bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single or multiple embryo transfer following in vitro fertilisation for improved neonatal outcome: A systematic review of the literature
Authors: DARE Marianna R. , CROWTHER Caroline A. , DODD Jodie M. , NORMAN Robert J. 
Published: July 2004

AbstractBackground:  The aim of the current review was to determine if single versus two or more embryos, or double versus three or more embryos, transferred to the woman of a subfertile couple at in vitro fertilisation (IVF) maximises the likelihood of pregnancy, while minimising the likelihood of multiple pregnancy and adverse sequelae.Methods:  Studies were identified that reported maternal, infant and cost outcomes following embryo transfer at IVF.Results:  Three randomised trials and 17 cohort studies were included. From two randomised trials, single embryo transfer was found to result in decreased incidence of clinical pregnancy, multiple pregnancy and low birthweight. In the cohort studies for single embryo transfer compared with transfer of two or more embryos the incidence of live birth and singleton pregnancies was unchanged, and the incidence of multiple pregnancies and low birthweight was reduced. For double embryo transfer compared with the transfer of three or more embryos, the incidence of clinical pregnancy, live birth, preterm birth and low birthweight babies was reduced.Conclusions:  Information on neonatal and maternal outcomes following transfer of different numbers of embryos is limited. Transfer of one embryo does not alter the likelihood of a singleton pregnancy or birth when compared to transfer of two or more embryos. Transfer of one or two embryos decreases the risk of a multiple pregnancy, preterm birth and low birthweight. Further large, well‐designed randomised trials are required to provide maternal and neonatal outcomes of relevance to a couple undergoing IVF.
Presence of a single fetal major anomaly in a twin pregnancy does not increase the preterm rate
Authors: CHANG Yao‐Lung , CHAO An‐Shine , CHENG Po‐Jen , CHUNG Chao‐Lun , CHUEH Ho‐Yen , CHANG Shuenn‐Dyh , SOONG Yung‐Kuei 
Published: July 2004

AbstractObjective:  To evaluate whether the presence of one major anomaly in a twin pregnancy would affect the perinatal outcome of the unaffected co‐twin.Materials and methods:  From 1992 May to July 2003, a total of 1400 twin pregnancies were included in the present study and there were 35 pairs of twins with one major anomaly. Major anomaly was defined as the anomaly that had a significant impact on neonatal morbidity and mortality. The perinatal outcomes of the affected and unaffected co‐twins, the gestational age of diagnosis of the anomaly and the gestational age of delivery were the parameters for evaluation.Result:  The incidence of a twin with one major anomaly was 2.5%. Nineteen of 35 (54.3%) affected twins and five of the 35 (14.3%) unaffected co‐twins suffered a perinatal death. In the five cases of unaffected co‐twins suffering a perinatal death, four were intrauterine fetal deaths and one was a neonatal death. Three of the perinatal deaths of the unaffected co‐twins could be attributed to twin‐to‐twin transfusion syndrome. The gestational age at delivery, the perinatal mortality rate, and the incidence of low 5 min Apgar scores of the unaffected co‐twins were not different from those in twin pregnancies without a major anomaly.Conclusion:  The perinatal outcomes of the unaffected co‐twin were not affected by the fact that its counterpart had one major anomaly, nor were these twin pregnancies at increased risk of preterm labour.
Factors identified during the neonatal period associated with risk of cerebral palsy
Authors: WALSTAB Janet E. , BELL Robin J. , REDDIHOUGH Dinah S. , BRENNECKE Shaun P. , BESSELL Christine K. , BEISCHER Norman A. 
Published: July 2004

AbstractObjective:  To identify factors during the neonatal period that are associated with the subsequent development of cerebral palsy (CP).Design:  Case–control study.Setting:  Ten hospitals in Victoria, Australia.Sample:  Cases were babies with moderate or severe CP identified from the Victorian Cerebral Palsy Register. Controls were matched with cases for year of birth, plurality, sex, birthweight, gestation and hospital of birth.Methods:  A range of neonatal variables was compared between cases and controls, initially in a univariate analysis and subsequently in a logistic regression. The analysis was matched where possible. Where missing data prevented a matched analysis, an adjusted unmatched analysis was performed.Main outcome measures:  Those neonatal factors making an independent contribution to the risk of CP in both term and preterm infants.Results:  Among babies born at term, 73% of cases and 2% of controls were identified by at least one of the following factors: seizures, congenital abnormalities of the brain and elsewhere, ‘other lesions’, abnormal muscle tone and meconium aspiration. Among babies born preterm, 68% of cases and 26% of controls were identified by the following factors: seizures, intraventricular haemorrhage, periventricular leukomalacia, ‘other lesions’ and abnormal muscle tone.Conclusions:  The neonatal factors which best identify neonates who will subsequently develop CP are different for term and preterm babies. Babies born at term are identified more efficiently than those born preterm. Among term babies especially, some of these factors are clearly of a long‐standing nature and are not associated with delivery.
Late pregnancy termination within a legislated medical environment
Authors: DICKINSON Jan E. 
Published: July 2004

AbstractAims:  To review the indications and outcomes for abortion beyond 20 weeks’ gestation within an environment of legislated notifiable pregnancy termination.Methods:  In Western Australia legislation allowing abortion ≥20 weeks’ gestation for serious maternal‐fetal conditions was enacted in May 1998. Late abortions are only permitted in a single state institution and are notifiable by law. All pregnancy terminations ≥20 weeks’ gestation performed since this legislation were prospectively identified with the indications and outcomes reviewed.Results:  During the study period, 219 women underwent abortion ≥20 weeks’ gestation, representing 0.5% of all abortions in the state. Comparison with 438 contemporanous medical abortions for fetal anomaly at 14–20 weeks’ gestations was made. Misoprostol was the primary abortifacient for both. The median maternal age for termination at 14–20 weeks was 32 years (interquartile range (IQR) 27, 36) and 30 years (IQR 26, 34) at ≥20 weeks’ gestation (P < 0.001). There was no significant difference in maternal gravidity or parity. The principal indications for terminations ≥20 weeks were: karyotypic (28.8%); cardiac anomalies (15.5%) and neural tube defects (11.9%). Cardiac anomalies represented 5.0% of fetal anomaly terminations at 14–20 weeks (P < 0.01). The median time for medical abortion was 15.4 h (IQR 11.5, 23.2) at 14–20 weeks’ gestation compared with 18.3 h (IQR 13.3, 26.1) at gestations greater than 20 weeks (P < 0.001). A total of 13.2% of terminations were performed at gestations beyond 24 weeks.Conclusions:  Abortion ≥20 weeks’ gestation under medically regulated legislation is used primarily for serious fetal anomalies. The women are younger and the abortion duration is greater for late pregnancy termination compared with those conducted at earlier gestations. The majority of late terminations occur <23 weeks’ gestation and the incidence has remained stable since the legislation was enacted.
First Australian trial of the birth‐training device Epi‐No: A highly significantly increased chance of an intact perineum
Authors: KOVACS Gabor T. , HEATH Penny , HEATHER Campbell 
Published: July 2004

AbstractBackground:  A German report suggested significantly better outcomes in terms of perineal care, second stage length and neonatal outcome for users of Epi‐No.Objective:  To carry out a pilot study of the first use of the Epi‐No birth training device in Australia for women having their first baby.Study population and methods:  Forty‐eight primigravidae having their confinement at Birralee Birthing Unit who used the device compared to all other primigravida who delivered during the same period.Results:  The study shows a highly significantly improved outcome for the perineum when users are compared to primigravid non‐user controls. We could not demonstrate decreased instrumental delivery rates nor a better outcome in term of Apgar scores.Discussion:  The Epi‐No device should be offered as an option to all primigravidae to use during the late third trimester.
Bone structure effect on root resorption
Authors: Otis LL , Hong JSH , Tuncay OC 
Published: July 2004

Structured AbstractAuthors – Otis LL, Hong JSH, Tuncay OCObjectives – To explore if alveolar bone shape and density might promote external apical root resorption.Setting and Sample Population – Panoramic radiographs of 700 patients who had orthodontic treatment at Temple University were reviewed and 22 patients with radiographic evidence of root resorption on the lower incisors were selected for the study. Exclusion criteria included a history of systemic diseases, craniofacial abnormalities, tooth injury, endodontically treated teeth, and impacted teeth.Methods – Pre‐treatment (T1) and post‐treatment (T2) cephalometric radiographs were converted into digital format and enhanced to reduce contrast variability and improve edge definition. Tooth length, root length, root area, alveolar area around the root including cortical area, area of medullary bone, and area of the symphysis were measured using an interactive software algorithm. A region of interest within the symphysis was also defined and trabecular space area and fractal dimension calculated as an estimate of bone density.Results – Root area and tooth length were correlated negatively with changes in root area, tooth area, and root length. Larger teeth demonstrated a greater amount of root resorption. Dentoalveolar complex dimensions remained relatively unchanged during tooth movement. The amount of alveolar bone around the root, thickness of cortical bone, density of the trabecular network, and fractal dimension showed no significant correlation with the extent of the external apical root resorption.Conclusions – The results of this study suggest that the density and morphology of the dentoalveolar complex are not significant factors in the etiology of external apical root resorption.
The first year of a formal emergency medicine training programme in Papua New Guinea
Authors: Curry Chris , Annerud Carolyn , Jensen Simon , Symmons David , Lee Marian , Sapuri Mathias 
Published: July 2004

AbstractObjective:  To describe a programme catalyzing the development of emergency medicine in Papua New Guinea (PNG).Methods:  Five emergency physicians rotated through a new position of Senior Lecturer in Emergency Medicine in the University of PNG during 2003. The position was established as a consequence of emergency physician input supported by AusAID in 2002.Results:  Fifth (final)‐year medical students and medical officers in the Emergency Department at Port Moresby General Hospital undertook formal and bedside problem based learning. The first trainees for a Master of Medicine in Emergency Medicine programme were inducted and supported. Emergency department management was provided with specialist input. Research projects were initiated, dealing with snakebite, chloroquine toxicity and HIV/AIDS. The first year of an emergency nursing curriculum was supported.Conclusions:  There is now considerable enthusiasm for the development of emergency medicine as the hospital generalists’ specialty. Emergency nursing training has also made a start. Limitations on resources will require flexibility to sustain the project. Further support by emergency physicians will be needed.
Do radiographs requested from a paediatric emergency department in New Zealand need reporting?
Authors: Higginson Ian , Vogel Sally , Thompson John , Aickin Richard 
Published: July 2004

AbstractObjectives:  To ascertain whether plain radiographs interpreted by doctors working in a paediatric ED need reporting by radiologists.Methods:  Prospective observational study based in a paediatric teaching hospital.Results:  The overall disagreement rate was 26.1%. The clinically significant disagreement rate was 4.8%. There was no relationship between seniority or confidence of ED doctor, and likelihood of disagreement. Disagreement was more likely where radiographs were interpreted during normal working hours (P < 0.05). Chest films, then abdominal films, then skeletal films were more likely to result in disagreement (P < 0.0001). However, this relationship was reversed when considering rates of clinically significant disagreement (P < 0.05). The highest risk of disagreement was in chest films initially thought to be normal, and the lowest in skeletal films initially thought to be abnormal.Conclusion:  All radiographs requested on patients discharged from the paediatric ED should be reported. Reporting need not be immediate.
Why don't trainees pass the emergency medicine fellowship examination?
Authors: Rogers Ian R , Leach Debbie , Brookes Jennifer G 
Published: July 2004

AbstractThe pass rate in the Australasian College for Emergency Medicine Fellowship exams between 1996 and 2003 inclusive averaged 61%, substantially lower than that of other specialties with comparable training structures. The explanation for this pass rate, which many would judge as unacceptably low, is likely to be multi‐factorial. Possible factors that should be considered include trainee selection, training programme structure, the impact of the Director of Emergency Medicine Training, examination preparation, examination validity and examination reliability. Each of these potential factors needs to be addressed in a systematic fashion in the context of inevitable and increasing internal and external scrutiny of the outcomes of our training programme.
Injury patterns and preventability in prehospital motor vehicle crash fatalities in Victoria
Authors: Ryan Matt , Stella Julian , Chiu Herman , Ragg Michael 
Published: July 2004

AbstractObjective:  To examine the pattern of anatomical injury in victims of motor vehicle crashes who die prior to reaching hospital. Cases were identified where death was an unexpected outcome.Methods:  A retrospective review of autopsy case records including police reports, of all persons who died in motor vehicle crashes between 1 January 1998 and 31 December 1999 and underwent full autopsy at the Victorian Institute of Forensic Medicine (VIFM). Those cases where the victim died in the prehospital phase were examined. Abbreviate Injury Scores and Injury Severity Scores were calculated in each case. Bull's probit analysis was used to identify unexpected deaths.Results:  There were 352 motor road crash fatalities identified that underwent autopsy at the VIFM in the study period. Two hundred and six of these were prehospital deaths involving motor vehicles, which satisfied specified criteria. 82% (95% CI: 77.7–86.3%) of cases had Abbreviated Injury Scores of 5 (critical) or 6 (incompatible with life). 80.1% (95% CI: 75.7–84.5%) had an Injury Severity Score greater than 40. 36.9% (95% CI: 34.5–39.3%) of cases had the maximum Injury Severity score of 75. 88.8% (95% CI: 85–92.7%) of cases sustained a head injury and 83.9% (95% CI: 79.8–88.2%) a chest injury. Possibly preventable fatality was identified in 30 (14.6% 95% CI: 13.9–15.3%) cases.Conclusion:  In motor vehicle crash fatalities, most victims who die before reaching hospital do so because of major injury, with the head and chest the commonest regions involved. A large proportion of these injuries could be considered unsurvivable regardless of treatment. Earlier intervention or retrieval of such patients is unlikely to influence outcome in the majority of cases.
Does potassium concentration measured on blood gas analysis agree with serum potassium in patients with diabetic ketoacidosis?
Authors: Fu Phyllis , Douros George , Kelly Anne‐Maree 
Published: July 2004

AbstractObjective:  The aims of this study were to define the maximum clinically acceptable difference between potassium concentrations on different samples and to determine the degree of agreement between potassium concentration measured on blood gas analysis and serum for patients with diabetic ketoacidosis (DKA).Methods:  This project comprised two sub studies. In the first, 15 emergency physicians, intensivists and endocrinologists were surveyed and asked to mark on a line with markings at 0.5 mmol/L intervals, the maximum clinically acceptable differences (both above and below the ‘true’ value) between potassium concentration measured on different samples. The maximum clinically acceptable difference was calculated as the median of responses. The second study was a retrospective agreement study. Patients with an ED diagnosis of DKA were identified from a computer database. They were eligible for inclusion if they had both blood gas analysis including potassium concentration and serum potassium concentration and pH was less than 7.3. Data collected included potassium concentration on serum and blood gas samples, pH, serum glucose concentration and time of sample collections. Data were analysed using bias plot and Spearman correlation analyses.Results:  The maximum clinically acceptable difference was defined as 0.5 mmol/L for both over and underestimation of potassium concentration. Fifty patients were studied with a median pH of 7.17 and median serum glucose of 29.5 mmol/L. Difference in potassium concentration between samples ranged from −0.9–2.9 mmol/L. 80% of sample pairs had a difference within the maximum clinically acceptable difference defined previously. The magnitude of difference between samples correlated with serum glucose (P = 0.0033, coefficient 0.41) but not with pH.Conclusion:  This study suggests that potassium concentration derived from blood gas analysis may not be an acceptable substitute for serum potassium concentration in patients with diabetic ketoacidosis, particularly at higher serum glucose concentrations.
Incorrect instruction in the use of the Valsalva manoeuvre for paroxysmal supra‐ventricular tachycardia is common
Authors: Taylor David McD , Wong Lu Fee 
Published: July 2004

AbstractObjective:  Success rates for the Valsalva manoeuvre (VM) in treatment of paroxysmal supraventricular tachycardia (SVT) vary with performance technique. This study aimed to assess whether ED doctors instruct their patients to perform the recommended VM technique (supine position for 15 s).Methods:  A multicentre, observational study of 35 ED registrars and 17 emergency physicians. Each doctor was asked to describe how he/she would instruct a patient in SVT to perform the VM.Results:  Only five (9.6%) doctors would position their patient correctly and 31 (59.6%) would incorrectly instruct their patient to assume a sitting or semirecumbent position. Only five (9.6%) doctors would give specific instructions to blow for at least 15 s and 34 (65.4%) would instruct their patient to blow ‘as long as you can’. Only four (7.4%) doctors would use a sphygmomanometer to measure intrathoracic pressure during the VM. There were no significant differences (P > 0.05) between the registrar and physician group responses for any study endpoint.Conclusion:  Few ED doctors correctly instruct their patients in the VM technique recommended for management of SVT. Hence, maximal vagal tone and SVT conversion rates may not be achieved in many cases. The use of the recommended VM technique is encouraged.
Orientalism and the Modern Myth of "Hinduism"
Authors: King Richard 
Published: July 2004

AbstractIs there really a single ancient religion designated by the catch-all term 'Hinduism' or is the term merely a fairly recent social construction of Western origin? This paper examines the role played by Orientalist scholars in the construction of Western notions of Indian religion by an examination of the origins of the concept of 'Hinduism'. It is argued that the notion of 'Hinduism' as a single world religion is a nineteenth century construction, largely dependent upon the Christian presuppositions of the early Western Orientalists. However, exclusive emphasis upon the role of Western Orientalists constitutes a failure to acknowledge the role played by key indigenous informants (mostly from the brāhmana castes) in the construction of modern notions of 'the Hindu religion'. To ignore the indigenous dimension of the invention of 'Hinduism' is to erase the colonial subject from history and perpetuate the myth of the passive Oriental. The paper concludes with a discussion of the accuracy and continual usefulness of the term 'Hinduism'.
Opposites Attract: the Body and Cognition in a Debate over Baptism
Authors: Vial Theodore 
Published: July 2004

AbstractAnalysis of a change in a historical rite of passage, the baptism ceremony in Zurich in the 1860s, shows the relative strengths and weaknesses of recent developments in the field of ritual studies. Those who argue that ritualized action is an embodied negotiation of power relations are helpful in understanding why various groups in society fought either for or against the ritual change. But the weak structural component of these theories and an inadequate model of human action make them unable to account for speech acts in ritual, or for the change in the Zurich ritual. Cognitive theories of ritual are far more successful in explaining the force of specific structural changes. Far from being incompatible, these different approaches to ritual, if based on an adequate model of human agency, are complementary and necessary for an adequate account of the historical ritual change examined.
Women's History and Ottoman Sharia Court Records: Shifting Perspectives in Social History
Authors: Agmon Iris 
Published: July 2004

AbstractThis paper revisits some methodological and conceptual aspects of scholarly works on the social history of Middle Eastern women based on Ottoman court records that were published in the last three decades. It discusses the main approaches employed by historians in the field for analyzing court records, and the circumstances that shaped these patterns. It shows that, during the 1970s and 1980s, this body of scholarly works on women's history, as part of Middle Eastern social history, adhered to historiographical approaches that did not follow the "cultural turn" characterizing West European and North American historiography. This situation, however, has recently changed.