ScienceDaily (Oct. 13, 2011) ? Diagnosis guidelines may be inadequate to help clinicians detect viable pregnancies thought to be miscarriages
Current guidelines that help clinicians decide whether a woman has had a miscarriage are inadequate and not reliable, and following them may lead to the inadvertent termination of wanted pregnancies. This is the conclusion of a series of papers published in the international journal Ultrasound in Obstetrics and Gynecology. "This research shows that the current guidance on how to use ultrasound scans to detect a miscarriage may lead to a wrong diagnosis in some cases. Health professionals need clearer evidence-based guidance to prevent this happening," says Professor Basky Thilaganathan, Editor-in-Chief of the journal.
A miscarriage is often confirmed by using an ultrasound scan to see whether there is any sign of a pregnancy sac or embryo in the womb, and women understandably expect that when a diagnosis of miscarriage is made there is no room for error.
In four studies based at Imperial College London, UK, Queen Mary, University of London, UK, and the Katholieke Universiteit Leuven, Belgium, researchers found that current definitions used to diagnose miscarriage could lead to an incorrect diagnosis.
One piece of research showed that the data behind the current guidelines are based on old and unreliable evidence. "The majority of ultrasound standards used for diagnosis of miscarriage are based on limited evidence," says author Dr. Shakila Thangaratinam, who works in the Women's Health Research Unit at Queen Mary, University of London.
When there are suspicions that a woman has had a miscarriage, common practice is to use ultrasound to measure the size of the gestational sac and the embryo. One study shows that in some cases cut-off values to define miscarriage in these circumstances cannot be relied upon.
When there is doubt about the diagnosis of miscarriage, current guidance suggests the pregnancy sac should be re-measured seven to ten days later. If the sac does not grow, it is assumed that a miscarriage has occurred. However, a study led by Professor Tom Bourne from Imperial College London found that perfectly healthy pregnancies may show no measurable growth over this period of time.
"By identifying this problem we hope that guidelines will be reviewed so that inadvertent termination of wanted pregnancies cannot happen. We also hope backing will be given to even larger studies to test new guidelines prospectively," says Bourne. "Currently there is a risk that some women seeking reassurance with pain or bleeding in early pregnancy may be told they have had a miscarriage, and choose to undergo surgical or medical treatment when the pregnancy is in fact healthy."
The final study revealed that there is up to a 20% variation in the size of gestational sacs reported when different clinicians measure the same pregnancies. If the first measurement over-estimated the sac size and the second measurement some days later underestimated it, then it would be easy to incorrectly conclude that no growth had occurred. "These errors could lead to a false diagnosis of miscarriage being made in some women," says a co-author of this study, Dr. Anne Pexsters of the Katholieke Universiteit Leuven.
"Many of us in clinical practice have been concerned for some time about possible errors relating to the diagnosis of miscarriage. We are pleased that our data have identified where these errors might occur so that we can prevent mistakes happening in the future," says Professor Dirk Timmerman from Katholieke Universiteit Leuven and co-author of three of the research papers.
Almost 20 years ago a landmark enquiry based in Cardiff, UK, drew attention to the fact that early pregnancies can be inappropriately classified as a miscarriage. The authors of the newly published papers believe their data show how to define miscarriage more carefully, with the emphasis being placed on only intervening when there is no doubt about the diagnosis of miscarriage.
"For most women sadly there is nothing we can do to prevent a miscarriage, but we do need to make sure we don't make things worse by intervening unnecessarily in on-going pregnancies. We hope our work means that the guidelines to define miscarriage are made as watertight as we would expect for defining death at any other stage of life," says Professor Bourne.
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CHICAGO ? The Cubs are still talking with the Boston Red Sox about compensation in a deal to bring general manager Theo Epstein to Chicago, a person familiar with the negotiations said Friday.
Epstein has agreed to a deal with the Cubs and would leave Boston with a year remaining on his contract, the person said on condition of anonymity because the negotiations are confidential. The deal is reportedly for five years.
Whether the Cubs have to send the Red Sox cash, prospects or both was not clear, though various reports say the two sides were not in agreement Thursday. The talks continued Friday for a second day.
Any deal would have to be approved by Major League Baseball.
Red Sox owner John Henry said Friday he didn't want Epstein to leave.
"I'd love to have Theo back. I would have loved for Theo to have been our general manager for the next 20 years," Henry told WBZ Radio in Boston on Friday.
"That was my hope. That would have been my hope. But you don't always get what you want. I did everything I could, personally _and so did (Red Sox executives) Tom (Werner) and Larry (Lucchino) to make that happen. But the fact that is, and I think people don't understand this, the fact is that being the general manager in Boston or being the manager in Boston is a terrifically tough job."
Epstein got the job at age 28 in 2002.
"He never saw the general manager's role as longer than 10 years for himself," Henry said. "I mean, maybe he did early on, but certainly after a few years he knew the stress of this job was too much."
The potential arrival of Epstein has Cubs fans in a tizzy. It has been greeted with even more fanfare than the hiring of marquee managers Dusty Baker and Lou Piniella in an effort to end a World Series championship drought that reached 103 years after a 71-91 finish this season.
Epstein, now 37, was at the helm when the Red Sox ended an 86-year World Series championship drought in 2004 and won the title again in 2007.
Cubs chairman Tom Ricketts fired GM Jim Hendry in July after another disappointing season and wants a GM schooled in both old-school scouting and the new world of statistical analysis. The Yale-schooled Epstein would fit both requirements.
Another potential stumbling block could be which members of the Red Sox's organization ? if any ? Epstein would be allowed to take with him to Chicago.
Epstein also has his critics after the Red Sox collapsed in September and missed the playoffs for a second straight year. Some of his big-contract players like John Lackey, Edgar Renteria, Daisuke Matsuzaka didn't measure up while another, outfielder Carl Crawford, struggled in his first season with the Red Sox.
Epstein's first order of business ? if and when the deal is complete ? could be to determine the future of manager Mike Quade, who has one year left on his two-year deal.
___
AP Sports Writer Jimmy Golen in Boston contributed.
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WARSAW, Poland ? Poland's former President Lech Walesa says he supports the Occupy Wall Street movement in New York that protests corporate greed.
The Nobel Peace laureate told The Associated Press that he is planning either a visit or a letter to the protesters.
"I am weighing now how and when to best support them, without doing any harm," Walesa said Thursday.
Since mid-September, the protesters have besieged a park near Wall Street to rally against corporate greed, saying that is the main cause for the U.S.'s failing economy. Similar protests are planned across Europe this weekend, including in Poland's capital, Warsaw.
The 68-year-old Walesa said the global economic crisis has made people aware that "we need to change, reform the capitalist system" because we need "more justice, more people's interests, and less money for money's sake."
"We cannot accept a situation when capitalism is making huge money and then does not know what to do with it," Walesa told the AP. "It should invest in new jobs."
"People are most important," he said.
The legendary freedom leader said employees, employers and representatives of state and local governments should get together to work out solutions that would best serve the people and the societies.
"For now, capitalism is working to produce more money but does not see the people," Walesa said. "This problem is getting worse across the world."
Walesa led Poland's anti-communist Solidarity movement that eventually brought democracy and a market economy to the country in 1989. Between 1990-95, he served as the country's first popularly elected president and he now campaigns across the world for global democracy and human rights.
Since communism's fall, Poland has developed into a market economy with a European social safety net. Its economy has grown steadily since joining the European Union in 2004 and it even avoided a recession during the global downturn of 2008-2009 ? the only EU country to do so.
However, Poland remains plagued by legacies of communism ? like high unemployment of almost 12 percent and low wages ? and problems brought by capitalism, like a growing gap between the country's rich and poor.
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UNION TOWNSHIP, N.J. ? Officials in a New Jersey school district are investigating claims that a high school teacher who advises a prayer group posted remarks on her Facebook page that described homosexuality as "perverted" and said it "breeds like cancer."
Attorney John Paragano saw posts by teacher Viki Knox before they were removed and alerted the Union Township school district, he told The Star-Ledger of Newark.
Paragano, who argued the teacher should be dismissed, told the newspaper that Knox objected to a school display celebrating Lesbian Gay Bisexual and Transgender Month. Union Chief School Administrator Patrick Martin told The Associated Press Thursday that the district is investigating.
"We're taking it very seriously and taking all appropriate action," he said. Martin declined to comment on Knox's employment status, citing personnel privacy rules.
A message left Thursday for Knox at the main office of Union High School, where she is a teacher, was not returned.
Paragano said he gave school officials a copy of Knox's Facebook page after he'd been contacted by a parent.
The page was not accessible Thursday. But Knox is alleged, in the copy of the page cited by the Star-Ledger, to have called homosexuality "a perverted spirit that has existed from the beginning of creation" and a "sin" that "breeds like cancer."
Officials from the gay rights groups said that although Knox's alleged anti-gay views are protected by the Constitution, she has a responsibility as a teacher to be a role model for students.
"Educators have a responsibility to nurture their students as they develop into young adults ? and that includes making sure they feel supported and know that there is nothing wrong with being LGBT," Human Rights Campaign President Joe Solmonese said in a prepared statement. "Her alleged public rant is irresponsible and sends a dangerous message to her students."
Garden State Equality issued a statement questioning Knox's ability as a teacher to enforce the state's new anti-bullying law. The law was signed in January and is considered among the toughest in the country for its requirement that schools have anti-bullying policies.
The law was adopted after the suicide last year of Tyler Clementi, a Rutgers University freshman whose roommate is accused of using a webcam to spy on his intimate encounter with another man.
The American Civil Liberties Union of New Jersey defended Knox's First Amendment right to make the comments but said the school system also has the right to investigate whether she is performing her job in accordance with school policies and anti-bias laws.
___
Information from: The Star-Ledger, http://www.nj.com/starledger
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NAIROBI, Kenya?? Suspected Somali militants entered the world's largest refugee camp Thursday and abducted two Spanish women working with an aid group after shooting and wounding their Kenyan driver ? the third kidnapping of Europeans in Kenya in six weeks.
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Police pursued the gunmen by land and air, just as they had done following a nighttime kidnapping of a French woman from an island resort earlier this month . In September, a British woman was abducted ? and her husband was shot to death ? at a coastal resort.
The kidnappings by armed Somalis underscore the ease with which militants can cross into Kenya, take hostages and return to a land where power is determined by AK-47s and bandoliers of ammunition.
The police expressed confidence in capturing the gunmen even though the last two kidnappings saw the female captives taken into Somalia.
Regional police chief Leo Nyongesa said he believes the attackers came from Somalia because that was the direction they fled after Thursday's abduction from the Dadaab refugee camp, about 50 miles from the Somalia-Kenya border.
"We are following them by the road and air. We have closed the borders. We are tracking them down," Nyongesa said.
Closing the border, however, is impossible. The frontier is marked by a poorly manned border crossing and wide expanses of wilderness on either side of the road, which allows militants ? and Kenya's military at times ? to cross with ease.
The world's largest refugee camp, Dadaab would qualify as Kenya's third-most populous city and has become a mini-Somali state.
Tens of thousands of new Somalis have flooded Dadaab in the last three months to escape famine. The camp holds nearly a half-million Somalis, some of them third-generation refugees.
Kenyan officials have won international praise for accepting so many refugees fleeing hunger and war, but those who live near Dadaab complain that the Somali population increases insecurity.
The gunmen hijacked the vehicle in which the aid workers for Doctors Without Borders were riding and shot their driver in the neck, according to Baijo Mohamed, a youth leader in the Dadaab refuge camp.
A statement from the aid group gave few details but said the injured driver was hospitalized in stable condition.
"Two international staff are missing. A crisis team has been set up to deal with this incident," the group said.
In Spain, a Foreign Ministry official confirmed that two Spanish women who do logistics for the group were abducted. The official spoke on condition of anonymity in line with ministry rules.
Story: French woman snatched by boat from Kenya to SomaliaThe attack could complicate the aid effort at Dadaab, even though aid workers already operate under security requirements. U.N. staff must have armed escorts and most aid workers must be inside secure compounds before nightfall.
"I am deeply, deeply shocked and saddened. This is unacceptable," said Adan Keynan, chairman of the Kenyan parliament's defense and foreign relations committee. "This is a barbaric action, and the people of responsible nations must unite and fight this menace. This is an organized criminal gang who are hell-bent on causing fear and mayhem among people of Kenya."
After the successful kidnappings on Kenya's coast ? abductions that have harmed the country's tourism sector ? Internal Security Minister George Saitoti said "stringent measures" have been implemented to deter attacks along the border.
Story: British woman held by pirates reportedly 'sick with fever'But a Kenya-based security official said there had been indications of a pending attack in Dadaab. About two weeks ago, Somalis approached translators working for aid groups and asked about the nationalities of foreign staff, the official said, speaking on condition of anonymity because he was not authorized to talk to the media.
Gunmen took the French woman from her home near the resort town of Lamu on Oct. 1. Kenyan authorities gave chase but said the militants escaped into Somalia. The government blamed the al-Qaida-linked militant group al-Shabab.
In early September, six gunmen believed to have been Somali pirates shot to death David Tebbutt, 58, and kidnapped his wife, Judith, at the exclusive Kiwayu Safari Village hotel north of Lamu on the coast near the Somali border. The British couple were staying at the resort, which consists of 18 cottages dotted along a white sand beach fringed with palms.
Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Source: http://www.msnbc.msn.com/id/44888139/ns/world_news-africa/
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HELENA, Mont. ? A 911 call captured two women's voices saying, "Don't do it," and, "You took my husband," before gunshots rang out in a shooting that left a man and a woman dead in a Helena apartment, according to court documents filed Friday.
The documents provided new details into the Thursday morning slayings of Joseph Andrew Gable, 48, and Sunday Cooley Bennett, 50, at Gable's home. Gable's estranged wife, Michelle Coller Gable, appeared in court Friday on two counts of deliberate homicide.
The shooting happened just two days after Joseph Gable filed for divorce from his wife of 25 years and three weeks after he attempted to obtain a protection order from her after she came to Helena from her home in Maryland. District Judge Dorothy McCarter denied that request, writing in her order, "No personal danger or threat involved."
Just after 6 a.m. Thursday, a woman called 911 from the apartment and said a man was being shot by his wife, and the wife was going to shoot the caller, too, according to an affidavit by Helena police Lt. Corey Livesay.
The 911 recording captured the sound of gunshots, then the woman who called 911 could be heard saying, "Don't shoot me, you b----," and, "Don't do it," according to the affidavit.
A second female voice said, "You took my husband," then gunshots were heard once more.
Responding officers found a woman in the apartment's doorway who said her husband had been shot and she needed help, Livesay wrote. The officers heard groaning and saw an injured man lying across the doorway. They dragged him away and laid him on a sidewalk because he was unable to move, according to the documents and interviews with neighbors.
The man told officers, "My wife shot me," and, "Sunday is in the basement."
Inside, they found a dead woman near a staircase with an apparent gunshot wound to her chest, Livesay wrote. They also found two handguns and spent ammunition.
Joseph Gable died from his gunshot wounds at a hospital later that morning. His wife was treated for an undisclosed injury and released into police custody.
Michelle Gable, handcuffed and in an orange jail jumpsuit, made a brief court appearance Friday to hear the charges against her. The 48-year-old told Justice of the Peace Michael Swingley that she understood the charges and that she had requested a public defender.
Swingley set bail at $250,000, which is $50,000 more than prosecutors recommended. Gable's next hearing was scheduled for Oct. 28.
Police did not release any information about Bennett, other than to say she had recently moved to Helena from Texas. Her relationship to Joseph Gable was not immediately clear.
A white vehicle with Texas plates registered to Robert and Sunday Bennett was parked in Gable's driveway the morning of the shooting, police said.
Two phone numbers listed for Sunday Cooley Bennett in Rosenberg, Texas, were disconnected.
On Sept. 20, Joseph Gable sought a temporary protection order from his wife, saying that he and his Michelle Gable were separated but that she had shown up in Helena from her home in Clinton, Md.
He alleged that his wife was stalking him and then confronted him at his apartment while he was trying to change the locks. He said she threw a laptop computer down the stairs, tried to block him from leaving the apartment and prevented him from driving away because her rental car was parked behind his vehicle.
"She has been out of Montana on the East Coast in Maryland for over two years, came back unannounced and is trying to disrupt my life anyway she can, apparently," he wrote in court documents.
He said his wife didn't have any firearms that he knew of, but he accused her of intimidation and holding him against his will, along with stalking. He asked that McCarter order Michelle Gable to stay at least 1,500 feet away from his home or office. McCarter denied the request the next day.
Joseph Gabler, in his petition to dissolve his marriage, said the pair had been married in 1986 at Andrews Air Force Base in Maryland, and that they have no children. He wrote that he is a computer support specialist and that he worked for the Montana Department of Transportation.
He said the reason for the divorce is that "there is serious marital discord" and "no reasonable prospect of reconciliation."
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TALLAHASSEE, Florida?? Saying it's time to stop letting convicted killers "get off that easy," a Florida state lawmaker wants to use firing squads or the electric chair for those on death row.
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Rep. Brad Drake filed a bill this week that would end the use of lethal injection in Florida executions.
Instead, those with a death sentence would choose between electrocution or a firing squad.
Drake, a Republican, said the idea came to him after having a conversation with a constituent at a Waffle House over the legal battles associated with last month's execution of Manuel Valle .
Valle's lawyers tried to stop the execution by arguing that a new lethal drug cocktail would cause him pain and constitute cruel and unusual punishment.
Drake said in a news release that the bill was filed to "end the debate" over what drugs to use.
'Lead cocktail'
"We still have Old Sparky. And if that doesn't suit the criminal, then we will provide them a .45 caliber lead cocktail instead," he said in the release.
"I am sick and tired of this sensitivity movement for criminals. Every time there is a warranted execution that is about to take place, some man or woman is standing on a corner holding a sign, yelling and screaming for humane treatment," he added. "I have no desire to humanely respect those that are inhumane."
The Republican-controlled Florida Legislature will consider Drake's bill during the 2012 session.
The bill, which is available online, says a change in the method of execution "does not increase the punishment or modify the penalty of death for capital murder."
"Nothing contained in this chapter is intended to require any ... employee of the Department of Corrections or any other person to assist in any aspect of an execution which is contrary to the person's moral or ethical beliefs," it adds.
Deborah Denno, a professor at Fordham University law school and an expert on methods of execution, said Drake's idea was a "good suggestion."
She told msnbc.com in a telephone interview that a firing squad execution was the "most humane" and "most dignified" method of those that can be used in the U.S.
Denno said this was probably followed by hanging, with lethal injections and the electric chair tied for third and lethal gas as the least humane method.
'Wild West'
She said this was partly because there are trained marksmen capable of carrying out firing squad executions properly, whereas the U.S. does not have executioners properly trained in the other methods because too few were carried out.
"I think people think of it as an antiquated procedure ... without realizing it's so much more humane than what we do to kill people," Denno said of firing squad executions. "Ironically, they equate it with the Wild West ... (and) barbarity."
Denno said she opposed the death penalty as it is currently administered, saying it was used disproportionally against minorities and low-income people.
But said she was not sure she would be against it if it was "perfectly applied" and used against "the worst of the worst."
Valle, 61, fatally shot Coral Gables officer Louis Pena in 1978. He also shot fellow officer Gary Spell, who was saved by his bulletproof vest and later testified against Valle.
Florida Supreme Court had temporarily halted the execution after Valle's attorneys argued the state's use of the drug pentobarbital in its three-drug lethal injection cocktail might not render Valle unconscious, thus subjecting him to significant pain when the other two drugs were administered.
Pena's son, also named Louis Pena, was 19 when his father was killed and now is 53.
After the execution, he noted that Valle's case worked through the courts for years, adding: "He killed a cop and lived 33 years. This man lived another lifetime after taking a life."
The Associated Press contributed to this report.
Source: http://www.msnbc.msn.com/id/44889145/ns/us_news-crime_and_courts/
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WordPress comes with user authentication feature and give facility to multiple users to access the website at the same time each user can access the website with his or her own user rights. In most cases in the development of a traditional websites the developers have to add authentication and user access features in separate way but in WordPress, this is comes as a native feature. Using with various extensions it is possible to build a powerful social networking website with almost no investment and at a much faster rates compare to hiring a developer to do it. Templates are important aspects to achieve a consistent look and feel throughout the website so one needs not to worry about those pages which are destroying the look of your entire website.
WordPress represents all web pages within a template and the best part is a template can be manipulated at any point in time so there is no need to revisit each and every web page in order to change how it looks because a single click is all it requires to change the look and feel of the entire website. WordPress makes it easy for people around the various sections to work on a website at a same time. Now, there is no longer a dependency where one has to remain dependant on the designer or programmer in order to get their content uploaded on the website. Once user has given the proper permissions and with proper rights anyone with a supported web browser can create content to use on the website and have it published. All newly published pages from the single template have the same site-wide template which makes sure that a consistent look and feel is maintain throughout the website and it allows the use of extensions feature which is perhaps the most powerful feature of Word Press.
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(Reuters) ? JPMorgan Chase & Co's quarterly earnings fell 4 percent as the European debt crisis pushed investment banking clients to the sidelines, but results were helped by an accounting gain the bank can take when markets are in turmoil.
Excluding the accounting adjustment, JPMorgan's third-quarter profit dropped 25 percent. Shares of the second-biggest U.S. bank fell 3 percent to $32.18 in early trading Thursday.
The results, the first from a major U.S. bank for the quarter, underscore how market turmoil has clobbered investment bank revenue. With stock markets plunging, companies are more reluctant to issue securities or acquire rivals.
JPMorgan Chief Executive Jamie Dimon said the company is cutting 1,000 jobs in its investment bank. Banks globally are laying off staff in the wake of weak stock and corporate credit markets.
Nancy Bush, a bank analyst and contributing editor at SNL Financial, said, "The underlying trends are quite subdued for JPMorgan, and I don't see any reason to think they'd be different for Goldman or Morgan Stanley."
The bank did post 1 percent loan growth, which Dimon said was a positive for the economy. The bank spent more buying back shares than it earned during the quarter.
JPMorgan posted quarterly earnings of $4.3 billion, or $1.02 per share, down from $4.4 billion, or $1.01 per share, in the same quarter last year.
The results were muddied by adjustments for the market value of the bank's debt, which gave it a $1.9 billion pre-tax gain. When the bank's debt weakens relative to U.S. Treasuries, it can record an accounting gain.
Wall Street analysts had estimated on average that the bank earned 91 cents a share. It was not clear if the bank's results were comparable with that estimate.
Despite the weak environment in investment banking, JPMorgan bought back $4.4 billion of stock during the quarter, and its diluted outstanding shares fell about 3 percent.
"We have a tremendous amount of capital," Dimon said in a conference call with reporters after the results came out.
"They are putting their money where their mouth is" with the buybacks, said David Dietze, chief investment strategist at Point View Wealth Management in Summit, New Jersey.
"It shows a degree of confidence. They don't see a cash crunch. The takeaway here is to be more optimistic about regional bank results but not be jumping up and down about the prospects of Morgan Stanley and Goldman Sachs."
Morgan Stanley and Goldman Sachs Group Inc are due to report third-quarter results next week.
FALLING FEES
JPMorgan's investment banking fees were down 31 percent from a year earlier to $1 billion. Revenue from stock and bond trading was down 14 percent, not counting the accounting gain.
The report from JPMorgan comes as the industry struggles to hold onto recent profits after losing tens of billions of dollars in the financial crisis.
Overall, financial company earnings in the third quarter are expected to be up only about 1 percent from a year earlier, to $33 billion, according to Thomson Reuters I/B/E/S surveys of analysts covering banking stocks in the S&P 500 index. Five years ago the industry's quarterly earnings were more than 50 percent higher, according to Thomson Reuters Proprietary Research.
Shares of JPMorgan have fallen with other bank stocks, losing 22 percent their value this year through Wednesday, compared with a 3.5 percent drop in the Standard & Poor's 500 index.
Results from JPMorgan, which never reported a quarterly loss during the financial crisis, are closely watched by investors and bank executives for clues to the results other banks.
In eight of the last 11 quarters, banking sector stocks moved in the same direction as JPMorgan shares for several days after the bank posted its results, Gerard Cassidy, analyst at RBC Capital Markets, said earlier this week.
(Reporting by David Henry in New York, additional reporting by Clare Baldwin; editing by John Wallace)
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