bluuebunny/crossref_metadata_2025_split huggingface dataset:
Britain in a Continental War: The Civil-Military Debate Over the Strategical Direction of the Great War of 1914-1918
Authors: Woodward David R. 
Published: November 2007

The friction between civil and military authorities was never greater than during the Great War of 1914-1918. The unprecedented casualties suffered by the British Army and involvement of every element of British life in the conflagration gave added intensity to this conflict. The ability of British democracy to wage total war was put to a severe test. Where did the responsibility of the civilians end in formulating strategy? Where did the authority of the soldiers begin? This strategic debate largely centered on the size of Britain's commitment to the ghastly slaughter in the trenches of the Western Front.Before 1914 British war planners had thought of a short war with at most only limited involvement in Europe. After Britain's plunge into war, the civil and military authorities decided to employ the small professional British Army on the continent to save France from being overrun, a decision made easier by the widespread belief that the war would be over within a few months. By this continental commitment Britain became involved in a long and bloody war of attrition in France and Flanders.As 1914 ended in stalemate in the West with few of the original members of the British Expeditionary Force still on their feet the debate over the employment of future British armies began in earnest. The government's chief military adviser was Lord Kitchener, the Secretary of State for War. Although the public viewed Kitchener as Britain's greatest soldier, his appointment was almost certainly a mistake.
Second Trimester Abortion by Rivanol with or Without Cervical Dilatators: A randomized comparison
Authors: Schubert Werner , Cullberg Goran 
Published: November 2007

Fifty women undergoing second trimester legal abortion were randomly assigned to one of three groups: 1. given Rivanol and left with ballon catheter in the cervical canal with addition of oxytocin infusion. 2. same treatment as above but catheter removed and replaced by a Lamicel cervical dilatator, 5 mm in diameter; 3. as group 2, but with a 6 mm Laminaria tent inserted. Induction‐abortion interval and need for analgesics were recorded, as well as possible side effects and complications.No statistical differences were found between the three groups for any of the parameters.We have thus not been able to show any advantages of using Laminaria or Lamicel osmotic cervix dilatators in second trimester abortions.
On the evaluation of routine ultrasound screening in the third trimester for detection of light for gestational age (LGA) infants
Authors: Secher N. J. , Hansen P. Kern , Lenstrup C. , Eriksen P. Sindberg , Thomsen Birthe Lykke , Keiding N. 
Published: November 2007

Based upon 2 194 consecutive pregnancies with known gestational age, formulas for weight deviation predicted in the 32nd and 37th gestational week were estimated by multiple linear regression on the measurements of the abdominal d iameter (AD) and the biparietal diameter (BPD) of the first 64% of the pregnancies. The usefulness of the screening was evaluated on the remaining 36%. An attempt to diagnose light for gestational age (LGA) infants resulted in either a low sensitivity or a low predictive value of a positive test.The late third trimester screening was more sensitive than the early, indicating LGA as a late phenomenon in pregnancy. Knowing the result from the late scanning, the result from the early scanning contributed almost no further information about whether the infant would be LGA at birth. Basic epidemiological characteristics of other comparable investigations on high‐risk pregnancies and non selected pregnancies are presented.
24‐Hour Home Par Weighing Test Versus 1‐Hour Ward Test In The Assessment Of Mild Stress Incontinence
Authors: Lose Gunnar , Jørgensen Lisbeth , Thunedborg Per 
Published: November 2007

Twenty‐three normal volunteers and 31 women admitted for stress or mixed incontinence underwent two 24‐hour home pad weighing tests. In the patients the test result was compared with the result obtained with the 1‐hour ward pad weighing test. Median pad weight gain was 4 g/24‐h, with an upper 99% limit of 8 9/24 h in normal women. The median urine loss was 17 g/24‐h in the patients. Eighteen (58%) patients were classified as incontinent according to the result of the 1‐h ward test, versus 28 (90%) according to the result of the 24‐h home test. There was no significant correlation between the result of the 1‐h test and the 24‐h test. In the patients, test‐retest analysis showed a significant variation in the result of the 24‐h test.It is concluded that the better of two 24‐h home tests is more sensitive for confirmation incontinence than is one 1‐h ward test. Consequently, the 24‐h home test is of practical use as a screening test for incontinence. The reproducibility of the test, however, seems insufficiently satisfactory to allow of its use in comparative scientific studies.
Prospective Counselling After Prenatal Diagnosis Of Fetal Malformations: Interventions And Parental Reactlons
Authors: Langer Martin , Ringler Marianne 
Published: November 2007

A model of prospective counselling and intervention after prenatal diagnosis of fetal malformation is presented. 13 patients/couples with severe malformations were fully counselled, 3 patients/couples interviewed post‐termination. Objectives of the counselling strategy were to support patient autonomy, facilitate mourning and reduce narcissistic damage.Counselled patients showed certain benefits concerning the acceptance of the malformation and feelings of autonomy. Integration of psychodynamic knowledge into routine care and obligatory psychotherapeutic counselling are proposed.
A birthweight‐for‐gestation standard based on 4737 twins born in Sweden between 1983 and 1985
Authors: Rydhström Håkan 
Published: November 2007

Objective: To construct a birthweight‐for‐gestation chart based on a population‐based material of twins born during a restricted period of time.Material and methods: Nearly all live‐born twins born in Sweden between 1983 and 1985, 4737 all told, were included. Excluded from the analysis were 4.7% of the twins that were not on record at the Medical Birth Registry, 1.8% that died before or during birth, and 8.8% that were without a recorded date of birth or only had information on gestational duration estimated from the first day of the last menstrual period.Results: The standard deviation in birthweight was considerable in most gestational weeks; the range (±2 SD) was 1000–3400 g even if exclusively twins (pregnancies) with estimated date of birth from ultrasound examination early in the second trimester were included. Intra‐pair discordance increased with gestational duration, especially for un‐like‐sexed twins, to reach over 400 g at term. On average, boys weighed 92 g more than girls and twins to multiparae weighed 250 g more than twins to primiparae. Maternal age affected birthweight for twins to primiparae, but not to multiparae.Conclusion: Although the problems with secular trends in birthweight were avoided by using a population‐based material during a restricted time period, and only twin pregnancies dated with ultrasound were included, the standard deviation in most gestational weeks was still considerable, reflecting the multiplicity of factors involved in determining the birthweight of twins.
The trend of erythrocyte sodium parallels the pattern of diastolic blood pressure in preeclampsia
Authors: Tranquilli Andrea L. , Garzetti G. Gioele , Romanini Carlo 
Published: November 2007

Objective: To describe the trend of intracellular sodium in patients who develop preeclampsia.Study design: In this longitudinal study, we determined intraerythrocyte sodium (Nai) in 303 primigravid pregnancies every fourth week from gestational week 10 through week 38. The study group included 274 normotensive and 29 chronic hypertensive gravidae. During the study, 26 normotensive and six chronic hypertensive pregnant women developed preeclampsia.Results: Chronic hypertensives showed higher baseline intraerythrocyte sodium, compared to the normotensives. The women who developed preeclampsia demonstrated a significant increase in Nai concentration from 26–30 weeks onward. Data from blood pressure recordings paralleled data from Nai.Conclusion: Due to the possible role of Nai on intracellular free calcium mobilization, our findings support a possible involvement of defective cell membrane function in the development of preeclampsia.
Low dose iron supplementation does not cover the need for iron during pregnancy
Authors: Thomsen Jösrn Kvist , Prien‐Larsen Jens Christian , Devantier Agnete , Fogh‐Andersen Niels 
Published: November 2007

Objective ‐ To determine: 1) if 18 mg iron daily is sufficient to cover the iron need during normal pregnancy, and 2) if women, who will not need iron supplementation during pregnancy, can be identified by early screening.Design ‐ In a prospective study the women were randomized to receive either 18 or 100 mg iron daily from the 16th week until delivery. Investigations were performed in the 16th, 30th, and 38th week.Subjects ‐ Healthy nulliparae (n = 43) experiencing a normal singleton pregnancy. Only women with a normal hemoglobin concentration and intact iron stores (S‐Ferritin 15 ug/ I) in the 16th week were included.Variables ‐ These measurements were done consecutively: 1) the total hemoglobin mass (with carbon monoxide), 2) S‐Ferritin, 3) S‐Transferrin, 4) S‐Iron, 5) red cell indices (hemoglobin concentration, hematocrit, MCV, MCHC).Results ‐ Changes in red cell indices and S‐Transferrin were equal in the two groups. There was no significant difference in S‐Ferritin in the 16th week. In the 30th week 3 women (14%) in the 100 mg group and 11 (52%) in the 18 mg group had empty iron stores (p<0.05). The numbers were 1 (5%) and 15 (72%) in the 38th week (p< 0.0001). The increment in total hemoglobin mass was equal in the two groups from the 16th to the 30th week (13% in the 100 mg group and 12% in the 18 mg group). From the 30th to the 38th week the increment in total hemoglobin mass was largest in the 100 mg group (8.1% versus 2.7%, p<0.05). Conclusion ‐ Despite a normal hemoglobin concentration and intact iron stores in the 16th week, an iron supplementation of 18 mg daily is not sufficient to cover the iron need in many pregnant women in the 3rd trimester.
Atrial natriuretic peptide (ANP) decrease during normal pregnancy as related to hemodynamic changes and volume regulation
Authors: Thomsen JØrn Kvist , Fogh‐Andersen Nlels , Jaszczak Poul , Glese Jørn 
Published: November 2007

Background. Volume regulation and hemodynamic functions change during pregnancy, leading to marked increases in blood volume and cardiac output, peripheral vasodilatation and reduced sensitivity to angiotensin. Atrial natriuretic peptide (ANP) is intimately involved in fluid and sodium homeostasis and exerts marked relaxant activity on vascular smooth muscle pre‐contracted with angiotensin. This study was performed to clarify the rôle of ANP as a regulator of maternal physiology.Methods. 40 normal primigravidae were examined five times during pregnancy plus 12 weeks after delivery. Each time were measured: ANP, aldosterone, renin, blood volume (carbon monoxide), cardiac output (Doppler), blood pressure and sodium excretion. Interdependence of the changes in ANP and in the other parameters was tested using Spearman's rank correlation test on the delta (δ)‐values (the differences between investigations).Results. P‐ANP in the 20th week was 11.4 (8.5−18.9) pmol 1−1 (median, 25 and 75 percentiles), the same as 12 weeks after delivery, 11.5 (9.6−15.2) pmoll−1, and in a non‐pregnant control group, 10.4 (9.0−12.5) pmol l−1 (n = 20). All measurements of P‐ANP during the 3rd trimester were lower than in the 20th week and 12 weeks after delivery,p<0.0001 (Wilcoxon matched‐pairs test). There was a negative correlation between changes in P‐ANP and changes in: a) blood volume, R = −0.69, /?< 0.0001, b) aldosterone, R = −0.58, p<0.0001, c) renin, R= – 0.54, p<0.001, d) cardiac output, R= – 0.61, P<0.0001. There was a positive correlation between changes in P‐ANP and changes in: a) fractional excretion of sodium, R = 0.54, p< 0.0001, and b) total peripheral resistance, R = 0.52, p<0.0001.Conclusion. Decrease in p‐ANP is one of the mechanisms whereby blood volume is increased and maintained during pregnancy. The competitive relationship between ANP and the renin‐aldosterone system in regulating sodium balance and fluid volume is preserved during pregnancy. The results substantiate the physiological importance of ANP as a regulator of blood volume. ANP does not function as a vasodilatator during pregnancy.
Vitamin D deficiency amongst Pakistani women in Oslo
Authors: Brunvand Leif , Haug Egil 
Published: November 2007

To evaluate the vitamin D status in pregnant Pakistani women living in Oslo, we measured levels of serum calcidiol, calcitriol, vitamin D binding protein (DBP), osteocalcin, free calcium (Ca2+), phosphorous, alkaline phosphatase and intact parathyroid hormone (PTH). Thirty Pakistani and 23 Norwegian women who delivered vaginally after uncomplicated pregnancies were included.The serum levels of calcidiol were significantly lower in the Pakistani group (p > 0.0001) as compared with the Norwegians, the mean values being 15.1 nmol/1 and 43.1 nmol/1, respectively. PTH levels were above 5.5 pmol/1 in 13 of the Pakistanis, none of the Norwegians. There were no differences in calculated free calcitriol, free calcium and inorganic phosphorus between the groups. Alkaline phosphatase was high, while osteocalcin was low in both groups, but there were no significant differences between the groups.This study shows that there is a widespread vitamin D deficiency amongst pregnant Pakistani women living in Oslo, indicating the need for vitamin D supplementation to these women and their children.
Factors influencing vaginal cytology, pH and bacterial flora in elderly women
Authors: Milsom Ian , Arvidsson Leif , Ekelund Peter , Molander Ulla , Eriksson Olle 
Published: November 2007

Objective. To evaluate factors influencing the vaginal micro‐environment in elderly women. Study design. Vaginal pH, cytology (Karyopyknotic index, KPI) and bacterial cultures were assessed in 350 women (age 72.2 ± 1.4 years, range 65–84 years) who were not taking estrogens. Results. Vaginal pH was 6.5 ± 0.1, KPI was 3.0 ± 0.9% and bacteria of fecal type dominated. However, in some women the vaginal micro‐environment resembled that of fertile women, with a predominance of laclobacilli (n = 68), low pH (n = 41) and an increased maturation index (n = 57). KPI was higher (p > 0.001) in women weighing ≥ 85 kg, or with a body mass ≥ 9th decentile or with a diastolic blood pressure ≥ 100 mmHg and in women (p > 0.05) with a high menopausal age (≥ 53 years). Vaginal pH was lower (p > 0.001), KPI was higher (p > 0.01) and there was an increased (p >0.05) presence of lactobacilli in smokers compared to non‐smokers.Conclusions. The latter finding is somewhat paradoxical as cigarette smoking has previously been shown to negatively influence estrogen metabolism. The influence of cigarette smoking on the vaginal micro‐environment may be a direct local effect of nicotine.
Hormonal replacement therapy and sexuality in a population of Swedish postmenopausal women
Authors: Lindgren R. 
Published: November 2007

All women (n = 2465) living in the community of Linköping, Sweden, aged 55, 57, 59 and 65 years were studied in a cross‐sectional trial concerning the prevalence of vasomotor symptoms, hormonal replacement therapy (HRT) and sexual activities. After one reminder, answers were received from 1867 (76%) women. In all, 51% of the women reported vasomotor symptoms. Ten percent of the women used HRT at the time of the survey. Another 10% of the women had previously used oral HRT but had abandoned treatment. One third of these women reported no vasomotor symptoms when they abandoned treatment. One fifth ceased treatment after recommendation from their physician and another fifth because of ‘fear’ of hormonal treatment.Sixty‐two percent of the women reported sexual activity. The most common reasons for not having a regular sex‐life were lack of partner or lack of desire.
Induced abortion: Effects of marital status, age and parity on choice of pregnancy termination
Authors: Skjeldestad Finn Egil , Borgan Jens‐Kristian , Daltveit Anne Kjersti , Nymoen Erik H. 
Published: November 2007

Objective. To study the impact of marital status, age and parity on the decision regarding pregnancy termination over time among pregnant Norwegian women.Design. National surveillance data of induced abortions and births.Material. All women terminating their pregnancies (n = 174,590) as registered in the Abortion File in the Central Bureau of Statistics and all women giving birth (n = 639,551) as registered in the Medical Birth Registry of Norway between January 1, 1979 and December 31, 1990 were eligible for the study. Included in the analysis of pregnancy outcome were records with complete information on marital status, age and parity, which comprise 93.8% (n= 163,826) of all women having had an induced abortion and 99.0% (n = 633,542) of all women giving birth during the time period.Outcome measure. The proportion of pregnancies terminated as induced abortions and the relative risk of pregnant women choosing abortion in strata of marital status, age and parity.Statistical methods. Trend analysis of the proportion of pregnancies terminated as induced abortions in different time periods in categories of marital status, age and parity.Results and conclusion. From the first three‐year period 1979‐81 to the last three‐year period 1988‐90 there was a decreasing tendency to choose abortion among unmarried pregnant women above 20 years of age and married women with two or more children. In the other strata of marital status, age and parity there were no changes over the time period, except for married women 20‐24 years of age which was the only group that showed an increasing abortion tendency over the time period.The prospect of single parenthood was the strongest determinant for choosing abortion independent of age and parity. Within all age groups of married women the abortion tendency increased more with parity than age. Cohabiting women chose abortion significantly more often than married women did. However, the true estimate of choosing abortion among cohabiting women was closer to married women than to single women. In order to find out the importance of other social factors and attitudes in the decision making process regarding pregnancy outcome, adjustments must be made for marital status, age and parity.
Autonomic cardiovascular control in normal and pre‐eclamptic pregnancy
Authors: Eneroth‐Grimfors Eva , Westgren Magnus , Ericson Mats , Ihrman‐Sandahl Christina , Lindblad Lars Erik 
Published: November 2007

Background. Pre‐eclampsia is regarded as a primary placental disorder, in which defect placentation causes endothelial and cardiovascular disturbances. Evidence of disturbed neural cardiovascular control in this condition has been suggested, as well as in other hypertensive diseases. The purpose of the present study was to non‐invasively evaluate the sympatho‐vagal balance during normal and pre‐eclamptic pregnancy.Methods. In twelve healthy pregnant women, thirteen pre‐eclaniptic women and ten non‐pregnant controls. Heart rate, blood pressure and breathing movements were registered and recorded on B tape recorder for off‐line analysis. Variability in heart rate, blood pressure and breathing movements were computed by an autoregressive spectral analysis algorithm. Heart rate variability was quantitated as the area under the spectral curve, and Student's t‐test was performed on logarithmic values.Results. Heart rate variability contained two major components in power, a low frequency peak predominantly attributed to sympathetic tone, and a high frequency peak reflecting vagal tone. Women with pre‐eclampsia were characterized by a significantly reduced high frequency peak compared to healthy pregnant (p = 0.03) and non‐pregnant (p = 0.02) women. In the low frequency band there were no significant differences in power between the groups. Blood pressure variability did not differ between the groups.Conclusion. The present results indicate that pre‐eclampsia is associated with decreased vagal control of the heart. Furthermore, the results indicate that pregnancy per se does not change sympatho‐vagal balance.
Post partum platelet count in maternal blood
Authors: Dahlstrøm Berit L. , Nesheim BrittIngjerd 
Published: November 2007

Background. Thrombocytopenia in pregnancy, during and after delivery can be an indicator of seriouh preeclampsia or any condition accompanied by disseminated intravascular coagulation (DIC). In order to recognize thrombocytopenia, it is important to know the expected platelet count in healthy women. Literature search gave no information regarding changes of platelel count in healthy women shortly after uneventful pregnancies and uncomplicated deliveries, either vaginal or cesarean section. The intention of this study was to investigate whether there were any such changes.Methods. Blood samples were taken on admission to the obstetric ward, first and third day after vaginal delivery (11 patients) or cesarean section (11 patients). Platelet count, hemoglobin coilcentration and hematocrit was measured for each blood sample.Results. There was no significant change in platelet count after vaginal delivery. Following cesarean section there was a median decrease in platelet count of 12.5′%, the first postoperative day, and a median increase of 5% the third postoperative day.Conclusions. Platelet count remains unchanged after uncomplicated vaginal delivery. Shortly following normal pregnancy and uncomplicated cesarean section platelets should be expected to decrease slightly.
The incidence of repeat induced abortion a prospective cohort study
Authors: Skjeldestad Finn Egil 
Published: November 2007

Background. To measure the cumulative incidence of first and second repeat induced abortion and what differentiates first‐time repeaters from non‐repeaters.Methods. The study population comprised 2925 women who had their first induced abortion at the University Hospital of Trondheim, Norway between January 1, 1987 and December 31. IOYI. Repeat induced abortion within the study period was measured as a cumulative incidence of second and third induced abortion. Survival analyses and logistic regression analysis were applied using ‘repeater’ as the dependent variable.Result. The cumulative incidence of second induced abortion was 3.7% at end of first year, 7.1% at end of second year, 9.9% at the end of third year, and 12.3% at four completed years of observation. The cumulative incidence of third induced abortion was 0.1% at the end of first year. 0.6% at the end of second, 1.3%, at the end of third and 2.0% at four years of Observation. The cumulative incidence of the third abortion, measured as the time at risk from the second to the third abortion, remained twice that of the cumulative incidence of the second abortion after one year of observation (p< 0.001). At the first abortion. Variables predicting a risk for repeat induced abortion were age, occupational status and becoming pregnant is a result of a contraceptive failure.Conclusion. Repeat induced abortion is inevitable. The incidence of repeat induced abortions doubled from the second to the third abortion, indicating that the moral threshold for choosing an abortion after recognition of an unplanned pregnancy is the first induced abortion. More detailed studies on the effect of intensified contraceptive counselling programs after the first abortion are needed.