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STUDY QUESTION: Is salpingotomy cost effective compared with salpingectomy in women with tubal pregnancy and a healthy contralateral tube? SUMMARY ANSWER: Salpingotomy is not cost effective over salpingectomy as a surgical procedure for tubal pregnancy, as its costs are higher without a better ongoing pregnancy rate while risks of persistent trophoblast are higher. WHAT IS KNOWN ALREADY: Women with a tubal pregnancy treated by salpingotomy or salpingectomy in the presence of a healthy contralateral tube have comparable ongoing pregnancy rates by natural conception. Salpingotomy bears the risk of persistent trophoblast necessitating additional medical or surgical treatment. Repeat ectopic pregnancy occurs slightly more often after salpingotomy compared with salpingectomy. Both consequences imply potentially higher costs after salpingotomy. STUDY DESIGN, SIZE, DURATION: We performed an economic evaluation of salpingotomy compared with salpingectomy in an international multicentre randomized controlled trial in women with a tubal pregnancy and a healthy contralateral tube. Between 24 September 2004 and 29 November 2011, women were allocated to salpingotomy (n = 215) or salpingectomy (n = 231). Fertility follow-up was done up to 36 months post-operatively. PARTICIPANTS/MATERIALS, SETTINGS, METHODS: We performed a cost-effectiveness analysis from a hospital perspective. We compared the direct medical costs of salpingotomy and salpingectomy until an ongoing pregnancy occurred by natural conception within a time horizon of 36 months. Direct medical costs included the surgical treatment of the initial tubal pregnancy, readmissions including reinterventions, treatment for persistent trophoblast and interventions for repeat ectopic pregnancy. The analysis was performed according to the intention -to-treat principle. MAIN RESULTS AND THE ROLE OF CHANCE: Mean directmedical costs per woman in the salpingotomy group and in the salpingectomy group were €3319 versus €2958, respectively, with a mean difference of €361 (95%confidence interval €217 to €515). Salpingotomy resulted in a marginally higher ongoing pregnancy rate by natural conception compared with salpingectomy leading to an incremental cost-effectiveness ratio €40 982 (95% confidence interval 2 €130 319 to €145 491) per ongoing pregnancy. Since salpingotomy resulted in more additional treatments for persistent trophoblast and interventions for repeat ectopic pregnancy, the incremental cost-effectiveness ratio was not informative. † The ESEP Group members are listed in the Appendix. & The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com Human Reproduction, Vol.30, No.9 pp. 2038-2047, 2015 Advanced Access publication on July 13, 2015 doi: LIMITATIONS, REASONS FOR CAUTION: Costs of any subsequent IVF cycles were not included in this analysis. The analysis was limited to the perspective of the hospital. WIDER IMPLICATIONS OF THE FINDINGS: However, a small treatment benefit of salpingotomy might be enough to cover the costs of subsequent IVF. This uncertainty should be incorporated in shared decision-making. Whether salpingotomy should be offered depends on society's willingness to pay for an additional child. STUDY FUNDING/COMPETING INTEREST(S): Netherlands Organisation for Health Research and Development, Region Västra Götaland Health & Medical Care Committee. TRIAL REGISTRATION NUMBER: ISRCTN37002267. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Becker J, Westerhuis M, Sterrenburg K, van den Akker E, van Beek E, Bolte A, van Dessel T, Drogtrop A, van Geijn H, Graziosi G, van Lith J, Mol B, Moons K, Nijhuis J, Oei S, Oosterbaan H, Porath M, Rijnders R, Schuitemaker N, Wijnberger L, Willekes C, Visser G, Kwee A. Fetal blood sampling in addition to intrapartum ST-analysis of the fetal electrocardiogram: evaluation of the recommendations in the Dutch STAN® trial. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03027.x. Objectives To evaluate the recommendations for additional fetal blood sampling (FBS) when using ST-analysis of the fetal electrocardiogram. Design Prospective cohort study. Setting Three academic and six non-academic teaching hospitals in the Netherlands. Population Labouring women with a high-risk singleton pregnancy in cephalic position beyond 36 weeks of gestation. Methods In labouring women allocated to the STAN® arm of a previously published randomised controlled trial who underwent one or more FBS during delivery, we assessed whether FBS was performed according to the trial protocol and how fetal acidosis, defined as an FBS pH < 7.20, was related to ST-waveform analysis. Main outcome measures The number of FBS showing fetal acidosis, related to the different STAN® criteria where additional FBS is recommended. Results Among 2827 women monitored with STAN®, 297 underwent FBS, of whom 171 (57.6%) were performed according to the predefined criteria and 126 were performed in absence of these criteria. In the first group, rates of fetal acidosis (pH < 7.20) were two of 18, none of nine, 12 of 111 and three of 33 when FBS was taken for abnormal cardiotocogram (CTG) at the start, intermediary CTG at the start, abnormal CTG >60 minutes, and poor electrocardiogram quality, respectively. When the predefined criteria were not met and ST-analysis showed no ST-events, only two incidents of fetal acidosis were seen. Conclusions The performance of FBS is valuable in the advised STAN® criteria. When these criteria are not met, performance of FBS does not seem helpful in the detection of fetal acidosis. [ABSTRACT FROM AUTHOR]

The posterior pole cytoplasm of early embryos of Drosophila melanogaster was irradiated with increasing doses of U.V. light at a wave length specific for nucleic acids 35 and 75 min after ovoposition, when nuclei were still inside the yolk mass. Probit analysis showed that: Sterility was higher in irradiations performed at 35 min. Mortality was higher in the experiment performed at 75 min. After treatment at 35 min, sterility and mortality were independent phenomena. The numbers of targets involved in germ cell determination were of the order of tens and hundreds at 35 and 75 min respectively. The numbers of targets involved in viability were of several orders of magnitude in both developmental stages. The irradiation, even at very low doses, caused a background effect which was probably due to 'old' embryos. The sex ratio was distorted in favour of females at high doses and of males at low doses. [ABSTRACT FROM AUTHOR]

The posterior pole of Drosophila melanogaster eggs was irradiated with ultraviolet light of 253.7 nm wavelength; different batches were irradiated at different times after oviposition, ranging from less than 10 mins to 125 mins. Two different experiments were run at different dose levels: 280 μW/mm and 530 μW/mm. A differential response to irrariation was observed in relation to the age of the treated eggs. Embryo mortality increased with egg age in both experiments (Fig. 1). No differential effects on larval mortality were found in egg batches irradiated between 15 and 95 mins of age in either experiment (Fig. 3). The incidence of sterility in the survivors was higher when the eggs were irradiated before 55 mins or when pole nuclei were present. The overall incidence of sterility was much higher in the high-dose experiment (Fig. 4). Sterility is considered as a measure of damage to germ cell precursors, most probably involving RNA. On this basis the probability of the affected RNA being messenger RNA stored in polar granules is discussed. [ABSTRACT FROM AUTHOR]

Studies the characterization of microsatellite loci in Coffea arabica and related coffee species. Population structure and molecular basis; Inter-species gene flow and progeny; Scientific implications of the study.

Abstract Background For most tubal ectopic pregnancies (EP) surgery is the treatment of first choice. Whether surgical treatment should be performed conservatively (salpingostomy) or radically (salpingectomy) in women wishing to preserve their reproductive capacity, is subject to debate. Salpingostomy preserves the tube, but bears the risks of both persistent trophoblast and repeat ipsilateral tubal EP. Salpingectomy, avoids these risks, but leaves only one tube for reproductive capacity. This study aims to reveal the trade-off between both surgical options: whether the potential advantage of salpingostomy, i.e. a better fertility prognosis as compared to salpingectomy, outweighs the potential disadvantages, i.e. persistent trophoblast and an increased risk for a repeat EP. Methods/Design International multi centre randomised controlled trial comparing salpingostomy versus salpingectomy in women with a tubal EP without contra lateral tubal pathology. Hemodynamically stable women with a presumptive diagnosis of tubal EP, scheduled for surgery, are eligible for inclusion. Patients pregnant after in vitro fertilisation (IVF) and/or known documented tubal pathology are excluded. At surgery, a tubal EP must be confirmed. Only women with a tubal EP amenable to both interventions and a healthy contra lateral tube are included. Salpingostomy and salpingectomy are performed according to standard procedures of participating hospitals. Up to 36 months after surgery, women will be contacted to assess their fertility status at six months intervals starting form the day of the operation. The primary outcome measure is the occurrence of spontaneous viable intra uterine pregnancy. Secondary outcome measures are persistent trophoblast, repeat EP, all pregnancies including those resulting from IVF and financial costs. The analysis will be performed according to the intention to treat principle. A cost-effectiveness analysis will be performed within a decision analysis framework, based on costs per live birth, including IVF treatment whenever a spontaneous pregnancy does not occur. Patients' preferences will be assessed using a discrete choice experiment. Discussion This trial will provide evidence on the trade off between salpingostomy and salpingectomy for tubal EP in view of the pros and cons of both interventions and will offer guidance to clinicians in making the right treatment choice. Trial registration Current Controlled Trials ISRCTN37002267