A study of progress of labour using intrapartum translabial ultrasound, assessing head station, direction, and angle of descent

Intrapartum translabial ultrasound (ITU) has the potential to objectively and quantitatively assess the progress of labour. The relationships between the different ITU parameters and their development during normal term labour have not been studied.

A prospective study of the impact of air pollution on respiratory symptoms and infections in infants

Rationale: There is increasing evidence that short-term exposure to air pollution has a detrimental effect on respiratory health, but data from healthy populations, particularly infants, are scarce. Objectives: To assess the association of air pollution with frequency and severity of respiratory symptoms and infections measured weekly in healthy infants. Methods: In a prospective birth cohort of 366 infants of unselected mothers, respiratory health was assessed weekly by telephone interviews during the first year of life (19,106 total observations). Daily mean levels of particulate matter (PM10), nitrogen dioxide (NO2), and ozone (O3) were obtained from local monitoring stations. We determined the association of the preceding week's pollutant levels with symptom scores and respiratory tract infections using a generalized additive mixed model with an autoregressive component. In addition, we assessed whether neonatal lung function influences this association and whether duration of infectious episodes differed between weeks with normal PM10 and weeks with elevated levels. Measurements and Main Results: We found a significant association between air pollution and respiratory symptoms, particularly in the week after respiratory tract infections (risk ratio, 1.13 [1.02-1.24] per 10 μg/m(3) PM10 levels) and in infants with premorbid lung function. During times of elevated PM10 (>33.3 μg/m(3)), duration of respiratory tract infections increased by 20% (95% confidence interval, 2-42%). Conclusions: Exposure to even moderate levels of air pollution was associated with increased respiratory symptoms in healthy infants. Particularly in infants with premorbid lung function and inflammation, air pollution contributed to longer duration of infectious episodes with a potentially large socioeconomic impact.

Effect of varying injection rates of a saline chaser on aortic enhancement in CT angiography: phantom study

The effect of varying injection rates of a saline chaser on aortic enhancement in computed tomography (CT) angiography was determined. Single-level, dynamic CT images of a physiological flow phantom were acquired between 0 and 50 s after initiation of contrast medium injection. Four injection protocols were applied with identical contrast medium administration (150 ml injected at 5 ml/s). For baseline protocol A, no saline chaser was applied. For protocols B, C, and D, 50 ml of saline was injected at 2.5 ml/s, 5 ml/s, and 10 ml/s, respectively. Injecting the saline chaser at twice the rate as the contrast medium yielded significantly higher peak aortic enhancement values than injecting the saline at half or at the same rate as the contrast medium (P < 0.05). Average peak aortic enhancement (HU) measured 214, 214, 218, and 226 for protocols A, B, C, and D, respectively. The slower the saline-chaser injection rate, the longer the duration of 90% peak enhancement: 13.6, 12.2, and 11.7 s for protocols B, C, and D, respectively (P > 0.05). In CT angiography, saline chaser injected at twice the rate as the contrast medium leads to increased peak aortic enhancement and saline chaser injected at half the rate tends towards prolonging peak aortic enhancement plateau.

Clinical outcomes following subgingival application of a novel erythritol powder by means of air polishing in supportive periodontal therapy: a randomized, controlled clinical study

OBJECTIVES The aim of this prospective, randomized, controlled clinical study was to compare the clinical outcomes of the subgingival treatment with erythritol powder by means of an air-polishing (EPAP) device and of scaling and root planing (SRP) during supportive periodontal therapy (SPT). METHOD AND MATERIALS 40 patients enrolled in SPT were randomly assigned to two groups of equal size. Sites had to show signs of inflammation (bleeding on probing [BOP]-positive) and a probing pocket depth (PPD) of ≥ 4 mm, however, without presence of detectable subgingival calculus. During SPT, these sites were treated with EPAP or SRP, respectively. Full mouth and site-specific plaque indices, BOP, PPD, and clinical attachment level (CAL) were recorded at baseline (BL) and at 3 months, whereas the percentage of study sites positive for BOP (BOP+) was considered as primary outcome variable. Additionally, patient comfort using a visual analog scale (VAS) and the time needed to treat per site was evaluated. RESULTS At 3 months, mean BOP level measured 45.1% at test sites and 50.6% at control sites, respectively, without a statistically significant difference between the groups (P > .05). PPD and CAL slightly improved for both groups with comparable mean values at 3 months. Evaluation of patient tolerance showed statistically significantly better values among patients receiving the test treatment (mean VAS [0-10], 1.51) compared to SRP (mean VAS [0-10], 3.66; P = .0012). The treatment of test sites was set to 5 seconds per site. The treatment of control sites, on the other hand, lasted 85 seconds on average. CONCLUSION The new erythritol powder applied with an air-polishing device can be considered a promising modality for repeated instrumentation of residual pockets during SPT. CLINICAL RELEVANCE With regard to clinical outcomes during SPT, similar results can be expected irrespective of the two treatment approaches of hand instrumentation or subgingival application of erythritol powder with an air-polishing device in sites where only biofilm removal is required.

A Longitudinal Assessment of Sleep Timing, Circadian Phase, and Phase Angle of Entrainment across Human Adolescence

The aim of this descriptive analysis was to examine sleep timing, circadian phase, and phase angle of entrainment across adolescence in a longitudinal study design. Ninety-four adolescents participated; 38 (21 boys) were 9-10 years ("younger cohort") and 56 (30 boys) were 15-16 years ("older cohort") at the baseline assessment. Participants completed a baseline and then follow-up assessments approximately every six months for 2.5 years. At each assessment, participants wore a wrist actigraph for at least one week at home to measure self-selected sleep timing before salivary dim light melatonin onset (DLMO) phase - a marker of the circadian timing system - was measured in the laboratory. Weekday and weekend sleep onset and offset and weekend-weekday differences were derived from actigraphy. Phase angles were the time durations from DLMO to weekday sleep onset and offset times. Each cohort showed later sleep onset (weekend and weekday), later weekend sleep offset, and later DLMO with age. Weekday sleep offset shifted earlier with age in the younger cohort and later in the older cohort after age 17. Weekend-weekday sleep offset differences increased with age in the younger cohort and decreased in the older cohort after age 17. DLMO to sleep offset phase angle narrowed with age in the younger cohort and became broader in the older cohort. The older cohort had a wider sleep onset phase angle compared to the younger cohort; however, an age-related phase angle increase was seen in the younger cohort only. Individual differences were seen in these developmental trajectories. This descriptive study indicated that circadian phase and self-selected sleep delayed across adolescence, though school-day sleep offset advanced until no longer in high school, whereupon offset was later. Phase angle changes are described as an interaction of developmental changes in sleep regulation interacting with psychosocial factors (e.g., bedtime autonomy)

Visualization and quantification of air embolism structure by processing postmortem MSCT data.

Venous air embolism (VAE) is an often occurring forensic finding in cases of injury to the head and neck. Whenever found, it has to be appraised in its relation to the cause of death. While visualization and quantification is difficult at traditional autopsy, Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) offer a new potential in the diagnosis of VAE. This paper reports the findings of VAE in four cases of massive head injury examined postmortem by Multislice Computed Tomography (MSCT) prior to autopsy. MSCT data of the thorax were processed using 3D air structure reconstruction software to visualize air embolism within the vascular system. Quantification of VAE was done by multiplying air containing areas on axial 2D images by their reconstruction intervals and then by summarizing the air volumes. Excellent 3D visualization of the air within the vascular system was obtained in all cases, and the intravascular gas volume was quantified.

Stratospheric age of air variations between 1600 and 2100

The current understanding of preindustrial stratospheric age of air (AoA), its variability, and the potential natural forcing imprint on AoA is very limited. Here we assess the influence of natural and anthropogenic forcings on AoA using ensemble simulations for the period 1600 to 2100 and sensitivity simulations for different forcings. The results show that from 1900 to 2100, CO₂ and ozone-depleting substances are the dominant drivers of AoA variability. With respect to natural forcings, volcanic eruptions cause the largest AoA variations on time scales of several years, reducing the age in the middle and upper stratosphere and increasing the age below. The effect of the solar forcing on AoA is small and dominated by multidecadal total solar irradiance variations, which correlate negatively with AoA. Additionally, a very weak positive relationship driven by ultraviolett variations is found, which is dominant for the 11 year cycle of solar variability.

Phase relationships between orbital forcing and the composition of air trapped in Antarctic ice cores

Orbital tuning is central for ice core chronologies beyond annual layer counting, available back to 60 ka (i.e. thousands of years before 1950) for Greenland ice cores. While several complementary orbital tuning tools have recently been developed using δ¹⁸Oatm, δO₂⁄N₂ and air content with different orbital targets, quantifying their uncertainties remains a challenge. Indeed, the exact processes linking variations of these parameters, measured in the air trapped in ice, to their orbital targets are not yet fully understood. Here, we provide new series of δO₂∕N₂ and δ¹⁸Oatm data encompassing Marine Isotopic Stage (MIS) 5 (between 100 and 160 ka) and the oldest part (340–800 ka) of the East Antarctic EPICA Dome C (EDC) ice core. For the first time, the measurements over MIS 5 allow an inter-comparison of δO₂∕N₂ and δ¹⁸Oatm records from three East Antarctic ice core sites (EDC, Vostok and Dome F). This comparison highlights some site-specific δO₂∕N₂ variations. Such an observation, the evidence of a 100 ka periodicity in the δO₂∕N₂ signal and the difficulty to identify extrema and mid-slopes in δO2∕N2 increase the uncertainty associated with the use of δO₂∕N₂ as an orbital tuning tool, now calculated to be 3–4 ka. When combining records of δ¹⁸Oatm and δO₂∕N₂ from Vostok and EDC, we find a loss of orbital signature for these two parameters during periods of minimum eccentricity (∼ 400 ka, ∼ 720–800 ka). Our data set reveals a time-varying offset between δO₂∕N₂ and δ¹⁸Oatm records over the last 800 ka that we interpret as variations in the lagged response of δ¹⁸Oatm to precession. The largest offsets are identified during Terminations II, MIS 8 and MIS 16, corresponding to periods of destabilization of the Northern polar ice sheets. We therefore suggest that the occurrence of Heinrich–like events influences the response of δ¹⁸Oatm to precession.

Nanometer-size anisotropy of injection-molded polymer micro-cantilever arrays

Understanding and controlling the structural anisotropies of injection-molded polymers is vital for designing products such as cantilever-based sensors. Such micro-cantilevers are considered as cost-effective alternatives to single-crystalline silicon-based sensors. In order to achieve similar sensing characteristics,structure and morphology have to be controlled by means of processing parameters including mold temperature and injection speed. Synchrotron radiation-based scanning small- (SAXS) and wide-angle x-ray scattering techniques were used to quantify crystallinity and anisotropy in polymer micro-cantilevers with micrometer resolution in real space. SAXS measurements confirmed the lamellar nature of the injection-molded semi-crystalline micro-cantilevers. The homogenous cantilever material exhibits a lamellar periodicity increasing with mold temperature but not with injection speed. We demonstrate that micro-cantilevers made of semi-crystalline polymers such as polyvinylidenefluoride, polyoxymethylene, and polypropylene show the expected strong degree of anisotropy along the injection direction.

Removal of enamel caries with an air abrasion powder

This study compared the efficiency of air abrasion on enamel caries with selective enamel powder (SEP) or with alumina powder and a negative and positive control group. Ninety-three extracted molars with non-cavitated incipient enamel lesions were selected. After embedding the roots in resin, each lesion was sectioned perpendicular to the surface and photographed. Each lesion was classified microscopically as having or not having dentin involvement. The lesions were distributed into four groups with an equal number of enamel caries with or without dentin involvement. Each group was treated differently: Group 1 had SEP abrasion, Group 2 had alumina abrasion, Group 3 had sodium bicarbonate abrasion (negative control) and Group 4 had bur treatment (positive control). The surface was rephotographed after treatment. Superimposition of the photographs identified areas of "correct-excavation," "under-excavation" and "over-excavation." There were no statistical differences between lesions treated with or without dentin involvement for Groups 2 through 4. However, in the SEP group, all measured areas were significantly influenced by dentin involvement. In pairwise comparisons, no statistical differences were found between the alumina and bur groups. The SEP group, however, showed statistically significant differences for each area compared to the alumina group in enamel caries without dentin involvement. SEP performed as well as alumina and bur in lesions with dentin involvement. SEP is different in its ablative properties toward caries with dentin involvement or no dentin involvement. In terms of dental treatment, SEP seems to have a diagnostic potential for enamel lesions before operative intervention in patients with high caries risk.

Development of a computer-assisted high-pressure Injection device for vertebroplasty

A novel computer-assisted injection device for the delivery of highly viscous bone cements in vertebroplasty is presented. It addresses the shortcomings of manual injection systems ranging from low-pressure and poor level of control to device failure. The presented instrument is capable of generating a maximum pressure of 5000 kPa in traditional 6-ml syringes and provides an advanced control interface for precise cement delivery from outside radiation fields emitted by intraoperative imaging systems. The integrated real-time monitoring of injection parameters, such as flow-rate, volume, pressure, and viscosity, simplifies consistent documentation of interventions and establishes a basis for the identification of safe injection protocols on the longer term. Control algorithms prevent device failure due to overloading and provide means to immediately stop cement flow to avoid leakage into adjacent tissues.