bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subsequent birth outcomes after an unexplained stillbirth: preliminary population‐based retrospective cohort study
Authors: Robson Stephen , Chan Annabelle , Keane Rosemary J , Luke Colin G 
Published: February 2008

SUMMARYThe objective of this study was to determine whether women who have experienced an unexplained stillbirth have a higher risk of adverse perinatal outcomes in subsequent births. We compared 316 subsequent births to women with a previous unexplained stillbirth, with 3160 births to women with no previous history of stillbirth, matched by year of birth, in the period 1987–1997, from the South Australian perinatal database, using logistic regression analysis. There was no increase in the rate of stillbirth and no statistically significant increase in the rate of perinatal death (OR 1.62 [95% CI 0.63^4.20]) or neonatal death, although larger studies are needed to confirm this. However, after adjusting for age, parity, and hospital category of birth, women who had a previous stillbirth had increased incidences in subsequent births of abnormal glucose tolerance or gestational diabetes (a fourfold increase); induction of labour and elective Caesarean section; fetal distress and postpartum haemorrhage; and forceps and emergency Caesarean delivery and preterm birth, which were independent of Induction of labour. Gestational age at birth and birthweight were also significantly reduced, suggesting a need for close monitoring of their future pregnancies.
Manual removal of the placenta ‐ a case control study
Authors: Titiz Hasan , Wallace Allan , Voaklander Donald C 
Published: February 2008

SUMMARYThe aim of this study was to determine the incidence and complications related to manual removal of the placenta in a regional hospital in Australia. The study was carried out at the Goulburn Valley Base Hospital in Shepparton. The hospital medical records were reviewed from 1992 to 1999. A total of 3734 singleton live vaginal deliveries took place during the 7‐year study period. The placenta was removed manually in 114 women (3%). For a control group, a series of 113 women who had singleton live vaginal deliveries from the same period were chosen at random. The case and control groups were similar in age, parity, and gravidity.A previous history of retained placenta and a history of preterm delivery in the current pregnancy were significantly related to retained placenta (OR 9.8 [95% CI 1.1–85.5] and OR 5.6 [95% CI 1.1–26.8], respectively). The cases received significantly more blood transfusions than the control group (13% versus 0%). Decreased maternal age was also significantly related to retained placenta. There were also more post‐delivery dilatation and curettage (D&C) operations and diagnosis of endomyometritis in the case group. However, these differences were not statistically significant. One woman, in the case group, had to have a hysterectomy due to placenta accreta.
Fetomaternal alloimmune thrombocytopenia: a literature review and statistical analysis
Authors: Spencer Jillian A , Burrows Robert F 
Published: February 2008

SUMMARYExploring prognostic factors that determine outcomes in fetomaternal alloimmune thrombocytopenia (FMAIT), a search of Medline was performed covering the years 1966 to April 1998.376 articles were collected and reviewed; 140 articles contained the case histories of 297 mothers and 433 pregnancies that fulfilled entry criteria. More than 30 data variables were sought from these cases. The data were analysed using SPSS and Arcus Quickstat Biomedical.Nineteen different antigen incompatibilities were documented, the majority being human platelet antigen (HPA)‐la (77.3%), HPA‐3a (3.5%) and HPA‐5b (3.5%). The relative risk reduction (RRR) in mortality with any intervention was 57% (0.19‐0.77) p = 0.009. Treatment of HPA‐la (P1A1) pregnancies with intravenous immunoglobulin (IVIG) increased the likelihood of a neurologically normal outcome, relative risk (RR) 1.68, confidence interval (1.3‐2.2) p = 0.0003. Treatment of HPA‐la (P1A1) pregnancies with only antenatal complementary platelet transfusions increased the likelihood of a neurologically normal outcome, RR 1.63 (1.1–2.1) p = 0.01.Despite reviews of more than 400 cases of FMAIT, few prognostic variables are identifiable. Although IVIG appears to reduce the risk of intracranial haemorrhage (ICH), the dosage and timing of IVIG treatment was varied. This study highlights the need for standardised and directed research.
A randomised controlled trial comparing a dilating vaginal speculum with a conventional bivalve speculum
Authors: Thomas Anna , Weisberg Edith , Lieberman Devora , Fraser Ian S 
Published: February 2008

SUMMARYCervical smears are traditionally taken with the aid of a metal or disposable plastic bivalve speculum. Many women complain of discomfort with these specula. This study compares the efficacy and women's experiences of a new ‘dilating speculum’ called the Veda‐scope1‘11’, with a conventional metal bivalve speculum (Pederson).The aims of this study were: to determine whether the Veda‐scope provides adequate visualisation of the cervix and vaginal walls and an adequate cervical cytology specimen; and to compare user acceptability and women's levels of comfort between the Veda‐scope and the bivalve speculum.Sixty‐four women were randomised to be examined with the Veda‐scope and 60 with the bivalve speculum, by one of two operators. Each woman completed a questionnaire that included subjective views of their previous cervical smear experiences, and acceptability of the examination at the study consultation. Cytologists were blinded as to which speculum was used for cervical sampling.Of women examined, 78–83% of women found Veda‐scope examinations comfortable, compared to 38–62% of women who found examinations with the bivalve comfortable; 94% of the women preferred the ‘comfort’ of the Veda‐scope. The Veda‐scope was as good as the bivalve speculum in providing samples for cytological analysis following the initial learning curve, and also provided markedly superior magnified views of the cervix and vaginal fornices.
Active management of the third stage at Caesarean section: a randomised controlled trial of misoprostol versus Syntocinon
Authors: Lokugamage AU , Paine M , Bassaw‐Balroop K , Sullivan KR , Refaey H El , Rodeck CH 
Published: February 2008

SUMMARYThe objective of this trial was to investigate whether 500 ug oraJ misoprostol given immediately after delivery of the neonate at Caesarean section is as effective as a bolus intravenous injection of 10 iu Syntocinon in stimulating uterine contractions and thereby reducing blood loss.Forty women undergoing elective or emergency Caesarean section were included in a placebo‐controlled randomised trial.Group 1 received oral misoprostol and a placebo intravenous bolus and Group 2 received intravenous Syntocinon and oral placebo tablets.The main outcome measures were estimated blood loss at Caesarean section, drop in serum haemoglobin, and the need for additional uterotonic agents.We found that there was no significant difference (p = 0.75) in estimated blood loss between the two groups. No differences were observed in the decrease in haemoglobin, requirement for additional oxytocics, the need for blood transfusion or the degree of shivering in each group (p > 0.05 in each case).We concluded that oral misoprostol could be used as an alternative oxytocic agent for the third stage at Caesarean section. However, there is an obvious need for a larger randomised controlled trial to be undertaken. Previous published studies have concentrated on vaginal births and further studies should be extended to Caesarean deliveries.
Sonographic estimation of fetal weight in maerosomic fetuses: diabetic versus non‐diabetic pregnancies
Authors: Wong SF , Chan FY , Cincotta RB , Oats JJ , Mclntyre HD 
Published: February 2008

SUMMARYThe objective of this study is to compare the accuracy of sonographic estimation of fetal weight of maerosomic babies in diabetic vs non‐diabetic pregnancies. All babies weighing 4000 g or more at birth, and who had ultrasound scans performed within one week of delivery were included in this retrospective study. Pregnancies with diabetes mellitus were compared to those without diabetes mellitus. The mean simple error (actual birthweight ‐ estimated fetal weight); mean standardised absolute error (absolute value of simple error (g)/actual birthweight (kg)); and the percentage of estimated birthweight falling within 15% of the actual birthweight between the two groups were compared.There were 9516 deliveries during the study period. Of this total 1211 (12.7%) babies weighed 4000 g or more. A total of 56 non‐diabetic pregnancies and 19 diabetic pregnancies were compared. The average sonographic estimation of fetal weight in diabetic pregnancies was 8% less than the actual birthweight, compared to 0.2% in the non‐diabetic group (p < 0.01). The estimated fetal weight was within 15% of the birthweight in 74% of the diabetic pregnancies, compared to 93% of the non‐diabetic pregnancies (p < 0.05). In the diabetic group, 26.3% of the birthweights were underestimated by more than 15 %, compared to 5.4% in the non‐diabetic group (p < 0.05).In conclusion, the prediction accuracy of fetal weight estimation using standard formulae in maerosomic fetuses is significantly worse in diabetic pregnancies compared to non‐diabetic pregnancies. When sonographic fetal weight estimation is used to influence the mode of delivery for diabetic women, a more conservative cut‐off needs to be considered.
Symptoms and HPV infection of the vulva: clinical manifestations or mere coincidence?*
Authors: Ayer Bhuvana , Fischer Arthur , Spurrett Brian , Houghton Roger 
Published: February 2008

SUMMARYTwo hundred women with abnormal Pap smears and/or vulvar symptoms and 30 with normal Pap smears were investigated to determine the association between symptoms and (i) human papilloma virus infection of the vulva, and (ii) a spongiotic tissue reaction or a spongiotic dermatitis of the vulva. All had vulvar colposcopy and biopsy.Human papilloma virus infection was diagnosed by histopathology and in situ hybridisation technique. HPV infection was present in biopsies of 48% of asymptomatic women and 33% with symptoms (p = 0.13) and HPV DNA in 37% of asymptomatic women and 31% with symptoms (p = 0.72). Spongiotic tissue reaction was diagnosed in 53.5% of asymptomatic women compared to 74% of symptomatic women (p = 0.007). This study suggests that vulvar symptoms are not clinical manifestations of HPV infection, but may be caused by dermatitis rather than HPV infection per se.
Wernicke's encephalopathy due to hyperemesis gravidarum: an under‐recognised condition
Authors: Togay‐Isikay Canan , Yigit Aytac , Mutluer Nermin 
Published: February 2008

SUMMARYWe present a case of a 25‐year‐old woman with drowsiness, nystagmus, severe ataxia and areflexia, which developed six weeks after admission to an obstetric clinic for hyperemesis gravidarum.She had been treated with intravenous dextrose and electrolyte solutions and antiemetics. Magnetic resonance imaging (MR1) performed on the fifth day of her neurologic symptoms showed increased intensity in both thalami, periaqueductal grey matter, the floor of the fourth ventricle and superior cerebellar vermis in T2 weighted and FLAIR images.Clinical signs and MRI findings were consistent with the diagnosis of Wernicke's encephalopathy. On the third day of thiamine replacement, neurologic signs improved dramatically.In addition to our case, we review 29 previously reported cases of Wernicke's encephalopathy associated with hyperemesis gravidarum, and emphasize the importance of thiamine supplementation to women with prolonged vomiting in pregnancy, especially if they are given intravenous or parenteral nutrition.
Assessing Conservation Action for Substitution of Missing Dynamics on Former Military Training Areas in Central Europe
Authors: Jentsch Anke , Friedrich Silke , Steinlein Thomas , Beyschlag Wolfram , Nezadal Werner 
Published: February 2008

Abstract Disproportionately large numbers of threatened and endangered species and unusually high biodiversity have been documented on former military training areas. However, throughout the world, nature protection areas on former military grounds are faced with the dilemma of preserving ecosystems that must change. In central Europe, many of these areas are characterized by dry acidic grasslands on sandy soils. However, these resource‐limited ecosystems are faced with two interacting threats: missing disturbance dynamics and increasing atmospheric nitrogen deposition from urban agglomerations. The goal of this study was to assess the effectiveness of conservation action for substitution of missing dynamics. Impacts on plant species assembly, performance of functional groups, soil nutrient availability, and successional trajectory are analyzed. Of particular concern is mimicking beneficial effects of military maneuver on pioneer species such as Corynephorus canescens, which is endangered in many countries. In a controlled field experiment, we manipulated mechanical disturbances representing conservation measures—harrowing, topsoil removal, tilling, and tank driving. Our findings suggest that only topsoil removal and tank driving effectively remove organic material and create self‐sustaining vegetation dynamics. Topsoil removal affects both filters in community assembly: the abiotic filter related to soil resources and the biotic filter related to competition between species. We further demonstrate that plant functional groups based on growth form show different rates of recruitment after disturbance with graminoids‐dominating initial dynamics. This study provides basic information on effective conservation strategies for dry acidic grasslands on former military training areas.
Molecular detection of the brevetoxin‐producing dinoflagellate Karenia brevis and closely related species using rRNA‐targeted probes and a semiautomated sandwich hybridization assay1
Authors: Haywood Allison J. , Scholin Christopher A. , Marin Roman , Steidinger Karen A. , Heil Cynthia , Ray Jason 
Published: February 2008

Brevetoxins produced by the marine dinoflagellate Karenia brevis (C. C. Davis) G. Hansen et Moestrup cause neurotoxic shellfish poisoning (NSP) in human consumers and also endanger a variety of coastal wildlife. In the eastern Gulf of Mexico the presence and abundance of this species have traditionally been monitored using light microscopy (LM) observations of whole water samples. Various molecular probe methods now enable detection of multiple species from a single sample, allowing rapid sample analysis. We describe the development of sandwich hybridization assays (SHAs) for Karenia brevis, K. selliformis Haywood, Steid. et L. MacK., K. mikimotoi (Miyake et Kominami ex M. Oda) G. Hansen et Moestrup, K. papilionacea Haywood et Steid., the Karlotoxin‐producer Karlodinium veneficum (D. Ballant.) J. Larsen (=K. micrum), and Gymnodinium aureolum (Hulburt) G. Hansen, comb. nov. The assays require no nucleic acid purification and use LSU rRNA‐targeted probes and a semiautomated, 96‐well plate format. Probes tested in matrix format were specific relative to rRNAs of all nontarget species used. The response of the SHA for a constant number of K. brevis cells per unit volume of homogenate depended on the growth status of a culture, decreasing for senescent cells relative to actively growing cells. The results of preliminary field tests of the K. brevis SHA indicated that cells collected from natural populations tended to return a lower signal than those harvested from laboratory cultures, but these results are nonetheless very encouraging. These preliminary field studies show that robust standards are required for cell identification and enumeration, with which new methods can be compared.
Comparative effects of the quality and quantity of light and temperature on the growth of Planktothrix agardhii and P. rubescens1
Authors: Oberhaus L. , Briand J. F. , Leboulanger C. , Jacquet S. , Humbert J. F. 
Published: February 2008

The effects of temperature, light intensity, and quality on the growth of the cyanobacteria Planktothrix agardhii (Gomont) Anag. et Komárek and P. rubescens (Gomont) Anag. et Komárek were assessed in batch cultures. The relative competitiveness of the green‐pigmented P. agardhii and the red‐pigmented P. rubescens was evaluated in separate and mixed cultures, under different light intensities and qualities (green, red, and white), and at two different temperatures, chosen as representative of the natural conditions favoring the respective blooms of each species. In monocultures, the P. rubescens strain appeared to be particularly well adapted to low intensities of green light and displayed a strong photoinhibition under high irradiance levels. The P. agardhii strain appeared less specialized with regard to light quality and also less sensitive to photoinhibition at higher irradiances. In competition experiments, temperature (15°C vs. 25°C) was the most important parameter in determining relative fitness of the species and competitive success. At 15°C, P. rubescens appeared to be much more competitive than P. agardhii, while P. agardhii was more competitive at 25°C. Under low irradiance, however, the pigmentation of these strains was of primary importance in determining the outcomes of the competition experiments. On the basis of our experimental results and on field observations, we propose that the successful growth leading to the proliferation of these two differently pigmented strains may largely depend on the combined conditions of light and temperature. The two strains, being genetically close relatives, could therefore be considered as two ecotypes that are adapted to different light and temperature environments. Competition experiments showed that the combination of these parameters largely controls the success of one strain in comparison to the other.
Interspecific differences in the response of juvenile stages to physical stress: fluorometric responses of fucoid embryos to variation in meteorological conditions1
Authors: Lamote Morgane , Johnson Ladd E. , Lemoine Yves 
Published: February 2008

Chl fluorescence during and immediately after low tide under four meteorological conditions was measured in embryos of three fucoid algae [Ascophyllum nodosum (L.) Le Jol., Fucus vesiculosus L., and Fucus distichus subsp. edentatus Bach. (Pyl.) H. T. Powell] vertically distributed in the intertidal zone in Québec, Canada. Artificial substrata with attached embryos of each species were outplanted into each zone and into two different microhabitats: under and outside an adult canopy. Several fluorescence measurements were made using pulse‐amplitude‐modulated (PAM) fluorometry, from which maximum quantum yield (Fv/Fm), effective quantum yield (φPSII), relative electron transport rate (rETR), and nonphotochemical quenching (NPQ) were calculated. Fv/Fm, φPSII, and rETR decreased, and NPQ increased during low tide, most rapidly under the most desiccating meteorological conditions (i.e., sunny‐windy weather). The species occurring lowest in the vertical distribution, F. distichus subsp. edentatus, was the most affected, and the two highest species, A. nodosum and F. vesiculosus, only rarely differed. Tidal height itself also influenced the decline in fluorescence parameters, with more gradual declines in lower zones, except under the least desiccating conditions (i.e., cloudy‐calm weather). Recovery upon reimmersion was rapid in all circumstances. Under a canopy, decreases in maximum and effective quantum yields were more gradual than in exposed locations. Although the young stages of these species were affected by physical conditions experienced during low tide and their exact response depended on the precise meteorological conditions, differences in responses among species were surprisingly small. The abilities of young stages to withstand aerial conditions were, however, consistent with the zonation patterns of adults, and conditions under an adult canopy offered some protection.
Species boundaries and global biogeography of the Alexandrium tamarense complex (Dinophyceae)1
Authors: Lilly Emily L. , Halanych Kenneth M. , Anderson Donald M. 
Published: February 2008

Alexandrium catenella (Whedon et Kof.) Balech, A. tamarense (M. Lebour) Balech, and A. fundyense Balech comprise the A. tamarense complex, dinoflagellates responsible for paralytic shellfish poisoning worldwide. The relationships among these morphologically defined species are poorly understood, as are the reasons for increases in range and bloom occurrence observed over several decades. This study combines existing data with new ribosomal DNA sequences from strains originating from the six temperate continents to reconstruct the biogeography of the complex and explore the origins of new populations. The morphospecies are examined under the criteria of phylogenetic, biological, and morphological species concepts and do not to satisfy the requirements of any definition. It is recommended that use of the morphospecies appellations within this complex be discontinued as they imply erroneous relationships among morphological variants. Instead, five groups (probably cryptic species) are identified within the complex that are supported on the basis of large genetic distances, 100% bootstrap values, toxicity, and mating compatibility. Every isolate of three of the groups that has been tested is nontoxic, whereas every isolate of the remaining two groups is toxic. These phylogenetic groups were previously identified within the A. tamarense complex and given geographic designations that reflected the origins of known isolates. For at least two groups, the geographically based names are not indicative of the range occupied by members of each group. Therefore, we recommend a simple group‐numbering scheme for use until the taxonomy of this group is reevaluated and new species are proposed.
Evaluation of gene expression profiles of immature dendritic cells prepared from peripheral blood mononuclear cells
Authors: Shin Jeong Won , Jin Ping , Fan Yong , Slezak Stefanie , David‐Ocampo Virginia , Khuu Hanh M. , Read Elizabeth J. , Wang Ena , Marincola Francesco M. , Stroncek David F. 
Published: February 2008

BACKGROUND: Dendritic cells (DCs) generated ex vivo from peripheral blood monocytes or mobilized CD34+ cells and intended for clinical immunotherapy are typically characterized by morphologic, phenotypic, and functional assays. Assay results are highly dependent on conditions used to prepare the cells, so there is no standard assay battery for clinical DC products. This study evaluated gene expression profiling for characterization of immature DCs prepared from monocytes that had been elutriated from normal donor peripheral blood mononuclear cells (PBMNCs) immediately after collection or after storage at 4°C for 48 hours.STUDY DESIGN AND METHODS: RNA was isolated from fresh and 48‐hour‐stored PBMNCs, elutriated monocytes, elutriated lymphocytes, and immature DCs from five healthy subjects and was analyzed with a cDNA gene expression microarray with 17,500 genes.RESULTS: Unsupervised hierarchical clustering separated the 40 products into four groups: one with all 10 immature DCs, one with all 10 elutriated lymphocytes, one with 7 PBMNCs, and one with 10 elutriated monocytes and 3 PBMNCs. Within each of the four groups, however, fresh and stored products, or products derived from fresh or stored products, clustered together. Comparison of genes differentially expressed by fresh versus stored products (paired t tests, p < 0.005) found 273 genes that differed between fresh and stored PBMCs, 429 between lymphocytes elutriated from fresh versus stored PBMNCs, 711 between monocytes elutriated from fresh versus stored PBMNCs, and 3 between immature DCs prepared from monocytes elutriated from fresh versus stored PBMCs.CONCLUSIONS: This study demonstrates the potential utility of gene expression profiling for characterization of cell therapy products.