bluuebunny/crossref_metadata_2025 huggingface dataset:
Massive postpartum haemorrhage after uterus‐conserving surgery in placenta percreta: the danger of the partial placenta percreta
Authors: Teo SBL , Kanagalingam D , Tan H‐K , Tan L‐K
Published: April 2008

Placenta percreta is a rare but potentially life‐threatening condition associated with high maternal mortality and morbidity rates, usually arising from severe obstetric haemorrhage. Due to rising caesarean section rates, an increase in the incidence of morbidly adherent placentas (accreta, increta and percreta) has been observed. Various treatment strategies have been employed in different centres, ranging from performing a caesarean hysterectomy at the time of delivery to leaving the placenta in situ, with or without adjuvant internal iliac and uterine arterial embolisation and/or methotrexate therapy. In the case of placenta percreta, irrespective of the treatment method employed, women are still at high risk of life‐threatening haemorrhage and morbidity secondary to placental invasion beyond the confines of the uterine serosa into surrounding organs, most commonly the bladder. We describe an unusual case of a partially adherent placenta percreta in which partial separation of the normally implanted placenta led to torrential haemorrhage on the third postoperative day after the placenta was left in situ at the time of delivery. We therefore advise caution in following a conservative approach in the treatment of cases of placenta percreta in which the percreta feature is only partial and will discuss the merits and disadvantages of alternative options.
Ethnic differences in preterm birth and its subtypes: the effect of a cumulative risk profile
Authors: Goedhart G , Van Eijsden M , Van Der Wal MF , Bonsel GJ
Published: April 2008

Objective  To explore the effect of potentially explanatory risk factors on ethnic differences in the prevalence of preterm birth (PTB) and its subtypes.

Design  Prospective population‐based cohort study.

Setting and population  Pregnant women from Amsterdam attending their first antenatal visit for obstetric care. A total of 8266 women participated (response rate 67%). Ethnicity was based on the country of birth of the pregnant woman’s mother: the Netherlands, Surinam, the Antilles, Turkey, Morocco, Ghana and other non‐Dutch countries. Exclusion criteria were multiple births and gestational age at delivery less than 24 weeks.

Methods  Risk factors were obtained using a multilingual questionnaire and from the Dutch Perinatal Registration. Risk factors were summed into a cumulative risk score. Multiple logistic regression analyses were performed.

Main outcome measures  Odds ratios with 95% CIs were calculated for total, spontaneous and iatrogenic (medically indicated) preterm births for the ethnic minority groups versus the Dutch reference group.

Results  After adjustment for all risk factors, the Surinamese (OR 1.6, 95% CI 1.2–2.4), Ghanaian (OR 2.0, 95% CI 1.1–3.6) and Antillean (OR 1.6, 95% CI 0.8–3.3) women had a higher risk of PTB compared with the Dutch women, in particular for iatrogenic preterm birth (OR 2.1, 95% CI 1.0–4.4; OR 3.2, 95% CI 1.0–10.4; OR 3.6, 95% CI 1.1–11.2, respectively). The ethnic minority groups had a higher cumulative risk score (ranging from 2.1 to 3.7) compared with the Dutch group (1.8). Adjustment for the cumulative risk score considerably decreased the risk of PTB among the Surinamese (OR 1.2, 95% CI 0.9–1.7), Ghanaian (OR 1.3, 95% CI 0.8–2.3) and Antillean (OR 1.2, 95% CI 0.6–2.4) women.

Conclusions  A cumulation of risk factors, mainly observed among the ethnic minority groups, contributes to the explanation of ethnic differences in PTB prevalence.
Maternal obesity, length of gestation, risk of postdates pregnancy and spontaneous onset of labour at term
Authors: Denison FC , Price J , Graham C , Wild S , Liston WA
Published: April 2008

Objective  To investigate the effect of maternal body mass index (BMI) on postdates pregnancy, length of gestation and likelihood of spontaneous onset of labour at term.

Design  Retrospective cohort study.

Setting  Swedish Medical Birth Register.

Population  A total of 186 087 primiparous women (of whom 143 519 had spontaneous onset of labour at term) who gave birth between 1998 and 2002.

Methods  Mann–Whitney test, one‐way analysis of variance, linear regression and single variable logistic regression.

Main outcome measures  Postdates pregnancy (≥294 days or 42+0 weeks), length of gestation and likelihood of spontaneous onset of labour at term.

Results  About 6.8% of pregnancies delivered postdates. Higher maternal BMI (kg/m2) during the first trimester was associated with longer gestation (P < 0.001) as was a greater change in BMI between the first and third trimesters (BMI measured on admission prior to delivery) with mean (SD) gestation at delivery of 280.7 (8.6) and 283.2 (8.6) days for increases in BMI of <2 and ≥10 kg/m2, respectively. Higher BMI during the first trimester was associated with a lower chance of spontaneous onset of labour at term. Compared with BMI 20 to <25 kg/m2, the odds ratios (95% CI) for spontaneous onset of labour at term were 1.21 (1.15–1.27) for BMI of <20 kg/m2, 0.71 (0.69–0.74) for BMI of 25 to <30 kg/m2, 0.57 (0.54–0.60) for BMI of 30 to <35 kg/m2 and 0.43 (0.40–0.47) for BMI of ≥35 kg/m2. Higher BMI during the first trimester (BMI of ≥35 kg/m2 compared with BMI of 20 to <25 kg/m2) was also associated with an increased risk of complications including stillbirth (OR 3.90, 95% CI 2.44–6.22), gestational diabetes (OR 5.61, 95% CI 4.61–6.83) and caesarean section (OR 2.39; 95% CI 2.20–2.59).

Conclusions  Higher maternal BMI in the first trimester and a greater change in BMI during pregnancy were associated with longer gestation and an increased risk of postdates pregnancy. Higher maternal BMI during the first trimester was also associated with decreased likelihood of spontaneous onset of labour at term and increased likelihood of complications.
Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down’s syndrome
Authors: Boyd PA , DeVigan C , Khoshnood B , Loane M , Garne E , Dolk H ,   EUROCAT working group
Published: April 2008

Objective  To ‘map’ the current (2004) state of prenatal screening in Europe.

Design  (i) Survey of country policies and (ii) analysis of data from EUROCAT (European Surveillance of Congenital Anomalies) population‐based congenital anomaly registers.

Setting  Europe.

Population  Survey of prenatal screening policies in 18 countries and 1.13 million births in 12 countries in 2002–04.

Methods  (i) Questionnaire on national screening policies and termination of pregnancy for fetal anomaly (TOPFA) laws in 2004. (ii) Analysis of data on prenatal detection and termination for Down’s syndrome and neural tube defects (NTDs) using the EUROCAT database.

Main outcome measures  Existence of national prenatal screening policies, legal gestation limit for TOPFA, prenatal detection and termination rates for Down’s syndrome and NTD.

Results  Ten of the 18 countries had a national country‐wide policy for Down’s syndrome screening and 14/18 for structural anomaly scanning. Sixty‐eight percent of Down’s syndrome cases (range 0–95%) were detected prenatally, of which 88% resulted in termination of pregnancy. Eighty‐eight percent (range 25–94%) of cases of NTD were prenatally detected, of which 88% resulted in termination. Countries with a first‐trimester screening policy had the highest proportion of prenatally diagnosed Down’s syndrome cases. Countries with no official national Down’s syndrome screening or structural anomaly scan policy had the lowest proportion of prenatally diagnosed Down’s syndrome and NTD cases. Six of the 18 countries had a legal gestational age limit for TOPFA, and in two countries, termination of pregnancy was illegal at any gestation.

Conclusions  There are large differences in screening policies between countries in Europe. These, as well as organisational and cultural factors, are associated with wide country variation in prenatal detection rates for Down’s syndrome and NTD.
Substandard care in maternal mortality due to hypertensive disease in pregnancy in the Netherlands
Authors: Schutte JM , Schuitemaker NWE , Van Roosmalen J , Steegers EAP ,   Dutch Maternal Mortality Committee
Published: April 2008

Objectives  To review the standard of care in cases of maternal mortality due to hypertensive diseases in pregnancy and to make recommendations for its improvement.

Design  Care given to women with hypertensive disease in pregnancy was audited and substandard care factors identified.

Setting  Confidential enquiry by the Dutch Maternal Mortality Committee (MMC) from the Netherlands Society of Obstetrics and Gynaecology.

Population  All maternal deaths reported to the MMC due to hypertensive disease in pregnancy in the Netherlands during the years 2000–04.

Methods  Assessment for substandard care factors using a checklist based on the Dutch guideline of ‘Hypertensive Disorders in Pregnancy’.

Main outcome measures  Substandard care in cases of maternal mortality due to hypertensive diseases in pregnancy.

Results  A total of 27 cases of maternal death due to hypertensive disease in pregnancy were reported to the committee in the study period. In 26 cases (96%), substandard care factors were present, of which in 17 cases (63%), these were for more than five different items. In community midwifery care, the most frequent substandard care factor was no testing for proteinuria when clearly indicated (41%). In hospital care, the most frequent substandard care was related to insufficient diagnostic testing when indicated (41%), insufficient management of hypertension by obstetricians (85%), no use or inadequate use of magnesium sulphate (67%), inadequate stabilisation before transport to tertiary care centres and/or delivery (52%) and failure to consider timely delivery (44%).

Conclusions  Education of pregnant women concerning danger signs of hypertensive disease should be improved. Training of midwives and obstetricians should be improved in the following areas: performing basic diagnostic tests, adequate management of hypertension and eclampsia, with more attention to treatment of systolic blood pressure. This training should be guided by clear local protocols. Delivery should not be delayed in serious cases of hypertensive disease in pregnancy, not only after 32–34 weeks but also in early‐onset pre‐eclampsia as maternal risks often outweigh possible fetal benefits of temporising management.
Swyer syndrome: presentation and outcomes
Authors: Michala L , Goswami D , Creighton SM , Conway GS
Published: April 2008

Objective  To establish the spectrum of presentation, natural history and gynaecological outcomes in women with Swyer syndrome.

Design  Retrospective notes review.

Setting  Tertiary referral centre for disorders of sex development.

Population  A total of 29 adult women with Swyer syndrome.

Methods  Information was collected on age at diagnosis, biometric characteristics, timing of gonadectomy, histology of gonad, bone mineral density, uterine size and fertility.

Main outcome measures  Age at diagnosis, risk of gonadal malignancy, bone mineral density, uterine size.

Results  With regard to presentation, 26/29 (90%) women in this series presented with delayed puberty, and the median age at diagnosis was 17.2 years (range 0–55 years). The median age at gonadectomy was 18 years (range 9–33 years). Histology of the gonad was available in 22 women and demonstrated streak gonads with no evidence of malignancy in 12, dysgerminoma in 7 and gonadoblastoma in 3. The youngest patient diagnosed with dysgerminoma was 10 years old. The median height of the women was 1.73 m (range 1.54–1.95 m). Twelve out of the 20 (60%) women had evidence of osteopenia on dual energy X‐ray absorptiometry scan. The uterine size and shape was assessed in eight women after completion of induction of puberty, and the uterine cross‐section was found to be significantly lower than that in normal controls. Fertility was achieved with ovum donation in three women, all of whom had live births and one subsequently had a second successful pregnancy.

Conclusion  Early diagnosis of Swyer syndrome is necessary in view of the risk of dysgerminoma that can develop at an early age. Adequate hormone replacement is required to maintain bone mineral density and may improve the uterine size and shape.
The risk of unexplained antepartum stillbirth in second pregnancies following caesarean section in the first pregnancy
Authors: Wood SL , Chen S , Ross S , Sauve R
Published: April 2008

Objective  To determine if a previous caesarean section increases the risk of unexplained antepartum stillbirth in second pregnancies.

Study design  Retrospective cohort study.

Setting  Large Canadian perinatal database.

Population  158 502 second births.

Methods  Data were obtained from a large perinatal database, which supplied data on demographics, pregnancy complications, maternal medical conditions, previous caesarean section and pregnancy outcomes.

Main outcome measures  Total and unexplained stillbirth.

Results  The antepartum stillbirth rate was 3.0/1000 in the previous caesarean section group compared with 2.7/1000 in the previous vaginal delivery group (P= 0.46). Multivariate logistic regression modelling, including terms for maternal age (polynomial), weight >91 kg, smoking during pregnancy, pre‐pregnancy hypertension and diabetes, did not document an association between previous caesarean section and unexplained antepartum stillbirth (OR 1.27, 95% CI 0.92–1.77).

Conclusion  Caesarean section in the first birth does not increase the risk of unexplained antepartum stillbirth in second pregnancies.
Lactate concentration in umbilical cord blood is gestational age‐dependent: a population‐based study of 17 867 newborns
Authors: Wiberg N , Källén K , Herbst A , Åberg A , Olofsson P
Published: April 2008

Objective  To study the influence of gestational age on lactate concentration in arterial and venous umbilical cord blood at birth and to define gestational age‐specific reference values for lactate in vigorous newborns.

Design  Population‐based comparative.

Setting  University hospitals.

Sample  Vigorous newborns with validated umbilical cord blood samples.

Material and methods  From 2000 to 2004, routine cord blood gases, lactate and obstetric data from two university hospitals were available for 17 867 newborns from gestational week 24 to 43. After validation of blood samples and inclusion only of singleton pregnancies aimed for vaginal delivery, 10 700 women remained. Among those, reference values were defined in 10 169 vigorous newborns, that is in newborns with a 5‐minute Apgar score corresponding to the gestational age‐specific median value minus 1 point score, or better.

Main outcome measures  Cord lactate concentration relative to gestational age.

Results  The arterial and venous lactate concentrations increased monotonously with gestational age from 34 weeks. Considerable differences were found between mean and median values, but after logarithmic transformation the log‐lactate values were normally distributed. Simple linear regression analysis showed a significant association between the log‐lactate values and gestational age (P < 10−6, R2= 0.024). Reference curves were constructed after anti‐logarithmic transformation. Both the gestational age and the time of the second stage of labour influenced, independently of each other, the lactate concentrations.

Conclusions  Lactate concentrations in arterial and venous umbilical cord blood are increasing significantly with advancing gestational age.
Delayed umbilical cord clamping at birth has effects on arterial and venous blood gases and lactate concentrations
Authors: Wiberg N , Källén K , Olofsson P
Published: April 2008

Objective  To estimate the influence of delayed umbilical cord clamping at birth on arterial and venous umbilical cord blood gases, bicarbonate (), base excess (BE) and lactate in vigorous newborns.

Setting  University hospital.

Design  Prospective observational.

Sample  Vaginally delivered term newborns.

Material and methods  Umbilical cord arterial and venous blood was sampled repeatedly every 45 seconds (T0= time zero; T45= 45 seconds, T90= 90 seconds) until the cord pulsations spontaneously ceased in 66 vigorous singletons with cephalic vaginal delivery at 36–42 weeks. Longitudinal comparisons were performed with the Wilcoxon signed‐ranks matched pairs test. Mixed effect models were used to describe the shape of the regression curves.

Main outcome measures  Longitudinal changes of umbilical cord blood gases and lactate.

Results  In arterial cord blood, there were significant decreases of pH (7.24–7.21), (18.9–18.1 mmol/l) and BE (−4.85 to −6.14 mmol/l), and significant increases of PaCO2 (7.64–8.07 kPa), PO2 (2.30–2.74 kPa) and lactate (5.3–5.9 mmol/l) from T0 to T90, with the most pronounced changes at T0–T45. Similar changes occurred in venous blood pH (7.32–7.31), (19.54–19.33 mmol/l), BE (−4.93 to −5.19 mmol/l), PaCO2 (5.69–5.81 kPa) and lactate (5.0–5.3 mmol/l), although the changes were smaller and most pronounced at T45–T90. No significant changes were observed in venous PO2.

Conclusion  Persistent cord pulsations and delayed cord clamping at birth result in significantly different measured values of cord blood acid–base parameters.
Transoesophageal echocardiography should be considered in patients with ischaemic stroke or transient ischaemic attack
Authors: Strandberg Marjatta , Marttila Reijo J , Helenius Hans , Hartiala Jaakko
Published: April 2008

Background and purpose:  In this present study, we tried to find out if there is a subgroup of patients that should not undergo transoesophageal echocardiography (TEE) after an ischaemic stroke or transient ischaemic attack (TIA).

Methods:  A total of 441 consecutive unselected patients with ischaemic stroke or TIA suitable for anticoagulation were examined with TEE in the acute phase. The patients were divided into five subcategories according to their rhythm, age and the findings in carotid sonography, and into two groups according to the presence of clinical risk factors for ischaemic stroke or TIA.

Results:  From the 441 studied patients, 60 (14%) had chronic or paroxysmal atrial fibrillation (AF) and 381 (86%) were in sinus rhythm (SR). Of the patients in SR, 46 (12%) were below 50 years old. The carotid sonography was conducted in 240 patients above 50 years old and in SR, and <50% internal carotid artery (ICA) stenosis was found in 194 (81%) patients and ≥50% ICA in 46 (19%) patients. Potential cardiac sources of embolism were found in patients both with AF or in SR (70% versus 46%), both below and above 50‐year‐old patients in SR (37% versus 47%), both in over 50‐year‐old patients in SR with <50% ICA stenosis and ≥50% ICA stenosis (41% versus 61%) and in patients in SR either without or with clinical risk factors for ischaemic stroke or TIA (43% versus 51%). On the basis of the TEE study, oral anticoagulation was started in 36 (9%) patients in SR.

Conclusion:  These results support TEE in patients with ischaemic stroke or TIA who are candidates for receiving oral anticoagulation.
Effects of Poverty and Lack of Insurance on Perceptions of Racial and Ethnic Bias in Health Care
Authors: Stepanikova Irena , Cook Karen S.
Published: April 2008

Objective.To investigate whether poverty and lack of insurance are associated with perceived racial and ethnic bias in health care.

Data Source.2001 Survey on Disparities in Quality of Health Care, a nationally representative telephone survey. We use data on black, Hispanic, and white adults who have a regular physician (N=4,556).

Study Design.We estimate multivariate logistic regression models to examine the effects of poverty and lack of health insurance on perceived racial and ethnic bias in health care for all respondents and by racial, ethnic, and language groups.

Principal Findings.Controlling for sociodemographic and other factors, uninsured blacks and Hispanics interviewed in English are more likely to report racial and ethnic bias in health care compared with their privately insured counterparts. Poor whites are more likely to report racial and ethnic bias in health care compared with other whites. Good physician–patient communication is negatively associated with perceived racial and ethnic bias.

Conclusions.Compared with their more socioeconomically advantaged counterparts, poor whites, uninsured blacks, and some uninsured Hispanics are more likely to perceive that racial and ethnic bias operates in the health care they receive. Providing health insurance for the uninsured may help reduce this perceived bias among some minority groups.
Does Hospital Performance on Process Measures Directly Measure High Quality Care or Is It a Marker of Unmeasured Care?
Authors: Werner Rachel M. , Bradlow Eric T. , Asch David A.
Published: April 2008

Objective. Quality measures may be associated with improved outcomes for two reasons. First, measured activities may directly improve care. Second, success on these measures may be a marker for other unmeasured aspects of high quality care. Our objective is to test the contribution of both possible effects.

Data Sources. 2004 Medicare data on hospital performance from Hospital Compare and risk‐adjusted mortality rates from Medicare Part A claims.

Study Design. We studied 3,657 acute care U.S. hospitals and compared observed differences in condition‐specific hospital mortality rates based on hospital performance with expected differences in mortality from the clinical studies underlying the measures.

Principal Findings. Differences in observed mortality rates across U.S. hospitals are larger than what would be expected if these differences were due only to the direct effects of delivering measured care.

Conclusions. Performance measures reflect care processes that both improve care directly and are also markers of elements of health care quality that are otherwise unmeasured. This finding suggests that process measures capture important information about care that is not directly measured, and that these unmeasured effects are in general larger than the measured effects.
Effectiveness of Voluntary Conservation Agreements: Case Study of Endangered Whales and Commercial Whale Watching
Authors: WILEY DAVID N. , MOLLER JUST C. , PACE RICHARD M. , CARLSON CAROLE
Published: April 2008

Abstract:  The use of voluntary approaches to achieve conservation goals is becoming increasingly popular. Nevertheless, few researchers have quantitatively evaluated their efficacy. In 1998 industry, government agencies, and nongovernmental organizations established a voluntary conservation program for whale watching in the northeast region of the United States, with the intent to avoid collisions with and harassment of endangered whales by commercial and recreational whale‐watching vessels. One important aspect of the program was the establishment of 3 speed zones within specific distances of whales. We wanted to determine the level of compliance with this aspect of the program to gauge its efficacy and gain insights into the effectiveness of voluntary measures as a conservation tool. Inconspicuous observers accompanied 46 commercial whale‐watching trips from 12 companies in 2003 (n= 35) and 2004 (n= 11). During each trip, vessel position and speed were collected at 5‐second intervals with a GPS receiver. Binoculars with internal laser rangefinders and digital compasses were used to record range and bearing to sighted whales. We mapped whale locations with ArcGIS. We created speed‐zone buffers around sighted whales and overlaid them with vessel‐track and speed data to evaluate compliance. Speeds in excess of those recommended by the program were considered noncompliant. We judged the magnitude of noncompliance by comparing a vessel's maximum speed within a zone to its maximum recorded trip speed. The level of noncompliance was high (mean 0.78; company range 0.74–0.88), some companies were more compliant than others (p= 0.02), noncompliance was significantly higher in zones farther from whales (p < 0.001), and operators approached the maximum speed capabilities of their vessel in all zones. The voluntary conservation program did not achieve the goal of substantially limiting vessel speed near whales. Our results support the need for conservation programs to have quantifiable metrics and frequent evaluation to ensure efficacy.
The Ecological Future of the North American Bison: Conceiving Long‐Term, Large‐Scale Conservation of Wildlife
Authors: SANDERSON ERIC W. , REDFORD KENT H. , WEBER BILL , AUNE KEITH , BALDES DICK , BERGER JOEL , CARTER DAVE , CURTIN CHARLES , DERR JAMES , DOBROTT STEVE , FEARN EVA , FLEENER CRAIG , FORREST STEVE , GERLACH CRAIG , CORMACK GATES C. , GROSS JOHN E. , GOGAN PETER , GRASSEL SHAUN , HILTY JODI A. , JENSEN MARV , KUNKEL KYRAN , LAMMERS DUANE , LIST RURIK , MINKOWSKI KAREN , OLSON TOM , PAGUE CHRIS , ROBERTSON PAUL B. , STEPHENSON BOB
Published: April 2008

Abstract:  Many wide‐ranging mammal species have experienced significant declines over the last 200 years; restoring these species will require long‐term, large‐scale recovery efforts. We highlight 5 attributes of a recent range‐wide vision‐setting exercise for ecological recovery of the North American bison (Bison bison) that are broadly applicable to other species and restoration targets. The result of the exercise, the “Vermejo Statement” on bison restoration, is explicitly (1) large scale, (2) long term, (3) inclusive, (4) fulfilling of different values, and (5) ambitious. It reads, in part, “Over the next century, the ecological recovery of the North American bison will occur when multiple large herds move freely across extensive landscapes within all major habitats of their historic range, interacting in ecologically significant ways with the fullest possible set of other native species, and inspiring, sustaining and connecting human cultures.” We refined the vision into a scorecard that illustrates how individual bison herds can contribute to the vision. We also developed a set of maps and analyzed the current and potential future distributions of bison on the basis of expert assessment. Although more than 500,000 bison exist in North America today, we estimated they occupy <1% of their historical range and in no place express the full range of ecological and social values of previous times. By formulating an inclusive, affirmative, and specific vision through consultation with a wide range of stakeholders, we hope to provide a foundation for conservation of bison, and other wide‐ranging species, over the next 100 years.
Why the Conservation of Forest Genetic Resources Has Not Worked
Authors: GEBUREK THOMAS , KONRAD H.
Published: April 2008

Abstract:  Genetic diversity is indispensable for long‐term forest sustainability and is therefore mentioned in numerous binding and nonbinding political covenants calling for action. Nevertheless, there are significant obstacles to the conservation of forest genetic resources. We discuss hindrances to genetic conservation, mainly in Europe. We identified impediments by reviewing the literature and on the basis of the experiences of the authors in this field and their participation in related political processes. The impediments include (1) difficulties in assessing and monitoring genetic erosion and human impacts (e.g., by the lack of markers showing adaptive variation and the lack of record keeping on the use and transfer of forest‐tree germplasm), (2) complexities of European national structures that make the development of a common strategy toward forest genetic conservation problematic, (3) lack of effective forest governance in many parts of the world, (4) the general unattractiveness of genes as flagships in raising public awareness, (5) lack of integration of genetic aspects into biodiversity conservation, and (6) the fact that scientists and politicians are often at cross‐purposes. To overcome these impediments, forest geneticists and their peers in species conservation have to participate more actively in decision making. In doing so, they must be prepared to face challenges on 2 fronts: participating in political processes and the provision of significant research findings to ensure that decisions with respect to forest genetic diversity are politically implementable and effectively address targets.
Rates of Movement of Threatened Bird Species between IUCN Red List Categories and toward Extinction
Authors: BROOKE M. de L. , BUTCHART S.H.M. , GARNETT S.T. , CROWLEY G.M. , MANTILLA‐BENIERS N.B. , STATTERSFIELD A.J.
Published: April 2008

Abstract:  In recent centuries bird species have been deteriorating in status and becoming extinct at a rate that may be 2–3 orders of magnitude higher than in prehuman times. We examined extinction rates of bird species designated critically endangered in 1994 and the rate at which species have moved through the IUCN (World Conservation Union) Red List categories of extinction risk globally for the period 1988–2004 and regionally in Australia from 1750 to 2000. For Australia we drew on historical accounts of the extent and condition of species habitats, spread of invasive species, and changes in sighting frequencies. These data sets permitted comparison of observed rates of movement through the IUCN Red List categories with novel predictions based on the IUCN Red List criterion E, which relates to explicit extinction probabilities determined, for example, by population viability analysis. The comparison also tested whether species listed on the basis of other criteria face a similar probability of moving to a higher threat category as those listed under criterion E. For the rate at which species moved from vulnerable to endangered, there was a good match between observations and predictions, both worldwide and in Australia. Nevertheless, species have become extinct at a rate that, although historically high, is 2 (Australia) to 10 (globally) times lower than predicted. Although the extinction probability associated with the critically endangered category may be too high, the shortfall in realized extinctions can also be attributed to the beneficial impact of conservation intervention. These efforts may have reduced the number of global extinctions from 19 to 3 and substantially slowed the extinction trajectory of 33 additional critically endangered species. Our results suggest that current conservation action benefits species on the brink of extinction, but is less targeted at or has less effect on moderately threatened species.
Premature Ventricular Contractions Arising from the Pulmonary Artery: The Use of Multielectrode Array Mapping and Cryoablation
Authors: SHANMUGAM NESAN , LIEW REG , SNEDDON JAMES , WARD DAVID
Published: April 2008

Premature ventricular contractions with a left bundle branch block‐like morphology and inferior axis typically originate from the right ventricular outflow tract; however, they can also originate from the pulmonary artery.

We report two patients with frequent premature ventricular contractions who underwent successful cryoablation of ectopics arising from the posterolateral region of the pulmonary artery. The safe and effective use of cryoablation within the pulmonary artery is discussed. We recommend the use of noncontact mapping with multielectrode array catheter in facilitating the technique and providing a more accurate localization of the ectopic focus within the pulmonary artery, compared with conventional pace mapping methods.
When an ICD is Not the Answer… Hypothyroidism‐Induced Cardiomyopathy and Torsades de Pointes
Authors: ELLIS CHRISTOPHER R. , MURRAY KATHERINE T.
Published: April 2008

Introduction:
An increasing number of patients with left ventricular (LV) dysfunction are referred for placement of an implantable cardioverter‐defibrillator (ICD).

Case Report:
A 78‐year‐old female with fatigue, palpitations, and presyncope was referred for consideration of an ICD because of a cardiomyopathy and nonsustained ventricular tachycardia (VT). Her evaluation revealed severe hypothyroidism, marked QT prolongation, and episodes of torsades de pointes. With levothyroxine therapy, her ventricular arrhythmias rapidly abated, with subsequent normalization of LV function and the QT interval.

Conclusions:
This report highlights the critical importance of detecting hypothyroidism as an unusual cause for reversible cardiomyopathy and ventricular arrhythmias.
Quantitative Analysis of the Duration of Slow Conduction in the Reentrant Circuit of Ventricular Tachycardia After Myocardial Infarction
Authors: LI YI‐GANG , WANG QUN‐SHAN , ISRAEL CARSTEN W. , GRÖNEFELD GERIAN , LU SHANG‐BIAO , EHRLICH JOACHIM R , HOHNLOSER STEFAN H.
Published: April 2008

Background:
Few data are available to define the circuits in ventricular tachycardia (VT) after myocardial infarction and the conduction time (CT) through the zone of slow conduction (SCZ). This study assessed the CT of the SCZ and identified different reentrant circuits.

Methods:
During VTs, concealed entrainment (CE) was attempted. The SCZ was identified by a difference between postpacing interval (PPI) and VT cycle length (VTcl) ≤30 ms. Since the CT in the normally conducting part of the VT circuit is constant during VT and CE, a CE site within the reentrant circuit with (S‐QRS)/PPI ≥ 50% was classified as an inner reentry in which the entire circuit was within the scar, and a CE site with (S‐QRS)/PPI < 50% as a common reentry in which part of the circuit was within the scar and part out of the scar.

Results:
CE was achieved in 20 VTs (12 patients). Six VTs (30%) with a (S‐QRS)/PPI ≥50% were classified as inner reentry and 14 VTs (70%) with a (S‐QRS)/PPI <50% during CE mapping as common reentry. The EG‐QRS interval (308 ± 73 ms vs 109 ± 59 ms, P < 0.0001) was significantly longer and the incidence of systolic potentials higher (4/6 vs 0/12, P < 0.001) in the inner reentry group. For the 14 VTs with a common reetry, the CT of the SCZ was 348 ± 73 ms, while the CT in the normal area was 135 ± 50 ms.

Conclusion:
According to the proposed classification, 30% of VTs after myocardial infarction had an entire reentrant circuit within the scar. In VTs with a common reentrant circuit, the CT of the SCZ is approximately four times longer than the CT in the normal area, accounting for more than 70% of VTcl.
Trading Speed for Accuracy? Managing Goal Conflict and Accommodation in the U.S. Unemployment Insurance Program
Authors: Wenger Jeffrey B. , O'Toole Laurence J. , Meier Kenneth J.
Published: April 2008

Public managers must often cope with competing and conflicting goals. The common formulation is to assume that managers must trade‐off goals against each other. But is this always true? An alternative hypothesis is that sometimes managers may instead be able to improve outcomes on multiple goals simultaneously—by altering management practices. We test this “trade‐off” notion using a panel of state‐level administrative data from the U.S. unemployment insurance (UI) system from 1997 to 2004 and qualitative interviews from selected states. The trade‐off examined is timeliness of UI benefit payments versus the quality of UI determinations. In general, we find that state administrators often adopt management practices that facilitate improved outcomes for both timeliness and quality, indicating no trade‐off but instead a synergy between outcomes. We also find evidence of a feedback effect linking higher performance on timeliness to better quality determinations.
Oxygen Potential Measurement of Americium Oxide by Electromotive Force Method
Authors: Otobe Haruyoshi , Akabori Mitsuo , Minato Kazuo
Published: April 2008

The oxygen potentials of AmO2−x were measured in the x range of 0.01–0.5 and the temperature range of 1000–1333 K by the electromotive force method. The oxygen potentials at 1333 K were −19.83 kJ/mol for x=0.019 and −319.1 kJ/mol for x=0.485, which were higher than those of CeO2−x by approximately 200 kJ/mol for the corresponding x values. From the dependence of the oxygen potentials on x and temperature, a tentative phase diagram of Am–O system was proposed, which suggested the presence of the intermediate phases of Am7O12 and Am9O16 in the Am–O system.
Crystallization of TiO2 Powders and Thin Films Prepared from Modified Titanium Alkoxide Precursors
Authors: Karatchevtseva Inna , Cassidy David J. , Zhang Zhaoming , Triani Gerry , Finnie Kim S. , Cram Sandra L. , Barbé Christophe J. , Bartlett John R.
Published: April 2008

The modification of titanium alkoxides by chemical reactions with ligands yields complexes or molecular clusters that are substantially different from those of the parent alkoxides. In this study, we investigate the structural evolution of powders and thin films prepared from two titanium oxo‐alkoxyacylate clusters with different oxo‐core structures [Ti6(μ3‐O)2(μ2‐O)2](CH3COO)8(μ2‐OiPr)2(OiPr)6 and [Ti6(μ3‐O)6](μ‐RCOO)6(OiPr)6 ([6,4] and [6,6], respectively) as a function of annealing temperature. The structural evolution of powders and thin films prepared from the corresponding parent alkoxide Ti(OiPr)4 (TiP) were also investigated for comparison. In all powders, the amorphous‐to‐anatase transformation occurred upon heating to 400°C. In sharp contrast, the anatase‐to‐rutile transformation of the powder prepared from the [6,6] cluster was significantly inhibited compared with the conventionally derived powder, with no rutile being detected even after annealing at 800°C for 1 h. This was attributed to the small crystallite size in the [6,6]‐derived powder, which is lower than the critical size previously reported for the anatase‐to‐rutile transformation in similar sol–gel‐derived materials. In thin films, the amorphous‐to‐anatase phase transition also occurred at temperatures as low as 400°C for coatings deposited from conventional TiP precursor and [6,4] cluster solutions. However, in contrast to the corresponding powders no rutile nucleation occurred even at 800°C in either film.
Effect of Ultrasonic Treatment on the Crystallization Kinetic Parameters of BaNaB9O15 Glasses
Authors: Vaish Rahul , Varma K. B. R.
Published: April 2008

Transparent glasses of BaNaB9O15 (BNBO) were fabricated via the conventional melt‐quenching technique. X‐ray powder diffraction (XRD) and differential scanning calorimetry (DSC) carried out on the as‐quenched samples confirmed their amorphous and glassy nature, respectively. Nonisothermal crystallization processes in BNBO glasses before and after ultrasonic surface treatment (UST) with suspension of BNBO particles in acetone medium have been investigated using DSC. Kinetic parameters were determined by using modified Johnson–Mehl–Avrami equations. The computed values of kinetic parameters of the samples before and after UST were compared. The values for the onset of crystallization temperature, activation energy and Avrami exponent were found to be lower for ultrasonic‐treated samples. The activation energies for the nucleation and crystallization of BNBO glasses were also determined.
Microstructure of Nanocrystalline Yttria‐Doped Zirconia Thin Films Obtained by Sol–Gel Processing
Authors: Butz Benjamin , Störmer Heike , Gerthsen Dagmar , Bockmeyer Matthias , Krüger Reinhard , Ivers‐Tiffée Ellen , Luysberg Martina
Published: April 2008

Nano‐ and microcrystalline yttria‐stabilized zirconia (YSZ) thin films with a dopant concentration of 8.3±0.3 mol% Y2O3 were prepared with a variation in grain size by two orders of magnitude. A sol–gel‐based method with consecutive rapid thermal annealing was applied to fabricate YSZ films, resulting in about 400 nm YSZ on sapphire substrates. The average grain sizes were varied between 5 nm and 0.5 μm by heat treatment in the temperature range of 650°–1350°C for 24 h. High‐resolution (HRTEM) and conventional transmission electron microscopy analyses confirmed specimens—irrespective of the thermal treatment—consisting of cubic (c‐)ZrO2 grains with nanoscaled tetragonal precipitates coherently embedded in the cubic matrix. Energy‐dispersive X‐ray spectroscopy and HRTEM on a large number of specimens yielded a homogeneous yttria concentration within the grains and at the grain boundaries with the absence of impurities, i.e. silica at the grain boundaries.
The Protest Game: Animal Rights Protests and the Life Sciences Industry
Authors: Metcalfe David
Published: April 2008

In 1997 a small group of animal rights protesters devised a strategy of legal and illegal protests that almost closed down one of Europe's largest animal testing firms, Huntingdon Life Science (HLS). The animal rights protesters successfully disrupted the operations of HLS and severed its links with some of the world's largest financial institutions. This case study examines the “protest game” that was played between the animal rights protesters, HLS, and its business partners. In the first section, I describe the interactions between the parties to the dispute, applying negotiation analytic concepts to better explicate the structure of the game, the alternatives available to the players, and the psychological heuristics and biases that influenced decision making. The conclusion suggests alternative ways in which the protesters and the life sciences industry could resolve the dispute over the ethics and cruelty of animal testing.
Sharks, Saints, and Samurai: The Power of Ethics in Negotiations
Authors: Young Mark
Published: April 2008

In this article, I explore the notion that ethics, far from being a check or drag on negotiator power, can actually help to enhance it. As the example of Nelson Mandela negotiating with the South African government showed, ethics (or at least the perception of being ethical) can be a major source of power, diminishing or even neutralizing many other weaknesses. I explore some of the principal ethical dilemmas facing negotiators and illustrate the sometimes surprising ways that “right” ethical choices can actually increase negotiator power. This occurs not only in the more superficial case of instrumental or even prudential ethics, (the province of “saints” and “sharks”), where “right” behavior is employed to gain short‐term advantage or to improve long‐term negotiator reputation, but even more so in the case of intrinsic “principled” negotiation, where the “right” thing is done for its own sake. As in the case of the medieval Japanese samurai, ethics can be a major source of power. This thesis is then illustrated anecdotally in three practical examples, leading to a proposal for how to deepen and apply this lesson to negotiation analysis and practice.
The Role of Play and Humor in Creative Conflict Management
Authors: Sclavi Marianella
Published: April 2008

In this article, I draw on the theories of three scholars whose works have not typically been part of the negotiation and conflict resolution canon (Arthur Koestler, Edward T. Hall, and Gregory Bateson) to develop the beginnings of a new model for creative and constructive conflict transformation that features playfulness and humor as its key components. I explore the connections between Koestler's theory of bisociation in the act of creation, Hall's ideas about the cultural construction of emotional responses, and Bateson's theories about the role of play and humor in human communication. All three authors focused particularly on body language and on the cognitive impact of emotions. Drawing on their theories and the connections between them, I suggest the theoretical underpinnings of a model for approaching conflict in which displacements and surprises, playfulness, humor, and “punch lines” can serve to reframe issues and open up new avenues for consensus building and resolution.
Emerging roles for protein histidine phosphorylation in cellular signal transduction: lessons from the islet β‐cell
Authors: Kowluru Anjaneyulu
Published: April 2008

Introduction

Protein histidine phosphorylation in prokaryotes and eukaryotes

Identification and characterization of histidine kinases in the pancreatic β‐cell

A membrane‐associated histidine kinase phosphorylates the Gβ‐subunit of trimeric G‐proteins

A novel histone H4‐phosphorylating histidine kinase in islets β‐cells

Regulation of protein histidine phosphorylation in islet β‐cells

Functional consequences of protein histidine phosphorylation

Regulation of the mitochondrial function via protein histidine phosphorylation

Regulation of ion channels

Regulation of isoprenoid metabolism

Protein histidine phosphatases

• Potential defects in histidine phosphorylation in

islets derived from the Goto‐Kakizaki rat, a model for type 2 diabetes

Conclusions and future research

Protein phosphorylation represents one of the key regulatory events in physiological insulin secretion from the islet β‐cell. In this context, several classes of protein kinases (e.g. calcium‐, cyclic nucleotide‐ and phospholipid‐dependent protein kinases and tyrosine kinases) have been characterized in the β‐cell. The majority of phosphorylated amino acids identified include phosphoserine, phosphothreonine and phosphotyrosine. Protein histidine phosphorylation has been implicated in the prokaryotic and eukaryotic cellular signal transduction. Most notably, phoshohistidine accounts for 6% of total protein phosphorylation in eukaryotes, which makes it nearly 100‐fold more abundant than phosphotyrosine, but less abundant than phosphoserine and phosphothreonine. However, very little is known about the number of proteins with phosphohistidines, since they are highly labile and are rapidly lost during phosphoamino acid identification under standard experimental conditions. The overall objectives of this review are to: (i) summarize the existing evidence indicating the subcellular distribution and characterization of various histidine kinases in the islet β‐cell, (ii) describe evidence for functional regulation of these kinases by agonists of insulin secretion, (iii) present a working model to implicate novel regulatory roles for histidine kinases in the receptor‐independent activation, by glucose, of G‐proteins endogenous to the β‐cell, (iv) summarize evidence supporting the localization of protein histidine phosphatases in the islet β‐cell and (v) highlight experimental evidence suggesting potential defects in the histidine kinase signalling cascade in islets derived from the Goto‐Kakizaki (GK) rat, a model for type 2 diabetes. Potential avenues for future research to further decipher regulatory roles for protein histidine phosphorylation in physiological insulin secretion are also discussed.
Caveolin‐1: an ambiguous partner in cell signalling and cancer
Authors: Quest Andrew F. G. , Gutierrez‐Pajares Jorge L. , Torres Vicente A.
Published: April 2008

Introduction

The caveolins

Caveolin‐1 in cell physiology

Caveolin‐1 in cancer

Concluding remarks

Caveolae are small plasma membrane invaginations that have been implicated in a variety of functions including transcytosis, potocytosis and cholesterol transport and signal transduction. The major protein component of this compartment is a family of proteins called caveolins. Experimental data obtained in knockout mice have provided unequivocal evidence for a requirement of caveolins to generate morphologically detectable caveolae structures. However, expression of caveolins is not sufficient per seto assure the presence of these structures. With respect to other roles attributed to caveolins in the regulation of cellular function, insights are even less clear. Here we will consider, more specifically, the data concerning the ambiguous roles ascribed to caveolin‐1 in signal transduction and cancer. In particular, evidence indicating that caveolin‐1 function is cell context dependent will be discussed.