Prematurity in a Sample of Brazilian Twins: A Cross-Sectional Study .
Objective: To evaluate the characteristics of newborns of pregnant women attending a public maternity hospital in Rio de Janeiro, Brazil.
Methods: A retrospective cross-sectional study of records of newborn twins from adult and adolescent pregnancies. Twins were divided into two groups, Twin 1, the first one delivered, and Twin 2, the second. The association between gestational age at birth and neonatal characteristics were analysed using Chi Square and Fisher's exact tests and associations were considered significant when p-values were ≤ 0.05.
Results: We evaluated 218 infants with a mean gestational age of 35.7 weeks at birth. The groups twin 1 and 2 showed, respectively, average weight at birth of 2343.9 grams (SD = 627.3) and 2267.6 grams (SD = 608.2). Most twins of group 1 presented appropriate birth weight (n = 53; 48.6%) and were classified as appropriate for gestational age (n = 88; 80.7%). The group twin 2 had, mostly, low birth weight (n = 55; 50.5%), and were classified as appropriate for gestational age (n = 93; 85.3%). Prematurity was relevant to the development of postnatal complications (twin 1 - p = 0.002; twin 2 - p = 0.001) and low birth weight (twins 1 - p = 0.000; twins 2 - p = 0.000) for both groups.
Conclusion: Prematurity was an important risk factor for the development of postnatal metabolic and respiratory complications and low birth weight for both groups.
Twin pregnancies are high maternal and fatal risk and few studies consider the magnitude of the associated factors (maternal family history, advanced maternal age, high parity, personal history of twin pregnancy, ovulation induction and use of assisted reproductive technologies) in obstetrical management [1-2]. They represent a high number of admissions to the intensive care unit and is described that perinatal mortality is proportional to maternal age  and the number of foetuses, four to six times higher compared to singleton pregnancies [4-5].
The twins have changes of different magnitudes in childhood, compared to single newborns, with a strong tendency to be born with low weight and gestational age . According to the survey "Nasser no Brazil" the rate of neonatal mortality in twin pregnancies corresponds to 52.2 per 1,000 live births which represents a 5 times greater risk for neonatal mortality multiple foetuses compared to single .
The fatal development of twins is virtually identical to the single foetuses up to 32 weeks of pregnancy and then there is a slowdown in growth and may result in high rates of intrauterine growth restriction (IUGR) in term pregnancies [8-9]. About 10% of monozygotic twins (derived from individuals of a fertilized egg) have a weight of disagreement at birth more than 10% and higher expectation of being classified as small for gestational age (SGA) [9, 10].
The low weight at birth in twin research, complication capable of raising birth rates Caesarean, prematurity and disabling accommodation postpartum whole is rarely described in the literature. In Porto Alegre, Brazil, a rate of 24.7% of low birth weight in twin pregnancies in 11 years of research has demonstrated .
Some of multiple pregnancy associated changes represent high maternal and fatal risk highlighting the fatal anomaly, intrauterine death, premature rupture of membranes and discordant preterm delivery, conjoined twins, twin to twin transfusion syndrome and TRAP sequence (Twin Reversed Arterial Perfusion Sequence) or twin acardiac .
Preterm birth in twin pregnancy has an average occurrence rate of 30% to 50% being more prevalent in monochorionic pregnancies (present only one placenta) than dichorionic (two different placentas) . The mean gestational age at birth to the twins is three weeks shorter than for single gestation and birth weight will depend on the time of pregnancy is significantly lower for twins . In addition to prematurity, monochorionicity is one of the most important factors responsible for morbidity and mortality in twin pregnancies .
The reduction in preterm birth rates is one of the main goals of prenatal care in twin pregnancies . However, when considering the reduction of fatal mortality considering birth weight and gestational age, are as ideal references 2500g to 2800g and 36 to 37 weeks. Population studies show that perinatal mortality increased from 38 weeks gestation, being prudent to anticipate the interruption of delivery in these pregnancies [16- 17].
Knowing the neonatal anthropometric and clinical conditions of the twin structure will enable the pre care and post-natal and promote fatal development. This study aims to evaluate the characteristics of newborn twin pregnant women assisted in a public hospital in Rio de Janeiro, analysing gestational age and birth weight.
Cross-sectional study, consisting of twin newborns born adult and adolescent women who were followed during the prenatal and childbirth in a public maternity hospital in the city of Rio de Janeiro, from January / 2011 to December / 2013. The sample was for convenience and the data obtained from medical chart review.
The survey was conducted at a maternity hospital located in the south of the city of Rio de Janeiro, health unit has multiservice, specializes in services to multiple pregnancies.
Inclusion criteria were twin neonates born to adolescent and adult pregnant women, double pregnancy (two foetuses), mono or dizygotic, mono or dichorionic, mono or dianoetic accompanied prenatal and delivery in the study hospital. They excluded pregnant women who have undergone abortion process or intrauterine fatal death during prenatal care and conjoined twins.
In the period studied were met in 6442 maternity mothers with single or twin pregnancies, being selected 151 medical records of twin pregnant women and their newborns, which were analyzed 109 who met the inclusion criteria for the study. They were excluded from the study, 42 records, for pregnant women did not undergo prenatal and / or delivery in maternity studied, because they are triplet pregnancies and due to the occurrence of discordant intrauterine death or Vanish Twin in different gestational ages. They selected 218 twins divided into two groups, called T1 as the first born and the last T2.
The collection of medical record data was performed by trained staff and recording information of pregnant women occurred in standardized protocol containing maternal information and newborns (sociodemographic, clinical, obstetrical and gynaecological, prenatal care, childbirth and postpartum , anthropometric and nutritional).
The dependent variables were: gestational age at birth according to ultrasonography (premature, if < 37 weeks; term, if > 37 weeks) and weight rating birth measured continuously and categorically (normal weight, if > 2500g; low weight is < 2500 g, very low birth weight if < 1500 g, extremely low weight if < 1000g).
Independent variables related to foetuses were studied, such as: classification of newborns according to gestational age at birth (extreme immaturity if < 28 weeks; preterm if < 37 weeks, the term is between 37 to 42 weeks), weight (grams), length (cm) and head circumference at birth (cm); Apgar 1 and 5 minutes (< 7, low vitality at birth,> 7, adequate vitality at birth) [18-20]; somatic Capurro (weeks); classification of weight according to gestational age  (small for gestational age - SGA if weight < 10th percentile; appropriate for gestational age - AGA, if weight is between 10 and 90 percentiles, large for gestational age - LGA if weight> 90th percentile) ; presence of congenital anomalies; site postpartum hospital stay (rooming or Neonatal Intensive Care Unit - NICU); reason for hospitalization in the NICU; type of food during hospitalization (zero diet, breast milk exclusively, only infant formula, breast milk associated with infant formula, total parenteral nutrition or exclusively associated with infant formula); fatal complications in the first seven days of life (neither, metabolic, respiratory, malformations, infectious, early neonatal death - when this occurs within 7 days after delivery); length of stay; weight, length and head circumference at discharge.
Exploratory data analysis was performed with a description of the sample with estimates of mean and standard deviation (SD) for continuous variables and proportions for categorical variables. The association between gestational age at birth and neonatal characteristics were analyzed using Chi Square and Fisher's Exact tests were considered significant p values less than 0.05. Statistical analysis was performed with SPSS (Statistical Package for Social Sciences) software for Windows version 21.0.
Two hundred and eighteen newborns twins with were evaluated with a mean gestational age at birth of 35.7 weeks by ultrasound (SD = 3.1). The births were caesarean of type in 92.7% of the sample (n = 101) and 7.3% (n = 8) were vaginal. Considering maternal characteristics were evaluated 109 women, 101 adults with an average age of 28.3 years (SD = 5.1) and 8 adolescents with a mean age of 16.2 years (SD = 1.9).
The T1 and T2 presented, respectively, average weight at birth of 2343.9g (SD = 627.3) and 2267.6g (SD = 608.2), length of 44.6 cm (SD = 4, 1) and 44.6cm (SD = 4.0), head circumference of 32.4cm (SD = 2.7) and 32.1cm (SD = 2.6) and mean gestational age by method Capurro of 36.0 weeks (SD = 3.0) and 36.1 weeks (SD = 2.7).
The average length of hospital stay for the T1 was 13 days (SD = 21.8) ranging from 1-105 days and the average high weight was higher than the birth weight, corresponding to 2429.5g (SD = 452.3). T2 remained on average 12.7 days (SD = 22.1) admitted, ranging from 2-117 days and mean weight at discharge equal to 2336.8g (SD = 420.3). Information about the head circumference and length at discharge were underreported or were not available in the medical records of all twins. Information regarding the T1 showed that they had an average head circumference of 33,2cm (n = 10, SD = 2.7) and the G2 was 32,1cm (n = 10, SD = 2.7) at the time of hospital.
The early neonatal death was similar in T1 (n = 2; 1.8%) and T2 (n = 2, 1.8%) as described in Table 1. Most T1 was male (n = 56; 51.9%) had adequate birth weight (n = 53; 48.6%) showed good vitality at birth according to the Apgar at 1 (n = 94; 86.2%) and 5 minutes (n = 106; 97.2%) were classified as AGA (n = 88; 80.7%) were in accommodation postpartum set (n = 58; 53.2%) and were fed composed of infant formula and breast milk (n = 73; 67.0%).
Most T2 was woman (n = 56; 51.4%) had low birth weight (n = 55; 50.5%), good vitality at birth according to the Apgar score at 1 (n = 106; 97.2%) and 5 minutes (n = 106; 97.2%) were classified as AGA (n = 93; 85.3%) remained in the accommodation postpartum set (n = 61, 56, 0%) and were fed a combination of breast milk and infant formula (n = 76; 69.7%) (Table 1).
Table 1: Conditions at birth, clinical and anthropometric characteristics of twins followed in a public maternity of Rio de Janeiro, RJ.
Label: T1 (Twin 1), T2 (Twin 2), GA (Gestational Age), NICU (Neonatal Intensive Care Unit).
Among the T1 newborns, 38.5% (n = 42) had metabolic complications, highlighting hypoglycaemia and jaundice. Respiratory changes occurred in 23.9% of cases (n = 26) mainly respiratory distress and hyaline membrane disease. Regarding T2, 37.6% had metabolic complications (n = 41), especially hypoglycaemia and jaundice and 20.2% respiratory complications (n = 22), especially tachypnea.
Given the high prevalence of prematurely born foetuses (47.7%), neonatal characteristics were described as gestational age at birth of T1 and T2 (Tables 2 and 3).
Label: T1 (Twin 1), NICU (Neonatal Intensive Care Unit), TPN (Total Parenteral Nutrition).
Table 3: Relationship of neonatal characteristics with gestational age at birth of T2 followed in a public maternity in Rio de Janeiro, RJ, Brazil.
Label: T2 (Twin 2), NICU (Neonatal Intensive Care Unit), TPN (Total Parenteral Nutrition).
The prematurely born T1 showed higher weight deviation (low weight, very low birth weight and extremely low birth weight) compared to those born at term (p = 0.000). The same results were found for T2 (p = 0.000).
The first minute Apgar score was satisfactory to both, however, observed a higher number of premature twins with index less than 7, showing a low fatal birth for T1 (p = 0.017) and T2 (p = 0.001). The Apgar 5 minutes no difference to T1 (p = 0.245) T2 (p = 0.245) were born prematurely or not.
The analysis of the gestational age at birth and weight rating for gestational age showed no significant difference with respect to T1 (p = 0.387) and T2 (p = 0.086).
According to the site postpartum hospital stay, it is observed that more premature infants were allocated in the neonatal NICU after delivery compared to those who were born with adequate gestational age, both the T1 (p = 0.000) , as for T2 (p = 0.000).
During the hospital stay, it is observed that only premature neonates receiving TPN isolated (T1) or associated with infant formula and / or breast milk (T1 and T2), and it was identified that two premature neonates were zero diet during admission evolving to death. The breast milk supply alone was higher for the group of infants with adequate gestational age T1 (p = 0.029) and T2 (p = 0.001).
Neonatal complications were identified in greater numbers in T1 (p = 0.002) and T2 (p = 0.000) with gestational age at birth less than 37 weeks, unlike those with adequate gestational age.
Identify gaps in relation to the study of twins makes it possible to propose solutions to reduce maternal and fatal morbidity and mortality. Prematurity, associated with maternal complications of multiple pregnancies should be investigated in order to minimize risks to the mother-child binomial .
Prematurity and the average maternal age were relevant factors in this study and may represent adverse perinatal outcomes. Research in Mexico , which analyzed the determinants of birth weight in 244 double pregnancies, found average maternal age in adult of 28 years (SD = 7.0) and gestational age at birth 35 weeks , similar to those found in this study. Doss et al.  , showed that the optimal gestational age associated with lower Perinatal mortality is more than 38 weeks pregnancy and births less than 36 weeks gestation, the risk of infectious complications, respiratory and admission to NICU rise by 4 to 6 times. Garner and Oliveira de Barros , in a study with women from multiple pregnancies by assisted reproduction techniques found mean maternal age of 33.9 years and 64.9% of births before 36 weeks.
Most deliveries were caesarean (92.7%) in the sample, far superior results to those found in national and international studies. American survey of 377 twin pregnancies found 52.5% of spontaneous births and 47.5% caesarean , different from that found in this study. However, in Rio de Janeiro, Brazil, study of 104 twin pregnancies  showed 69% of surgical deliveries. In São Paulo, Brazil, study of 249 twin pregnancies revealed that 84.8% were caesarean , approaching the results found in this study. Caesarean section is recommended in monoamniotic pregnancies when the fetes are not in cephalic presentation and if there is high risk for the combination of abdominal and vaginal delivery  may represent maternal and fatal protection factor .
Much of the concepts were classified as low birth weight, being more frequent for G2 than for G1. In Maringa, Paraná, Brazil, Cardim and colleagues  found low birth weight in 64% of the sample. Maximiano  showed a higher frequency of low birth weight in group 2 (60.6%), a result similar to that found in this study. The low birth weight may be related to prematurity, maternal complications and gestational weight gain and should be a relevant factor in neonatal care.
Twins are at greater risk of developing intrauterine growth deviations compared to single, very often characterized as IUGR . Understanding this dynamic depends on weight ratings considering the gestational age according to the recommendations for the twin foetuses. In the present study, the majority of the twin 1 and 2 was classified as AGA and approximately 15% were SGA. We also observed that 3.7% were classified as T1 LGA, while no T2 reached this classification.
The vitality at birth can determine the neonatal development and is related to the hospital stay and institutional costs. Most twin 1 and 2 showed good fatal according to Apgar first and fifth minutes. A similar result was found by Maximiano  also noted that among the twin 1 and 2, the first present with higher Apgar scores than the others. Neonatal depression, represented by Apgar score < 7, was seen in only 2.7% of a sample of 1429 multiple Argentine newborns , lower than that found in this study.
Metabolic complications were proportionally higher than the other (respiratory, infectious, malformations and neonatal death), both for the T1 as for the T2 and, among them, stood out hypoglycaemia and jaundice and death in the early neonatal period occurred similarly for both twins. A study conducted in São Paulo, Brazil, from 131 medical records of multiple pregnancies resulting from assisted reproduction techniques showed that 37.5% of newborns had jaundice and early neonatal death rate reached 2.7% .
Lateral and colleagues  demonstrated that early neonatal mortality rate reached 2.9% (n = 42) in a sample of 10-year study of multiple pregnancies in Buenos Aires, Argentina. Early neonatal death was lower than that found in other studies may reflect the proper development of the fetes and possibly indicating an effective prenatal care. The care offered to pregnant women in the twin study of motherhood can be extremely important factor to contribute to the findings of this study, as there are specific institutional protocols that guide the perinatal care, in addition to the infrastructure available for quality care.
Postnatal stay in the NICU was lower than in rooming-ing for both twins, which may represent a good postnatal prognosis. Doss and colleagues  demonstrated that premature birth is responsible for high admission rates in intensive care units and the risk six times higher for those with 36 gestational weeks compared to 38 weeks and that the risk decreases with increasing age gestational at birth. Recommendations for the prenatal care of twin pregnancies [34-35] consider that dichorionic pregnancies should be discontinued, electively, at 37 weeks, while for monochorionic is considered 36 weeks and to prolong gestation to 38 weeks increases the risk of fatal death.
Preterm birth caused by premature labour, premature rupture of membranes or iatrogenic factors, is the most important fatal complications in multiple pregnancies and increases the adverse neonatal outcomes [34, 36]. It is usual for the multiple pregnancies that labour occurs spontaneously before 37 weeks and the mean gestational age is inversely related to the number of foetuses: 35-36 weeks for twins, 32 to 34 for triplets and less than 30 for other categories of multiple pregnancy .
Low birth weight was significantly related to preterm birth for both the T1 and T2. In 2006, the United States, 60% of twin births were premature, classified as low birth weight and that 1 to 10 twins (n = 13,983) was born less than 1500g .
The Apgar score in the first minute below 7 was rated among the twin 1 and 2 and it was observed that in premature infants, the prevalence of this change was higher. The same finding was not repeated for the Apgar score in the fifth minute. Study in Caxias do Sulk, Rio Grande do Sulk, Brazil, with multiple pregnancies (n = 193) showed similar results and associated low Apgar score with a reduction in umbilical artery pH, which can be caused by prolonged labour (more than 60 minutes) which can increase the risk of neonatal acidosis.
Preterm newborns may require intensive care during the neonatal period and in relation to premature twins, this assumption is confirmed. It was observed a significant relationship between the NICU - Neonatal and preterm delivery for T1 and T2. The admission to intensive care unit was 10% higher for twins at 36 weeks gestation than for newborns only in an American sample with 260 twins and the main causes for this high admission would be transient tachypnea, suspected sepsis and infants small for gestational age .
Brazil recommends that breastfeeding is encouraged for all newborns . In the present study breast milk supply often associated with infant formula for T1 and T2 was similar, regardless of gestational age at birth. Qualitative study  that investigated breastfeeding in twin, identified that problems like long-time duration of breastfeeding, exhaustion, lack of help in the care of children and information with respect to power multiple, can be factors for the failure of this practice and, in addition, many women find that their milk is not strong enough for twins, asking thus the supply of infant formula. Damato and colleagues  show that the main unfavourable conditions related to multiple breastfeeding would prematurity, lack or weak sucking reflex, neurological immaturity and the permanence of the concepts for long periods in intensive care. Important to note that the supply of infant formula and parenteral nutrition can significantly increase hospital costs and family after discharge, should be minimized and better conducted in health facilities.
The particularities involving multiple pregnancies and care for twin newborns are important objects of study, especially the growing number of cases arising from technological development to enable safe assisted reproduction techniques and advanced maternal age [40,43].
The limitations of this study was the fact that present data in a single maternity in Rio de Janeiro, Brazil, which prevents generalized conclusions about the population of twin pregnancy; the lack of comparison of data from twin newborns studied with a group of unique newborns, which could demonstrate features differential between these population groups.
In this study, prematurity constitute an important risk factor for the development of postnatal complications and low birth weight neonates of both. Good fatal vitality to T1 and T2 shown by the Apgar score and the adequacy of the weight / gestational age can be considered important findings and translate adequacy of maternal and fatal care. The rooming-in for most newborns and breast milk supply consists of experiences that enable early hospital discharge and good nutrition of twin newborns. The reduced early neonatal death rate may reflect the quality of perinatal care.
The authors' contributions are as follows: N.F.A.A., E.M.A.L and C.S.. contributed to the study design and data analyses; N.F.A.A. was the principal investigator and contributed to the study design and interpretation of the findings and wrote the manuscript; N.F.A.A., P.C.P, N.S.R., D.R.C., E.M.A.L. and C.S. contributed to the subject briefings and data collection. All authors read and approved the final version of the manuscript.
Authors signed a confidentiality agreement for medical data. The study followed the standards of the National Health Council and it was approved by the Research Ethics Committee from the Maternity School of the Federal University of Rio de Janeiro at 07/18/14 (protocol CAE 329977114.9.0000.5275).
MOREIRA DE SÁ RA, RIBEIRO DA SILVA N, FILGUEIRAS DE REZENDE KR, Gestação Gemelar: problemas em dobro? Femina. 2008;365(12):749-755.
SPELLACY WN, HANDLER A, FERRE CD. A case-control study of 1253 twin pregnancies from a 1982-1987 perinatal data base. Obstetrics and Gynaecology, 1990;75(2):168-171.
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COLLETO D, G M & ROSÁRIO H. Gestações múltiplas em amostras de uma população da cidade de São Paulo. Einstein, 2004;2(1):9-13.
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LANSKY S, FRICHE AA L, CAMPOS D, BITTENCOURT, SDA, LAZARO DE CARVALHO M, CAVALCANTE RS & ALVES DA CUNHA A.J.L. Pesquisa Nascer no Brasil: perfil da mortalidade neonatal e avaliação da assistência à gestante e ao recém-nascido. Caderno de Saúde Pública, 2014;30(Suppl 1):S192-S207.
KEET MP, JAROSZEWICZ AM & LOMBARD CJ. Follow-up study of physical growth of monozygous twins with discordant with-pair birth weights. Paediatrics. 1986;77(3):336-344.
MARTINS WP, BARRA DA & MAUAD-FILHO F. Gestação múltipla – aspectos clínicos. Femina, 2006;34(6):423-431.
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Wash, halve and deseed the chillies, then cut into thin strips.
Briefly dip the tomatoes into boiling water, remove, plunge into cold water, then peel off the skins. Remove the stalks, cutting in a v-shape, then dice the flesh.
Wash the thyme, shake dry and chop the leaves.
Peel the garlic, cut in half and rub around the inside of a pan.
Heat the oil in the pan and saute the onions and thyme for 2-3 minutes over a medium heat.
Add the pepper and saute for 2-3 minutes. Add the tomatoes and cook for a further 3 minutes.
Whisk the eggs with the sour cream and season with salt, pepper and freshly grated nutmeg. Pour over the vegetables and cook for 5-8 minutes over a low heat until set.
Wash the parsley, shake dry and roughly chop the leaves. Scatter over the omelette and serve.


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Mental Incapacity Not a Defense to ERISA's Exhaustion Requirement
Mental incapacity can be used as a defense for many legal issues. However, a recent federal court ruled that in cannot be used as a defense to the administrative remedy exhaustion requirements in the Employee Retirement Income Security Act of 1974.
The Background of The Case
Originally, the plaintiff was on short-term disability from the defendant, Hartford Life and Accident Insurance Company, for depression. This was later transitioned to long-term disability. However, the Hartford terminated those long-term benefits in early 2017 because depression benefits were limited to 4 months.
Prior to the termination, the Hartford sent the plaintiff a benefit determination letter. This letter included information about her appeal options, but stated she had to appeal within 180 days of receiving the letter. It further explained that if her appeal was denied, she could then bring an ERISA civil action.
Over 18 months later, the plaintiff sent a letter to the Hartford stating that she wished to appeal her termination. She then initiated her case in federal court.
The mental incapacity argument
After she initiated her case, the Hartford moved to have it dismissed because she failed to exhaust all of her administrative remedies, prior to filing. Generally, in ERISA cases, plaintiffs must exhaust all administrative remedies before filing in court. In this case, the Hartford argued that because she failed to appeal the Hartford's decision in time (i.e., exhaust that administrative remedy), she could not now file in federal court. However, the plaintiff, among a few other arguments, contended that she had a mental incapacity that made her not competent to understand the appeal deadline.
Unfortunately for plaintiffs hoping to use this argument, the judge did not allow the mental incapacity argument against the ERISA exhaustion requirements. Instead, he stated that the only allowable defenses are futility or inadequate remedy.
Many courts have a strict adherence policy for ERISA exhaustion requirements. Luckily, as this case comes from the 11th District, which Washington, D.C., is not part of, this case is not mandatory law for locals. Though, it can persuade local judges to find the same. This is why it is so important to contact legal counsel early in the process.
Posted in ERISA Benefits Claims Litigation
Enforcing Your Employee Retirement Income Security Act Rights - 07/10/21
Those individuals who receive employee health insurance through a group benefits plan have certain rights and protections. A 1974 federal ...
Retirement Plans That Are Protected by Federal Legislation - 07/01/21
The Employee Retirement Income Security Act (ERISA) is federal legislation that allows government officials to maintain oversight over different employee-administered ...
Are Pension Plans Adequately Funded? - 06/06/21
Pension plans in the District of Columbia and around the country have to be funded in order to fulfill their ...
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Q: Unity-Android Plugin (Black Screen) I'm making a unity plugin for android. When I run my application on native, it runs perfectly. But when i call the same function from unity, it makes the background black and unity scene (by default in blue colour) doesn't show. What is the problem?

A: 1.you should put the xml layout file under eclipse project to Unity project
2.you should register the Activity in manifest, and the manifest should be put to Unity project too.
3.make sure your operation is in UIThread.

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Carly Simon – The Story Behind, "You're So Vain"
The UFO Craze Of The '60s and '70s
50 Vintage Wedding Photos So Beautiful We Can't Look Aw...
Carnival of Souls: Creating Horror On A Low Budget
Entertainment | October 28, 2021
Source: (IMDb).
In 1961, Herk Harvey was working for Centron, an industrial and educational film company. He was driving home to Lawrence, Kansas, when he stopped to explore the Saltair Pavilion outside Salt Lake City, Utah. The pavilion, which was an abandoned ballroom, inspired Harvey. Later, he called his friend John Clifford, to ask him to write a screenplay based on the pavilion. The only restriction was the final scene, which would feature the ghouls dancing in the ballroom. Within three weeks, Clifford had written Carnival of Souls, the story of Mary Henry (Candace Hilligoss), a survivor of a car accident after a drag race.
Source: (YouTube).
Mary Encounters The Pavilion
After the accident, Mary moves to Utah, where she has taken a job playing the organ in a church. During the ride through the desert, her radio will only play organ music and she starts to have visions of a strange, ghoulish man, only called "the Man." She also glimpses the abandoned pavilion on the shores of the Great Salt Lake, and she learns from a gas station attendant that it had been a bathhouse, then a dancehall, and, before it closed, a carnival. Once in Utah, Mary rents a room in a boarding house, and the proprietor informs her that there is one other boarder. Eventually, Mary meets this other boarder, Mr. Linden (Sidney Berger), a creepy man who is determined to become better acquainted with Mary even after she initially rebuffs him. After unpacking her suitcase, Mary goes to the church where she will be playing the organ. The minister drives her out to get a closer look at the pavilion, and when she is tempted to enter and explore, the minister informs her that it would be illegal.
"The Man". Source: (ScreenRant).
She Is Haunted By Ghouls
She starts to not only see "the Man" who no one else can see, but she starts to experience interludes when no one can see or hear her; it seems as if she no longer exists. At the church, she starts to practice, and her music shifts from playing a hymn to playing eerie music. When the minister hears her, he denounces the music and insists that she resign. As things continue to crumble around her, she becomes convinced that she has to go to the pavilion. While there, she finds herself surrounded by ghouls, including "the Man," who becomes her dancing partner. She tries to run away, and the ghouls chase her onto the beach.
Source: (Pinterest).
It Did Not Require Special Effects To Create Its Horror
Carnival of Souls lacks the special effects of many horror movies but, according to the Time Out film guide, relies on the "striking black-and-white compositions, disorienting dream sequences and eerie atmosphere." These elements, coupled with the organ music, help to create a film that some consider one of the best horror films of the 1960s.
The dance scene. Source: (ScreenRant).
Making Due With Limited Funds
The film cost $33,000 to make, although it started with a budget of only $17,000. Harvey raised that money by asking local businessmen to invest $500 in the film. The remainder of the budget was deferred. Harvey worked with a crew of only five, which helped to keep costs under control. Harvey, who had worked on industrial films, used the techniques he had learned to help cut production costs. He hired an assistant director, Reza Badiyi, an Iranian immigrant who was just starting his career (he would go on to film iconic film and television show openings and montages). The lead actress, Candace Hilligoss, was only paid approximated $2,000 for her performance. He also played the role of "the Man" himself, eliminating the need to hire another actor for the role. Much of the filming was done in Lawrence and he paid just $50 to rent the Saltair Pavilion, using students from the Mormon School of Modern Dance to stage the ballroom scene.
Finding A Second Life
When the film was first released, it was largely unnoticed after its world premier at the Main Street Theatre in Lawrence, Kansas in September 1962. It was marketed as a B movie, and its relatively new distribution company went bankrupt. However, it found its way to late-night television, becoming a bit of a cult classic, and, in 1989, was re-released for arthouse screenings. Carnival of Souls, Herk Harvey's directorial debut, would be his only feature film, although the understated horror film would be cited as an influence for other filmmakers, including David Lynch and George A. Romero.
Tags: Candace Hilligoss | ghouls | Sidney Berger
Linda Speckhals
When she's not out walking her dog, or taking in a baseball game, Linda loves learning about history, science, and philosophy. She will travel wherever the wind may blow, and happily loses herself in a book, whenever she can. At heart, she is a music loving tree-hugger.
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Disney Channel Alum Ashley Tisdale Is Pregnant With Her First Child
<a href="http://www.apimages.com/Search?query=ashley+tisdale&ss=10&st=kw&entitysearch=&toItem=15&orderBy=Newest&searchMediaType=excludecollections">AP </a>
Posted at 1:10 PM, Sep 18, 2020
Celebrity baby bump alert! Ashley Tisdale just revealed that she is expecting her first child with husband Christopher French.
The 35-year-old Disney Channel alum married the Annie Automatic singer in 2014, and now the couple will soon be welcoming a little addition to their family.
Tisdale, who is best known for her roles in Disney productions like "High School Musical," "Phineas and Ferb" and "The Suite Life of Zach & Cody," began dating French all the way back in 2012.
Tisdale shared touching pictures of her growing belly on social media, just days after posting a sweet message to her husband to celebrate their anniversary:
pic.twitter.com/1MevLFswWl
— Ashley Tisdale (@ashleytisdale) September 17, 2020
The happy couple were married in a Bohemian-style marriage that they somehow kept a secret from the press. However, many of Tisdale's "High School Musical" co-stars, including Vanessa Hudgens, were in attendance, with Hudgens reportedly serving as a bridesmaid.
"I think from the moment that him and I met, I just knew it," Tisdale said in an interview with Ryan Seacrest in 2013. "I was like, 'OK, this is the guy,' and he knew the same thing. It's just this feeling that, it doesn't get any better. I just can't explain it."
French, who formerly dated "The Big Bang Theory" star Kaley Cuoco, is also a music producer who has worked with his wife. In 2013, he produced and co-wrote the song "You're Always Here," with Tisdale, which was a tribute to her late grandfather.
Dan Steinberg/Invision for Talent Resources/AP Images
Last year, Tisdale participated in a reproductive health campaign called "Women Who Know," which was created to encourage women to learn more about their options for birth control. At the time, she said she wasn't ready to become a mother yet.
"For me, it's like, it's okay to not want to start a family right away," Tisdale said in July 2019. "People are always asking me about that, but it's just not the right time. And I have options out there."
Now, it looks like she's ready to embrace motherhood! Congrats to the happy couple.
This story originally appeared on Simplemost. Checkout Simplemost for other great tips and ideas to make the most out of life.
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