Children conceived by in vitro fertilisation after fresh embryo transfer

AIMS: To compare the outcome in in vitro fertilisation (IVF) children (after fresh embryo transfer) from multiple and singleton births with one another, and with normally conceived control children. METHODS: A cohort of 278 children (150 singletons, 100 twins, 24 triplets and four quadruplets), conceived by IVF after three fresh embryos had been transferred, born between October 1984 and December 1991, and 278 normally conceived control children (all singletons), were followed up for four years after birth. They were assessed for neonatal conditions, minor congenital anomalies, major congenital malformations, cerebral palsy and other disabilities. Control children, all born at term, were matched for age, sex and social class. RESULTS: The ratio of male:female births was 1.03. Forty six per cent of IVF children were from multiple births; 34.9% were from preterm deliveries; and 43.2% weighed less than 2500 g at birth. The IVF singletons were on average born one week earlier than the controls, weighed 400 g less, and had a threefold greater chance of being born by caesarean section. The higher percentage of preterm deliveries was largely due to multiple births and they contributed to neonatal conditions in 45.0% of all IVF children. The types of congenital abnormalities varied: 3.6% of IVF children and 2.5% of controls had minor congenital anomalies, and 2.5% of IVF children and none of the controls had major congenital malformations. The numbers of each specific type of congenital abnormality were small and were not significantly related to multiple births. IVF children (2.1%) and 0.4% of the controls had mild/moderate disabilities. They were all from multiple births, including two children with cerebral palsy who were triplets. CONCLUSIONS: The outcome of IVF treatment leading to multiple births is less satisfactory than that in singletons because of neonatal conditions associated with preterm delivery and disabilities in later childhood. A reduction of multiple pregnancies by limiting the transfer of embryos to two instead of three remains a high priority.     

C60 Detection in Soot Formed in Benzene Liquid Spray Combustion in a Shock Tube

H.P.L.C. and mass spectrometry.     

A technique for fractionated stereotactic radiotherapy in the treatment of intracranial tumors

PURPOSE: The excellent treatment results obtained with traditional radiosurgery have stimulated attempts to broaden the range of intracranial disorders treated with radiosurgical techniques. For major users of radiosurgery this resulted in a gradual shift from treating vascular diseases in a single session to treating small, well delineated primary tumors on a fractionated basis. In this paper we present the technique currently used in Montreal for the fractionated stereotactic radiotherapy of selected intracranial lesions. METHODS AND MATERIALS: The regimen of six fractions given every other day has been in use for "fractionated stereotactic radiotherapy" in our center for the past 5 years. Our current irradiation technique, however, evolved from our initial method of using the stereotactic frame for target localization and first treatment, and a "halo-ring" with tattoo skin marks for the subsequent treatments. Recently, we developed a more precise irradiation technique, based on an in-house-built stereotactic frame which is left attached to the patient's skull for the duration of the fractionated regimen. Patients are treated with the stereotactic dynamic rotation technique on a 10 MV linear accelerator (linac). RESULTS: In preparation for the first treatment, the stereotactic frame is attached to the patient's skull and the coordinates of the target center are determined. The dose distribution is then calculated, the target coordinates are marked onto a Lucite target localization box, and the patient is placed into the treatment position on the linac with the help of laser positioning devices. The Lucite target localization box is then removed, the target information is tattooed on the patient's skin, and the patient is given the first treatment. The tattoo marks in conjunction with the target information on the Lucite target localization box are used for patient set-up on the linac for the subsequent 5 treatments. The location of the target center is marked with radio-opaque markers on the target localization box and verified with a computerized tomography scanner prior to the second treatment. The same verification is done prior to other treatments when the target center indicated by the target localization box disagrees with that indicated by the tattoo marks. The new position of the target center is then determined and used for treatment positioning. CONCLUSION: The in-house-built frame is inexpensive and easily left attached to the patient's skull for the 12 day duration of the fractionated regimen. Positioning with the Lucite target localization box verified with tattoo marks ensures a high level of precision for individual fractionated treatments.     

Design and fabrication of biphasic cellular materials with transport properties – A modified bidirectional evolutionary structural optimization procedure and MATLAB program

Heat and mass transfer in macellular materials signifies an important topic of research for a range of advanced applications such as in thermal, aerospace, geotechnical and scaffold tissue engineering etc. Based on the mathematical similarity of various transport problems, this paper proposes a modified bidirectional evolutionary structural optimization (BESO) method for design of biphasic microstructural composites with desirable transport properties. The cellular materials considered herein comprise periodic base cells and the homogenization technique is adopted to determine their effective (bulk) properties. The key is to optimize the topology of base cell model for minimizing the difference between the effective and target transport properties. Numerical examples agree well with the well-known benchmarking microstructures and some of them are prototyped using biphasic solid free-form fabrication (SFF) technology. To facilitate comprehension of the algorithm, a short MATLAB program is provided in the Appendix.     

Curative potential of combined modality therapy for advanced Hodgkin's disease

During the period from 1969 through 1977, 124 patients with advanced Hodgkin's disease underwent treatment with combination chemotherapy and radiotherapy. Sixty-three cases were previously untreated, and 61 were relapses following radical radiotherapy for localized Hodgkin's disease. No patient in this series had received prior chemotherapy. Of 102 patients (84%) who have entered complete remission, 92 remain in complete remission with a median follow up time of five years, 10 patients having relapsed, and acute leukemia having developed in 2. The cumulative survival rate for all 124 patients is 80% at five years; the relapse-free survival rate is 74%. In many, if not most cases, the Hodgkin's disease appears to be cured. We have also identified two subgroups of patients for whom the prognosis is worse than for patients with advanced-stage disease as a whole. Patients over the age of 40 years have a five-year survival rate of only 45%, compared with 89% for all other patients. Those Stage IV patients with multiple extranodal sites of involvement have a five-year survival rate of 48%, compared with 81% for other Stage IV patients with only a single extranodal site involved.     

Leptomeningeal mycosis fungoides

Central nervous system involvement with mycosis fungoides complicated the clinical course of a patient at a time when his skin was clinically free of disease following systemic chemotherapy. A leptomeningeal syndrome of blurred vision and papilledema, and confusion progressing to coma, was associated with elevated spinal fluid pressure and abnormal spinal fluid cells morphologically similar to those seen in the Sezary syndrome. The symptoms were dramatically reversed by intrathecal methotrexate, brain irradiation, and steroids. Mycosis fungoides recurred in the skin, in the spinal fluid, and in both eyes. Despite continued systemic and intrathecal chemotherapy, the patient died from mycosis fungoides. This is the second patient reported with meningeal mycosis fungoides.     

Systemic methotrexate toxicity. A pharmacological study of its occurrence after intrathecal administration in a patient with renal failure

Methotrexate pharmacokinetic studies, performed on a patient with renal impairment who had toxic effects following 20 mg/sq m of intrathecally administered methotrexate, demonstrated prolonged serum concentrations of the drug, which accounted for the condition. After the return of normal renal function, pharmacokinetic studies were repeated following the same dose and route of administration of methotrexate. On this occasion there was a rapid clearance of serum methotrexate below toxic levels.     

Improving access to biodiversity data for,and from,EIAs – a data publishing framework built to global standards

Biodiversity information obtained during environmental impact assessments (EIAs) is rarely accessible for other uses following the completion of the EIA. Such data need to be made readily accessible; adding them to publicly accessible national datasets is important if biodiversity science, conservation and future decisions based on environmental assessment are to benefit from new biodiversity data and improved biodiversity data coverage. An ‘EIA Biodiversity Data Publishing Framework’, based on the Global Biodiversity Information Facility (GBIF) global standards, is thus proposed to meet this need. This paper outlines the GBIF-catalysed initiative to establish such an operational framework for uptake by the EIA community, as well as options that are available for data publishing in the absence of such a framework. It reviews the current state of accessibility and management of the primary biodiversity data associated with EIA studies, and highlights the urgent need for uptake of a range of data-publishing tools and best practices for making EIA biodiversity data exchangeable using globally accepted standards. Lessons learnt from pilot projects in India and South Africa underline the call for the rapid uptake of a national-to-global scale EIA Biodiversity Data Publishing Framework.     

Direct ink writing of bismuth molybdate microwave dielectric ceramics

Additive manufacturing via direct ink writing and microwave dielectric characterisation of commercially produced low sintering temperature bismuth molybdenum oxide ceramics, have been both performed for the first time, following a powder-to-product holistic approach. We demonstrated that direct ink writing is an excellent candidate for producing dielectric substrates to be used for wireless telecommunication applications operating at microwave (MW) frequencies, with great repeatability and properties comparable to ceramics fabricated via conventional processing routes. The optimum density (relative density of ρ_r ≈ 93%) of the 3D printed test samples was obtained by sintering at 660 °C for 2 h, resulting in a relative permittivity ε_r = 35.7, dielectric loss tanδ = 0.0004 and microwave quality factor Q × f = 14,928 GHz. Sintering at higher temperatures promoted a porosity increase due to mismatching grain growth mechanisms and phase decomposition, that collectively hindered the test samples’ microwave dielectric performance in terms of achievable relative permittivity (ε_r) and dielectric loss (tanδ).