bluuebunny/crossref_metadata_2025 huggingface dataset:
Does conservation planning matter in a dynamic and uncertain world?
Authors: Meir Eli , Andelman Sandy , Possingham Hugh P.
Published: July 2004

Loss of biodiversity is one of the world's overriding environmental challenges. Reducing those losses by creating reserve networks is a cornerstone of global conservation and resource management. Historically, assembly of reserve networks has beenad hoc, but recently the focus has shifted to identifying optimal reserve networks. We show that while comprehensive reserve network design is best when the entire network can be implemented immediately, when conservation investments must be staged over years, such solutions actually may be sub‐optimal in the context of biodiversity loss and uncertainty. Simple decision rules, such as protecting the available site with the highest irreplaceability or with the highest species richness, may be more effective when implementation occurs over many years.
Minimizing the cost of environmental management decisions by optimizing statistical thresholds
Authors: Field Scott A. , Tyre Andrew J. , Jonzén Niclas , Rhodes Jonathan R. , Possingham Hugh P.
Published: July 2004

Environmental management decisions are prone to expensive mistakes if they are triggered by hypothesis tests using the conventional Type I error rate (α) of 0.05. We derive optimal α‐levels for decision‐making by minimizing a cost function that specifies the overall cost of monitoring and management. When managing an economically valuable koala population, it shows that a decision based on α = 0.05 carries an expected cost over $5 million greater than the optimal decision. For a species of such value, there is never any benefit in guarding against the spurious detection of declines and therefore management should proceed directly to recovery action. This result holds in most circumstances where the species’ value substantially exceeds its recovery costs. For species of lower economic value, we show that the conventional α‐level of 0.05 rarely approximates the optimal decision‐making threshold. This analysis supports calls for reversing the statistical ‘burden of proof’ in environmental decision‐making when the cost of Type II errors is relatively high.
Diversity and composition of tropical soil nitrifiers across a plant diversity gradient and among land‐use types
Authors: Carney Karen M. , Matson Pamela A. , Bohannan Brendan J. M.
Published: July 2004

Ammonia‐oxidizing bacteria (AOB) perform the rate‐limiting step of nitrification, a key ecosystem process that in part determines the fate of nitrogen in ecosystems. However, little is known about the factors that determine soil AOB diversity or composition, especially in tropical systems. Using a set of study systems in Costa Rica, we examined whether plant diversity or land‐use influenced AOB diversity or composition and whether AOB diversity or composition were associated with nitrification rates. We characterized the molecular diversity and composition of AOB via polymerase chain reaction amplification, cloning, and sequencing of 16S rDNA. We found that AOB diversity or composition did not change significantly across plant diversity treatments. In contrast, AOB differed among land‐use types in some measures of diversity and in composition, and differences in AOB composition among land‐use types were correlated with potential rates of nitrification. Our results suggest that anthropogenic changes of ecosystems can alter microbial communities in ways that may affect the processes they mediate.
Species–energy relationships and habitat complexity in bird communities
Authors: Hurlbert Allen H.
Published: July 2004

Species–energy theory is a commonly invoked theory predicting a positive relationship between species richness and available energy. The More Individuals Hypothesis (MIH) attempts to explain this pattern, and assumes that areas with greater food resources support more individuals, and that communities with more individuals include more species. Using a large dataset for North American birds, I tested these predictions of the MIH, and also examined the effect of habitat complexity on community structure. I found qualitative support for the relationships predicted by the MIH, however, the MIH alone was inadequate for fully explaining richness patterns. Communities in more productive sites had more individuals, but they also had more even relative abundance distributions such that a given number of individuals yielded a greater number of species. Richness and evenness were also higher in structurally complex forests compared to structurally more simple grasslands when controlling for available energy.
Effect of trap design, trap size and pheromone dose on male capture of two pine bast scales species (Hemiptera: Matsucoccidae): implications for monitoring and mass‐trapping
Authors: Branco M. , Jactel H. , Silva E. B. , Binazzi A. , Mendel Z.
Published: July 2004

Abstract 1 The effects of pheromone dose, trap size and trap design on the capture of maleMatsucoccus feytaudiwere studied in maritime pine forests of Portugal, France and Italy, andMatsucoccus josephiin Aleppo pine stands of Israel.

2 Males of both species respond to racemic mixtures of the respective sex pheromone at a dosage as low as 25 µg. However, for low population densities ofM. feytaudi, a 50 µg dosage was needed to guarantee male catches significantly different from the control trap.

3 Male capture increased with increasing dosage up to a threshold level for both species. Overdose repellence was not observed even with baits containing 1600 and 2200 µg of the pheromone ofM. josephiandM. feytaudi, respectively.

4 ForM. feytaudi, a higher dose–response was observed at medium population densities, whereas lesser captures were registered at low and high population densities, suggesting female competition in the latter case.

5 Catches ofM. feytaudimales were not affected by trap design, whereasM. josephimales were caught in significantly greater numbers in delta traps. Large traps caught significantly more males of both species.

6 The relative higher male catches in the marginal zone of the sticky traps is probably related to males landing behaviour in the vicinity of the pheromone source.

7 The shape and size of the trap did not affect the bias of the estimates of male catches. However, the plate traps provided higher precision. Both bias and precision improved with increasing dose.
Interactions between the stem‐mining weevils Ceutorhynchus napi Gyll. and Ceutorhynchus pallidactylus (Marsh.) (Coleoptera: Curculionidae) in oilseed rape
Authors: Dechert Georg , Ulber Bernd
Published: July 2004

Abstract  1 The rape stem weevil Ceutorhynchus napi Gyll. and the cabbage stem weevil Ceutorhynchus pallidactylus (Marsh.) share the same habitat and food resource within the stems of oilseed rape, Brassica napus L. var. oleifera. Interactions occurring between these two sympatric species on this host were studied under both field and laboratory conditions.

2 The oviposition preference of C. pallidactylus and the within‐plant distribution of eggs and larvae were examined in field plots of oilseed rape. Female C. pallidactylus tended to lay their eggs in plants already infested by eggs and larvae of C. napi rather than in uninfested plants. The within‐plant distribution of the egg batches of C. pallidactylus did not differ significantly between uninfested plants and those preinfested by C. napi. Ovipositing females of C. napi and C. pallidactylus generally showed a significant preference for plants with larger stem diameter.

3 Laboratory choice tests provided further evidence for the oviposition preference of C. pallidactylus. Females laid significantly more eggs in leaves of plants that had been previously infested by C. napi than in leaves of previously uninfested plants.

4 Larvae of C. pallidactylus showed a significant shift of their feeding niche towards the stem base when feeding in individual plants attacked by both species. This possibly indicates ressource partitioning between C. pallidactylus and C. napi. The within‐plant distribution of C. napi larvae was not affected by the simultaneous attack of C. pallidactylus.

5 The size of the head capsule of full‐grown larvae of C. napi and C. pallidactylus was not significantly correlated with the diameter of the stem of their host plant or with the number of conspecific larvae within individual plants.
Oral toxicity and impact on fecundity of three insecticidal proteins on the gregarious ectoparasitoid Eulophus pennicornis (Hymenoptera: Eulophidae)
Authors: Bell H. A. , Kirkbride‐Smith A. E. , Marris G. C. , Edwards J. P. , Gatehouse A. M. R.
Published: July 2004

Abstract  1 The effects of three insecticidal transgene proteins on selected life parameters of the ectoparasitoid Eulophus pennicornis were investigated.

2 When incorporated into the diet of the adult wasp, the lectins GNA (snowdrop lectin) and Con A (jackbean lectin) significantly reduced longevity at doses of 0.1% w/v and above. At a dose rate of 0.1% w/v, GNA and Con A reduced mean longevity to approximately 13 and 10 days, respectively, compared with average control lifespans of approximately 20 days. The trypsin inhibitor from cowpeas, CpTI, had no marked effect on longevity.

3 Both lectins reduced reproductive fitness of parasitoids when dosed before exposure to hosts. The 1.0% dose reduced fecundity by over 35% for GNA and 70% for Con A. Although reduced fecundity may have been a function of shorter lifespans, smaller egg loads in female wasps provided evidence to suggest that higher lectin doses may have interfered with egg maturation processes.

4 Both lectins were readily detected in whole body extracts of the parasitoid and were seen to persist within their bodies for at least 24 h after cessation of feeding on lectin‐containing diets.

5 The results would indicate that the ingestion of the lectins, either through host feeding or through the consumption of nectar, may pose a hazard to parasitic wasps if present at sufficiently high concentrations.
The G20 at the Cancun Ministerial: Developing Countries and Their Evolving Coalitions in the WTO
Authors: Narlikar Amrita , Tussie Diana
Published: July 2004

In large measure, the voice that developing countries were able to exercise in Cancun was a result of their effective coalition formation. In this paper we present a brief overview of the various coalitions that played an important role at Cancun. The greater part of this paper focuses on one among these various coalitions: the G20 on agriculture. The G20 presents an especially fascinating case of a coalition that combined a great diversity of members and apparently incompatible interests. All theoretical reasoning and historical precedent predicted that the group would collapse in the endgame. And yet the group survived. We investigate the sources of the unity of this group and trace them to a process of learning that allowed the group to acquire certain structural features and develop strategies that helped to cement it further. While our central dependent variable is the cohesion of the G20, we also address the derivative question of the costs and benefits of maintaining such coalitions. The Cancun coalitions give us an excellent case of coalitions that managed to retain their cohesion, but also ended up with a situation of no agreement rather than a fulfilment of even some of their demands. We examine some of the causes behind the impasse in the negotiation process and suggest ways in which future outcomes could be improved.
Misalignment of the Baht and its Trade Balance Consequences for Thailand in the 1980s and 1990s
Authors: Rajan Ramkishen S. , Sen Rahul , Siregar Reza Y.
Published: July 2004

This paper examines Thailand's pre‐crisis exchange rate policy, focusing on the degree of the country's real exchange rate misalignment pre‐crisis and its consequent effects on Thailand's trade balance with its two large trading partners, the US and Japan, in the 1980s and 1990s. Defining misalignment as the difference between actual and ‘equilibrium’ exchange rates, we estimate three key ‘equilibrium’ exchange rates of the Thai baht: (a) the real effective equilibrium exchange rate of the Thai baht against its twenty‐two major trading partners; (b) the bilateral real equilibrium exchange rates of the baht against the US dollar; and (c) the bilateral real equilibrium exchange rate of the baht against the Japanese yen.
US Economic Sanctions Against China: Who Gets Hurt?
Authors: Yang Jiawen , Askari Hossein , Forrer John , Teegen Hildy
Published: July 2004

The United States maintains a broad spectrum of economic sanctions against China ranging from export controls to prohibitions on certain imports. Our study finds that, although from a macroeconomic perspective, US sanctions have had no significant adverse effect on China's overall economic growth and trade between the two countries, they do have a negative impact on producers and consumers in both countries. US economic sanctions have hindered technology transfer to China and US investment in China. US restrictions on imports from China have caused deadweight losses for the US due to higher domestic production costs for import substitutes and a reduction in consumption. US export controls have hindered US exports to China and contributed to large US trade deficits with China. The export controls have also caused losses of high‐paid jobs in the United States and benefited competitors from other countries. In addition, US economic sanctions against China have had significant third‐party effects. China's diversification of imports to sources other than the United States may have a long‐term effect on US exports to China even after US economic sanctions against China are lifted.
A Note on Global Welfare in Pharmaceutical Patenting
Authors: Scherer F. M.
Published: July 2004

This paper revisits the question of whether global welfare is higher under a uniform world‐wide system of pharmaceutical product patents or with international rules allowing low‐income nations to free‐ride on the discoveries of firms in rich nations. Key variables include the extent to which free‐riding reduces the discovery of new drugs, the rent potential of rich as compared to poor nations, the ratio of the marginal utility of income in poor as compared to rich nations, and the competitive environment within which R&D decisions are made. Global welfare is found to be higher with free‐riding across plausible discovery impairment and income utility combinations, especially when rent‐seeking behaviour leads to an expansion of R&D outlays exhausting appropriable rents.
A Conditional Approach for Multivariate Extreme Values (with Discussion)
Authors: Heffernan Janet E. , Tawn Jonathan A.
Published: July 2004

Multivariate extreme value theory and methods concern the characterization, estimation and extrapolation of the joint tail of the distribution of a d-dimensional random variable. Existing approaches are based on limiting arguments in which all components of the variable become large at the same rate. This limit approach is inappropriate when the extreme values of all the variables are unlikely to occur together or when interest is in regions of the support of the joint distribution where only a subset of components is extreme. In practice this restricts existing methods to applications where d is typically 2 or 3. Under an assumption about the asymptotic form of the joint distribution of a d-dimensional random variable conditional on its having an extreme component, we develop an entirely new semiparametric approach which overcomes these existing restrictions and can be applied to problems of any dimension. We demonstrate the performance of our approach and its advantages over existing methods by using theoretical examples and simulation studies. The approach is used to analyse air pollution data and reveals complex extremal dependence behaviour that is consistent with scientific understanding of the process. We find that the dependence structure exhibits marked seasonality, with ex- tremal dependence between some pollutants being significantly greater than the dependence at non-extreme levels.
Markov Chain Monte Carlo Methods for High Dimensional Inversion in Remote Sensing
Authors: Haario H. , Laine M. , Lehtinen M. , Saksman E. , Tamminen J.
Published: July 2004

We discuss the inversion of the gas profiles (ozone, NO3, NO2, aerosols and neutral density) in the upper atmosphere from the spectral occultation measurements. The data are produced by the ‘Global ozone monitoring of occultation of stars’ instrument on board the Envisat satellite that was launched in March 2002. The instrument measures the attenuation of light spectra at various horizontal paths from about 100 km down to 10–20 km. The new feature is that these data allow the inversion of the gas concentration height profiles. A short introduction is given to the present operational data management procedure with examples of the first real data inversion. Several solution options for a more comprehensive statistical inversion are presented. A direct inversion leads to a non-linear model with hundreds of parameters to be estimated. The problem is solved with an adaptive single-step Markov chain Monte Carlo algorithm. Another approach is to divide the problem into several non-linear smaller dimensional problems, to run parallel adaptive Markov chain Monte Carlo chains for them and to solve the gas profiles in repetitive linear steps. The effect of grid size is discussed, and we present how the prior regularization takes the grid size into account in a way that effectively leads to a grid-independent inversion.
Bayesian Analysis of the Scatterometer Wind Retrieval Inverse Problem: Some New Approaches
Authors: Cornford Dan , Csató Lehel , Evans David J. , Opper Manfred
Published: July 2004

The retrieval of wind vectors from satellite scatterometer observations is a non-linear inverse problem. A common approach to solving inverse problems is to adopt a Bayesian framework and to infer the posterior distribution of the parameters of interest given the observations by using a likelihood model relating the observations to the parameters, and a prior distribution over the parameters. We show how Gaussian process priors can be used efficiently with a variety of likelihood models, using local forward (observation) models and direct inverse models for the scatterometer. We present an enhanced Markov chain Monte Carlo method to sample from the resulting multimodal posterior distribution. We go on to show how the computational complexity of the inference can be controlled by using a sparse, sequential Bayes algorithm for estimation with Gaussian processes. This helps to overcome the most serious barrier to the use of probabilistic, Gaussian process methods in remote sensing inverse problems, which is the prohibitively large size of the data sets. We contrast the sampling results with the approximations that are found by using the sparse, sequential Bayes algorithm.
Probabilistic Sensitivity Analysis of Complex Models: A Bayesian Approach
Authors: Oakley Jeremy E. , O'Hagan Anthony
Published: July 2004

In many areas of science and technology, mathematical models are built to simulate complex real world phenomena. Such models are typically implemented in large computer programs and are also very complex, such that the way that the model responds to changes in its inputs is not transparent. Sensitivity analysis is concerned with understanding how changes in the model inputs influence the outputs. This may be motivated simply by a wish to understand the implications of a complex model but often arises because there is uncertainty about the true values of the inputs that should be used for a particular application. A broad range of measures have been advocated in the literature to quantify and describe the sensitivity of a model's output to variation in its inputs. In practice the most commonly used measures are those that are based on formulating uncertainty in the model inputs by a joint probability distribution and then analysing the induced uncertainty in outputs, an approach which is known as probabilistic sensitivity analysis. We present a Bayesian framework which unifies the various tools of prob- abilistic sensitivity analysis. The Bayesian approach is computationally highly efficient. It allows effective sensitivity analysis to be achieved by using far smaller numbers of model runs than standard Monte Carlo methods. Furthermore, all measures of interest may be computed from a single set of runs.
Exact Filtering for Partially Observed Continuous Time Models
Authors: Fearnhead Paul , Meligkotsidou Loukia
Published: July 2004

The forward–backward algorithm is an exact filtering algorithm which can efficiently calculate likelihoods, and which can be used to simulate from posterior distributions. Using a simple result which relates gamma random variables with different rates, we show how the forward–backward algorithm can be used to calculate the distribution of a sum of gamma random variables, and to simulate from their joint distribution given their sum. One application is to calculating the density of the time of a specific event in a Markov process, as this time is the sum of exponentially distributed interevent times. This enables us to apply the forward–backward algorithm to a range of new problems. We demonstrate our method on three problems: calculating likelihoods and simulating allele frequencies under a non-neutral population genetic model, analysing a stochastic epidemic model and simulating speciation times in phylogenetics.
A Nonparametric Test to Compare Survival Distributions with Covariate Adjustment
Authors: Heller Glenn , Venkatraman E. S.
Published: July 2004

The analysis of covariance is a technique that is used to improve the power of a k-sample test by adjusting for concomitant variables. If the end point is the time of survival, and some observations are right censored, the score statistic from the Cox proportional hazards model is the method that is most commonly used to test the equality of conditional hazard functions. In many situations, however, the proportional hazards model assumptions are not satisfied. Specifically, the relative risk function is not time invariant or represented as a log-linear function of the covariates. We propose an asymptotically valid k-sample test statistic to compare conditional hazard functions which does not require the assumption of proportional hazards, a parametric specification of the relative risk function or randomization of group assignment. Simulation results indicate that the performance of this statistic is satisfactory. The methodology is demonstrated on a data set in prostate cancer.
Primary progressive multiple sclerosis: clinical and paraclinical characteristics with application of the new diagnostic criteria
Authors: Dujmović I. , Mesaroš Š , Pekmezović T. , Lević Z. , Drulović J.
Published: July 2004

The aim of our study was to analyse clinical and paraclinical characteristics of patients with multiple sclerosis (MS) with previous diagnosis of primary‐progressive (PP) MS according to the Poser's criteria and further investigate if they fulfil the McDonald's diagnostic criteria for this disorder. A total of 561 MS patients were registered in the database at the Institute of Neurology, Belgrade, from 1 January 1997 to 31 December 2000 and 63 of them (11.2%) with previous diagnosis of PPMS were analysed retrospectively. Male/female ratio was 1.3:1 and mean age at onset 33.2 years. Most frequent at onset were pyramidal (in 73% of patients) and sensory symptoms (in 41% of patients); 74.6% of patients had greater than or equal to nine brain magnetic resonance imaging (MRI) lesions. Intrathecal oligoclonal immunoglobulin G (IgG) was detected in 96.7% and prolonged visual evoked potentials (VEP) P100 latency in 82.4% of patients. Of the total study group of 561 patients, 10.2% fulfilled the recently recommended McDonald's diagnostic criteria for the diagnosis of PPMS. Our findings further support the significance of the brain/spinal cord MRI, cerebrospinal fluid and VEP findings for precise diagnostic assessment in patients with suspected PP form of MS.
Improvement in quality of life in patients with advanced Parkinson's disease following bilateral deep‐brain stimulation in subthalamic nucleus
Authors: Lezcano E. , Gómez‐Esteban J. C. , Zarranz J. J. , Lambarri I. , Madoz P. , Bilbao G. , Pomposo I. , Garibi J.
Published: July 2004

In this article we investigate the changes observed in the scales that quantify the quality of life (PDQ‐39) in patients that have already completed 1 and 2 years of bilateral subthalamic stimulation (DBS‐STN). Fourteen patients were evaluated 1 year after DBS‐STN; the evaluation was repeated on 11 of them, 2 years after surgery. All of them suffered from Parkinson's disease with a 14.3 (±5.7) years history of motor complications. Patients were selected according to CAPSIT criteria. All of them were implanted bilateral electrodes in the subthalamic nucleus. The parameters applied were UPDRS II, UPDRS III, PDQ‐39, and the scale of quality of life for caregivers (SQLC). Scorings in motor scales (UPDRS III) improved 45% in relation to the first year, and 48% in relation to the second year (P < 0.001). Patient's quality of life (PDQ‐39 summary index) improvement was 62% 2 years after surgery (P < 0.001), and caregivers’ quality of life improvement was 68% (P = 0.002) by the same time. DBS‐STN is a therapy that efficiently improves the quality of life of selected patients with Parkinson's disease. This improvement is still present 2 years after surgery and has a positive impact on caregivers quality of life.
Prevalence of persistent vegetative state/apallic syndrome in Vienna
Authors: Stepan Ch. , Haidinger G. , Binder H.
Published: July 2004

The aim of the project was to survey the hospital prevalence of apallic syndrome in a federal state in Austria at an exact point in time. To achieve this, a point prevalence study was carried out on 28 November 2001 in the Vienna region. The central element was a questionnaire, which provided an exact recording of the patients’ condition. An additional preliminary task was to check all the discharge diagnoses in the hospitals of the Vienna Hospital Association (Wiener Krankenanstalten Verbund) between 1996 and 2000 according to the ICD‐9 diagnoses for apallic syndrome. These data should serve to cross‐check the recorded results. All hospitals (n = 48) and nursing facilities (n = 44) in Vienna were included in this investigation. As the aim of the study was to record the prevalence of apallic syndrome in the population of Vienna, four patients of the group with full‐stage apallic syndrome (n = 36) were excluded as they were from other federal states. In total, 32 hospital patients who met the clinical criteria for apallic syndrome (full‐stage) were recorded. The point prevalence of apallic syndrome was 1.9/100 000 inhabitants. As a result of this study, the exact survey of hospital prevalence of apallic syndrome could be found. As a consequence, the Viennese government has developed a rehabilitation concept for patients with apallic syndrome in Vienna.
Type I cerebral dural arteriovenous fistulas of the lateral sinus: clinical features in 24 patients
Authors: Raupp S. , Van Rooij W. J. , Sluzewski M. , Tijssen C. C.
Published: July 2004

To review the clinical and diagnostic characteristics of type I cerebral dural arteriovenous fistulas (CDAVF) of the lateral sinus medical records of 24 patients with Type I CDAVF were retrospectively reviewed. All patients were interviewed aiming at presenting symptoms, impact on daily functioning, diagnostic delay, relevant medical history and post‐treatment status. Nineteen of 24 patients (79%) were women. The median age at the time of diagnosis was 56 years (range 32–69). Unilateral pulsatile tinnitus was the presenting symptom in all patients. A bruit could be heard at auscultation on the retroauricular skull in all patients. The median diagnostic delay was 17.9 months (range 1–120). Standardized magnetic resonance imaging (MRI) of the brain was normal in all patients. The diagnosis of CDAVF was confirmed on cerebral angiography. In conclusion, CDAVF type I of the lateral sinus occurs predominantly in middle aged women and presents with unilateral pulsatile tinnitus, which resulted in impairment of social and occupational functioning in the vast majority of patients. An audible bruit at retroauricular auscultation confirms the clinical diagnosis of a cerebral dural fistula. MRI is not helpful in the diagnosis and cerebral angiography is indicated to classify the dural fistula.
Comparison of the arrhythmogenic effects of tauro‐ and glycoconjugates of cholic acid in an in vitro study of rat cardiomyocytes
Authors: Gorelik J. , Shevchuk A. , de Swiet M. , Lab M. , Korchev Y. , Williamson C.
Published: July 2004

Obstetric cholestasis is associated with intrauterine death. In obstetric cholestasis, primary bile acids are more commonly conjugated with taurine than glycine, while glycoconjugates predominate in normal pregnancy. Using an in vitro model of rat cardiomyocytes, we compared the effect of tauro‐ and glycoconjugated cholate on cardiomyocyte rhythm, contraction amplitude and network integrity. We demonstrated that taurocholate had a more marked effect on all of these parameters, and the effects of the glycoconjugates were fully reversible while those of tauroconjugates were not. The increased proportion of tauroconjugated bile acids in obstetric cholestasis may contribute to the aetiology of the intrauterine death associated with the condition.
Ketanserin in pre‐eclamptic patients: transplacental transmission and disposition in neonates
Authors: Hanff L.M. , Visser W. , Roofthooft D.W.E. , Bulsink M.J.E. , Vermes A. , Steegers E.A.P. , Vulto A.G.
Published: July 2004

The aim of this prospective, observational study was to assess transplacental transmission of ketanserin, an antihypertensive drug used in pre‐eclampsia, and to determine disposition and effects in the neonate after maternal ketanserin use. In 22 pregnant women with severe pre‐eclampsia, admitted to the antenatal ward in the period 1999–2001, the ratio of drug levels in the umbilical cord to drug levels in maternal blood just before delivery was used as an indicator of placental transmission. Disposition of ketanserin was assessed using neonatal plasma concentrations of ketanserin in eight neonates after birth. A median placental transmission was found in the pre‐eclamptic women of 0.95 (0.612–1.24) for ketanserin and for its metabolite, ketanserinol, of 0.60 (0.5–0.77). Pharmacologically relevant concentrations of ketanserin were found in the neonate after delivery. The elimination half‐life of ketanserin in the neonate varied between 12.7 and 43.7 hours (median 19.3 hours) and of ketanserinol between 13.8 and 34.4 hours (median 18.7 hours). Despite the high placental transmission and disposition in the neonate, no apparent adverse effects in the neonates could be detected. In conclusion, a high placental transmission of ketanserin and its metabolite ketanserinol occurred after maternal treatment of pre‐eclampsia with ketanserin and pharmacologically active concentrations of ketanserin are found in the neonate for a prolonged period after delivery.
How long should urinary bladder catheterisation be continued after vaginal prolapse surgery?
Authors: Hakvoort R.A. , Elberink R. , Vollebregt A. , Van der Ploeg T. , Emanuel M.H.
Published: July 2004

Objective  To determine whether prolonged urinary bladder catheterisation after vaginal prolapse surgery is advantageous.

Design  Randomised controlled trial.

Setting  A large training hospital in the Netherlands.

Population  Patients undergoing anterior colporrhaphy.

Methods  One hundred patients were included. Patients were randomised into two groups. In one group (n= 50), a transurethral catheter was in place for four days post‐operatively and removed on the fifth post‐operative day. In the other group (n= 50), catheterisation was not prolonged and the catheter was removed the morning after surgery. Residual volumes after removal of the catheter were measured by ultrasound scanning. Where residual volumes of >200 mL were found the patient was recatheterised for three more days. Urinary cultures were taken before removal of the catheter. Six patients were excluded: four in the standard prolonged catheterisation group and two in the not prolonged catheterisation group.

Main outcome measures  Need for recatheterisation, urinary tract infection, mean duration of catheterisation and hospital stay.

Results  Residual volumes exceeding 200 mL and need for recatheterisation occurred in 9% in the standard prolonged catheterisation group versus 40% of patients in the not prolonged catheterisation group (OR 0.15, 95% CI 0.045–0.47). Positive urine cultures were found in 40% of cases in the standard prolonged catheterisation group compared with 4% in the not prolonged catheterisation group (OR 15, 95% CI 3.2–68.6). Mean duration of catheterisation was 5.3 days in the standard prolonged catheterisation group and 2.3 days in the not prolonged catheterisation group (P < 0.001). Mean duration of hospitalisation was 7 days in the standard prolonged catheterisation group and 5.7 days in the not prolonged group (P < 0.001).

Conclusion  The disadvantages of prolonged catheterisation outweigh the advantages, therefore, removal of the catheter on the morning after surgery may be preferable and longer term catheterisation should only be undertaken where there are specific indications.
Thrombophilia and stillbirth: possible connection by intrauterine growth restriction
Authors: Weiner Zeev , Beck‐Fruchter Ronit , Weiss Amir , Hujirat Yasir , Shalev Eliezer , Shalev Stavit A.
Published: July 2004

Objective  To define the association between thrombophilia and unexplained stillbirth.

Design  A case–control study.

Setting  Obstetric department in a university affiliated hospital (Ha'Emek Medical Center, Afula).

Population  A total of 53 women who delivered stillborns between March 1998 and June 2002 and 59 women with unremarkable obstetric history who delivered at the same period.

Methods  Presence of genetic and acquired markers of thrombophilia was investigated.

Main outcome measure  Presence or absence of thrombophilia.

Results  Thrombophilia was found in 34% of the women who delivered stillborns and in 20% of the 59 women with normal pregnancies (non‐significant). However, significantly higher prevalence of thrombophilia (73%) was found in women who delivered small for gestational age stillborns compared with women who delivered normal birthweight stillborns (73%vs 18.4%, P < 0.0001).

Conclusions  There is no association between thrombophilia and stillbirth, overall. However, there is a clear association between thrombophilia and stillbirth of extremely growth restricted infants.
Preterm birth and maternal country of birth in a French district with a multiethnic population
Authors: Zeitlin J. , Bucourt M. , Rivera L. , Topuz B. , Papiernik E.
Published: July 2004

Objectives  This analysis explores the association between preterm birth and maternal country of birth in a French district with a multiethnic population.

Design  Prospective observational study.

Setting  District of Seine‐Saint‐Denis in France

Population  48,746 singleton live births from a population‐based birth register between October 1998 and December 2000.

Methods  We compare preterm birth rates by mother's country of birth controlling for demograhic and obstetric factors as well as insurance coverage and timing of initiation of antenatal care.

Main outcome measures  Overall preterm birth rates and preterm birth rates by timing of delivery (<33 weeks versus 33–36 weeks of gestation), mode of onset (spontaneous or indicated preterm birth) and the presence of hypertension in pregnancy.

Results  Women born in Northern Africa, Southern Europe and South/East Asia did not have higher preterm birth rates than women born in continental France. Rates were significantly higher for women born in the overseas French districts in the Caribbean and Indian Ocean and Sub‐Saharan Africa. Excess risk was greatest for early preterm births, medically indicated births and preterm births associated with hypertension.

Conclusions  Patterns of preterm birth with relation to timing, mode of onset and medical complications among of Afro‐Caribbean origin should be confirmed in future research.
The tension‐free vaginal tape in older women
Authors: Karantanis Emmanuel , Fynes Michelle M. , Stanton Stuart L.
Published: July 2004

Objective  To evaluate peri‐operative morbidity, continence outcome and patient satisfaction in older women (≥65 years) compared with younger women undergoing tension‐free vaginal tape.

Design  Case controlled study.

Setting  Tertiary Urogynaecology Unit.

Sample  Women undergoing tension‐free vaginal tape for urodynamic stress incontinence between July 1999 and July 2002 were included. Those with detrusor overactivity, voiding difficulty at urodynamics or requiring concomitant prolapse surgery were excluded.

Methods  Older women were case matched to a younger cohort for BMI, parity, mode of anaesthesia and whether it was a primary or secondary continence procedure.

Main outcome measures  Operative morbidity and continence outcome were assessed at six weeks. After a minimum six months follow up, patient satisfaction and continence outcome were assessed using the Genitourinary Treatment Satisfaction Score (GUTSS).

Results  The median hospital stay was one day and overall urinary tract infection rate was similar in both groups. Post‐operative voiding difficulty rates were 3% in older versus 15% in younger women (P= 0.09). At six weeks, 65% of older versus 79% of younger women were dry (P= 0.2). At a median of 12 months, 15 (45%) of older versus 24 (73%) of younger women had no urinary symptoms (P= 0.05). Median GUTSS scores for satisfaction with continence outcome were lower for older 90% compared with 100% in younger women (P= 0.003).

Conclusions  Tension‐free vaginal tape is an effective continence intervention in older women but has a lower continence satisfaction rate compared with younger women.
Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh
Authors: Dwyer Peter L. , O'Reilly Barry A.
Published: July 2004

Objective  To determine the efficacy and safety of a new technique using Atrium polypropylene mesh (Atrium, Hudson, New Hampshire, USA) as an overlay graft for repair of large or recurrent anterior and posterior compartment prolapse.

Design  A retrospective review of women who had vaginal prolapse surgery with Atrium mesh reinforcement.

Setting  Tertiary referral urogynaecology unit in Australia.

Population  Forty‐seven women where mesh was placed under the bladder base with lateral extensions onto the pelvic sidewall, 33 women where a Y‐shaped mesh was placed from the sacrospinous ligaments to the perineal body and 17 women who had mesh placement in both compartments.

Methods  Women were assessed by site‐specific vaginal examination pre‐operatively and post‐operatively at six weeks, six months and two years.

Main outcome measures  All complications. Rate of recurrent prolapse assessed by the Baden–Walker halfway classification system.

Results  Mean follow up was 29 months (range 6 to 52). Four of 64 women with anterior mesh placement (6%) developed a grade 2 asymptomatic cystocele. Five women (5%) required further surgery for recurrent prolapse at a non‐mesh site. Erosion occurred in nine women (9%). Three healed after intravaginal oestrogen cream, five after excision of exposed mesh and vaginal closure and one woman also had surgical closure of a rectovaginal fistula. The risk of mesh erosion decreased over the study period. Urinary, coital and bowel symptoms were significantly improved following surgery.

Conclusions  This technique shows promise in correcting pelvic organ prolapse. Vaginal mesh erosion is the most common complication and is related to surgical experience.
National survey for intrapartum and postpartum bladder care: assessing the need for guidelines
Authors: Zaki Mona M. , Pandit Meghana , Jackson Simon
Published: July 2004

Variation in the practice of intrapartum and postpartum bladder care reported by 189 maternity units in England and Wales hospitals was evaluated by analysing the data obtained from a postal questionnaire completed by labour ward managers or heads of midwifery. The survey revealed that there was no consensus of opinion about the diagnostic criteria for postpartum urinary retention and therefore the optimum management for voiding dysfunction remains controversial. In spite of the increasing awareness of the risk management issues involved, the majority of the units were found to be non‐compliant with the limited RCOG recommendations currently available. Although further research is needed to develop evidence‐based guidelines, all units should be timing and measuring the voided volume and ideally checking the first post‐void residual volume to ensure that retention does not go unrecognised.
A national survey of senior trainees surgical experience in hysterectomy and attitudes to the place of vaginal hysterectomy
Authors: Miskry Tariq , Magos Adam
Published: July 2004

We set out to determine the current status of training in vaginal hysterectomy in the UK. In total, 255 year 4 or 5 ‘Calman’ trainees were identified and sent an anonymous questionnaire assessing surgical experience, quality of training and attitudes towards vaginal hysterectomy. Our results demonstrate that senior trainees' experience in vaginal as opposed to abdominal hysterectomy is relatively poor. Despite this, trainees believed that the majority of hysterectomies should be done vaginally, and only a minority, laparoscopically.
Emergency contraceptive pills in Sweden: evaluation of an information campaign
Authors: Larsson Margareta , Eurenius Karin , Westerling Ragnar , Tydén Tanja
Published: July 2004

Objective  To evaluate a community‐based intervention regarding emergency contraceptive pills, including a mass media campaign and information to women visiting family planning clinics.

Design  Quasi‐experimental.

Setting  Two counties in Sweden.

Population  Eight hundred randomly selected women aged 16–30 years, 400 women in the intervention group and 400 in a comparison group.

Methods  Postal questionnaires before (2002) and after (2003) the intervention.

Main outcome measures  Exposure to the intervention, knowledge, attitudes, practices and intention to use emergency contraceptive pills.

Results  Before the intervention, the response rate was 71% (n= 564); after the intervention, the corresponding figure was 83% (n= 467); overall response rate 58%. Two‐thirds (64%) of the targeted women had noticed the information campaign. One out of six who had visited a family planning clinic during the intervention year recalled being given information about emergency contraceptive pills. Specific knowledge and attitudes improved over time in both groups, but there was no difference in change between the groups. The proportion of women who had used emergency contraceptive pills increased from 27% to 31% over time. Intention to use emergency contraceptive pills in case of need was reported by 74% of the women and remained stable over time, but logistic regression showed that information during the previous year contributed to willingness to use the method in the intervention group.

Conclusions  Knowledge, attitudes and practices about emergency contraceptive pills increased in both groups. Emergency contraceptive pills is gradually becoming a more widely known, accepted and used contraceptive method in Sweden, a trend that may have limited the impact of the intervention.
Dramatic reduction in triplet and higher order births in England and Wales
Authors: Simmons Rebecca , Doyle Pat , Maconochie Noreen
Published: July 2004

The proportion of multiple births has increased markedly since 1980 in England and Wales. A major contribution to this trend is thought to be the widespread introduction of assisted reproductive technologies. Despite a continuing (but slower) upward trend in twin maternities, analysis of recent data shows that the rate of triplet and higher order births in England and Wales has declined by one‐quarter since 1998. This probably reflects both voluntary and statutory regulation of treatment regimes. This downward trend will help alleviate the high burden of perinatal morbidity and mortality associated with multiple births.
Is home‐based administration of prostaglandin safe and feasible for medical abortion? Results from a multisite study in Vietnam
Authors: Ngoc Nguyen Thi Nhu , Nhan Vu Quy , Blum Jennifer , Mai Tran Thi Phuong , Durocher Jill M. , Winikoff Beverly
Published: July 2004

Objectives  To study the efficacy and acceptability of a simplified medical abortion regimen in Vietnam.

Design  Open‐label study.

Setting  One peri‐urban and three urban hospitals and four urban maternal–child health family planning clinics located in Northern, Central and Southern Vietnam.

Sample  A total of 1601 women seeking abortion services from January 2001 to December 2001.

Methods  Consenting women presenting for abortion services with gestations less than 56 days LMP who met the inclusion criteria were given 200 mg mifepristone and offered the choice of either home or clinic administration of 400 μg oral misoprostol two days later.

Main outcome measure  Complete abortion rate of 89.2% (n= 1395), with 1.5% (n= 24) of the women lost to follow up. The majority of women (>90%) reported that their medical abortion experience was either ‘very satisfactory’ or ‘satisfactory’.

Results  There was a strong preference for home administration of misoprostol, with more than four‐fifths of the study population selecting to administer the prostaglandin at home. Location of misoprostol administration did not affect efficacy rate. Regardless of location selected, women expressed a high degree of satisfaction with the medical abortion experience.

Conclusions  Medical abortion with the option of home administration of misoprostol is safe and feasible for introduction into the Vietnamese healthcare system.
Definition of mild, moderate and severe incontinence on the 24‐hour pad test
Authors: O'Sullivan R. , Karantanis E. , Stevermuer T.L. , Allen W. , Moore K.H.
Published: July 2004

The values for ‘mild’, ‘moderate’ and ‘severe’ urinary incontinence have not been determined for the 24‐hour pad test. To define these values, a prospective observational study was performed on 110 women with the primary symptom of urinary incontinence. Consenting women performed two 1‐hour pad tests one week apart, and seven 24‐hour pad tests for seven consecutive days. The 1‐hour pad test definitions for mild, moderate and severe were translated to centiles, and used to categorise the 24‐hour test values. This revealed that the range for ‘mild incontinence’ was between 1.3 and 20 g, ‘moderate incontinence’ ranged from 21 to 74 g, and ‘severe incontinence’ was defined as 75 g or more in 24 hours. Severity of leakage was analysed in relation to urodynamic diagnosis, age, parity and pelvic floor muscle strength. Increasing severity was associated with increasing age and parity. Women with detrusor overactivity were most likely to have severe leakage. In conclusion, this study defines the three grades of severity for the 24‐hour pad test, which may help to guide patients' choice between conservative and surgical treatment and is useful for stratified randomisation of controlled trial participants.