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The success of organizations or business networks depends on fast and well-founded decisions taken by the relevant people in their specific area of responsibility. To enable timely and well-founded decisions, it is often necessary to perform ad-hoc analyses in a collaborative manner involving domain experts, line-of-business managers, key suppliers or customers. Current Business Intelligence (BI) solutions fail to meet the challenges of ad-hoc and collaborative decision support, slowing down and hurting organizations.The main goal of our envisioned system, which will be designed and implemented in a future research project, is to realize a highly scalable and flexible platform for collaborative, ad-hoc BI over large data sets. This will be achieved by developing methodologies, concepts and an infrastructure to enable an information self-service for business users and collaborative decision making over high-volume data sources within and across organizations.

Small fibre connectors capable of handling medium powered lasers are available on the market from multiple suppliers. Typical connector types are the SMA905 and LD80. The capability to handle power losses, for example radiation falling outside the fibre core is, due to the small size and restrictive design, limited. A new type of SMA fibre connector, designed for high-power loss capability will be presented. The basic principle is to strip off the losses in terms of radiation rather than being absorbed in the fibre connector. The radiation is instead absorbed in the female connector housing or within the laser housing, where it can easily be cooled away. In this paper both the principles and measurement of power capability are presented. Furthermore, in order to give a perspective of the available high-power SMA fibre connectors on the market today, a comparison between the best competitive products is presented.

This study describes the experience of screening and surgery in a sample of women who received false positive results during screening for familial ovarian cancer. It was hypothesised that these women might feel bitter and hostile at having been exposed to so much anxiety and suffering for the removal of a cyst. The results from both prospective questionnaire measures and retrospective interviews indicated that women were neither severely distressed nor angry about their experiences. The sensitive management of the screening process by clinic staff and a remarkable faith in the benefits of early intervention held by the women involved, appeared to have contributed to this positive outcome. Women's acceptance of major surgery seemed to be based on the premise that body parts which were not crucial to survival, and which were at risk of malignancy, were best removed under the circumstances. They seemed to derive considerable comfort from the belief that surgery rendered them invulnerable to the disease that had, in most cases, caused their mother a painful death. Nevertheless, many women described considerable stress at various stages in the procedure. An improvement in the quality and timing of information may further reduce anxiety.

From about 5200 B.C.E. to 4500 B.C.E., large numbers of Halaf communities appear over a very large area of northern Iraq, northern Syria and southern Turkey. Until recently, it was believed that th...

Objective To determine if the administration of glucocorticoids reduced the rate of ovarian hyperstimulation syndrome (OHSS) in high-risk patients after ovarian stimulation for in vitro fertilization (IVF). Design Prospective randomized study. Patients Thirty-one patients who were stimulated with human menopausal gonadotropin (hMG) after pituitary desensitization by gonadotropin-releasing hormone agonist and who developed > 20 follicles > 12 mm and/or had a serum estradiol (E 2 ) level of > 10,000 pmol/L on the day of administration of human chorionic gonadotropin (hCG). Interventions Patients were randomly divided into two groups. Those who were randomized to receive glucocorticoids (group A) (n = 17) were administered intravenous hydrocortisone, 100 mg, immediately after ultrasound (US)-directed oocyte recovery. Prednisolone, 10 mg three times per day, was given for 5 days starting on the day of oocyte recovery followed by prednisolone 10 mg two times a day for 3 days and 10 mg/d for 2 days. Those in group B (n = 14) did not receive any glucocorticoid treatment. In both groups, luteal support was provided by intramuscular injections of gestone 100 mg/d. Results The two groups of patients were comparable in terms of age, duration of infertility, and total dose of hMG used. All had polycystic ovaries on US examination. On the day of hCG administration, the mean number of follicles in the two groups were 26.76 ± 2.49 and 25.93 ± 1.44 and the serum E 2 concentration 13,404 ± 710 and 13,915 ± 901 pmol/L, respectively. There were no significant differences in the number of oocytes collected or in the fertilization, cleavage, and implantation rates in the two groups. The pregnancy rates per initiated cycle were 41.18% and 35.71%, respectively. Seven of the 17 patients (41.2%) who received glucocorticoids developed ovarian hyperstimulation syndrome compared with 6 of the 14 patients (42.9%) who did not receive glucocorticoids. Conclusions Administration of glucocorticoids to high risk patients did not reduce the rate of OHSS after ovarian stimulation for IVF.

Preeclampsia, intrauterine growth retardation, and abruptio placentae are associated with the failure of the placenta to create an adequate communication with the maternal vasculature and subsequently reduced placental perfusion, with secondary effects on villous maturation and placental function, thereby failing to meet the needs of the growing fetus. Also, primary failure of placental maturation has been linked with the chromosomally abnormal fetus. Doppler ultrasound allows examination of blood flow in maternal and fetal vessels and assists in our ability to understand, predict, and diagnose pregnancy complications. Over the last 10 years there has been a rapid development in the capacity and complexity of the equipment used for clinical Doppler examination, from simple continuous wave devices to duplex-color flow systems, and the advantages of these developments continue to be defined. As with all innovations there has been a period of extensive appraisal of this technology, and further applications of Doppler await clarification. This review puts the most recent publications in perspective, and points to the likely areas of interest in the future.

Objective To investigate whether pituitary desensitization with the gonadotropin-releasing hormone agonist (GnRH-a), buserelin acetate, before the administration of human menopausal gonadotropin (hMG) for ovarian stimulation in in vitro fertilization (IVF) is superior to the simultaneous administration of both hormones at the beginning of the treatment cycle. Design Prospective randomized study. Patients Ninty-one patients having their first attempt at IVF. Interventions Patients in group 1 (long protocol) were administered subcutaneous (SC) buserelin acetate 200 μ g/d from day 1 of the menstrual cycle, and hMG was started only after pituitary desensitization had been achieved at least 14days later. Patients in group 2 (short protocol) were administered SC buserelin acetate 200 μ g/d from day 2 and the same dose of hMG used in the long protocol from day 3 of the menstrual cycle. Results The median total amount of hMG required in both groups was comparable. There were significantly more follicles ( P =0.0001), oocytes ( P =0.0008), fertilized oocytes ( P =0.0001), and cleaved embryos ( P =0.0001), and a higher fertilization rate ( P =0.0047) in patients in group 1. The pregnancy rates per initiated cycle and per embryo transfer were 19.57% and 25.71% in group 1 compared with 8.89% and 16.67% in group 2. Conclusions The long protocol is superior in terms of significantly greater follicular recruitment, oocyte recovery and fertilization rates, and significantly greater number of embryos available for transfer. In general, it is the preferred method when GnRH-a are used for ovarian stimulation in IVF.

To determine whether there is a relationship between chronic fetal acidemia and subsequent neurodevelopment, a follow-up study was undertaken of 36 children with normal karyotype and morphology, who had prenatal cordocentesis for severe growth retardation. The main outcome measure was the Griffiths neurodevelopmental quotient. The children who had acidemia as fetuses (n = 13) had a significantly lower developmental quotient (mean = 91.8, SD = 6.3) than those with normal (n = 23) fetal blood pH (mean = 100.3, SD = 10.3; t = -2.68, p = 0.011). There was also a significant correlation between developmental quotient and the degree of fetal acidemia (r = 0.41, n = 36, p = 0.012). The pregnancies with acidemic fetuses had similar epidemiological characteristics to those with fetuses with a normal pH, except for a higher incidence of smoking. There was no significant correlation between the degree of growth retardation (birth weight expressed as multiples of SD from the mean for gestational age and sex) and fetal acidemia (r = -0.23, n = 36, NS) or subsequent Griffiths developmental quotient (r = -0.005, n = 36, NS). The results show an association between chronic fetal acidemia and subsequent impaired neurodevelopment. This observation suggests that future preventative interventions may be possible.

Management buyouts have been seen by some commentators as restoring the owner-manager to the commercial and industrial scene. If correct this presents a novel twist to the long-running sociological debate on ownership and control which sees ownership as separated from control at the individual level. This paper reports results from a study of Scottish-based buyouts which occurred between 1982 and 1989. Only a small proportion of the total buyout finance is raised in the form of voting shares, which does indeed enable the buy-out team, albeit at the personal risk of considerable sums of money, to obtain majority control of the voting equity. However, in firms formerly in private hands, it is often the case that, while the management team retain formal control, they hold a smaller proportion of the voting shares than the previous owners. Crucially, however, the financial institutions, in exchange for providing equity and debt finance, enforce conditions which potentially constrain the owner-managers severely. In the last analysis the overall strategy of the company is too often in the hands of its financiers to allow the conclusion that the management buyout represents the reversal of the separation of ownership and control.

Objective To compare Doppler indices of blood flow in the uterine and spiral arteries and the corpus luteum (CL), in ectopic and intrauterine pregnancies (IUPs). Design A prospective study of women with an ectopic or singleton IUP at the corresponding stage of gestation. Setting The Gynaecological Ultrasound Clinic, King's College Hospital. Patients Fifty-two women, 19 with an ectopic pregnancy (EP) and 33 with an IUP. Interventions All women were examined by transvaginal ultrasonography with color Doppler immediately before surgery. Main Outcome Measures The resistance index from the left and right uterine arteries, the spiral arteries, and the CL. The peak blood velocity (cm/sec) from the uterine arteries. The length of gestation. Results Fetal heart activity was observed in all cases of IUP at 5 weeks' gestation. Three women had an EP with a live embryo, 5 had an embryo with no heart activity, 5 contained only a yolk sac, and 2 had an empty sac. A hematocele was seen in 3 women, and 1 had tubal thickening. The mean uterine and spiral arterial resistance index decreased with the gestational age of IUPs but remained constant during EPs. Peak blood velocity in the uterine arteries increased with the gestational age of IUPs, and the values were significantly higher than in EPs. A CL was seen in 88% of women with an IUP and in 100% of women with an EP. The resistance index was similar in CL associated with both types of pregnancy, and the values did not change with gestational age. Conclusion These data show that: (1) blood flow impedance in the uterine and spiral arteries, and CL, is similar in IUPs and EPs and (2) peak flow velocity in the uterine arteries reflects a decreased blood supply to EPs.

Because of the climate and the nature of the sites, most archaeological material in the Near East has survived the passage of time in a reasonably well preserved state (at least, until recent decades). It remains true, however, that occasional deposits with exceptional preservation provide a level of detail that opens up new areas of interpretation to archaeologists. The classic examples are, perhaps, Çatalhöyük and Nahal Hemar. The ‘Burnt Village’ at Sabi Abyad is proving to be another where the new evidence is leading to a series of publications offering interpretations of the settlement which will have profound implications for our perception of the late Neolithic in northern Mesopotamia. This stimulating article amplifies one area of discussion, attempting to bring some of the most striking features of the ‘Burnt Village’ into a single, unified interpretation. Importantly, this unified interpretation draws on a range of contemporary approaches to understanding the past and, given the tendency of near eastern archaeologists to function in a degree of isolation from wider archaeological trends, this article is to be particularly welcomed. Inevitably it can be criticised in certain areas and it might have gone further in others but these comments start from the basis of welcoming, enjoying and being stimulated by this piece of work.

This paper presents the results of the STASIS(www.stasis-project.net) project and applies it to the area of semantic interoperability within technology enhanced learning platforms. Within the paper an innovative approach for creating a comprehensive application suite is introduced which allows partners to simplify the mapping process between data schemas of different e-Learning platforms. This mapping allows users to easily transfer content from one e-Learning platform to another and hence making it much easier to reuse e-Learning objects and to update to new e-Learning environments without spending serious resources on manual migration of content and user models.

Scotland's First Settlers comprised a survey project to locate and examine sites relating to the earliest, Mesolithic, settlement of the Inner Sound, along the coastlands between Skye and the west coast of Scotland. Particular foci of interest included the existence and nature of midden sites, the use of rockshelters and caves, and the different types of lithic raw material in use. In addition, information relating to the human use of the area up to the present day was recorded. Fieldwork took place over five years between 1999 and 2004: the entire coastline of the Inner Sound together with its islands was walked; 129 new archaeological sites were recorded; 36 sites were shovel pitted; 44 test pitted; and one major excavation took place. Excavation at Sand has been particularly exciting as it has resulted in the analysis of a shell midden dating to the early-mid seventh millennium BC, the early Mesolithic of Scotland. This report comprises the results of survey and excavation work as well as detailed artefact reports, full information on ecofacts such as shell, and bone, and information on the development of the landscape and environment, including sea level change. Finally, the broad-scale coverage of the project has led to a number of discussion points that have much to offer further work, both within the area and further afield. Digital material associated with this project is available through Archaeology Data Service archive http://dx.doi.org/10.5284/1000285 Scotland's First Settlers

Obsidian artefacts from Domuztepe (a large late Neolithic site in the Kahramanmaraş plain in south-east Turkey belonging to the Halaf culture and dated to c. 6000-5500 cal. BC) account for about 18%, or some 10,000 artefacts, of the chipped stone assemblage. Obsidian is one of the few non-local materials at Domuztepe and as well as being used to make tools it is also used to make items of jewellery, mirrors, bowls and axe-like objects. We know from the geochemical analysis of a relatively small number of artefacts that the obsidian was imported from eight different and widely separated sources in Central, NE and SE Anatolia. These sources are between 200 and 900km distant from Domuztepe. All these factors suggest that obsidian was valued not only as a raw material for tool manufacture but also as a material from which to make luxury items. As an exotic material it is also likely to have a key role in forging and maintaining social and economic relationships, both within the site and more widely. Understanding of the origins of the obsidians and the form in which they were obtained, worked and used, context by context, is key to this. However, difficulties arise with provenancing such a large assemblage, not least because conventional geo-chemical methods are unfeasibly expensive. This article documents the approaches we have developed to overcome this problem.

We are using transvaginal ultrasonography with color Doppler imaging to study changes in intrafollicular blood flow over the periovulatory period. We report here the findings from one volunteer (subject 9), who took two tablets of paracetamol (1000 mg) twice daily (between 07.00 and 08.00, and 18.00 and 19.00) for 2 consecutive menstrual cycle days (12 and 13) to alleviate a headache, which was shown retrospectively to have occurred within the duration of the luteinizing hormone (LH) surge in peripheral plasma. The drug appeared to have a profound effect on peak systolic blood velocity within the preovulatory follicle. Color (an index of blood velocity) disappeared and flow velocity waveforms were not detectable for at least 4 h. Color then re-appeared, but the peak systolic blood velocity had reduced by 69.8% (from 18.2 to 5.5 cm/s). The peak systolic blood velocity recovered subsequently to 16.3 cm/s, but the follicle did not rupture and continued to grow to a maximum diameter > 59 mm. There was no apparent effect of the drug on expected changes in the circulating levels of estradiol, LH, follicle stimulating hormone or progesterone. The secretory phase of the menstrual cycle lasted 13 days (i. e. day of LH peak to day of next menses minus one). We suggest that paracetamol taken at the time of the LH surge may affect intrafollicular peak systolic blood velocity and might inhibit ovulation. Possible molecular mechanisms are discussed.

The protection afforded by postmenopausal oestrogen replacement against cardiovascular disease is not fully explained by changes in plasma lipoproteins. To investigate the effect of oestrogen on arterial tone, Doppler ultrasound was used to assess blood flow characteristics in the internal carotid arteries of 12 postmenopausal women. Patients were studied pretreatment and at weeks 4, 6, 9, and 22 of therapy with transdermal oestradiol 50 micrograms/day. The pulsatility index (PI), which is thought to represent impedance to blood flow distal to the point of sampling, was measured from the flow velocity waveform. 11 of the 12 patients were within 5 years of menopause; 1 was 8 years postmenopausal but had experienced bleeding 4 years after menopause. In the 11 women there was a highly significant correlation (r = 0.77) between time since menopause and baseline PI. A similar correlation (r = 0.74) was observed when the episode of postmenopausal bleeding was redefined as time of menopause in the twelfth patient. For all 12 patients, there was a significant negative correlation (r = -0.70) between change in PI during transdermal oestradiol therapy and mean of baseline plus week 22 PI value. For all correlations between changes in PI and time since menopause, the longer the time the greater the fall in PI. These results, and previous observations of a reduction in uterine artery PI with oestradiol treatment, suggest that oestrogen has a generalised effect on the arterial system.

The perinatal findings of a pregnancy complicated by an umbilical cord abnormality associated with a small omphalocele are presented. The lesion was first observed at 18 weeks of gestation and was associated with elevated maternal serum α-fetoprotein. Serial ultrasound examinations showed major changes in the cord appearances and an associated small omphalocele was identified during the third trimester. Colour flow imaging showed no blood flow within the lesion and no obstruction nor involvement of the main umbilical vessels. Postnatal investigations demonstrated focal myxoid degeneration of the cord, a small omphalocele and no other fetal abnormalities.

In 21 severely growth-retarded, hypoxemic fetuses at 22–30 weeks' gestation, the effect of long-term maternal hyperoxygenation on serial Doppler measurements of the fetal descending thoracic aorta mean velocity (Vm), common carotid artery pulsatility index (PI) and umbilical artery PI was investigated. The treatment was continued on average for 4 weeks and delivery, at 26–34 weeks, was decided for fetal or maternal indications. In the subgroup of 12 fetuses that survived, the mean aortic Vm increased within 72 h of maternal hyperoxygenation. This increase continued for 1–8 weeks, after which there was a decrease to pretreatment values. In the subgroup of neonatal deaths (n = 5)) there was a non-significant increase in mean aortic Vm. In the subgroup of intrauterine deaths (n = 4), there was a non-significant trend for continuing deterioration in mean aortic Vm throughout the period of maternal hyperoxygenation. The mean carotid PI did not change significantly in any of the subgroups during maternal hyperoxygenation. However, in the subgroup that survived there was a tendency for improvement and in the subgroup of intrauterine deaths a tendency for deterioration. The mean umbilical artery PI did not change significantly in any of the groups or subgroups during maternal hyperoxygenation. Therefore, measurement of aortic Vm is a useful indicator of fetal response to maternal hyperoxygenation and its increase constitutes a favorable prognostic factor. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology

INTRODUCTION THE DEPRESSING statistics relating to the treatment of ovarian cancer are well known. In the United Kingdom this year about 5200 women will develop this cancer, and at least 80% will have died of their disease within five years [ 11. In the United States, the overall S-year survival rate, regardless of stage, is around 36% [2]. The changes in management with regard to surgery, chemotherapy and radiotherapy over the last few years have done little to improve the survival rate for such patients. As a result it has been suggested that the detection of the disease at an earlier stage (i.e. by screening) may solve the problem. This is clearly a gross assumption, especially as so little is known about the natural history of ovarian neoplasia. However, with no breakthrough in the treatment of this cancer imminent, the investigation of possible screening tests must be regarded as a priority. Young et al. [3] have presented the results of two randomised studies of the treatment of stage I disease, demonstrating a disease-free interval of over 5 years for 90% of patients with well or moderately well-differentiated tumours. Length time bias may of course be a factor. However, these data give encouraging support to the view that if the cancer is detected when it is confined to within the capsule of the ovary, the outcome for the majority of women following surgery might be improved. immediately is whether we are at a stage where such trials are required, and if so, what test or combination of tests should be used.

Transvaginal ultrasonography with colour flow mapping has been used to study changes in intra-follicular morphology and blood flow during a peri-ovulatory period in one volunteer. Aspects of uterine morphology and blood flow were also recorded. The intervals from a defined luteinizing hormone (LH) rise and peak to the mean time of follicular rupture were 37.5 and 17.5 h, respectively. Blood flow velocity waveforms were observed clearly at the time of the LH rise and blood vessels were visible when the hormone level reached a peak. Concurrently, the wall of the follicle became less clear, crenated, thicker and more echogenic. A structure resembling the detached cumulus and oocyte was seen before the follicle had ruptured. Peak systolic blood velocity was highest immediately after ovulation had occurred. Blood flow impedance in the uterine arteries suggested the presence of a circadian rhythm, but no pronounced daily changes were observed over the study period. In contrast, flow velocity waveforms were clearly visible in the endometrium around the time of ovulation. These preliminary data suggest that intra-follicular vascularization or angiogenesis may be critical processes that might be used to predict ovulation and could possibly be modified to help achieve or avoid a pregnancy.

Fifty-nine patients underwent 74 peritoneal oocyte and sperm transfer procedures. Forty-nine had previously failed treatment with inseminated frozen donor sperm and 10 had unexplained infertility. All procedures were carried out under ultrasound direction on an outpatient basis without general anesthetic by the transabdominal or vaginal route. Eighteen (24%) procedures resulted in pregnancy. Of these patients, 16 have delivered live infants (1 set of triplets, 2 twins, and 13 singletons) and 2 miscarried. Peritoneal oocyte and sperm transfer offers an outpatient-based alternative to gamete intrafallopian transfer (GIFT) for in vivo conception. It can also be used in patients scheduled for intrauterine insemination where stimulation is excessive because the number of oocytes replaced can be limited.

Doppler ultrasound provides a non-invasive method for the study of fetal haemodynamics. Animal studies on effects of hypoxia have provided evidence of a redistribution of cardiac output to favour perfusion of the fetal heart, adrenals and brain, at the expense of the carcass, gut and kidneys. This paper summarises the changes in fetal Doppler parameters with advancing gestation. Furthermore, it examines the alterations in fetal haemodynamics in relation to fetal blood oxygen tension in samples obtained by cordocentesis from small for gestational age (SGA) fetuses. In SGA fetuses increased downstream impedence to flow in the umbilical artery, as demonstrated by the absence of end-diastolic frequencies in the flow velocity waveforms (FVW), is associated with fetal hypoxia. This presumably reflects the underlying derangement of placental structure and function. The impedence to flow and mean blood velocity were also measured in FVWs from the descending thoracic aorta and common carotid artery, obtained by pulsed Doppler ultrasound, and from the middle cerebral and renal arteries obtained by colour flow imaging. There were significant correlations between the degree of fetal hypoxia and alterations in Doppler parameters, which were compatible with the brain sparing effect. Thus, in fetal hypoxia impedence to flow in the common carotid and middle cerebral arteries was decreased, whereas impedence in the aorta and renal artery was increased. There were simultaneous alterations in the mean blood velocity in the opposite direction to those in impedence.

The oxygenation and metabolism in appropriate (AGA) and small for gestational age (SGA) fetuses has been investigated by cordocentesis. The umbilical venous and arterial pO2 and pH decrease with gestational age while pCO2 increases and blood lactate concentration does not change. The mean umbilical venous blood glucose concentration is higher than in the umbilical artery indicating that there is fetal glucose uptake from the placenta. Similarly, the maternal glucose concentration is higher than the fetal and the levels in the two compartments are significantly correlated. The plasma insulin concentration increases exponentially with gestation reflecting the progressive maturation of the fetal pancreas. The fetal plasma cortisol does not change but the fetal plasma ACTH increases with gestation. Fetal plasma triglyceride concentration decreases exponentially with gestation and this is likely to be the result of increased utilization by the fetus for deposition into adipose tissue. There is a high correlation between fetal and maternal levels for individual amino acids and the concentration in the fetus is higher than in the mother, supporting the active transport of amino acids by the placenta. Some SGA fetuses are compromised by hypoxemia, hypercapnia, hyperlacticemia and acidosis, are starved of glucose and amino acids, and are hypertriglyceridemic. Furthermore, some of these fetuses are hypoinsulinemic and the degree of hypoinsulinemia is disproportional to the degree of hypoglycemia suggesting pancreatic dysfunction. In SGA fetuses the plasma cortisol is increased and the plasma ACTH decreased. Knowledge of human fetal oxygenation and metabolism may help in deciding the optional timing of delivery but may also constitute a basis for future fetal therapy in the form of oxygen and nutrient supplementation.

Transvaginal ultrasonography with color flow mapping has been used to study changes in intrafollicular blood flow and morphology during follicular rupture and presumed ovulation in one human volunteer. Detailed monitoring started on day 11 of the menstrual cycle and the follicle began to rupture at 14.30 on day 13. This event was preceded by a defined rise and peak in the level of immunoreactive serum luteinizing hormone (LH) by 42 h and 17 h 20 min, respectively. Blood vessels were clearly visible in the inner ring of the follicle (the granulosa layer) at the time of the LH peak and part of the granulosa (probably containing the oocyte) started to detach before the follicle ruptured. The maximum value for the peak blood velocity in the inner vessels was observed 10 s after the start of follicular rupture and there was a concurrent increase in the impedance to blood flow, as reflected by the resistance index and the pulsatility index. The follicle took 14 min 29 s to empty and the corpus haemorrhagicum started to form about 1 min later. These preliminary data suggest that intrafollicular angiogenesis and changes in blood flow can be monitored by a relatively non-invasive technique. Changes in vascularity might be used to predict imminent ovulation and could possibly be identified or modified biochemically to help achieve or avoid a pregnancy.

Codium fragile (Sur.) Hariot subsp. tomentosoides (van Goor) Silva, a widespread weedy species, is reported from Australia for the first time. Specimens were initially found in June 1996 in Corner Inlet, Victoria, where the species fouled fishing nets. This invasive chlorophycean alga was subsequently found in large numbers on 30 January 1997 in Port Phillip Bay and on 9 March 1998 in Western Port, Victoria. Presumably the species is native to Japan. The alga formed dense stands on rocky substrata in intertidal or in subtidal regions. In Port Phillip Bay, the species was also found attached to the common blue mussel Mytilus edulis planulatus Lamarck, and in Western Port it was found attached to the mud oyster Ostrea angasi Sowerby. Results of this study suggest that recruitment of juvenile germlings and growth of C. fragile subsp. tomentosoides differs between populations in Port Phillip Bay and those in Western Port.

Stuart Campbell gets a bird’s eye view over Australia’s vast Northern Territory as a registrar on board a medical retrieval plane

Twenty pregnancies with elevated maternal serum alpha-fetoprotein (MSAFP), a normal fetus and unusual or abnormal placental/cord sonographic features are reported. These include: (A) gigantic enlargement with multiple sonolucent spaces of different size and shape (n = 2; Swiss cheese); (B) placental masses of variable echogenicity (n = 5); (C) cord masses with central echo-dense zone and peripheral hypoechoic areas (n = 2); (D) enlarged placentas with patchy decrease of echogenicity (n = 6; jelly-like); and (E) large sonolucent spaces with turbulent blood flow surrounded by normal placental tissue (n = 5; placental lakes). After delivery, these ultrasound features were compared with pathologic findings. Diffuse mesenchymal hyperplasia of the stem villi were found in the gigantic placentas (n = 2). The placental masses corresponded to chorioangiomas (n = 3), infarct (n = 1) or subamniotic hematoma (n = 1) and the cord masses to angiomyxomas (n = 2). The 'jelly-like' placentas were related to subchorial thrombosis (n = 2), massive fibrin deposition (n = 1) or hypertrophy with no obvious abnormalities (n = 3). Large subchorial thrombosis (n = 2), or no obvious abnormalities (n = 3) were observed in placentas with large lakes. These findings suggest that a large range of placental and cord anomalies are associated with elevated MSAFP and are potentially diagnosable by routine sonographic examination at the time of AFP screening.

This study was designed to ascertain whether any benefit would be derived from aspirating ovarian cysts identified before ovarian stimulation in patients undergoing in vitro fertilization. Thirty-seven patients who had ovarian cysts were categorized into two groups: group A (n = 14) with baseline ovarian cysts and group B (n = 23) with ovarian cysts that developed during pituitary suppression with the gonadotropin-releasing hormone analog. Each group was prospectively randomized into two subgroups depending on whether the ovarian cysts were aspirated or not. In group A, there was a significantly greater number of follicles and oocytes in the ovaries in which cysts were aspirated. However, there was no significant difference in the total number of follicles, oocytes retrieved and fertilized, or in the final outcome. In group B, there was no significant difference in folliculogenesis between the aspirated and nonaspirated subgroups. These observations suggest that the presence of a baseline ovarian cyst may reduce folliculogenesis but do not support routine cyst aspiration if the patient has two functional ovaries.

In 81 small-for-gestational age fetuses (SGA) colour flow imaging was used to identify the fetal middle cerebral artery for subsequent pulsed Doppler studies. Impedence to flow (pulsatility index; PI) was significantly lower, and mean blood velocity was significantly higher, than the respective reference ranges with gestation. Fetal blood sampling by cordocentesis was performed in all SGA fetuses and a significant quadratic relation was found between fetal hypoxaemia and the degree of reduction in the PI of FVWs from the fetal middle cerebral artery. Thus, maximum reduction in PI is reached when the fetal PO2 is 2-4 SD below the normal mean for gestation. When the oxygen deficit is greater there is a tendency for the PI to rise, and this presumably reflects the development of brain oedema.

Uterine arterial blood flow was studied at defined times during the ovarian or menstrual cycles. Transvaginal colour pulsed ultrasound was used to identify the vessels in 23 healthy women. Blood flow impedance as reflected by the pulsatility index (PI) was determined for both arteries on 132 occasions. There was no significant difference in the PI values between the right and left arteries. The average PI value was used for subsequent analysis (range 0.5-5.6; mean 2.8). Peak mean PI values occurred on day 1 of menses (4.6), the day of the plasma oestradiol peak (3.7) and the day of the LH peak plus 3 (2.9). The lowest mean PI values (indicating the least impedance to blood flow) occurred on the day of the LH peak minus 6 (2.6), and the day of the LH peak plus 9 (1.9). There are complex temporal relationships between uterine blood flow, ovarian morphology, the concentrations of plasma oestradiol and progesterone and the thickness of the endometrium.

An analysis of southern Australian and selected type collections of species that can be ascribed to Lithophyllum and Titanoderma (Corallinaceae, Rhodophyta) has led to the discovery of considerable...

43 consecutive sets of triplet pregnancies progressing beyond 16 weeks and conceived following in vitro fertilisation at the Bourn Hallam Centre between 1984-1987 were included in the study. Follow-up information was available in the 31 sets born to United Kingdom residents. 91 live births resulted at an average gestation of 33 weeks and 2 days (range 26-38 weeks). All but one of the deliveries was by Caesarean section. The average birth weight was 1.85 kg and was significantly higher in the first-born triplet than in the third (1.93 kg versus 1.74 kg, respectively). The perinatal mortality rate amongst the triplets was 32.26 per thousand births, and the neonatal death rate was 21.98 per thousand live births. This compares favourably with the latest published data on perinatal mortality rates in triplets.

A prospective study was undertaken to assess whether changes in uterine blood flow could be used to detect endometrial cancer in 138 selected postmenopausal women (34 had uterine bleeding, 17 with endometrial cancer; 104 did not have uterine bleeding; 1 had endometrial cancer). Thirty-five of the asymptomatic women were receiving estrogen replacement therapy (ERT). The endpoints were endometrial (including tumoral) thickness and a pulsatility index (PI) derived from flow velocity waveforms recorded from both uterine arteries and from within a tumor. We found an overlap in endometrial thickness between those women with endometrial cancer and those without. The mean arterial PI value was invariably lower in women with postmenopausal bleeding and endometrial cancer (mean 0.91, range 0.31–1.49) than in those with other reasons for the blood loss (mean 3.83, range 1.95–6.40). The index was 1.10 in the woman with endometrial cancer but no sign of postmenopausal bleeding. Blood flow impedance was inversely related to stage of cancer. PI values in healthy women tended to increase slightly with age, but decrease during ERT. The detection rate was 100% within the limitations of the study design, and the false-positive rate was 1% for all women not receiving ERT and 11% for patients receiving ERT. Malignant tumors show signs of altered vascularization and a low PI (mean 0.49, range 0.29–0.92). We conclude that transvaginal ultrasonography, with or without color flow imaging, and blood flow analysis can be used to detect endometrial cancer in women with postmenopausal bleeding. A screening procedure for asymptomatic women must allow for changes in uterine blood flow during ERT.

In 68 red blood cell isoimmunized pregnancies the mean velocity of blood in the fetal aorta was measured by pulsed Doppler ultrasonography, and the fetal hemoglobin concentration was determined in blood samples obtained by cordocentesis. The values were compared to reference ranges of mean aortic velocity and hemoglobin for gestation, which were determined from 218 pregnancies that were not complicated by fetal hemolysis. In the red blood cell isoimmunized pregnancies there was a significant positive correlation between the aortic mean velocity and the hemoglobin deficit for the nonhydropic fetuses and a significant negative correlation between these two parameters for the hydropic fetuses. (Ann J OBSTET GYNECOL 1990;162:209-12.)

Our experience in 242 consecutive ultrasound directed follicle aspirations using the perurethral technique is reported. The mean number of follicles punctured per patient was 9.6 (range 20 to 35), resulting in a mean oocyte yield of 6.1 (range 0 to 31) per patient. It was necessary to change to another ultrasound directed route in 20 patients, and we failed to retrieve oocytes in a further 6 patients. There were no serious complications. The fertilization and cleavage rates were 68% and 91%, respectively. Embryo transfer was performed in 178 cases, resulting in 39 clinical pregnancies (21.9%). Ultrasound directed follicle aspiration by the perurethral route is an efficient way of collecting oocytes and is acceptable to patients. There is no need for general anaesthesia, so this technique is well suited to in vitro fertilization programs based on outpatient procedures.

Severe ovarian hyperstimulation syndrome (OHSS) is a rare but potentially fatal condition associated with conventional IVF treatment. It is found predominantly in women with polycystic ovaries who have an exaggerated response to exogenous FSH, leading to a large number of follicles and an overproduction of vascular endothelial growth factor with resultant excessive increases in vascular permeability. There is evidence to suggest that OHSS is also linked to the use of human chorionic gonadotrophin (HCG) to induce ovulation. Therefore, while HCG is essential for corpus luteum function, high amounts of HCG can lead to OHSS in high responders. In a pilot study, infertile patients at high risk of developing OHSS were given half the current minimum dose of HCG (i.e. 2500 IU). No woman developed moderate or severe OHSS; 13 women (61.9%) conceived and there were three twin pregnancies. In women at high risk of OHSS, a low dose of HCG appears to prevent the development of OHSS without compromising success rates.

Résumé: Les archéologues sont constamment confrontés à des problèmes chronologiques, qu’ils soient ou non le thème de leur recherche. Les chronologies sont utilisées pour ordonner le passé et offrir un cadre permettant de discuter les changements sociaux observés. Devoir reprendre et affiner les structures chronologiques au fur et à mesure que de nouvelles données apparaissent est une évidence; c’est l’un des objectifs de cet article. Néanmoins, les chronologies sont aussi des constructions artificielles créées par une compréhension qui reste partielle du passé faisant appel à une série de propositions, souvent mal étayées. Même des termes aussi employés que Hassuna, Samarra, Halaf, Obeid formatent notre appréhension du passé. Il devient alors nécessaire d’élucider et de remettre en question les hypothèses et les modèles sur lesquels reposent les chronologies. Cet article traite des 7e-5e millénaires cal. BC en Mésopotamie septentrionale, période qui traditionnellement voit se succéder le Hassuna/ Samarra, le Halaf qui en constitue le centre et l’Obeid. Il se focalise sur les idées sous-jacentes et les distorsions qui ont affecté nos précédentes séquences chronologiques, en insistant sur les façons dont notre connaissance des chronologies passées a pris forme puis a été utilisée. Une nouvelle approche de la chronologie de cette période, moins rigide, est proposée ici qui prend en compte les données les plus récentes et qui rend plus explicite le lien établi entre chronologie et interprétation des changements sociaux., Campbell Stuart. Rethinking Halaf Chronologies. In: Paléorient, 2007, vol. 33, n°1. pp. 103-136.

Despite the prevalence of protected areas, evidence of their impacts on people is weak and remains hotly contested in conservation policy. A key question in this debate is whether socioeconomic impacts vary according to social subgroup. Given that social inequity can create conflict and impede poverty reduction, understanding how protected areas differentially affect people is critical to designing them to achieve social and biological goals. Understanding heterogeneous responses to protected areas can improve targeting of management activities and help elucidate the pathways through which impacts of protected areas occur. Here, we assessed whether the socioeconomic impacts of marine protected areas (MPAs)—designed to achieve goals for both conservation and poverty alleviation—differed according to age, gender or religion in associated villages in North Sulawesi, Indonesia. Using data from pre-, mid- and post-implementation of the MPAs for control and project villages, we found little empirical evidence that impacts on five key socioeconomic indicators related to poverty differed according to social subgroup. We found suggestive empirical evidence that the effect of the MPAs on environmental knowledge differed by age and religion; over the medium and long terms, younger people and Muslims showed greater improvements compared with older people and Christians, respectively.

Aspirin therapy from the first trimester of pregnancy may benefit women at high risk for preeclampsia. We review publications from the past year that examine first-trimester screening studies for preeclampsia.For a false positive rate of 5%, first-trimester uterine artery Doppler studies will detect 50-65% of women who will develop severe preeclampsia (i.e. needing delivery before 35 weeks). Measurement of placental volume with three-dimensional ultrasound at 11-14 weeks detected 20% for a false positive rate of 10% in one study and further evaluation of this technique is needed. Maternal serum placental growth factor, vascular endothelial growth factor and soluble fms-like tyrosine kinase-1 have shown initial promise, but recent studies have shown no improvement in screening compared with using uterine artery Doppler alone. Placental protein 13 is the most promising serum marker and in combination with uterine Doppler may predict up to 90% of cases of severe preeclampsia for a false positive rate of 9%.First-trimester uterine artery Doppler can identify over half of women who will develop preeclampsia. Detection rates may be increased by a combination of uterine artery Doppler with first-trimester maternal serum markers, especially placental protein 13. Such high-risk women may be the most likely to benefit from pharmacological intervention in future trials.

The prophylactic use of vitamins E and C for the prevention of preeclampsia is currently being evaluated in multiple clinical trials in Canada, Mexico, the United Kingdom, the United States, and other developing countries. In addition to its antioxidant capacity, exogenous vitamin E may prevent an immunologic switch (Th1 to Th2) that is vital for early-to late transition in normal pregnancies. Moreover, vitamin E could be a potential interferon-gamma (IFN-gamma) mimic facilitating persistent proinflammatory reactions at the fetal-maternal interface. These untoward effects of dietary intake of vitamin E may be more pronounced in those treated cases that fail to develop preeclampsia. A critical test of this hypothesis would be to establish whether, under variable O2 tension, vitamin E is capable of affecting cytokine signaling in placental trophoblasts and maternal immune effector cells, both in early and late human pregnancies.

Human chorionic gonadotrophin (hCG) is released from placental trophoblasts and is involved in establishing pregnancy by maintaining progesterone secretion from the corpus luteum. Serum hCG is detected in the maternal circulation within the first 2–3 wks of gestation and peaks at the end of the first trimester before declining. In Down's syndrome (DS) pregnancies, serum hCG remains significantly high compared to gestation age-matched uncompromised pregnancies. It has been proposed that increased serum hCG levels could be due to transcriptional hyper-activation of the CGB (hCG beta) gene, or an increased half life of glycosylated hCG hormone, or both. Another possibility is that serum hCG levels remain high due to reduced availability of the hormone's cognate receptor, LHCGR, leading to lack of hormone utilization. We have tested this hypothesis by quantifying the expression of the hCG beta (CGB) RNA, LHCGR RNA and LHCGR proteins in chorionic villous samples. We demonstrate that chorionic expression of hCG beta (CGB) mRNA directly correlates with high serum hCG levels. The steady-state synthesis of LHCGR mRNA (exons 1–5) in DS pregnancies was significantly higher than that of controls, but the expression of full-length LHCGR mRNA (exons 1–11) in DS was comparable to that of uncompromised pregnancies. However, the synthesis of high molecular weight mature LHCGR proteins was significantly reduced in DS compared to uncompromised pregnancies, suggesting a lack of utilization of circulating hCG in DS pregnancies.

Objective: To evaluate the clinical impact of fetal echocardiography before 16 weeks’ gestation on the management of pregnancies with fetuses at risk of congenital heart disease. Design and setting: Observational study in a fetal medicine unit. Participants and methods: 222 consecutive women with high risk pregnancies (230 fetuses) underwent transabdominal fetal echocardiography at a median gestation of 14+1 weeks. For 10%, transvaginal scans were also performed. Criteria for normal scans were normal sequential segmental analysis, symmetrical four chamber view, normal semilunar valves, arterial outflow tracts, and ductal and aortic arches. Early scans were compared with mid-second trimester fetal echocardiography. Postmortem and postnatal data were added. Adverse pregnancy outcomes were diagnosis of a major cardiac or extracardiac abnormality, chromosomal defects, intrauterine death, or termination of pregnancy. Results: There were 21 abnormal cardiac scans (9%): 14 major structural defects (eight isolated, six with chromosomal or extracardiac abnormalities) in pregnancies resulting in three live births, one intrauterine death, and 10 terminated pregnancies. Seven scans showed asymmetry between right and left sided structures (two isolated, five with chromosomal or extracardiac abnormalities); six of the seven pregnancies were terminated. The scans were normal in 199 cases (87%). Cardiac follow up of 184 of 199 babies (93%) confirmed situs and connections. One case each of pulmonary stenosis and ventricular septal defect requiring postnatal intervention were diagnosed at later scans. In 28 of 199 (14%) babies there was a non-cardiac adverse outcome. First examination was not diagnostic for 10 (4%). Conclusion: Early fetal echocardiography in high risk pregnancies was diagnostic in 96%. Abnormal cardiac scans (isolated in 48%, major structrual defects in 67%) led to termination of pregnancy in 76%. Most cardiac scans were normal, allowing family reassurance. The high number of adverse outcomes with normal cardiac anatomy stresses the need for a multidisciplinary approach to early fetal echocardiography.

Coelomic fluid, placental tissue and maternal blood were collected at 7-10 weeks gestation from each of 58 women undergoing elective termination of pregnancy for psychological indications. In all samples, a 364 bp fragment of the human beta-globin gene spanning positions -23 to 341 was amplified. The restriction endonuclease Ddel was used to detect the sickle mutation which abolishes its restriction site. beta-Globin DNA was successfully amplified from all samples. In 53 cases a normal maternal beta-globin genotype was detected. In three out of five cases, where the maternal haemoglobin phenotype was HbAS, heterozygosity for the sickle mutation was demonstrated on analysis of coelomic fluid. In the remaining two cases a normal beta-globin genotype was observed. Three further coelomic fluid samples were found to be heterozygous for the sickle mutation. In these instances the maternal haemoglobin phenotype was normal, indicating paternal transmission of the sickle gene. The results of the present study have established that the diagnosis of sickle cell anaemia, and potentially other human single gene disorders, is feasible by coelocentesis.