bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrapartum transperineal ultrasound used to predict cases of complicated operative (vacuum and forceps) deliveries in nulliparous women
Authors: Sainz José A. , García‐Mejido José A. , Aquise Adriana , Bonomi María J. , Borrero Carlota , De La Fuente Paloma , Fernández‐Palacín Ana 
Published: September 2017

AbstractIntroductionThe objective of this study was to investigate the predictive value of intrapartum transperineal ultrasound in the identification of complicated operative (vacuum or forceps) deliveries in nulliparous women.Material and methodsProspective observational study of nulliparous women with an indication for operative delivery who underwent intrapartum transperineal ultrasound before fetal extraction. Managing obstetricians were blinded to the ultrasound data. Intrapartum transperineal ultrasound was performed immediately before blade application, both at rest and concurrently with contractions and active pushing. Operative delivery was classified as complicated when one or more of the following situations occurred: three or more tractions; a third‐/fourth‐degree perineal tear; significant bleeding during the episiotomy repair; major tear or significant traumatic neonatal lesion.ResultsA total of 143 nulliparous women were included in the study (82 vacuum‐assisted deliveries and 61 forceps‐assisted deliveries), with 20 fetuses in occiput posterior position. Forty‐seven operative deliveries were classified as complicated deliveries (28 vacuum‐assisted deliveries, 19 forceps‐assisted deliveries). No differences in obstetric, intrapartum or neonatal characteristics were observed between the study groups, with the following exceptions: birthweight (3229 ± 482 uncomplicated deliveries vs. 3623 ± 406 complicated deliveries; p < 0.003) and number of vacuum tractions (1.4 uncomplicated deliveries, 4.5 complicated deliveries; p < 0.0005). The strongest predictors of a complicated delivery, using the area under the receiver‐operating characteristics curve (AUC), were the angle of progression with active pushing (AoP2) (AUC 86.9%) and the progression distance with active pushing (PD2) (AUC 74.5%). The optimal cut‐off value for predicting a difficult operative delivery was an AoP2 of 153.5° (sensitivity 95.2%; false‐positive rate 5.9%) or PD2 of 58.5 mm (sensitivity 95.2%; false‐positive rate 7.1%).ConclusionsThe sonographic parameters AoP2 and PD2 can be used to predict cases of complicated operative deliveries in nulliparous women.
Children with neurodevelopmental disorders and disabilities: a population‐based study of healthcare service utilization using administrative data
Authors: Arim Rubab G , Miller Anton R , Guèvremont Anne , Lach Lucyna M , Brehaut Jamie C , Kohen Dafna E 
Published: September 2017

AimThe aim of this study was to identify children with neurodevelopmental disorders and disabilities (NDD/D) and compare their healthcare service utilization to children without NDD/D using provincial linked administrative data.MethodThe sample included children aged 6 to 10 years (n=183 041), who were registered with the British Columbia Medical Services Plan. Diagnostic information was used for the identification and classification of NDD/D in six functional domains. Healthcare service utilization included outcomes based on physician claims, prescription medication use, and hospitalization.ResultsOverall, 8.3% of children were identified with NDD/D. Children with NDD/D had higher healthcare service utilization rates than those without NDD/D. Effect sizes were: very large for the number of days a prescription medication was dispensed; large for the number of prescriptions; medium for the number of physician visits, different specialists visited, number of different prescription medications, and ever hospitalized; and small for the number of laboratory visits, X‐ray visits, and number of days hospitalized.InterpretationThe findings have policy implications for service and resource planning. Given the high use of psychostimulants, specialized services for both NDD/D and psychiatric conditions may be the most needed services for children with NDD/D. Future studies may examine patterns of physician behaviours and costs attributable to healthcare service utilization for children with NDD/D.What this paper adds

Children with neurodevelopmental disorders and disabilities (NDD/D) have higher healthcare service utilization than those without.

Based on provincial population‐based linked administrative health data, a sizeable number of children are living with NDD/D.

Given the high use of psychostimulants, specialized services for children with both NDD/D and psychiatric conditions may be the most needed services for children with NDD/D.
Efficacy and safety of alirocumab in insulin‐treated individuals with type 1 or type 2 diabetes and high cardiovascular risk: The ODYSSEY DM‐INSULIN randomized trial
Authors: Leiter Lawrence A. , Cariou Bertrand , Müller‐Wieland Dirk , Colhoun Helen M. , Del Prato Stefano , Tinahones Francisco J. , Ray Kausik K. , Bujas‐Bobanovic Maja , Domenger Catherine , Mandel Jonas , Samuel Rita , Henry Robert R. 
Published: September 2017

Video abstract: View a video abstract for this article.AimsTo investigate the efficacy and safety of alirocumab in participants with type 2 (T2D) or type 1 diabetes (T1D) treated with insulin who have elevated LDL cholesterol levels despite maximally tolerated statin therapy.MethodsParticipants at high cardiovascular risk with T2D (n = 441) or T1D (n = 76) and LDL cholesterol levels ≥1.8 mmol/L (≥70 mg/dL) were randomized 2:1 to alirocumab:placebo administered subcutaneously every 2 weeks, for 24 weeks' double‐blind treatment. Alirocumab‐treated participants received 75 mg every 2 weeks, with blinded dose increase to 150 mg every 2 weeks at week 12 if week 8 LDL cholesterol levels were ≥1.8 mmol/L. Primary endpoints were percentage change in calculated LDL cholesterol from baseline to week 24, and safety assessments.ResultsAlirocumab reduced LDL cholesterol from baseline to week 24 by a mean ± standard error of 49.0% ± 2.7% and 47.8% ± 6.5% vs placebo (both P < .0001) in participants with T2D and T1D, respectively. Significant reductions were observed in non‐HDL cholesterol (P < .0001), apolipoprotein B (P < .0001) and lipoprotein (a) (P ≤ .0039). At week 24, 76.4% and 70.2% of the alirocumab group achieved LDL cholesterol <1.8 mmol/L in the T2D and T1D populations (P < .0001), respectively. Glycated haemoglobin and fasting plasma glucose levels remained stable for the study duration. Treatment‐emergent adverse events were observed in 64.5% of alirocumab‐ vs 64.1% of placebo‐treated individuals (overall population).ConclusionsAlirocumab produced significant LDL cholesterol reductions in participants with insulin‐treated diabetes regardless of diabetes type, and was generally well tolerated. Concomitant administration of alirocumab and insulin did not raise any safety concerns (NCT02585778).
Radiotherapy for the treatment of periocular tumours in the horse
Authors: Hollis A. R. 
Published: September 2017

SummaryPeriocular tumours are a relatively common problem in the horse, and present some unique challenges. Radiotherapy has long been considered the ‘gold standard’ for the treatment of periocular tumours in the horse, and there are various techniques of delivering this treatment. Although teletherapy and plesiotherapy are occasionally used, the most commonly used technique is interstitial brachytherapy. Low‐dose rate interstitial brachytherapy has reported success rates of between 74 and 100% for the treatment of periocular sarcoids, and other tumours can also be successfully treated using this technique. There are significant disadvantages to the low‐dose rate brachytherapy approach, and recently, a technique using high‐dose rate brachytherapy has been described with a reported success rate of 100% for periocular sarcoid treatment. Electronic brachytherapy is a technique which may provide an alternative to high‐dose rate brachytherapy, but its use for the treatment of periocular tumours has not been reported, and the requirement for general anaesthesia is a significant disadvantage.
Effect of 475°C embrittlement on the low cycle fatigue behaviour of lean duplex stainless steels
Authors: Strubbia Renata , Sennour Mohamed , Hereñú Silvina 
Published: September 2017

AbstractLean duplex stainless steels (LDSSs) with lower nickel and molybdenum are less susceptible to suffer spinodal decomposition than standard duplex stainless steels. It is the purpose of this work to study the effect of thermal embrittlement on the low cycle fatigue behaviour of 2 LDSSs with different Creq and Nieq. The correlation between the fatigue behaviour and the dislocation structure is attempted. Transmission electron microscopy was used to observe the dislocation microstructure. Additionally, STEM‐EDS technique in conjunction with Vickers microhardness measurements was used to characterize the amplitude of the spinodal decomposition. The results show that the LDSS with lower Creq and Nieq values exhibits improved fatigue properties in the as received and aged conditions. Furthermore, it is important to emphasize that with an adequate volume fraction of phases in LDSSs, the ageing treatment leads to an increase in strength without causing a great detriment in low cycle fatigue life.
Fatigue and damage accumulation in open cell aluminium foams
Authors: Pinto H. , Amini A. , Peña Á. , Moraga P. , Valenzuela M. 
Published: September 2017

AbstractOpen‐cell aluminium foams are a relatively new material with interesting uses in different engineering applications. This study investigates the fatigue behaviour and damage accumulation of metal foams via a fatigue analysis (Weibull E‐N model), a failure criterion (the relation among the prepeak compressive and tensile slopes, the reduction in the tensile stress, or the reduction in the compressive stress), and a mathematical approach (linear, quadratic, or exponential). As a result of combining the 3 mathematical approaches and 3 failure criteria, different approaches are obtained, analysed, and validated by using experimental data. Finally, the proposed approaches can be used to directly obtain the damage accumulation level for open‐cell metal foams under fully reversed cyclic loading as a function of the number of cycles applied, the total strain amplitude, and the initial damage accumulation condition.
Impacts of Streambed Heterogeneity and Anisotropy on Residence Time of Hyporheic Zone
Authors: Liu Suning , Chui Ting Fong May 
Published: September 2017

AbstractThe hyporheic zone (HZ), which is the region beneath or alongside a streambed, plays an important role in the stream's ecology. The duration that a water molecule or a solute remains within the HZ, or residence time (RT), is one of the most common metrics used to evaluate the function of the HZ. The RT is greatly influenced by the streambed's hydraulic conductivity (K), which is intrinsically difficult to characterize due to its heterogeneity and anisotropy. Many laboratory and numerical studies of the HZ have simplified the streambed K to a constant, thus producing RT values that may differ from those gathered from the field. Some studies have considered the heterogeneity of the HZ, but very few have accounted for anisotropy or the natural K distributions typically found in real streambeds. This study developed numerical models in MODFLOW to examine the influence of heterogeneity and anisotropy, and that of the natural K distribution in a streambed, on the RT of the HZ. Heterogeneity and anisotropy were both found to shorten the mean and median RTs while increasing the range of the RTs. Moreover, heterogeneous K fields arranged in a more orderly pattern had longer RTs than those with random K distributions. These results could facilitate the design of streambed K values and distributions to achieve the desired RT during river restoration. They could also assist the translation of results from the more commonly considered homogeneous and/or isotropic conditions into heterogeneous and anisotropic field situations.
Simulated gastrointestinal digestion and in vitro colonic fermentation of date (Phoenix dactylifera L.) seed polyphenols
Authors: Sirisena Sameera , Ajlouni Said , Ng Ken 
Published: September 2017

SummaryDate seeds are a by‐product of date fruit industry and a rich source of polyphenols. In this study, in vitro bioaccessibility and colonic fermentation of major polyphenols from date seed powder (DSP) and DSP‐fortified yoghurt (DSPY) were investigated using HPLC. Catechin, epicatechin and procyanidin A2, B1 and B2 were stable during simulated gastric and sequential intestinal digestion. Bioaccessibility was significantly (P < 0.05) higher for all compounds from DSPY compared with DSP. After in vitro colonic fermentation of insoluble digestion materials, most of the target compounds were metabolised by faecal bacteria to ferulic acid, 3‐hydroxyphenylacetic acid, 3‐phenylpropionic acid and 3‐(4‐hydroxyphenyl) propionic acid. DSPY contained significantly (P < 0.05) higher level of free polyphenols as indicated by higher bioaccessibility; however, the stability of the polyphenols and their fermentation products from DSPY were similar to that of DSP alone. These data would be useful in product developments incorporating DSP as a source of polyphenols in food products.
ENDOCARDIAL FIBROELASTOSIS
Authors: BEVERIDGE JOHN 
Published: September 2017

SUMMARYAttention is directed to endocardial fibroelastosis as a not uncommon cause of fatal heart disease in infancy, and one which is exciting an increasing amount of interest. Details are submitted of six patients who died from acute and chronic forms of the disease. In the acute form the symptomatology is alarming. Upon the vague and non‐specific background of irritability, refusal of food and restlessness, there develops a shock‐like condition in conjunction with neck and limb stiffness, cyanosis and respiratory distress. Death is usual in this form. In the chronic form the clinical picture is one of congestive cardiac failure with secondary pulmonary infection. In this form cardiac murmurs are present and the electrocardiogram is grossly abnormal. The possibility of diagnosis in life and the difficulty of differentiating fibroelastosis from other forms of heart disease causing cardiac failure in infancy are discussed. The suggestion is made that, with improved diagnosis, a greater number of infants will be found to suffer from this condition and yet not die. The outlines of medical treatment and of the current palliative surgical approach are presented.
AN EPIDEMIC OF PRIMARY ATYPICAL PNEUMONIA IN NORTH QUEENSLAND
Authors: DOHERTY R. L. 
Published: September 2017

SUMMARYAn epidemic of primary atypical pneumonia occurred in the Innisfail‐Tully district in the period November, 1954, to March, 1955.Febrile constitutional symptoms overshadowed the symptoms of pulmonary involvement. However, of 23 patients, all of whom showed radiological evidence of pneumonia, 20 had a cough. Three showed no abnormal physical signs in their chests. The average duration of fever was nine days.Five patients with similar clinical features showed no X‐ray changes. They are considered to form part of the epidemic.The patients showed no response to penicillin ; the clinical impression was formed that the broad‐spectrum antibiotics, especially tetracycline, were of value.Serological tests gave no evidence that Coxiella burneti or viruses of the psittacosis group were responsible for the outbreak. Only three patients of the 28 tested developed cold agglutinins ; two developed agglutinins against Streptococcus MG. Influenza virus could not be isolated from throat washings of seven patients.More than half of the patients studied were children. The epidemic appeared to reach its peak at the end of December, and the incidence diminished rapidly in January.Epidemics of primary atypical pneumonia have been described from army camps and from institutions ; outbreaks in scattered civilian communities, such as the one described, are uncommon.
OBSERVATIONS ON THE NATURE OF HORMONE‐INDUCED EOSINOPENIA
Authors: HUDSON BRYAN , DOIG ALISON 
Published: September 2017

SUMMARYThe possible causes for the disappearance of eosinophils from the peripheral blood following the administration of certain adrenal steroid hormones are reviewed.A series of experiments was performed in which the number of circulating eosinophils was determined at regular intervals following the intravenous administration of either ACTH or hydrocortisone.The results of these experiments show that under these circumstances the rate of disappearance of eosinophils is approximately constant. In no instance was the rate of disappearance described by an exponential function.It is claimed that this constant rate of disappearance implies an inhibition of the production or delivery of eosinophils by the bone marrow to the peripheral blood ; and that those cells in the circulation fulfil their normal physiological life span.The points in time at which the eosinopenic reaction is maximal have been determined. It is claimed that these represent estimates of the life span of eosinophil leucocytes. The range of such estimates is from 165 to 377 minutes.Other methods used to estimate the survival of leucocytes, in general, and eosinophils, in particular, are discussed in the light of these present observations.
GLYCOGEN STORAGE DISEASE WITH UNUSUAL RENAL LESIONS
Authors: POSEN S. 
Published: September 2017

SUMMARYA case is reported of Von Gierke's disease diagnosed at autopsy in a thirty‐one‐year‐old man.Glycogen isolated from the patient's liver constituted 4·7% of the weight of the organ, and was normal in all respects including ultracentrifugation.Glucose‐6‐phosphatase activity was much diminished in the patient's liver, as compared with a normal control. Lactic dehydrogenase activity was equal in both samples.Renal lesions included an aneurysm of the renal artery, distension of the convoluted tubules with glycogen and nodular glomerular lesions resembling those seen in diabetes mellitus.
PRIMARY ALDOSTERONISM
Authors: HUDSON BRYAN , BARNETT A. , BORNSTEIN J. 
Published: September 2017

SUMMARYA female patient, aged thirty‐one years, suffering from primary aldosteronism due to adrenal adenoma (Conn's syndrome) is described. She presented with hypertension of the order of 240/120 millimetres of mercury associated with weakness, polyuria up to five litres a day, and an electrocardiogram showin; ST depression and prominent U waves in various leads. The serum potassium content was lowered, and there was marked alkalosis with a failure to concentrate urine. The urine contained aldosterone in concentration of 10 to 11 microgrammes per litre, and the plasma aldosterone level was approximately • 8 microgrammes per 100 millilitres.A left suprarenal tumour, demonstrated by presacral air insufflation, was removed at operation. The hypertension and metabolic abnormalities reverted to normal.The alkalosis appeared to be secondary to the hypokælemia and was partly corrected by administration of potassium citrate. Observations suggested that the defect in urine concentration was due to antagonism to antidiuretic hormone.Methods used for estimating mineralo‐corticoid activity of plasma and urine are outlined.
THE EFFECT OF TIGLOIDINE ON EXTRAPYRAMIDAL SYNDROMES (HUNTINGTON'S CHOREA)
Authors: TRAUTNER E. M. , GERSHON S. 
Published: September 2017

SummaryThe tiglic esters of tropine and pseudo‐tropine (tigloidine) were tried in 12 cases of Huntington's chorea. Temporary, occasionally dramatic improvement was obtained in some cases and confirmed by withdrawal of the drug, the use of placebos and renewal of the original medication.The effective dose of the drug varied from case to case and ranged from moo to 400 milligrammes per day. The minimal effective dose was found to be very near to the optimal dose; no further improvement could be obtained by further increasing the dosage.No unpleasant side effects were observed in the subjects treated. No habituation was observed.In no case could all the symptoms of the illness be affected. In some cases mainly the motor disturbances were improved; in others there was mainly an improvement in mood, the patients becoming sometimes distinctly euphoric. The two effects did not seem to be connected, nor was the action of the drug predictable.The results are discussed. The investigation is being extended with the purpose of studying the dual action of the drug. Promising results have so far been observed in cases of pure depression as well as in pure motor‐disturbances (post‐traumatic spinal spastic paraplegias). These results are being prepared for publication.
ABDOMINAL PSEUDO‐DISTENSION WITH PAIN, DYSPNŒA AND DYSPHAGIA IN RELATION TO DISTURBED DIAPHRAGMATIC MOVEMENT
Authors: TYRER J. H. , MURPHY K. J. , EMMERSON B. T. 
Published: September 2017

SummaryThe mechanism of abdominal pseudo‐distension was studied in two hysterical patients and in four apparently normal adult males who could simulate the hysterical condition at will.It was concluded that the principal factor causing abdominal pseudo‐distension was substantial descent of the diaphragm caused by its own active, sustained contraction; this produced marked increase of abdominal girth and of intra‐abdominal pressure, whether exaggerated lumbar lordosis was present or absent. Exaggeration of lumbar lordosis as an isolated factor, far from producing abdominal pseudo‐distension, caused no increase of abdominal girth and no significant increase of intra‐abdominal pressure. Exaggeration of lumbar lordosis, however, increased slightly the convexity of the anterior abdominal profile. In the four apparently normal males, the increase of abdominal girth attainable by voluntarily forcing down the diaphragm was actually reduced by exaggeration of lumbar lordosis, probably because such lordosis also tended to make the anterior abdominal wall taut.Reasons are given for preferring the term “abdominal pseudo‐distension” to other terms.When the diaphragm shows such sustained contraction in hysteria, pain, dyspnoea and a type of dysphagia may occur; these are discussed.
BODY FAT, BLOOD PRESSURE AND SERUM CHOLESTEROL OF AUSTRALIAN MEN
Authors: WHYTE H. M. , GRAHAM I. A. D. , de WOLFE M. S. 
Published: September 2017

SummaryIn a survey of 129 men chosen at random from an industrial organization measurements were made of height, weight, skinfold thickness, circumference of the arm, blood pressure and serum cholesterol concentration. The interrelations between these factors are analysed.Blood pressure increased principally with age but also with body weight (presumably with obesity, though this was not proven). The serum cholesterol concentration, averaging 244 milligrammes per 100 millilitres, was apparently not related to age, obesity, blood pressure or dietary fat.Difficulties in assessing obesity and the possible implications of the results of the survey in regard to essential hypertension and vascular degeneration in obesity are discussed.
CATION STUDIES DURING INTRAVENOUS ANÆSTHESIA
Authors: HERCUS VICTOR , BOWMAN SHEILAH 
Published: September 2017

SummaryThe effect of pentobarbitone given intravenously on the hæmatocrit, on the serum sodium and potassium contents, and on the intracellular water, sodium and potassium concentrations of skeletal muscle has been investigated in sheep. S35O4 has been used to determine the extracellular space of muscle and the extracellular fluid volume of distribution.A significant fall in serum potassium level (from 5.5 to 4.6 milliequivalents per litre) and in hæmatocrit (from 37.4% to 30.2%) occurred under this anæsthetic agent.There was no change in intracellular water, sodium or potassium concentrations in the extracellular space of skeletal muscle, or in the volume or rate of distribution of S35O4 during anæsthesia.These results were not altered by splenectomy. The administration of adrenaline produced no changes in the hæmatocrit or in the serum potassium level.