Survey of ionospheric Pc3-5 ULF wave signatures in SuperDARN high time resolution data.

Ionospheric signatures of ultra-low frequency (ULF) wave in the Pc3-5 band (1.7-40.0 mHz) were surveyed using ~6 s resolution data from Super Dual Auroral Radar Network (SuperDARN) radars in the northern hemisphere from 2010 to 2016. Numerical experiments were conducted to derive wave period dependent thresholds for automated detection of ULF waves using the Lomb-Scargle periodogram technique. The spatial occurrence distribution, frequency characteristics, seasonal effects, solar wind condition and geomagnetic activity level dependence have been studied. Pc5 wave events were found to dominate at high and polar latitudes with a most probable frequency of 2.08 ± 0.07 mHz while Pc3-4 waves were relatively more common at midlatitudes on the nightside with a most probable frequency of 11.39 ± 0.14 mHz. At high latitudes, the occurrence rate of Pc4-5 waves maximizes in the dusk sector and during winter. These events tend to occur during low geomagnetic activity and northward interplanetary magnetic field (IMF). For the category of radially bounded but longitudinally extended Pc4 events in the duskside ionosphere, an internal driving source is suggested. At midlatitudes, the Pc3-4 occurrence rate maximizes premidnight and during equinox. This tendency becomes more prominent with increasing auroral electrojet (AE) index and during southward IMF, which suggests many of these events are Pi2 and Pc3-4 pulsations associated with magnetotail dynamics during active geomagnetic intervals. The overall occurrence rate of Pc3-5 wave events is lowest in summer, which suggests that the ionospheric conductivity plays a role in controlling ULF wave occurrence.

Molecular study of 33 families with Fraser syndrome new data and mutation review.

Fraser syndrome (FS) is an autosomal recessive malformation disorder characterized by cryptophthalmos, syndactyly, and abnormalities of the respiratory and urogenital tract. FS is considered to be the human equivalent of the murine blebbing mutants: in the mouse mutations at five loci cause a phenotype that is comparable to FS in humans, and thus far mutations in two syntenic human genes, FRAS1 and FREM2, have been identified to cause FS. Here we present the molecular analysis of 48 FS patients from 18 consanguineous and 15 nonconsanguineous families. Linkage analysis in consanguineous families indicated possible linkage to FRAS1 and FREM2 in 60% of the cases. Mutation analysis identified 11 new mutations in FRAS1 and one FREM2 mutation. Manifestations of these patients and previously reported cases with an FRAS1 mutation were compared to cases without detectable FRAS1 mutations to study genotype-phenotype correlations. Although our data suggest that patients with an FRAS1 mutation have more frequently skull ossification defects and low insertion of the umbilical cord, these differences are not statistically significant. Mutations were identified in only 43% of the cases suggesting that other genes syntenic to murine genes causing blebbing may be responsible for FS as well.

Using 2', 7'-dichlorodihydrofluorescein-diacetate to assess polysaccharides as immunomodulating agents.

Neutrophils play a key role in the defense against microbial infections. One of their primary weapons to destroy microbes is the production of reactive oxygen species (ROS). This paper shows how 2', 7'-dichlorodihydrofluorescein-diacetate (DCFH-DA) was used to measure the effects of polysaccharides on the production of ROS by polymorphonuclear leukocytes (PMNs). The DCFH-DA method has been designed to provide a highly sensitive, quantifiable, real-time assessment of ROS production by PMNs.

Influence of an educational program on medical students' attitudes to substance use disorders in pregnancy.

Substance use disorders (SUDs) in pregnancy are becoming increasingly prevalent. Our study aimed to measure the effect of a teaching module on alcohol, tobacco, and drug use on the attitude of second year medical students toward pregnant women with SUDs. A questionnaire was administered to 84 medical students before a 5-week systems block on human reproduction, which included specific learning events related to SUDs. The questionnaire was readministered at the completion of the block. Pre- and postintervention scores were compared. Students showed significant improvement (p < .05, reliability coefficient 0.90) in their level of comfort in dealing with womenwith SUD in pregnancy. Other positive trends relating to attitudes toward drug- and alcohol-dependent women during pregnancy were also identified. SUD teaching interventions among medical students can improve their comfort level and attitude toward pregnant women with SUDs. This supports the current initiative of Project CREATE (Curriculum Renewal and Evaluation of Addiction Training and Education) to implement a comprehensive undergraduate SUD teaching program in Canadian medical schools.

The effect of income pooling within a call group on rates of obstetric intervention.

BACKGROUND: On July 1, 1997, the call group at a tertiary referral hospital in Ottawa changed its remuneration. The authors tested the hypothesis that change in an obstetric call group's remuneration from individual fee-for-service billing to equal sharing of the pooled group income would result in reduced rates of obstetric intervention. METHODS: Intervention rates were compared for the 12 months before (1678 births) and the 12 months after (1934 births) the change. Data were collected on onset of labour, indication for induction of labour, mode of delivery and neonatal outcome. Statistical analysis was performed with Wilcoxon's signed-rank test. RESULTS: The mean rate of elective induction of labour was 38.6% in the year before the change and 33.3% in the year after the change (p = 0.01). There were small but statistically significant increases in the mean duration of labour and mean length of the second stage (p = 0.03). INTERPRETATION: Billing policy may affect clinical decisions. Our findings add weight to the literature showing increased intervention rates with fee-for-service remuneration.

Progestagens and anti-progestagens for pain associated with endometriosis.

BACKGROUND: Endometriosis is a gynaecological condition that presents either with the problem of infertility or with painful symptoms. The clinical observation of an apparent resolution of symptoms during pregnancy gave rise to the concept of treating patients with a pseudo-pregnancy regime. Initially combinations of high dose oestrogens and progestagens were used but this was subsequently replaced by progestogens alone. More recently progestogens of both progestagens and anti-progestagens in the treatment of symptomatiprogestogenssis OBJECTIVES: To determine the effectiveness of both the progestagens and anti-progestagens in the treatment of painful symptoms ascribed to the diagnosis of endometriosis. SEARCH STRATEGY: The search strategy of the Menstrual Disorders and Subfertility Group was utilised to identify all publications which described or might have described randomised trials of any progestagen or any anti-progestagen in the treatment of symptomatic endometriosis. SELECTION CRITERIA: Trials were included if they were randomised and considered the effectiveness of either a progestagen or an anti-progestagen in the treatment of painful symptoms associated with endometriosis. DATA COLLECTION AND ANALYSIS: Seven studies were considered to be appropriate for inclusion in this review. Only three studies evaluating progestagens were included (comparison with placebo, danazol and oral contraceptive plus danazol). All other studies compared the anti-progestagen, gestrinone, with other medical therapies. MAIN RESULTS: Progestagens appear to be an effective therapy for the painful symptoms associated with endometriosis. Gestrinone is as effective as other established medical therapies (danazol and GnRH analogues). REVIEWER'S CONCLUSIONS: The limited available data suggests that both continuous progestagens and anti-progestagens are effective therapies in the treatment of painful symptoms associated with endometriosis. Progestagens given in the luteal phase are not effective. These conclusions should be accepted cautiously due to a lack of data.

Accuracy of strategies for monitoring fetal heart rate in labor.

We investigated whether the accuracy of auscultation could be improved with the use of a heart rate meter. Six fetal heart rate (FHR) traces were presented in a random sequence to 30 subjects using a customized computer program in each of three modalities: auscultation by counting alone, auscultation with the aid of an FHR meter, and visual assessment. The following characteristics were assessed: baseline rate, baseline variability, periodic change, and interpretation of the trace. For baseline rate, counting was associated with consistent underestimation of the FHR, which became more evident as the heart rate increased. The variation observed with each method was greatest with counting. For baseline variability, the proportion of correct responses using a meter was comparable to visual assessment, whereas counting was significantly less effective in 4 of 6 traces. For periodic change, the use of a meter was superior to counting in 4 of 6 traces, but both were inferior to visual assessment in 4 of 6 traces. In the interpretation of the trace, the use of a meter was again superior to counting, but both were inferior to visual assessment. Discrepancies were most marked in the least reassuring traces. Assessment of the FHR is significantly more accurate with the aid of a heart rate meter, and reduces interobserver variation.

Management of splenic artery aneurysm rupture during trial of scar with epidural analgesia.

We report a case of ruptured splenic artery aneurysm during labor in which the clinical signs were masked by epidural analgesia. A high index of clinical suspicion must be maintained in cases of atypical epidural breakthrough pain, and attending clinicians must be prepared for the unexpected when faced with a maternal collapse.