 2008

OBJECTIVES: To examine, in community‐dwelling elderly persons with disabilities, the association between oral health—related quality of life (OHRQOL) as measured using the 14‐item Oral Health Impact Profile (OHIP‐14) and specific oral health, health, and disability status variables; life satisfaction; living alone; and low income.

DESIGN: Observational cross‐sectional.

SETTING: A Medicare demonstration conducted in 19 counties in three states.

PARTICIPANTS: Six hundred forty‐one disabled, cognitively intact, community‐dwelling individuals aged 65 and older.

MEASUREMENTS: The subjects' OHRQOL was assessed using the OHIP‐14, which was scored using three different methods. Data on oral health, health and functional status, life satisfaction, prior health services use, and sociodemographics were collected using interviewer‐administered questionnaires.

RESULTS: The participants' mean age was 79.1, and they were dependent in an average of 1.8 activities of daily living (ADLs); 43.1% were edentulous, 77.4% wore a denture, 40.4% felt that they were currently in need of dental treatment, and 64.7% had not had a dental examination in the previous 6 months. Seven of the 16 variables of interest had significant bivariate relationships using three OHIP scoring methods. Logistic regression analysis found that poor OHRQOL was significantly associated with perceived need for dental treatment (odds ratio (OR)=2.61), poor self‐rated health (OR=2.29), poor (OR=2.00) and fair (OR=1.73) mental health, fewer than 17 teeth (OR=1.74), and relatively poor cognitive functioning (OR=1.52).

CONCLUSION: OHRQOL is associated with some (perceived need for dental treatment, poor self‐rated health, worse mental health, fewer teeth, and relatively poor cognitive status) but not all (e.g., ADL and instrumental ADL dependence) measures of oral health, health, and disability status and not with life satisfaction, living alone, or low income.
Improving the Efficiency and Effectiveness of Grading Through the Use of Computer‐Assisted Grading Rubrics
Authors: Anglin Linda , Anglin Kenneth , Schumann Paul L. , Kaliski John A.
Published: February 2008

This study tests the use of computer‐assisted grading rubrics compared to other grading methods with respect to the efficiency and effectiveness of different grading processes for subjective assignments. The test was performed on a large Introduction to Business course. The students in this course were randomly assigned to four treatment groups based on the grading method. Efficiency was measured by the professor's time to grade the assignments; effectiveness was measured by a student satisfaction survey. Results suggest that the computer‐assisted grading rubrics were almost 200% faster than traditional hand grading without rubrics, more than 300% faster than hand grading with rubrics, and nearly 350% faster than typing the feedback into a Learning Content Management System. Results also seemed to indicate that the use of a computer‐assisted grading rubric did not negatively affect student attitudes concerning the helpfulness of their feedback, their satisfaction with the speed with which they received their feedback, or their satisfaction with the method by which they received feedback.
The Use of Problem‐Based Learning to Enhance MIS Education
Authors: Mykytyn Kathleen , Pearson Ann , Paul Souren , Mykytyn Peter P.
Published: February 2008

Many colleges of business require a course in computer applications concepts, often consisting of spreadsheet and database applications. Quite often, students resist taking the class because they do not see any worth to it, it duplicates what they already have taken, and they already know much of what is purported to be taught in the class. Instructors too are often frustrated with this class. This article suggests that part of the problem is the method of instruction often used: lecture and demonstration of tools followed by end‐of‐chapter assignments. We propose that problem‐based learning is an alternative instructional method that may produce more positive results for students. To examine this approach, a semester‐long study involving 186 business school students enrolled in a computer applications concept course of seven different sections was conducted. Student motivation, computer self‐efficacy, knowledge, and satisfaction were studied. Results strongly support a problem‐based learning approach as an instructional approach to teaching this class.

[I]t would be naive to regard PBL [Problem‐based Learning] as having reached some final stage of development. Indeed, the problem‐based approach is certainly not the end of innovation in professional education. Problem‐oriented strategies are but one set of examples of the broader category of systemic educational thinking and approaches which emphasize learning from experience (Boud & Feletti, 1998a, p. 13).
Using SERVQUAL to Measure the Quality of the Classroom Experience
Authors: Stodnick Michael , Rogers Pamela
Published: February 2008

Over the last three decades, higher education institutions have found themselves using vernacular that was once chiefly found in business disciplines, such as value‐added and competitive advantage. With the rising costs of tuition, newer‐generation students are seeing themselves more and more as customers and universities are beginning to adopt customer‐centric strategies and missions. However, even with this paradigm shift, little research has been done to extend traditional service management concepts to educational settings. This research attempts to bridge this gap by applying the SERVQUAL scale, a well‐validated and widely used service operations construct, to the classroom environment. The findings show that the SERVQUAL scale exhibits both reliability and convergent and divergent validity; in fact, in these regards, it outperforms traditional student assessment scales. Moreover, the scale can explain significant amounts of variances in student‐related outcome variables such as satisfaction and learning. This innovative approach to measuring classroom service quality does indeed show that students can be viewed as customers and has far‐reaching implications to all stakeholders in the delivery of higher education.
Comparison of Lesion Sizes Produced by Cryoablation and Open Irrigation Radiofrequency Ablation Catheters
Authors: PARVEZ BABAR , PATHAK VISHESH , SCHUBERT CHRISTINE M. , WOOD MARK
Published: February 2008

Introduction: The relative lesion sizes created by large electrode cryoablation catheter and irrigated radiofrequency (RF) ablation are not known. The purpose of this study was to directly compare lesion sizes created by cryoablation and irrigated RF under controlled conditions.

Methods and Results
: Ablation lesions were created in freshly harvested porcine left ventricular myocardium in a blood‐filled tissue bath using an 8‐mm‐tip cryoablation catheter and a 3.5‐mm‐tip open‐irrigated RF ablation catheter. Lesions were created under all permutations of the following conditions: electrode orientation vertical (perpendicular) or horizontal (parallel) to the tissue, electrode contact pressure at 6 or 20 g, and blood flow at 0.2 or 0.4 m/s over the electrode‐tissue interface. The largest lesion volumes created with cryoablation were 961 ± 103 mm3, compared with the largest lesions volumes created with RF of 680 ± 48 mm3 (P < 0.001). The 3‐way interactions among electrode orientation, contact pressure, and superfusate blood velocity accounted for the variation in lesion volumes for both catheters (both r2= 0.97, both P < 0.0001). The greater contact pressure increased lesion size for both cryoablation and RF. For cryoablation, lesion sizes were increased by the horizontal orientation and by the lower blood flow velocity. For open‐irrigated RF, lesion sizes were significantly reduced by the horizontal orientation, however.

Conclusions

: Depending on conditions of electrode orientation, contact pressure, and blood velocity, either 8‐mm‐tip cryoablation or open‐irrigated RF may produce the larger lesion volumes. Open‐irrigated RF lesion sizes are reduced in the horizontal catheter orientation.
Is Empirical Four Pulmonary Vein Isolation Necessary for Focally Triggered Paroxysmal Atrial Fibrillation? Comparison of Selective Pulmonary Vein Isolation Versus Empirical Four Pulmonary Vein Isolation
Authors: PAK HUI‐NAM , KIM JIN SEOK , SHIN SEUNG YONG , LEE HYUN SOO , CHOI JONG IL , LIM HONG EUY , HWANG CHUN , KIM YOUNG‐HOON
Published: February 2008

Background:
We questioned whether the empirical four pulmonary vein (PV) isolation (EmPVI) was necessary in patients with paroxysmal atrial fibrillation (PAF) triggered from clearly and reproducibly defined arrhythmogenic PVs.

Methods:
We compared the selective or ipsilateral isolation of the PVs triggering AF (SePVI: n = 42) and EmPVI (n = 35) in 77 patients (males 80.5%, mean age 53.0 ± 13.4 years) with PAF who underwent radiofrequency catheter ablation (RFCA). Arrhythmogenic PVs were identified by the immediate recurrence of AF three consecutive times after cardioverting AF.

Results:
(1) The duration of the RF energy deliveries (P < 0.01) and total procedure time (P < 0.01) were shorter for the SePVI than the EmPVI. (2) During a mean follow‐up of 38.6 ± 23.1 months, the AF recurrence rate was 38.1% in the SePVI group and 25.7% in the EmPVI group (P = NS). (3) A redo‐ablation was performed in 25 patients, and 81.0% of the recurrent arrhythmogenic foci were found at a previously ablated PV or ipsilateral PV. (4) In 15.4% of the SePVI and 20.0% of the EmPVI procedures, AF recurred after 32.5 ± 15.2 months of the redo‐ablation. Subsequently, the AF‐free rate for each group was 88.1% (37/42) in the SePVI group and 91.4% (32/35) in the EmPVI group (P = NS).

Conclusions:
In patients with clearly documented arrhythmogenic PVs, the SePVI of the PV triggering the AF or an ipsilateral PV had a comparable long‐term success rate and shorter RF energy delivery and procedure times than the EmPVI.
Changes in the Isolated Delayed Component as an Endpoint of Catheter Ablation in Arrhythmogenic Right Ventricular Cardiomyopathy: Predictor for Long‐Term Success
Authors: NOGAMI AKIHIKO , SUGIYASU AIKO , TADA HIROSHI , KUROSAKI KENJI , SAKAMAKI MIHOKO , KOWASE SHINYA , OGINOSAWA YASUSHI , KUBOTA SHOICHI , USUI TATSUYA , NAITO SHIGETO
Published: February 2008

Introduction: Although successful ablation of ventricular tachycardia (VT) is feasible in arrhythmogenic right ventricular cardiomyopathy (ARVC), long‐term recurrence is common. The aim of this study was to assess the usefulness of a change in the isolated delayed component (IDC) as an endpoint of the catheter ablation in ARVC.

Methods and Results: Eighteen patients (48 ± 11 years) with ARVC were studied. Detailed endocardial mapping of the right ventricle (RV) was performed during sinus rhythm. IDCs were recorded in 16 patients and the latest IDCs were related to the VT circuit. Catheter ablation was carried out in the areas with the IDCs. At the end of the session, the IDC was electrically dissociated in one, disappeared in five, exhibited second‐degree block in one, was significantly delayed (≥50 ms) in three, and remained unchanged in six. The change in the IDC was correlated with the change in the type II/III late potentials in the signal‐averaged electrocardiography (ECG) and the inducibility of the clinical VT after the ablation. During a follow‐up of 61 ± 38 months, VT recurred in six. The patients with a changed IDC had a significantly lower VT recurrence than those with no IDC or an unchanged IDC (P < 0.02).

Conclusion: In patients with ARVC, (1) the IDCs during sinus rhythm are related to the clinical VT and can be a target for the ablation, (2) a change in the IDC can be used as an endpoint, and (3) qualitative analyses of the serial signal‐averaged ECGs may be useful for the long‐term follow‐up.
Comparison of Stent Versus Balloon Angioplasty for Pulmonary Vein Stenosis Complicating Pulmonary Vein Isolation
Authors: PRIETO LOURDES R. , SCHOENHAGEN PAUL , ARRUDA M. JANINE , NATALE ANDREA , WORLEY SARAH E.
Published: February 2008

Introduction: Pulmonary vein stenosis (PVS) is a rare but significant complication of pulmonary vein isolation (PVI). Dilation and stent angioplasty have been described but not compared.

Methods and Results: All percutaneous interventions for PVS complicating PVI between December 2000 and March 2007 were reviewed. Acute success, defined as post‐intervention stenosis ≤30%, and long‐term outcome of dilation versus stent angioplasty were compared. Freedom from restenosis was defined as freedom from repeat intervention. Overall outcome for all interventions was examined. We studied 34 patients with 55 stenotic veins followed for a mean of 25 months. Dilation was performed in 39 veins and stenting in 40 veins (16 primarily, 24 after dilation restenosis). Acute success and restenosis rates were 42% and 72% for dilation versus 95% (P < 0.001) and 33% for stenting. Time to restenosis was greater for stent angioplasty (P = 0.003). Stents ≥10 mm in diameter had lower restenosis than smaller stents. Risk factors for restenosis included small reference vessel diameter and longer time from PVI to intervention for PVS. All but two patients experienced improvement (n = 10) or resolution of symptoms (n = 22). The mean percent stenosis decreased from 82% to 21% for the entire cohort and mean flow to the lung quadrant increased from 10% to 17%.

Conclusion: Stent angioplasty results in less restenosis than dilation, particularly for stents ≥10 mm. Early referral may improve long‐term patency by minimizing reference vessel atrophy. Most patients with PVS post‐PVI can be improved symptomatically with catheter intervention.
Enhanced Thermal Conductivity of Polymer Matrix Composite via High Solids Loading of Aluminum Nitride in Epoxy Resin
Authors: Lee Eun‐Sung , Lee Sang‐Mock , Shanefield Daniel J. , Cannon W. Roger
Published: February 2008

Most semiconductor devices are now packaged in an epoxy polymer composite, which includes silica powder filler for reducing the thermal expansion coefficient. However, increased heat output from near‐future semiconductors will require higher thermal conductivity fillers such as aluminum nitride (AlN) powder, instead of silica. Dispersant chemistry is applied, in order to achieve a high volume percentage of AlN powder in epoxy without causing excessive viscosity before the epoxy monomer is crosslinked, thereby increasing the thermal conductivity of the composite. In the preliminary experiment, high solids loading, up to 57 vol%, was achieved with a wide particle size distribution, and the viscosity of that dispersion was 60 000 to 90 000 cps, resulting in easy flow by gravity alone at room temperature. The highest thermal conductivity of the composites measured by the hot‐disk method was 3.39 W/mK, which is approximately 15 times higher than pure epoxy. The Agari and Uno model was a good fit to the experimental data. Electronic I–V curves obtained after encapsulation of testing devices indicated that the highly AlN‐filled epoxy slip appeared to be feasible for use in the encapsulation of integrated circuit chips.