Association of birth weight and current body size to blood pressure in female twins

It has been proposed that low birth weight is associated with high levels of blood pressure in later life. The aim of this study was to assess the relationship of blood pressure to birth weight and current body size during growth and adulthood. A total of 711 female multiple births, with one group of 244 in their growth phase mean age 12.0 (2.3)(SD) years and the other of 467 adults (mean age 35.2 (12.6) years), had height, weight and both systolic (SBP) and diastolic (DBP) blood pressures measured, and self-reported their birth weight. Regression analyses were performed to assess the cross-sectional and within-pair associations of blood pressure to birth weight, with and without adjustments for current body size. Within-pair analysis was based on 296 twin pairs. Cross-sectionally, a reduction in birth weight of 1 kg was associated with 2 to 3 mm Hg higher age-adjusted SBP, which was of marginal significance and explained about 2% of the population variance. Adjustment for body mass index did not significantly change this association. Within-pair analyses found no association between birth weight and SBP or DBP,even after adjusting for current body size. After age, current body size was the strongest predictor of systolic BP. The weak association of blood pressure to birth weight cross-sectionally is of interest, but any within-pair effect of birth weight on blood pressure must be minimal compared with the effect of current body size.

Separation of conjoined twins: experiences of perioperative nurses and their recommendations

Background: Within an 8-month period, an unprecedented and historical first in Queensland, Australia, the perioperative nurses were members of teams involved in the surgical separation of two sets of conjoined twins. Little is known about the (dis)stress that some of these perioperative nurses experienced nor how best to support them during such experiences.

Aim: The aim of this paper is to report on the qualitiative study that explored the experiences of those perioperative nurses involved in the surgical separation of cojoined twins and from their stories propose recommendations to support perioperative nurses who are confronted with such workplace experiences.

Methods: Using a narrative methodology, nine perioperative nurses shared their stories of being involved in the surgical separation of conjoined twins in Australia. Narrative and thematic analyses were conducted and recommendations to support perioperative nurses through workplace (dis)stress were identified. Participants validated the findings and recommendations.

Findings: The analyses revealed the themes of professionalism, teamwork, 'them vs. us' and emotional loads.

Discussion: The sensationalism around the rarity of conjoined twins brought an intensive intrusiveness from the world media. As a result, secrecy within the hospital about the conjoined twin cases created divisions between those perioperative nurses on the teams and those not. The processes and outcomes of the two surgical cases were in contrast to each other. For some perioperative nurses this caused distress. It is essential that professional support is offered in a way in which the perioperative nurse can take it up without fear of negative judgement.

Twinning and the ductility of magnesium alloys Part II. “Contraction” twins

Magnesium and its alloys do not in general undergo the same extended range of plasticity as their competitor structural metals. The present work presents part II of a study that examines some of the roles deformation twinning might play in the phenomenon. A series of tensile and compression tests results are reported for common wrought alloys: AZ31, ZK60 and ZM20. These data are combined with EBSD analysis and simple flow stress models to argue the following: (i) that “contraction” double twinning (which enables contraction along the c axis) can decrease the uniform elongation, and (ii) that compression double twinning can also account for shear failure at low strains. The last of these is described as a combined consequence of strain softening of the continuum and the local generation of twin sized voids.

Twinning and the ductility of magnesium alloys Part I: “Tension” twins

Magnesium and its alloys do not in general undergo the same extended range of plasticity as their competitor structural metals. The present work is part I of a study that examines some of the roles deformation twinning might play in the phenomenon. A series of tensile test results are reported for the common wrought alloy AZ31. These data are employed in conjunction with a simple constitutive model to argue that View the MathML source twinning (which gives extension along the c-axis) can increase the uniform elongation in tensile tests. This effect appears to be similar to that seen in Ti, Zr and Cu–Si and in the so called TWIP phenomenon in steel.

Changes in body composition as determinants of longitudinal changes in bone mineral measures in 8 to 26 year old female twins

Between 1990 and 1998, we conducted a longitudinal study of 286 female twins aged 8 to 25 years at baseline (60 monozygotic (MZ) pairs, 44 dizygotic (DZ) pairs and 78 unpaired twins), measured on average 2.4 times (range 2–6) with an average of 1.8 years between measurements (range 0.7–6.7 years). Areal bone mineral density (ABMD) at the lumbar spine, total hip and femoral neck, total body bone mineral content (BMC), total body soft tissue composition (lean mass and fat mass) were measured by dual-energy X-ray absorptiometry, and height and menarchial status were also recorded. Median annual changes in height were negligible at 4 years post-menarche. During the “linear growth” period up to 4 years post-menarche, ABMD at the lumbar spine, total hip and femoral neck increased with annual change in lean mass by 1.7 (S.E. 0.1), 1.4 (0.1) and 1.0 (0.1) percent per kilogram per year, respectively (all p<0.001), independently of changes in fat mass or height. During the “post-linear growth” period, ABMD at the total hip and femoral neck increased with annual change in fat mass by 0.3 (0.1) and 0.5 (0.1) percent per kilogram per year (all p<0.01), independent of change in lean mass. Annual changes in total body BMC were associated with annual changes in lean mass (1.9 (0.2) percent per kilogram), in fat mass (1.3 (0.2) percent per kilogram) and in height (0.7) (0.2) percent per centimeter) during linear growth, and in fat mass (1.0 (0.1)) and lean mass (0.6 (0.1)) percent per kilogram post-linear growth (all p<0.001). We conclude that changes in bone mineral measures are strongly associated with changes in lean mass during linear growth, while post-linear growth, changes in fat mass are the predominant, although weaker, predictor. These findings suggest that the strong cross-sectional association between bone mineral measures and lean mass is established during growth and development, and that fat mass emerges as a more powerful determinant of bone change in healthy adult females.

Characteristics of the contraction twins formed close to the fracture surface in Mg-3A1-1Zn alloy deformed in tension

Characteristics of the “contraction” twins, formed close to the fracture surface in Mg–3Al–1Zn alloy deformed in tension approximately perpendicular to the grain c-axes, are investigated using transmission electron microscopy. The grain c-axis contractions were largely accommodated by {1011}-{1012} source double-twins in a variant characterized by 38° ⟨1210⟩ source twin/matrix misorientation in conjunction with dislocation slip. A possible interpretation of the observed preference for this variant formation is given and some crystal plasticity modelling is performed to elucidate the matter.

Effect of particles on the formation of deformation twins in a magnesium-based alloy

The deformation behaviour of the age hardenable alloy Mg–5%Zn after different precipitation treatments has been examined. It has been found that during compressive deformation, fine particles increase the number of twins that form, but reduce the size and total volume fraction of twins. Visco-plastic selfconsistent modelling has been used to show that the presence of precipitates hardens the twin and prismatic slip systems more than the basal slip system. It is proposed that because the {10 ¯12} twin requires basal slip to accommodate the twinning shear, this twin type will always be hardened equal to, or more than, the basal slip system in response to precipitation.

The effect of particles on twins and magnesium

This dataset includes orientation from xray diffraction, electron diffraction, and microstructural characterisation. Some transmission electronmicroscopy is also included.

The influence of twinning on the hot working flow stress and microstructural evolution of magnesium alloy AZ31

The microstructural evolution during compression (at 350°C and a strain rate of 0.01s-1) was examined for magnesium alloy AZ31 received in the "as-cast" condition. It was revealed that at low strains, many twins are produced and dynamically recrystallized (DRX) grains form as a necklace along pre-existing grain boundaries. At higher strains, DRX stagnates, most likely due to the accommodation of deformation in the DRX fraction of the material. It was also observed that twin boundaries act as sites for the nucleation of DRX grains. The analysis was repeated for samples pre-compressed to a strain of 0.15 at room temperature prior to the hot deformation step. The idea of these additional tests was to increase the degree of twinning and therefore the density of sites for the nucleation of DRX. It was found that statically recrystallized (SRX) grains developed at the twins during heating to the test temperature. When these samples were deformed, the peak flow stress was reduced by approximately 20% and the development of DRX was enhanced. This can be attributed to the accelerated nucleation of DRX in the refined SRX structure.

Microstructural features of rolled mg-3Al-1Zn

The microstructures of hot- and cold-rolled Mg-3Al-1Zn (AZ31) are examined using scanning electron and optical microscopy. It is shown that the microstructures following multipass hot rolling and annealing are more uniform than those formed by heavy single pass rolling and annealing. The importance of twins in producing intragranular recrystallization is evident, although the most dominant nucleation site is grain boundaries. The cold-rolled structure after a rolling reduction of 15 pct is dominated by the presence of deformation twins. Twin trace analysis suggests that approximately two thirds of the twins are a form of “c-axis compression” twin. A number of “c-axis tension” twins were also observed and additional in-situ scanning electron microscopy experiments were performed to confirm earlier observations that suggest these twins can form after deformation, during unloading.

Microstructural development during hot working of Mg-3AI-1Zn

he microstructural evolution is examined during the hot compression of magnesium alloy AZ31 for both wrought and as-cast initial microstructures. The influences of strain, temperature, and strain rate on the dynamically recrystallized microstructures are assessed. Both the percentage dynamic recrysallization (DRX) and the dynamically recrystallized grain size were found to be sensitive to the initial microstructure and the applied deformation conditions. Lower Z conditions (lower strain rates and higher temperatures) yield larger dynamically recrystallized grain sizes and increased percentages of DRX, as expected. The rate with which the percentage DRX increases for the as-cast material is considerably lower than for the wrought material. Also, in the as-cast samples, the percentage DRX does not continue to increase toward complete DRX with decreasing Z. These observations may be attributed to the deformation becoming localized in the DRX fraction of the material. Also, the dynamically recrystallized grain size is generally larger in as-cast material than in wrought material, which may be attributed to DRX related to twins and the inhomogeneity of deformation. Orientation maps of the as-cast material (from electron backscattering diffraction (EBSD) data) reveal evidence of discontinuous DRX (DDRX) and DRX related to twins as predominant mechanisms, with some manifestation of continuous DRX (CDRX) and particle-stimulated nucleation (PSN).

Pregnancy and lactation have no long-term deleterious effect on measures of bone mineral in healthy women: a twin study

BACKGROUND: The long-term effects of pregnancy and lactation on measures of bone mineral in women remain unclear.

OBJECTIVE: We studied whether pregnancy or lactation has deleterious long-term effects on bone mineral in healthy women.

DESIGN: We measured bone mineral density (BMD; g/cm(2)) in women aged > or = 18 y. Analyses were performed on 3 data sets: study 1, 83 female twin pairs (21 monozygous and 62 dizygous) aged (x +/- SD) 42.2 +/- 15.5 y who were discordant for ever having been pregnant beyond 20 wk; study 2, 498 twin pairs aged 42.3 +/- 15.0 y; and study 3, 1354 individual twins, their siblings, and family members.

RESULTS: In study 1, there were no significant within-pair differences in unadjusted BMD or BMD adjusted for age, height, and fat mass at the lumbar spine or total-hip or in total-body bone mineral content (BMC; kg) (paired t tests). In study 2, there was no significant within-pair difference in measures of bone mineral or body composition related to the within-pair difference in number of pregnancies. In study 3, subjects with 1 or 2 (n = 455) and > or = 3 pregnancies (n = 473) had higher adjusted lumbar spine BMD (2.9% and 3.8%, respectively; P = 0.001) and total-body BMC (2.2% and 3.1%; P < 0.001) than did nulliparous women (n = 426). Parous women who breast-fed had higher adjusted total-body BMC (2.6%; P = 0.005), total-hip BMD (3.2%; P = 0.04), and lower fat mass (10.9%; P = 0.01) than did parous non-breast-feeders.

CONCLUSION: We found no long-term detrimental effect of pregnancy or breast-feeding on bone mineral measures.

The effect of calcium supplementation on bone density in premenarcheal females: a co-twin approach

The age and developmental stage at which calcium supplementation produces the greatest bone effects remain controversial. We tested the hypothesis that calcium supplementation may improve bone accrual in premenarcheal females. Fifty-one pairs of premenarcheal female twins (27 monozygotic and 24 dizygotic; mean ± SD age, 10.3 ± 1.5 yr) participated in a randomized, single-blind, placebo-controlled trial with one twin of each pair receiving a 1200-mg calcium carbonate (Caltrate) supplement. Areal bone mineral density (aBMD) was measured at baseline and 6, 12, 18 and 24 months. There were no within-pair differences in height, weight, or calcium intake at baseline. Calcium supplementation was associated (P < 0.05) with increased aBMD compared with placebo, adjusted for age, height, and weight at the following time points from baseline: total hip, 6 months (1.9%), 12 months (1.6%), and 18 months (2.4%); lumbar spine, 12 months (1.0%); femoral neck, 6 months (1.9%). Adjusted total body bone mineral content was higher in the calcium group at 6 months (2.0%), 12 months (2.5%), 18 months (4.6%), and 24 months (3.7%), respectively (all P < 0.001). Calcium supplementation was effective in increasing aBMD at regional sites over the first 12–18 months, but these gains were not maintained to 24 months.