bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment and correction of skinfold thickness equations in estimating body fat in children with cerebral palsy
Authors: GURKA MATTHEW J , KUPERMINC MICHELLE N , BUSBY MARJORIE G , BENNIS JACEY A , GROSSBERG RICHARD I , HOULIHAN CHRISTINE M , STEVENSON RICHARD D , HENDERSON RICHARD C 
Published: October 2009

Aim To assess the accuracy of skinfold equations in estimating percentage body fat in children with cerebral palsy (CP), compared with assessment of body fat from dual energy X‐ray absorptiometry (DXA).Method Data were collected from 71 participants (30 females, 41 males) with CP (Gross Motor Function Classification System [GMFCS] levels I–V) between the ages of 8 and 18 years. Estimated percentage body fat was computed using established (Slaughter) equations based on the triceps and subscapular skinfolds. A linear model was fitted to assess the use of a simple correction to these equations for children with CP.Results Slaughter’s equations consistently underestimated percentage body fat (mean difference compared with DXA percentage body fat −9.6/100 [SD 6.2]; 95% confidence interval [CI] −11.0 to −8.1). New equations were developed in which a correction factor was added to the existing equations based on sex, race, GMFCS level, size, and pubertal status. These corrected equations for children with CP agree better with DXA (mean difference 0.2/100 [SD=4.8]; 95% CI −1.0 to 1.3) than existing equations.Interpretation A simple correction factor to commonly used equations substantially improves the ability to estimate percentage body fat from two skinfold measures in children with CP.
Development and validation of item sets to improve efficiency of administration of the 66‐item Gross Motor Function Measure in children with cerebral palsy
Authors: RUSSELL DIANNE J , AVERY LISA M , WALTER STEPHEN D , HANNA STEVEN E , BARTLETT DOREEN J , ROSENBAUM PETER L , PALISANO ROBERT J , GORTER JAN WILLEM 
Published: October 2009

Aim To develop an algorithmic approach to identify item sets of the 66‐item version of the Gross Motor Function Measure (GMFM‐66) to be administered to individual children, and to examine the validity of the algorithm for obtaining a GMFM‐66 score.Method An algorithmic approach was used to identify item sets of the GMFM‐66 (GMFM‐66‐IS) using data from 95 males and 79 females with cerebral palsy (CP; mean age 14y 7mo, SD 1y 8mo, range 12y 7mo to 17y 8mo). The GMFM‐66‐IS scores were then validated using combined data from three Dutch studies involving 134 males and 92 females with CP (mean age 7y, SD 4y 6mo, range 1y 4mo to 13y 8mo), representing all levels of the Gross Motor Function Classification System.Results The final algorithm contains three decision items from the GMFM‐66 that determine which one of four item sets to administer. The GMFM‐66‐IS has excellent agreement with the full GMFM‐66 both at a single assessment (intraclass correlation coefficient [ICC]=0.994, 95% confidence intervals [CI] 0.993–0.996) and across repeat assessments (ICC=0.92, 95% CI 0.89–0.95).Interpretation The GMFM‐66‐IS is a promising alternative to the full GMFM‐66. Users should be consistent in their choice of measure (GMFM‐66 or GMFM‐66‐IS) on repeat testing and clearly identify which method was used.
A randomised controlled trial of microwave endometrial ablation without endometrial preparation in the outpatient setting: patient acceptability, treatment outcome and costs
Authors: Jack Stuart A. , Cooper Kevin G. , Seymour Janelle , Graham Wendy , Fitzmaurice Ann , Perez Juan 
Published: October 2009

Objective  To compare outpatient microwave endometrial ablation (MEA) in the postmenstrual phase to standard MEA treatment after drug preparation in a day case theatre environment.Design  A randomised controlled trial.Setting  A large United Kingdom teaching hospital.Population  Two hundred and ten women complaining of excessive menstrual loss.Methods  Two hundred and ten women with excessive menstrual loss were randomised. Ninety‐seven women were treated as outpatients in the immediate post‐menstrual phase and 100 were treated in an operating theatre after hormonal preparation. All procedures were commenced under local anaesthesia with or without conscious sedation. Analysis was by modified intention to treat.Main outcome measures  Primary outcome measures were satisfaction with treatment (measured at one year) and acceptability of treatment (measured at two weeks). Secondary outcome measures were menstrual outcome and financial cost.Results  Significantly more women found treatment post‐menses acceptable; 86 (89.5%) versus 76 (76.0%) [difference in proportions 13.6%, 95% CI (3.0%, 23.9%)]. Similar numbers in each arm were totally or generally satisfied with the treatment, 86 (92.5%) versus 84 (88.4%) [difference in proportions 4.1%, 95% CI (−4.7%, 12.9%)] while amenorrhoea rates at one year were comparable, 52 (55.9%) versus 60 (61.9%). [difference in proportions −5.9%, 95% CI (−19.8%, 7.6%)]. The mean health service costs were £124 (95% CI £86–194) lower for the patients in the post‐menses group.Conclusion  MEA performed under local anaesthesia (with or without conscious sedation) in the post‐menstrual phase achieves high levels of satisfaction is very acceptable to patients and results in significantly reduced health service costs. Importantly menstrual outcomes are not affected by omission of drug preparation. There is now good evidence to support the use of MEA, without drug endometrial preparation, in the outpatient setting.
Thermal ablation performed in a primary care setting: the South Warwickshire Experience
Authors: Oláh Karl S. , Alliston Joanne , Jones Julia , Stewart Gavin , Mavrommatis Ruth 
Published: October 2009

Objective  To assess the feasibility of performing outpatient thermal ablation in a primary care setting.Design  Prospective study.Setting  A small peripheral hospital in the UK used by local general practitioners and visiting hospital practitioners for its outpatient facilities.Population  The area of South Warwickshire serves a population of 270,000.Methods  Two general practitioners were trained to perform outpatient thermal ablation using the Thermachoice thermal ablation system (Thermachoice II). The unit functioned autonomously with support from a local gynaecologist and radiologist, accepting referrals from hospital consultants and general practitioners.Main outcome measures  Severity of menstrual loss, premenstrual symptoms, dysmenorrhoea and quality of life assessed by visual analogue scales before treatment and at one month, two months, one year and two years.Results  Eighty‐seven women were treated. No major complications were encountered from the procedure. Reduction of menstrual loss or cure was reported by over 94% of women. Premenstrual syndrome (PMS) and symptoms of dysmenorrhoea were also improved by treatment. The majority of women were satisfied with the operation at one month (96%), two months (93%), one year (92%) and two years (94%).Conclusions  Thermal ablation is a simple procedure well suited to an outpatient setting. There are few complications as a result of the use of the thermal ablation catheters, and this study has shown that the procedure can be undertaken in a primary care setting with excellent results.
A randomised controlled trial of mifepristone in combination with misoprostol administered sublingually or vaginally for medical abortion up to 13 weeks of gestation
Authors: Hamoda Haitham , Ashok Premila W. , Flett Gillian M.M. , Templeton Allan 
Published: October 2009

Objective  To assess women's acceptability, the efficacy and side effects of sublingual versus vaginal administration of misoprostol in combination with mifepristone for medical abortion up to 13 weeks of gestation.Design  Randomised controlled trial.Setting  Aberdeen Royal Infirmary.Population  Women undergoing medical abortion under the terms of the 1967 Abortion Act.Methods  Mifepristone (200 mg) was given orally followed 36–48 hours later by misoprostol administration (sublingual: 600 μg; vaginal: 800 μg). A second dose of misoprostol 400 μg was given 3 hours later (sublingually or vaginally). Women between 9 and 13 weeks of gestation received a further (third) dose of misoprostol 400 μg (sublingually or vaginally), 3 hours later if abortion had not occurred.Main outcome measures  Women's acceptability, efficacy of the regimen and side effects experienced.Results  A total of 340 women were recruited (171 sublingual and 169 vaginal). A total of 70% of women in the sublingual group expressed satisfaction with the route of misoprostol administration; 18% answered ‘Don't know’ while 12% were dissatisfied, compared with 68%, 28% and 4%, respectively, in the vaginal group (P= 0.02). There was no significant difference in the need for surgical evacuation for women in the sublingual (3/158, 1.9%) and vaginal groups (4/156, 2.6%) (P= 0.70). Women receiving misoprostol sublingually were more likely to experience diarrhoea (P < 0.01), shivering (P < 0.01) and unpleasant mouth taste (P < 0.01).Conclusions  Sublingual administration of misoprostol is an effective alternative to vaginal administration for medical abortion up to 13 weeks of gestation. The prevalence of prostaglandin‐related side effects, however, was higher with this route of administration.
Long term review of laparoscopic sacrocolpopexy
Authors: Higgs P.J. , Chua H.‐L. , Smith A.R.B. 
Published: October 2009

Objective  Assessment of long term outcome following laparoscopic sacrocolpopexy.Design  Retrospective follow up study using standardised examination with pelvic organ prolapse quantification system (POP‐Q) and questionnaires.Setting  A tertiary urogynaecology unit in the North West of England.Population  One hundred and forty consecutive cases who had a laparoscopic sacrocolpopexy at St Mary's Hospital, Manchester, between 1993 and 1999.Methods  Women completed questionnaires and were examined in gynaecology clinic or sent postal questionnaires if unable to attend the clinic.Main outcome measures  Adequacy of vault support and recurrent vaginal prolapse assessed by POP‐Q score. Assessment of prolapse, urinary and bowel symptoms and sexual function using questionnaires.Results  One hundred and three women were contacted after a median of 66 months. Sixty‐six women were examined and a further 37 women filled in questionnaires only. Recurrent vault prolapse occurred in 4 of the 66 women who were examined. Prolapse had recurred or persisted in 21 of 66 women, with equal numbers of anterior and posterior vaginal wall prolapse. Overall, 81/102 (79%) said that their symptoms of prolapse were ‘cured’ or ‘improved’; 39/103 (38%) still had symptoms of prolapse. For every two women who were cured of their urinary or bowel symptoms, one woman developed worse symptoms.Conclusions  Among the 66 women available for examination laparoscopic sacrocolpopexy provided good long term support of the vault in 92%. Forty‐two percent of these women had recurrent vaginal wall prolapse. Despite this, 79% of women felt that their symptoms of prolapse were cured or improved following surgery.
Factors influencing repeat caesarean section: qualitative exploratory study of obstetricians' and midwives' accounts
Authors: Kamal Pallavi , Dixon‐Woods Mary , Kurinczuk Jennifer J. , Oppenheimer Christina , Squire Patricia , Waugh Jason 
Published: October 2009

Objective  To explore the views of health professionals on the factors influencing repeat caesarean section.Design  Qualitative study involving semi‐structured interviews with professionals who care for women in pregnancy and labour.Setting  Acute hospital trust with two maternity units and community midwifery service, Leicestershire, UK.Sample  Twenty‐five midwives and doctors.Methods  Interviews with professionals were undertaken using a prompt guide. All interviews were audiotaped and transcribed verbatim. Analysis was based on the constant comparative method, assisted by QSR N5 software.Main outcome measures  Identification of factors influencing professional decision making about repeat caesarean section.Results  Decision making in relation to repeat caesarean is a complex process involving several parties. Professionals identify the relevance of evidence for decision making for repeat caesarean. However, professionals feel that following strict protocols is of limited value because of the perceived substandard quality of evidence in this area, other external pressures and the contingent, unique and often unanticipated features of each case. Professionals also perceive that the organisation of care plays an important role in rates of repeat caesarean.Conclusions  Decision making for repeat caesarean is a social practice where standardised protocols may have limited value. Attention needs to be given to the multiple parties involved in the decision‐making process. Reflective practice, opinion leadership and role modelling may offer ways forward but will require evaluation.
Risk scoring system for prediction of obstetric anal sphincter injury
Authors: Williams Abimbola , Tincello Douglas G. , White Sarah , Adams Elisabeth J. , Alfirevic Zarko , Richmond David H. 
Published: October 2009

Objective  The objective was to begin the process of developing an antenatal risk scoring system, as a first step towards examining whether elective Caesarean section for women at high risk of injury could be an effective and acceptable intervention.Design  Retrospective study.Setting  Tertiary maternity unit in the UK.Population  One hundred and twenty‐three women who sustained an obstetric anal sphincter injury (OASI) and 123 controls without OASI.Methods  Case notes of women with a third or fourth degree tear between 1997 and 1999 were examined for risk factors. Controls matched for age and week of delivery were identified from the maternity record database and case records reviewed for the presence of risk factors. Unweighted and weighted risk scores were produced using odds ratios, and compared between cases and controls. Receiver operating characteristics (ROC) curve analysis of the risk scores was performed to discriminate between cases and controls and to calculate the sensitivity and specificity of each scoring system.Main outcome measures  Odds ratio (OR) and 95% confidence interval (CI) for each risk factor. Sensitivity and specificity from ROC curves for weighted and unweighted risk score.Results  Among the cases there were more nulliparous women (OR 1.77; CI 1.05–2.99) and a trend towards more women with an episiotomy (OR 1.57; CI 0.99–2.47). Among women with sphincter injury, trends towards more epidurals (OR 1.64; CI 0.97–2.75), and more babies weighing more than 4000 g among (OR 1.45; CI 0.85–2.49) were noted. The median unweighted risk score was 2 for cases and 2 for controls (P= 0.05), while the weighted risk score was 2.1 and 1.37 (P= 0.03), respectively. The ROC curves approximated to a straight line demonstrating very poor discrimination between cases and controls.Conclusion  The predictive test performed poorly, suggesting that the risk factors identified do not exert a large enough effect in a cohort of this size.
Faecal incontinence and mode of first and subsequent delivery: a six‐year longitudinal study
Authors: MacArthur Christine , Glazener Charis , Lancashire Robert , Herbison Peter , Wilson Don , Grant Adrian 
Published: October 2009

Objective  To investigate the prevalence of persistent and long term postpartum faecal incontinence and associations with mode of first and subsequent deliveries.Design  Longitudinal study.Setting  Maternity units in Aberdeen, Birmingham and Dunedin.Population  Four thousand two hundred and fourteen women who returned postal questionnaires three months and six years postpartum.Methods  Symptom data were obtained from both questionnaires and obstetric data from case‐notes for the index birth and the second questionnaire for subsequent births. Logistic regression investigated the independent effects of mode of first delivery and delivery history.Main outcome measures  Incontinence to bowel motions three months and six years after index birth. For delivery history, the outcome was incontinence only at six years.Results  The prevalence of persistent faecal incontinence was 3.6%. Almost 90% of these women reported no symptoms before their first birth. The forceps delivery of a first baby was independently predictive of persistent symptoms (OR 2.06, 95% CI 1.40–3.04). A caesarean section first birth was not significantly associated with persistent symptoms (OR 1.07, 95% CI 0.64–1.81). Delivering exclusively by caesarean section also showed no association with subsequent symptoms (OR 1.04, 95% CI 0.72–1.50) but ever having forceps was significantly predictive (OR 1.48, 95% CI 1.18–1.87). Other factors independently associated with persistent faecal incontinence were older maternal age, increasing number of births and Asian ethnic group. Birthweight and long second stage were not significantly associated.Conclusions  The risk of persistent faecal incontinence is significantly higher after a first delivery by forceps. We found no evidence of a lower risk of subsequent faecal incontinence for exclusive caesarean section deliveries.
Functional effects of somatostatin receptor 1 activation on synaptic transmission in the mouse hippocampus
Authors: Cammalleri Maurizio , Martini Davide , Timperio Anna Maria , Bagnoli Paola 
Published: October 2009

AbstractSomatostatin‐14 (SRIF) co‐localizes with GABA in the hippocampus and regulates neuronal excitability. A role of SRIF in the control of hippocampal activity has been proposed, although the exact contribution of each SRIF receptor (sst1–sst5) in mediating SRIF action requires some clarification. We used hippocampal slices of wild‐type and sst1 knockout (KO) mice and selective pharmacological tools to provide conclusive evidence for a role of sst1 in mediating SRIF inhibition of synaptic transmission. With single‐ and double‐label immunohistochemistry, we determined the distribution of sst1 in hippocampal slices and we quantified sst1 colocalization with SRIF. With electrophysiology, we found that sst1 activation with CH‐275 inhibited both the NMDA‐ and the α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid (AMPA)‐mediated responses. Results from sst1 KO slices confirmed the specificity of CH‐275 effects; sst1 activation did not affect the inhibitory transmission which was in contrast increased by sst4 activation with L‐803,087 in both wild‐type and sst1 KO slices. The AMPA‐mediated responses were increased by L‐803,087. Functional interaction between sst1 and sst4 is suggested by the finding that their combined activation prevented the CH‐275‐induced inhibition of AMPA transmission. The involvement of pre‐synaptic mechanisms in mediating inhibitory effects of sst1 on excitatory transmission was demonstrated by the finding that CH‐275 (i) increased the paired‐pulse facilitation ratio, (ii) did not influence the AMPA depolarization in the presence of tetrodotoxin, and (iii) inhibited glutamate release induced by epileptiform treatment. We conclude that SRIF control of excitatory transmission through an action at sst1 may represent an important contribution to the regulation of hippocampal activity.
Comparison of nuclear and capacitance‐based soil water measuring techniques in salt‐affected soils
Authors: Al‐Ain F. , Attar J. , Hussein F. , Heng L. K. 
Published: October 2009

AbstractA field calibration experiment was carried out on salt‐affected clayey soil in Syria, to compare the sensitivity to soil electrical conductivity (ECe), and bulk density (ρb) of two instruments for estimating soil moisture: the neutron probe (NP) and the Diviner 2000 capacitance probe (CP). The results showed that the values of the correlation coefficient of the calibration were decreased when the ECe and ρb values increased; this decrease was more pronounced for the Diviner 2000, indicating that it was more sensitive to ρb and ECe than the NP. When only scaled frequency was used in the fitted equation, the Diviner 2000 in wet soil underestimated soil water content significantly at all depths, but especially in the top layer, by up to 0.09 cm3/cm3 compared with gravimetric determinations. However, in dry soil, the Diviner 2000 overestimated the volumetric water content by up to 0.05 cm3/cm3 in the top 15 cm, and by 0.03 cm3/cm3 at 30‐45 cm depth. The performance of the neutron probe was better overall; using a factory calibration curve no significant differences were observed between NP estimates and the gravimetric values. Including both ρb and ECe in the calibration equations improved the fits, although the regression coefficient (R2) for the Diviner 2000 remained low.
Co‐ordinated autophagy with resveratrol and γ‐tocotrienol confers synergetic cardioprotection
Authors: Lekli Istvan , Ray Diptarka , Mukherjee Subhendu , Gurusamy Narasimman , Ahsan Md. Kaimul , Juhasz Bela , Bak Istvan , Tosaki Arpad , Gherghiceanu Mihaela , Popescu Lawrence M. , Das Dipak K. 
Published: October 2009

AbstractThis study compared two dietary phytochemicals, grape‐derived resveratrol and palm oil‐derived γ‐tocotrienol, either alone or in combination, on the contribution of autophagy in cardioprotection during ischaemia and reperfusion. Sprague‐Dawley rats weighing between 250 and 300 g were randomly assigned to one of the following groups: vehicle, ischaemia/reperfusion (I/R), resveratrol + I/R, γ‐tocotrienol + I/R, resveratrol +γ‐tocotrienol + I/R. For resveratrol treatments, the rats were gavaged with resveratrol (2.5 mg/kg) for 15 days while for γ‐tocotrienol experiments the rats were gavaged with γ‐tocotrienol (0.3 mg/kg) for 30 days. For the combined resveratrol +γ‐tocotrienol experiments, the rats were gavaged with γ‐tocotrienol for 15 days, and then gavaging continued with resveratrol along with γ‐tocotrienol for a further period of 15 days. After 30 days, isolated perfused hearts were subjected to 30 min. of global ischaemia followed by 2 hrs of reperfusion. Our results showed for the first time that at least in part, the cardioprotection (evidenced from the ventricular performance, myocardial infarct size and cardiomyocyte apoptosis) with resveratrol and γ‐toctrienol was achieved by their abilities to induce autophagy. Most importantly, resveratrol and γ‐tocotrienol acted synergistically providing greater degree of cardioprotection simultaneously generating greater amount of survival signal through the activation of Akt‐Bcl‐2 survival pathway. Autophagy was accompanied by the activation of Beclin and LC3‐II as well as mTOR signalling, which were inhibited by either 3‐methyl adenine (3‐MA) or Wortmannin. The autophagy was confirmed from the results of transmission electron microscopy and light microscopy as well as with confocal microscopy. It is tempting to speculate that during ischaemia and reperfusion autophagy along with enhanced survival signals helps to recover the cells from injury.