bluuebunny/crossref_metadata_2025 huggingface dataset:
Do transgender children (gender) stereotype less than their peers and siblings?
Authors: Olson Kristina R. , Enright Elizabeth A.
Published: September 2017

In the present work, we ask whether socially transitioned, transgender children differ from other children in their endorsement of gender stereotypes and response to others' gender nonconformity. We compare transgender children (N= 56) to a group of siblings of transgender children (N= 37), and a group of unrelated control participants (N= 56) during middle childhood (ages 6–8 years old). Our results indicate that transgender children and the siblings of transgender children endorse gender stereotypes less than the control group. Further, transgender children see violations of gender stereotypes as more acceptable, and they are more willing to indicate a desire to befriend and attend school with someone who violates gender stereotypes than the control participants. These results held after statistically controlling for demographic differences between families with and without transgender children. We discuss several possible reasons that can explain these differences.
Evaluating treatment options for spasticity
Authors: Langerak Nelleke G , Fieggen A Graham
Published: September 2017

This commentary is on the original article by Munger et al. on pages 1196–1203 of this issue.
Do children grow into cerebral palsy?
Authors: Von Hofsten Claes
Published: September 2017

This commentary is on the original article by Boxum et al. on pages 1164–1173 of this issue.
The prevalence of mental health disorders and symptoms in children and adolescents with cerebral palsy: a systematic review and meta‐analysis
Authors: Downs Jenny , Blackmore Amanda Marie , Epstein Amy , Skoss Rachel , Langdon Katherine , Jacoby Peter , Whitehouse Andrew J O , Leonard Helen , Rowe Peter W , Glasson Emma J ,   The Cerebral Palsy Mental Health Group
Published: September 2017

Aim

Mental health conditions and problems are often reported in children and adolescents with cerebral palsy (CP). A systematic review was undertaken to describe their prevalence.

Method

MEDLINE and PsycINFO databases from 1996 to 2016 were searched and reference lists of selected studies were reviewed. Studies were included if they reported point prevalence of mental health diagnoses or symptoms in a general population of children and/or adolescents with CP. Pooled prevalence for mental health symptoms was determined using a random effects meta‐analysis.

Results

Of the 3158 studies identified, eight met the inclusion criteria. Mental health disorders were diagnosed by psychiatric interview in one study, giving a prevalence of 57% (32 out of 56 children). The remaining seven studies (n=1715 children) used parent‐report mental health screening tools. The pooled prevalence for mental health symptoms using the Strengths and Difficulties Questionnaire (n=5 studies) was 35% (95% confidence interval [CI] 20–61) and using the Child Behavior Checklist (n=2 studies) was 28% (95% CI 22–36). Evidence was characterized by a moderate level of bias.

Interpretation

More studies are needed to ascertain the prevalence of mental health disorders. Mental health symptoms are common and mental health evaluations should be incorporated into multidisciplinary assessments for these children.

What this paper adds

Children with cerebral palsy and intellectual disability have a higher risk of mental health symptoms.

The prevalence of mental health symptoms for age and severity groups is unclear.
On the causes of trends in the seasonal amplitude of atmospheric CO2
Authors: Piao Shilong , Liu Zhuo , Wang Yilong , Ciais Philippe , Yao Yitong , Peng Shushi , Chevallier Frédéric , Friedlingstein Pierre , Janssens Ivan A. , Peñuelas Josep , Sitch Stephen , Wang Tao
Published: September 2017

No consensus has yet been reached on the major factors driving the observed increase in the seasonal amplitude of atmospheric CO2 in the northern latitudes. In this study, we used atmospheric CO2 records from 26 northern hemisphere stations with a temporal coverage longer than 15 years, and an atmospheric transport model prescribed with net biome productivity (NBP) from an ensemble of nine terrestrial ecosystem models, to attribute change in the seasonal amplitude of atmospheric CO2. We found significant (p < .05) increases in seasonal peak‐to‐trough CO2 amplitude (AMPP‐T) at nine stations, and in trough‐to‐peak amplitude (AMPT‐P) at eight stations over the last three decades. Most of the stations that recorded increasing amplitudes are in Arctic and boreal regions (>50°N), consistent with previous observations that the amplitude increased faster at Barrow (Arctic) than at Mauna Loa (subtropics). The multi‐model ensemble mean (MMEM) shows that the response of ecosystem carbon cycling to rising CO2 concentration (eCO2) and climate change are dominant drivers of the increase in AMPP‐T and AMPT‐P in the high latitudes. At the Barrow station, the observed increase of AMPP‐T and AMPT‐P over the last 33 years is explained by eCO2 (39% and 42%) almost equally than by climate change (32% and 35%). The increased carbon losses during the months with a net carbon release in response to eCO2 are associated with higher ecosystem respiration due to the increase in carbon storage caused by eCO2 during carbon uptake period. Air‐sea CO2 fluxes (10% for AMPP‐T and 11% for AMPT‐P) and the impacts of land‐use change (marginally significant 3% for AMPP‐T and 4% for AMPT‐P) also contributed to the CO2 measured at Barrow, highlighting the role of these factors in regulating seasonal changes in the global carbon cycle.
Extending Data Worth Analyses to Select Multiple Observations Targeting Multiple Forecasts
Authors: Vilhelmsen Troels N. , Ferré Ty P.A.
Published: September 2017

Hydrological models are often set up to provide specific forecasts of interest. Owing to the inherent uncertainty in data used to derive model structure and used to constrain parameter variations, the model forecasts will be uncertain. Additional data collection is often performed to minimize this forecast uncertainty. Given our common financial restrictions, it is critical that we identify data with maximal information content with respect to forecast of interest. In practice, this often devolves to qualitative decisions based on expert opinion. However, there is no assurance that this will lead to optimal design, especially for complex hydrogeological problems. Specifically, these complexities include considerations of multiple forecasts, shared information among potential observations, information content of existing data, and the assumptions and simplifications underlying model construction. In the present study, we extend previous data worth analyses to include: simultaneous selection of multiple new measurements and consideration of multiple forecasts of interest. We show how the suggested approach can be used to optimize data collection. This can be used in a manner that suggests specific measurement sets or that produces probability maps indicating areas likely to be informative for specific forecasts. Moreover, we provide examples documenting that sequential measurement election approaches often lead to suboptimal designs and that estimates of data covariance should be included when selecting future measurement sets.
Impact of enzyme inactivation conditions during the generation of whey protein hydrolysates on their physicochemical and bioactive properties
Authors: Le Maux Solène , Nongonierma Alice B. , Lardeux Claire , FitzGerald Richard J.
Published: September 2017

The thermal inactivation conditions (75 °C × 35 min, 80 °C × 10 min, 85 °C × 5 min and 90 °C × 5 min) for Protamex™ following bovine whey protein concentrate (WPC) hydrolysis was studied with the view to limiting WPC hydrolysate (WPH) aggregation while maintaining bioactivity. A decrease in the amount of large WPH aggregates formed was observed at inactivation temperatures ≤85 °C. However, the WPC appeared to be more hydrolysed on heating at 75 °C × 35 min, as Protamex™ was active for longer under these heating conditions. Significantly (P < 0.05), higher WPH antioxidant (oxygen radical absorbance capacity – ORAC) activity was obtained on inactivation at temperatures ≤80 °C. In contrast, the dipeptidyl peptidase IV (DPP‐IV) inhibitory properties of all WPH samples were similar (P > 0.05). A reduction in thermal treatment from 90 °C × 5 min to 85 °C × 5 min was sufficient to decrease the amount of large aggregates formed in the hydrolysate without altering its bioactive properties.
Impact of whey protein isolates and concentrates on the formation of protein nanoparticles‐stabilised Pickering emulsions
Authors: Li Dong , Chen Enmin , Chen Huanle , Zhou Huifang , Li Bin , Li Yan
Published: September 2017

Whey protein nanoparticles (NPs) were prepared by heat‐induced method. The influences of whey protein isolates (WPIs) and concentrates (WPCs) on the formation of NPs were first investigated. Then Pickering emulsions were produced by protein NPs and their properties were evaluated. After heat treatment, WPC NPs showed larger particle size, higher stability against NaCl, lower negative charge and contact angle between air and water. Dispersions of WPC NPs appeared as higher turbidity and viscosity than those of WPI NPs. The interfacial tension of WPC NPs (~7.9 mN/m at 3 wt% NPs) was greatly lower than that of WPI NPs (~12.1 mN/m at 3 wt% NPs). WPC NPs‐stabilised emulsions had smaller particle size and were more homogeneous than WPI NPs‐stabilised emulsions. WPC NPs‐stabilised emulsions had higher stability against NaCl, pH and coalescence during storage.
Inclusion complexes dispersed in polystyrene‐based labels for fruit ripening on demand
Authors: Capozzi Luigi C. , Bazzano Marco , Sangermano Marco , Pisano Roberto
Published: September 2017

In this work, the inclusion complexes of α‐cyclodextrin and ethylene were prepared by molecular encapsulation and then dispersed into a polystyrene film by solvent casting to produce active polymeric labels. These labels were produced to control ripening of fruit directly in the food container as an alternative to the injection of ethylene into thermo‐regulated chambers. The samples were characterised, and the ethylene release was found to be dependent on temperature and relative humidity in the atmosphere. Finally, experimental data were used to simulate a realistic scenario of fruit ripening into a food container, showing the possibility to trigger ripening with the active label within 2 days. Polystyrene/inclusion complex labels showed in situ release of ethylene, potentially able to trigger ripening of fruit in a food container within desired time, reducing costs in the supply chain and postharvest losses.
Antioxidant activities of Rapana venosa meat and visceral mass during simulated gastrointestinal digestion and their membrane ultrafiltration fractions
Authors: Luo Fenglei , Xing Ronge , Wang Xueqin , Yang Haoyue , Li Pengcheng
Published: September 2017

Rapana venosa (Rv) is an abundant marine snail resource with high content of protein. The antioxidant activities of Rv meat and visceral mass during simulated gastrointestinal (GI) digestion and their membrane ultrafiltration fractions were evaluated. Results indicated that visceral mass possessed stronger antioxidant activities than meat. The simulated GI digestion increased the hydroxyl radical scavenging activity while decreased the 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH) scavenging activity and reducing power. After membrane ultrafiltration, there were three fractions, that is molecular weight (MW) > 10 kDa, MW 3.5–10 kDa and MW < 3.5 kDa. Fractions with MW > 10 kDa and MW < 3.5 kDa showed the highest hydroxyl, DPPH radical scavenging activity, respectively. Fractions with MW 3.5–10 kDa and MW > 10 kDa showed the highest reducing power for meat and visceral mass, respectively. Rv hydrolysates exhibited significantly higher hydroxyl radical scavenging activity than the positive control vitamin C (Vc) and may serve as useful ingredients for application in food industry nutritional products.
A SURVEY OF THE TYPES AND SEVERITY OF EMPHYSEMA IN ROUTINE AUTOPSIES
Authors: SMITH K. VINER
Published: September 2017

The lungs of 103 unselected subjects were examined for emphysema by a variety of methods to study the frequency and severity of the types of emphysema common in an Australian community. A closer study was made of those from 80 subjects aged 51 to 80 years at death, and in particular of the 49 men in this group.

It was found that emphysema was much more common among men than among women, and it is most desirable that the findings for the two sexes be kept separate in future studies.

In both men and women the centrilobular type was most common. Most men with panacinar emphysema also had centrilobular emphysema; but most men with centrilobular emphysema did not have panacinar emphysema. The significance of this is not apparent. It was rare for a man to have one type of emphysema alone.

At death, acute bronchiolitis and bronchopneumonia were not more common in those subjects with emphysema, an observation which lends no support to the theory that acute bronchitis is a common cause of emphysema.
THE NATURAL HISTORY OF CHILDREN SUFFERING FROM VENTRICULAR SEPTAL DEFECT AND PULMONARY HYPERTENSION
Authors: FARRAR F. , DUNLOP IAN C.
Published: September 2017

In order to assess the progress of children suffering from ventricular septal defects, especially those with pulmonary hypertension, and to help to determine a time for operation, a number of such patients have had cardiac catheterization studies repeated some years after the original study. Each physiological study has been compared with corresponding clinical, radiographic and electrocardiographic findings.

Twenty‐one such patients have been included in the study, 18 of whom had significant pulmonary hypertension at the time of the investigation. Cardiac catheterization was repeated usually with a view to determining operability, so that figures may favour the doubtful and therefore more severe group.

Over the period of the study, seven of the 18 patients (39%) had a significant rise in pulmonary vascular resistance.

The electrocardiogram is a useful, although not infallible, guide to the trend of the pulmonary resistance.
INFECTION WITH MIMA POLYMORPHA : FATAL MENINGITIS AND SEPTICÆMIA
Authors: GOLDSTEIN GIDEON , COWLING DAVID C. , WALLCOWLING ALFRED J.
Published: September 2017

Mima polymorpha is an unusual organism, which may take a coccal or bacillary form and may show mixed positive and negative Gram‐staining. Infection with M. polymorpha in a girl, aged 15 years, with subclinical chronic hepatitis, was manifested by septicaemia, a florid purpuric rash and meningitis. The patient died after seven days from persisting shock and oliguria. The diagnosis was suggested by the finding of an organism resembling Mima in a smear from the cerebro‐spinal fluid, and was confirmed by growing M. polymorpha in cultures from the cerebro‐spinal fluid and blood.
THE NATURAL HISTORY OF THE NZB/NZW F1 HYBRID MOUSE: A LABORATORY MODEL OF SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: BURNET F. M. , HOLMES MARGARET C.
Published: September 2017

In confirmation of the work of Helyer and Howie, the F1 hybrids of NZB and NZW mice have shown a uniquely high incidence of kidney disease with a general resemblance to human systemic lupus erythematosus nephritis. All females died within one year, and amongst males the incidence was almost as high, but a proportion survived for long periods. The form of the mortality curve is an exceptional one.

Other features of interest to human medicine are the common occurrence of polyarteritis and of relatively massive thoracic or abdominal hæmorrhages. Serological studies indicated a late and irregular development of Coombs reactivity but a high proportion of positive results to tests for antinuclear factor. Lesions of the thymus were conspicuously larger than those in NZB mice and differed in histological structure.
THE RENAL EXCRETION OF URATE IN CHRONIC LEAD NEPHROPATHY
Authors: EMMERSON B. T.
Published: September 2017

Patients with chronic lead nephropathy frequently develop gout. A group of lead‐nephritic patients was therefore compared with a group of patients with chronic renal disease due to causes other than lead or primary gout in regard to the following features: (i) the plasma concentrations of urate and phosphate in relation to the creatinine clearance; (ii) the renal clearances of urate, creatinine, urea and phosphate; (iii) the effect on the urate clearance of elevation of the plasma urate concentration by a purine load; (iv) the effect on the urate clearance of partial blockade of tubular reabsorption of urate by a uricosuric drug.

When allowance was made for the differences in creatinine clearances between the groups, the findings were as follows. (i) The plasma‐urate concentrations were significantly higher in the lead‐nephritic group and did not tend to increase with increasing renal failure, whereas the plasma‐phosphate concentrations were not significantly different in the two groups and tended to increase with increasing renal failure. (ii) The lead‐nephritic group showed lower urate clearances and higher phosphate clearances than the non‐lead‐nephritic group, and the lead‐nephritic group alone showed significant regressions of the urate clearance on both the creatinine and urea clearances. (iii) With elevation of the plasma‐urate concentration by a purine load, there was a significant fall in the urate clearance in those lead‐nephritic patients who had a mean urate clearance of 3 ml. per minute or more. (iv) There was no significant difference between the increases in urate clearance after a uricosuric drug in the two groups.

These findings were consistent with a defect in renal excretion of urate in chronic lead nephropathy most readily explicable by defective tubular secretion of urate.
MYOCARDITIS ASSOCIATED WITH TOXOPLASMOSIS
Authors: HARVEY H. P. B. , MCLEOD J. G. , TURTLE J. R.
Published: September 2017

Three cases of cardiac failure are described, in all of which there was strong serological evidence for recent Toxoplasma infection. No other cause for myocardial disease was found. In all cases clinical improvement followed treatment, but evidence of residual cardiac damage persisted. One patient died three years after the initial acute illness, and autopsy findings were consistent with the diagnosis of myocardial toxoplasmosis.
THE MEASUREMENT OF ANDROGEN PRODUCTION IN NORMAL SUBJECTS
Authors: HUDSON BRYAN , DULMANIS AUSMA , COGHLAN JOHN P. , W1NTOUR MARELYN
Published: September 2017

The discovery of testosterone in urine and the development of methods for its measurement in plasma and urine have provided fresh approaches for the evaluation of androgen function in man. Production rates of testosterone have been measured in normal men and women by means of the principle of isotope dilution. The specific activity of urinary testosterone is measured after the administration of a tracer dose of isotopically labelled testosterone. Production rates have also been estimated by measuring the concentration of testosterone in plasma and its rate of clearance from plasma, the product of these two values being the blood production rate. In 14 males blood and urinary production rates were not significantly different, but in females the blood production rates were significantly lower than those determined from the specific activity of urinary testosterone.

The possible reasons for this discrepancy are analysed.
RELATIONSHIP BETWEEN RESISTANCE TO INSULIN AND BODY WEIGHT
Authors: NESTEL P. J. , MATAR K.
Published: September 2017

The relationship between increased body weight and resistance to insulin was studied in a group of 14 healthy men. The reduction in blood glucose and plasma free fatty acid (FFA) levels was measured during one‐hour infusions of insulin given in doses which would lead to physiological concentrations of insulin in the plasma.

A relationship could not be demonstrated between the blood glucose response and body weight. However, the FFA concentrations fell to lower levels in the leaner than in the heavier subjects, so that a highly significant direct relationship was found between body weight and the post‐insulin plasma FFA concentration.

The studies therefore show that, over a range of commonly encountered body weights, resistance to insulin develops with increasing fatness. The study also shows that the plasma FFA response to insulin is a more sensitive index of insulin resistance than the blood glucose response.
INULIN, 57Co‐LABELLED VITAMIN B12 AND ENDOGENOUS CREATININE CLEARANCES IN THE MEASUREMENT OF GLOMERULAR FILTRATION RATE IN MAN
Authors: JEREMY D. , MCIVER M.
Published: September 2017

In 14 cases, simultaneous clearances of inulin (range 39 to 160 ml. per minute) and endogenous creatinine were measured, and in 11 of these cases, the results were compared with the simultaneous clearance of radioactive (57Co) vitamin B12.

The clearance of free (dialysable) 57Co vitamin B12 correlates closely with inulin clearance (ρ=0·985), and can be used as a measure of glomerular filtration rate. [Clearance of vitamin B12 (free)=1·07 clearance of inulin—10·9±5·48 (2 S.D.). ]

The protein bound (non‐dialysable) fraction of the plasma 57Co vitamin B12 varied from patient to patient, and in the same patient at different times (range, 9·6% to 35·7%; mean, 17·7% of total), in spite of presaturation with stable vitamin B12. Because of this, the clearance of vitamin B12 is a valid measure of glomerular filtration rate only when correction is made for plasma protein binding as measured in the individual subject.

The correlation between inulin and endogenous creatinine clearance was less precise. [Ratio of clearance of creatinine to clearance inulin=1·20±0·38 (2 S.D.).]
A CLINICAL METHOD FOR ASSESSING THE VENTILATORY RESPONSE TO CARBON DIOXIDE
Authors: READ D. C.
Published: September 2017

A simple method of studying the regulation of ventilation has been developed so that rapid serial observations can be made in sick patients. The method is based on the progressive increase of Pco2 and the resulting stimulation of ventilation which occurs during rebreathing from a bag. A small bag is used in which the initial Pco2 is close to the Pco2 of mixed venous blood. With this technique, a Pco2 equilibrium is rapidly established between mixed venous blood, arterial blood and end‐expiratory gas. Subsequently, parallel changes develop in end‐expiratory Pco2 and ventilation. Under these conditions, changes in end‐expiratory Pco2 reflect the changes of medullary chemoreceptor Pco2 and the developing carbon dioxide stimulus.

Experiments are reported which establish the linearity, reproducibility and normal range of response‐curves relating ventilation (V̇E) to end‐expiratory Pco2. These V̇E/Pco2 response‐lines were only slightly disturbed by simulated abnormality of the body carbon dioxide storage capacity or acute depletion of the body carbon dioxide stores. V̇E/Pco2 response‐lines obtained by rebreathing and by the prolonged steady‐state method differed significantly in position but not in slope. The similarity in slope implies that the same proportion, Δ end‐expiratory Pco2/Δ chemoreceptor Pco2, is established for the two methods. The difference in position indicates a smaller Pco2 gradient between arterial blood and chemoreceptor tissue in the rebreathing method.

The method is particularly suited for clinical use, being rapid, tolerable and easily repeated. It avoids the necessity for sampling arterial or internal jugular venous blood, and can be performed by the bedside with the use of simple apparatus.
“ A.T. 10 “ AND DIHYDROTACHYSTEROL
Authors: PARFITT A. M.
Published: September 2017

The effect of pure dihydrotachysterol (D.H.T.) was compared with that of the old “ A.T. 10 ” in eight patients with hypoparathyroidism, and it was found that the “ A.T. 10 ” available in 1963–1964 was equivalent in therapeutic activity to 0.1 mg. of D.H.T. per capsule (or 0.2 mg. of D.H.T. per millilitre). It is concluded that the new “ A.T. 10 ” (containing 0.25 mg. of D.H.T. per millilitre) is 25% stronger than the old, and that patients whose therapy is changed to the new preparation in the same dose (by volume) may occasionally develop hypercalcaemia as a result.

The history of the various changes in the methods of assay of “ A.T. 10 ” is reviewed and the reasons why they were all fallacious are explained.

As judged by reported maintenance doses, the “ A.T. 10 ” available in 1963–1964 was only one‐third as potent in the treatment of hypoparathyroidism as that available in 1934–1942.
THE INCIDENCE OF GASTRECTOMY AND GASTRIC SECRETION IN MOTOR NEURON DISEASE
Authors: STIEL J. N.
Published: September 2017

In a review of 125 patients with motor neuron disease, no instance of gastrectomy was recorded, and the gastric secretions in five patients with motor neuron disease were found to be normal. These observations lead one to doubt the reported association between gastrectomy and motor neuron disease.
UNBALANCED C/E TRANSLOCATION EXHIBITING SOME CLINICAL FEATURES OF TRISOMY E
Authors: ILBERY P. L. T. , ALEXANDER J. M.
Published: September 2017

A male infant showed some features of trisomy E with a karyotypic appearance which was unbalanced. There were 44 autosomes and the chromosome sex was male. One of the autosomes interpreted as Chromosome 6 was longer than its partner in respect of the length of its long arms. The father had a balanced chromosome pattern exhibiting the same abnormal Chromosome 6, together with a chromosome interpreted as Number 17, showing deletion of most of its long arms.

The lack of some characteristics usually associated with trisomy E in the infant, especially the dermatoglyphic changes, are discussed in relation to chromosome mapping.
THE DIURETIC RESPONSE TO THE INTRAVENOUS ADMINISTRATION OF FRUSEMIDE
Authors: MCIVER MARGOT , JEREMY D.
Published: September 2017

Observations were made on the effect of frusemide given by intravenous injection on the glomerular filtration rate and the water and electrolyte excretion in 12 subjects.

The intravenous administration of frusemide caused either no change or slight reduction in the glomerular filtration rate. The basis for the “washout” effect in causing false clearance results is discussed.

Changes in free water clearance suggest that the drug has an action on the thick ascending limb of the loop of Henle.

Onset of diuresis was detectable in the third minute and the volume and saline diuresis reached a peak as early as the fifth minute after administration of the diuretic. A mean of 22% (range, 4·7% to 34·5%) of the glomerular filtrate, and 14·5% (range, 5·4% to 23%) of the filtered load of sodium, was excreted in the 45 minutes after the intravenous administration of frusemide.
MYASTHENIA GRAVIS : CLINICAL, SEROLOGICAL AND HISTOLOGICAL STUDIES IN RELATION TO THYMECTOMY
Authors: MACKAY I. R. , WHITTINGHAM S. , GOLDSTEIN G. , CURRIE T. T. , HARE W. S. C.
Published: September 2017

In 10 cases of myasthenia gravis correlative studies were made by means of autoimmune serological tests, electromyography, thymic X‐ray examination (pneumomediastinography) and assessment of thymic morphology in relation to the effects of thymectomy (nine cases) and thymic irradiation (one case).

The 10 patients were placed in three groups, namely (a) three young females with a non‐involuted thymus showing “thymitis” and negative results to serological tests who derived benefit from thymectomy, (b) four older females with thymic atrophy and positive results to serological tests who for the most part gained no benefit from thymectomy, and (c) three males with thymomas and positive results to serological tests who obtained benefit from thymectomy in two instances.

The presence of the characteristic autoantibody—the myoid antibody which reacted with thymic myoid cells and skeletal muscle—was helpful in diagnosis but did not appear to be related to neuromuscular block, neither was it of value in predicting the response to thymectomy. Electromyography with the decamethonium test showed, with one exception, the characteristic myasthenic responses irrespective of the patient's age, the presence or absence of myoid antibody, or the nature of the microscopic lesion in the thymus. The radiographic outline of the thymus as determined by pneumomediastinography correlated well with the size and shape of the resected thymus. The typical histological appearance in the thymus of abundant cortex and prominent medullary germinal centres and lymphocytosis was termed “thymitis” ; it was characteristic of the thymus of patients in group (a) and the residual thymus of patients with thymoma in group (c).

Our clinical observations could be correlated with experimental studies, indicating that myasthenia gravis is associated with a destructive “autoimmune thymitis”. It is suggested that “thymitis” is associated with the release from the medulla of an uncharacterized humoral agent which causes neuro‐muscular block.
ANTINUCLEAR FACTORS AND HUMAN LEUCOCYTES: REACTION WITH GRANULOCYTES AND LYMPHOCYTES
Authors: SMALLEY M. J. , MACKAY I. R. , WHITTINGHAM S.
Published: September 2017

We compared the reaction of antinuclear factor (ANF) with nuclei of lymphocytes, granulocytes and liver cells by retesting III sera known to have given a positive test for antinuclear factor with human blood smears. These sera could be placed in three groups, as follows: Group 1, 47 sera, reacted to equal titre with the nuclei of lymphocytes, granulocytes and rat liver nuclei; Group 2, 25 sera, reacted to much higher titre with the nuclei of granulocytes than with nuclei of lymphocytes and liver cells; Group 3, 39 sera, reacted only with the nuclei of granulocytes. Thus, reactive sera contained separate antinuclear factors for nuclei of lymphocytes and liver cells, and for granulocytes.

The presence of high titre lymphocyte‐reactive ANF characterized systemic lupus erythematosus, and was associated with lymphopenia (but not granulocytopenia) and a positive result to the LE cell test. Granulocyte‐specific ANF occurred in 4% of healthy subjects, but only to low titre (10 or less) ; high titres occurred in a range of diseases considered to be “ autoimmune ”, but had little diagnostic specificity and were not associated with cytopenias.

The fixed blood film has some advantages for ANF tests: it is inexpensive and readily available, the incidence and titre of reactions with lymphocyte nuclei and tissue nuclei are similar, and the granulocyte‐specific ANF can be recognized. However, it should be specified whether positive reactions are with all nuclei or only granulocyte nuclei.
THE CLINICAL USES OF HUMAN GONADOTROPHINS
Authors: TAFT PINCUS , ADEY F. D. , BROWN J. B. , DE KRETSER D. M. , EVANS J. H. , HUDSON BRYAN
Published: September 2017

With the recent preparation of hormones from human pituitaries and human postmenopausal urine, a wider range of pituitary gonadotrophin activity has become available for clinical use. To the luteinizing and interstitial cell stimulating effects of gonadotrophin prepared from human placentas can now be added the follicle stimulating activity of pituitary and urinary gonadotrophin.

The clinical applications of these hormones lie in both the diagnostic and therapeutic fields. Their administration as gonadal stimulants followed by measurement of gonadal response allows an assessment of function and the determination of the level of gonadal failure. The range of biological gonadotrophic activity of these hormones allows their use as effective replacement therapy in gonadotrophin deficiency states in both sexes and for the infertile female, even in the absence of obvious hypogonadotrophinism.
CYTOGENETIC STUDIES IN FAMILIAL LEUKÆMIAS
Authors: BAIKIE A. G. , GARSON O. MARGARET , SPIERS A. S. D. , FERGUSON JEAN
Published: September 2017

Familial aggregation of chronic granulocytic leukæmia is rare and even the occurrence of chronic granulocytic leukæmia in onto member of a family and another type of leukæmia in a close relative is very uncommon. When such instances occur they provide an opportunity for ascertaining if the Philadelphia chromosome (Ph1), characteristic of chronic granulocytic leukæmia, is ever an inherited rather than an acquired anomaly. The possible existence of a special liability to other chromosomal aberrations can be investigated in such families.

In a man with chronic granulocytic leukæmia whose mother had died of the same disease, the Ph1 was identified in bone marrow cells and in 50% of the dividing cells of peripheral blood cultured during a period of relapse. No Ph1‐positive cells were identified in a culture of subcutaneous fibroblasts, and so it may be assumed that in this patient the Ph1 was an acquired and not an inherited chromosomal abnormality.

The Ph1 was not present in cultures of peripheral blood leucocytes or of subcutaneous fibroblasts from a girl with acute leukemia whose father died of chronic granulocytic leukæmia.

These studies provide further evidence of the status of the Philadelphia chromosome as an acquired cytogenetic anomaly.
LONG‐TERM TREATMENT OF PORTAL‐SYSTEMIC ENCEPHALOPATHY WITH LACTULOSE
Authors: MA M. H. , McLEOD J. G. , BLACKBURN C. R. B.
Published: September 2017

Ten patients with chronic portal‐systemic encephalopathy have been treated with lactulose and dietary restriction of protein. The treatment was found to be effective in six cases for periods up to 12 months. Two patients with very advanced cirrhosis and hepatic decompensation failed to respond. Two other patients were intolerant of lactulose. It is concluded that lactulose is an effective drug in the treatment of chronic portal‐systemic encephalopathy, and is a useful substitute for neomycin.
THE ACUTE EFFECTS OF PORCINE CALCITONIN IN MAN
Authors: MARTIN T. J. , MELICK R. A.
Published: September 2017

The acute response to porcine calcitonin was studied in five normal subjects, four patients with thyrotoxicosis, eight with osteoporosis, and in two patients with hypercalcremia some months after renal transplantation. Serum calcium level was lowered in the thyrotoxic and hypercalcremic patients, and in three of those with osteoporosis. In all groups, calcitonin caused an increased rate of phosphate, calcium and sulphate excretion. Urinary hydroxyproline excretion was reduced only in those patients whose serum calcium level was lowered.

The results confirm that calcitonin lowers serum calcium level only in states of rapid bone resorption. They suggest that calcitonin may be of use in the study and treatment of osteoporosis.
The Pathogenesis of the Vascular and Glomerular Lesions of Rejection in Renal Allografts and their Modification by Antithrombotic and Anticoagulant Drugs
Authors: Kincaid-Smith Priscilla
Published: September 2017

The pathogenesis of the vascular and glomerular lesions of allograft rejection has been studied in 254 percutaneous biopsies from patients who have received cadaveric allografts. Evidence is presented that thromboses and residual lesions following organisation of thrombi are the major changes in vessels and glomeruli in allograft rejection and that these lead to glomerular and vascular obliteration and graft failure. The ultramicroscopic features of the glomerular lesions are thought to be typical of intravascular thrombosis and similar to those seen in a variety of other conditions where thrombi develop in glomerular capillaries.

Considerable modification of the vascular lesions was noted in patients treated early and continuously with dipyridamole combined with phenindione or heparin.

The similarities between vascular and glomerular lesions in allograft rejection and a wide variety of other renal diseases is noted. On the basis of these findings it is suggested that antithrombotic and anticoagulant drugs may modify the many glomerular and vascular lesions including those of glomerulonephritis, hypertension, thrombotic microangiopathy and the collagen diseases all of which have features in common with those of allograft rejection.
Heart‐Reactive Antibody, Serum Enzymes and Isoenzymes in the Diagnosis of Acute Rheumatic Fever
Authors: Jose D. G. , Barry H. , Goldblatt E. , Penfold J. , Welch J. S.
Published: September 2017

Three groups of laboratory tests were assessed for possible clinical application in the diagnosis of rheumatic carditis.

Serum antibody cross‐reactive with human myocardium and group A streptococcal cell membrane (heart‐reactive antibody—H.R.A.) was found in titres above the normal range in most patients with post‐streptococcal carditis, arthritis or glomerulonephritis and less often in patients with surgical myocardial damage. Patients with acute rheumatic carditis had lower titres on admission than those with acute rheumatic arthritis alone; after treatment titres rose in the carditis group but fell in children with arthritis. These findings suggested a possible pathogenic role for this antibody in rheumatic carditis, and suggest its determination to be useful in diagnosis.

Serum levels of glutamic oxaloacetic transaminase, lactic dehydrogenase and creatine phosphokinase were significantly higher in children with cardiac damage and in those with high titres of H.R.A., but the differences were not sufficiently great to be of clinical value.

Relative increases in the fast‐migrating isoenzyme of serum lactic dehydrogenase were found in patients with carditis, and its determination is considered to be of potential clinical value.
Catecholamine Excretion with Myocardial Ischaemia and Infarction
Authors: Rosenbaum Maurice , Doyle Austin E.
Published: September 2017

Serial daily estimations were made of the urinary catecholamine excretion in 64 patients during the first two weeks after the onset of myocardial infarction and in 27 patients after the onset of chest pain subsequently diagnosed as myocardial ischaemia. In most patients with myocardial infarction, the total excretion rate of catecholamines was elevated, mainly due to elevation of the noradrenaline excretion rate. The level of catecholamine excretion correlated well with the peak levels of S.G.O.T., LD.H. and w.e.e. Higher levels of all these variables were found in patients with cardiac failure, hypotension and ventricular arrhythmias. On the other hand, catecholamine excretion, enzyme levels and wee were only slightly elevated in the patients with sinus or nodal bradycardia, and catecholamine excretion was barely elevated in patients who suffered chest pain without infarction. Thus, catecholamine excretion after myocardial infarction correlates with the degree of cardiac damage, functional impairment and the incidence of some arrhythmias. It is concluded that the increased catecholamine excretion originates from the sympathetic nerve endings as a reflex result of the haemodynamic disturbance, with some possible contribution from the sympathetic endings in the damaged heart muscle.
Treatment of Acute and Chronic Arterial Occlusions with Streptokinase
Authors: Poliwoda H.
Published: September 2017

Fibrinolytic therapy with streptokinase has been in use in Germany for approximately 10 years. This report briefly reviews our experience with streptokinase therapy in arterial occlusion, and compares the results of thrombolytic therapy with surgery.
Resistiveness to Care as Experienced by Family Caregivers Providing Care for Someone With Dementia
Authors: Spigelmyer Pamela C. , Hupcey Judith E. , Smith Carol A. , Loeb Susan J. , Kitko Lisa
Published: September 2017

Purpose

This research explored family caregivers’ lived experiences of resistiveness to care when they provided care for people with dementia. The goal was to identify a general meaning of family caregivers’ lived experiences to target potential areas for future nursing interventions to help family caregivers manage their caregiving role and provide a base for future research surrounding resistiveness to care.

Design

Descriptive phenomenology was used to provide descriptions of eight family caregivers who provided care for someone with dementia and experienced resistiveness to care. Family caregivers were recruited from Alzheimer's support groups from June to November 2014.

Method

Caregiver interviews were transcribed verbatim and analyzed using scientific phenomenology to identify essential constituents of the experience.

Findings

The identified general meaning structure contained five essential constituents. These included self‐questioning of abilities; signal for increased future caregiver responsibilities; changed perception of personal self; unexpected emotional responses; and seeing a changed person, not the disease.

Conclusions

Study findings represent family caregivers’ lived perceptions of resistiveness to care, which are different from current research findings regarding nurses’ perceptions of resistiveness to care. The identified meaning structure indicates focus areas for future research and for nursing interventions to help family caregivers manage their distress when experiencing resistiveness to care.

Clinical Relevance

Identification of the meaning caregivers ascribe to their lived experience of resistiveness to care (five essential constituents) provides nurses with opportunities to help family caregivers (coproviders of care) holistically. Supporting caregivers in their caregiving role can decrease caregiver distress when resistiveness to care occurs.
Gonial Angle Measured by Orthopantomography as a Predictor of Maximum Occlusal Force
Authors: Miwa Shunta , Wada Masahiro , Murakami Shumei , Suganami Tohru , Ikebe Kazunori , Maeda Yoshinobu
Published: September 2017

Purpose

To establish the accuracy of measuring the gonial angle on an orthopantomogram (GAO), as defined by the anatomic relationship between the inferior and posterior borders of the mandible. Furthermore, to examine the relationship between GAO and maximum occlusal force (MOF) in the premolar and molar regions of healthy young adults.

Materials and Methods

Orthopantomograms of dry mandibles were obtained in three orientations in the sagittal plane, to represent variation in image acquisition in clinical settings. The GAO was measured using image‐processing software, and reliability was analyzed using the intraclass correlation coefficient. Then, GAO, MOF, gender, and body mass index (BMI) were measured in a cohort of healthy young adult volunteers. MOF was measured using an Occlusal Force Meter GM 10 device. The relationships between GAO, MOF, sex, and BMI were examined using the Pearson correlation coefficient and multiple regression analysis.

Results

In five dry mandibles, there was a high correlation between the GAOs measured in the different orientations (p < 0.001). In 58 healthy volunteers (31 women and 27 men, mean age 24.6 years), the mean GAO was 123.3° ± 7.5°. The mean MOFs at the first premolar, second premolar, and first molar teeth were 256.4 N ± 128.3 N, 319.0 N ± 171.7 N, and 487.5 N ± 227.2 N, respectively. Men had significantly greater MOF than women at all teeth. The GAO was significantly inversely correlated with MOF at the second premolar (r = −0.376, p = 0.005) and first molar teeth (r = −0.479, p < 0.001). Multiple regression analysis showed that GAO was a significant explanatory factor for MOF at the second premolar and first molar teeth (p = 0.012 and 0.001, respectively).

Conclusions

GAOs were measured accurately on the orthopantomograms taken in this study and were a reliable predictor of MOF between the second premolar and first molar teeth. A smaller GAO was associated with a greater MOF at the second premolar and first molar teeth.
‘Poisonous honey’: Recent writing on decadence and the 1890s
Authors: Freeman Nick
Published: September 2017

This essay is a round‐up of recent developments in research into decadence. Decadent literature and art have always had their adherents, but from the mid‐1980s, the growing influence of feminism and other forms of gendered reading, notably queer theory, began to transform their scholarly understanding. Rather than simply being concerned with artistic autonomy and despising the vulgar herd, decadents such as Oscar Wilde raised questions of subjectivity and identity, which would become increasingly important as the 20th century unfolded. Critics also began to revise the decadent “canon,” recognising the importance of women writers and extended its boundaries beyond 1895 or 1914, the two informally accepted markers of the movement's end. The essay discusses key books and writers on decadence, briefly considers the importance of digital humanities in decadent scholarship and posits some future directions, which critical writing on decadence may pursue.
Basalt–trachybasalt samples in Gale Crater, Mars
Authors: Edwards Peter H. , Bridges John C. , Wiens Roger , Anderson Ryan , Dyar Darby , Fisk Martin , Thompson Lucy , Gasda Patrick , Filiberto Justin , Schwenzer Susanne P. , Blaney Diana , Hutchinson Ian
Published: September 2017

The ChemCam instrument on the Mars Science Laboratory (MSL) rover, Curiosity, observed numerous igneous float rocks and conglomerate clasts, reported previously. A new statistical analysis of single‐laser‐shot spectra of igneous targets observed by ChemCam shows a strong peak at ~55 wt% SiO2 and 6 wt% total alkalis, with a minor secondary maximum at 47–51 wt% SiO2 and lower alkali content. The centers of these distributions, together with the rock textures, indicate that many of the ChemCam igneous targets are trachybasalts, Mg# = 27 but with a secondary concentration of basaltic material, with a focus of compositions around Mg# = 54. We suggest that all of these igneous rocks resulted from low‐pressure, olivine‐dominated fractionation of Adirondack (MER) class‐type basalt compositions. This magmatism has subalkaline, tholeiitic affinities. The similarity of the basalt endmember to much of the Gale sediment compositions in the first 1000 sols of the MSL mission suggests that this type of Fe‐rich, relatively low‐Mg#, olivine tholeiite is the dominant constituent of the Gale catchment that is the source material for the fine‐grained sediments in Gale. The similarity to many Gusev igneous compositions suggests that it is a major constituent of ancient Martian magmas, and distinct from the shergottite parental melts thought to be associated with Tharsis and the Northern Lowlands. The Gale Crater catchment sampled a mixture of this tholeiitic basalt along with alkaline igneous material, together giving some analogies to terrestrial intraplate magmatic provinces.
Caesarean Birth is Associated with Both Maternal and Paternal Origin in Immigrants in Sweden: a Population‐Based Study
Authors: Juárez Sol P. , Small Rhonda , Hjern Anders , Schytt Erica
Published: September 2017

Background

To investigate the association between maternal country of birth and father's origin and unplanned and planned caesarean birth in Sweden.

Methods

Population‐based register study including all singleton births in Sweden between 1999 and 2012 (n = 1 311 885). Multinomial regression was conducted to estimate odds ratios (OR) for unplanned and planned caesarean with 95% confidence intervals for migrant compared with Swedish‐born women. Analyses were stratified by parity.

Results

Women from Ethiopia, India, South Korea, Chile, Thailand, Iran, and Finland had statistically significantly higher odds of experiencing unplanned (primiparous OR 1.10–2.19; multiparous OR 1.13–2.02) and planned caesarean (primiparous OR 1.18–2.25; multiparous OR 1.13–2.46). Only women from Syria, the former Yugoslavia and Germany had consistently lower risk than Swedish‐born mothers (unplanned: primiparous OR 0.76–0.86; multiparous OR 0.74–0.86. Planned; primiparous OR 0.75–0.82; multiparous OR 0.60–0.94). Women from Iraq and Turkey had higher odds of an unplanned caesarean but lower odds of a planned one (among multiparous). In most cases, these results remained after adjustment for available social characteristics, maternal health factors, and pregnancy complications. Both parents being foreign‐born increased the odds of unplanned and planned caesarean in primiparous and multiparous women.

Conclusions

Unplanned and planned caesarean birth varied by women's country of birth, with both higher and lower rates compared with Swedish‐born women, and the father's origin was also of importance. These variations were not explained by a wide range of social, health, or pregnancy factors.