Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of Childhood Mortality and Morbidity on the Fertility Transition in sub‐Saharan Africa

type="main"> Child mortality rates have fallen substantially in developing countries since 1960. The expected fertility decline has followed only weakly in sub-Saharan Africa compared to other recent and historic demographic transitions. Disease and anthropometric data suggest that morbidity remains prevalent in Africa despite child survival improvements. The uniquely high infectious disease burden among children in Africa reduces population health and diminishes the returns to human capital investment, thwarting the quantity–quality tradeoff for children that typically accompanies the mortality transition. Individual-level data from the Demographic and Health Surveys are used to show that persistent morbidity has weakened the positive relationship between child mortality and total fertility rates throughout the region, slowing Africa's demographic transition.
Violence against women and the risk of fetal and early childhood growth impairment: a cohort study in rural Bangladesh

Objective: To assess whether different forms of family violence against women were associated with impaired size at birth and early childhood growth. Methods: A substudy embedded into a community-based food and micronutrient supplementation trial (MINIMat) of pregnant women in rural Bangladesh included a 2-year follow-up of the 3164 live-born children of participating women. Anthropometric data were collected from birth up to 24 months of age, and converted to WHO growth standard SD scores. Size at birth and early childhood growth were assessed in relation to women’s exposure to physical, sexual and emotional violence and the level of controlling behaviour in the family. Results: Fifty per cent of all women reported a lifetime experience of some form of family violence. The mean birth weight was 2701 g, 30% were low birth weight (<2500 g), mean birth length was 47.8 cm (17.5%, ⩽2 SD) and at 24 months of age 37% were underweight and 50% of the children were stunted. Exposure to any form of violence was negatively associated with weight and length at birth and weight-for-age and height-for-age SD scores at 24 months of age, as well as a change in weight and height SD score from birth to 24 months of age (p<0.05, adjusted for potential confounders). Conclusions: Violence against women was associated with an increased risk of fetal and early childhood growth impairment, adding to the multitude of confirmed and plausible health consequences caused by this problem.
Role of laparoscopy in the management of intussusceptions in children

Aim: To evaluate the role and efficacy of laparoscopic reduction of intussusceptions in children with failed initial hydrostatic reductions. Materials and Methods: This is a retrospective study of children who underwent laparoscopy for incomplete reductions following sonoguided hydrostatic reduction.Laparoscopy guided pneumatic reduction or laparoscopic reduction was done. Results: Hydrostatic reduction was successful in 76 (73.5%) of cases. Among 26 children in Laparoscopy group 8 showed completeness of reduction. Features of necrotic bowel were seen in 4 (15%) children requiring laparotomy. Among 14 children with incomplete reduction 3 (21%) children required pneumatic reduction under laparoscopic monitoring. 11 required laparoscopic reduction. None of the incomplete group with viable bowel required conversion to open surgery. No major complications were noted in any groups. The mean hospital stay was 1.8 days in hydrostatic group 4.2 days in laparoscopic group and 6.8 days in laparotomy group. No recurrence of intussusceptions noted. Conclusions: The role of laparoscopy in intussusceptions is evolving as a safe procedure and helps in avoiding laparotomy in large number of children with incomplete reduction. Non operative reduction is the gold standard in management of intussusceptions in children. Excellent results are obtained with either saline or pneumatic reductions. However, in few cases of, incomplete reduction or doubtful complete reduction with non operative technique poses problem for further management and may need laparotomy. Laparoscopy being less invasive has distinct advantage over open laparotomy. Use of Laparoscopy in the management of Intussusceptions is described in literature. We have analyzed our results of laparoscopic management of intussusceptions in children in our center.
The importance of nurse-led home visits in the assessment of children with problematic asthma

Objective: To evaluate and identify potentially modifiable factors in children with problematic asthma by a nurse-led assessment and home visit. Design: Observational cohort study. Setting: A tertiary paediatric respiratory centre. Patients: 71 children, aged 4.5–17.5 years, with problematic asthma currently under follow-up at a tertiary respiratory centre. Interventions: A nurse-led hospital visit followed by a home visit. Main outcome measures: Identification and attempted change of exacerbating factors so that further investigations and consideration of off-label, potentially toxic, asthma therapies were not necessary. Results: Potentially modifiable factors were identified in 56 (79%) children. Many children had multiple causes for poor control. The most important were ongoing allergen exposure, 22 children (31%); passive or active smoking, 18 children (25%); medication issues including adherence, 34 children (48%); psychosocial factors, 42 families (59%). The home visit contributed valuable information to this assessment. At the home visit house dust mite avoidance measures were found to be inadequate in 84% of those sensitised; medications were not easily available for inspection or were out of date in 23%; 74% of psychology referrals were made after the home visit. In 39 children (55%) the factors identified and the interventions recommended meant that further escalation of treatment was avoided. Conclusions: Nurse-led assessments including a home visit can help identify potentially modifiable factors for poorly controlled symptoms in children with problematic asthma.
Blood supply management during an influenza pandemic

The word pandemic is derived from the Greek words ‘all’ and ‘people’. Pandemics occur when a pathogen emerges to which the majority of human population has little or no immunity, resulting in rapid spread worldwide. If the pathogen is highly virulent, widespread morbidity and mortality occurs with enormous disruption in global infrastructure and systems. Although the term pandemic is most often used in modern times in relation to influenza, other pandemics would include the HIV pandemic as well as historical instances of smallpox, cholera and tuberculosis pandemics. The 20th Century was marked by three major influenza pandemics involving significant mortality. The ‘Spanish flu’ of 1918–1919 was associated with at least 50 million deaths, the ‘Asian flu’ of 1957–1958 with two million deaths and the ‘Hong Kong flu’ of 1968–1969 with one million deaths. Much of the assumptions upon which subsequent pandemic plans were developed are based on historical data from these three pandemics. In 2003, the emergence of SARS in Asia gave a deadly reminder of the speed and efficiency with which a new virus could spread in the modern era of air travel and globalization. Fortunately, SARS did not evolve into a pandemic. But the magnitude of its impact on the social and economic fabric in affected countries spurred greater focus on pandemic influenza planning. The many lessons learnt from the impact of SARS on blood supply and blood services also resulted in wider consciousness of the importance of contingency planning in the blood community. It was widely anticipated that the H5N1 avian influenza virus or a virus similar to this would be the source of the next pandemic in this century. Unexpectedly, the H1N1 virus emerged and unraveled many fixed assumptions upon which health authorities and international agencies had based their plans. It is a sharp reminder that every influenza outbreak or pandemic is unique, and that scenario plans need to be sufficiently flexible to adjust quickly to new situations. At the time of writing, the H1N1 virus still exhibits rapid infectivity but relatively low virulence. Time will tell if the virus will progress to increased virulence, or fade away to become yet another seasonal strain.
Symmetric dimethylarginine, an endogenous marker of glomerular filtration rate, and the risk for microalbuminuria in young people with type 1 diabetes

Objectives To perform a cross-sectional comparison of endogenous markers of glomerular filtration rate (GFR) (plasma symmetric dimethylarginine (SDMA) and estimated GFR (eGFR)) with a direct measure of GFR (using the plasma clearance of Inutest (In-GFR)), and a longitudinal evaluation of these markers in relation to the development of microalbuminuria, in young people with type 1 diabetes (T1D). Methods Longitudinal stored blood samples (n=1105) were available from 417 young people from the Oxford Regional Prospective Study (an inception cohort of 527 children followed for a median of 10.3 (interquartile range 7.1–12.3) years), for measurement of SDMA and creatinine. Additional annually collected data on anthropometric parameters, HbA1c, insulin dose and three early morning albumin:creatinine ratios were available. In-GFR was measured in a representative subgroup of 183 subjects. Main outcome measures SDMA and eGFR. Results SDMA and eGFR were significantly and similarly associated with In-GFR (r=−0.38 and r=0.36, p<0.001). Overall SDMA levels were lower in microalbuminuric (n=116) than normoalbuminuric subjects (n=301) (0.385±0.063 vs 0.412±0.059 µmol/l, p<0.001), probably reflecting hyperfiltration. The pattern of change in SDMA levels with age differed between microalbuminuric and normoalbuminuric subjects. Whereas SDMA levels declined in both groups until the age of 16 years, thereafter they tended to rise only in microalbuminuric subjects, probably reflecting a decline in renal function. Conclusions In this longitudinal study of young people with T1D, measurement of SDMA, in contrast to eGFR, proved to be a reliable marker in identifying changes in filtration rates associated with the development of microalbuminuria (MA).
On the relationship of human walking and running: automatic person identification by gait

The intimate relationship between human walking and running lies within the skeleto-muscular structure. This is expressed as a mapping that can transform computer vision derived gait signatures from running to walking and vice versa, for purposes of deployment in gait as a biometric or for animation in computer graphics. The computer vision technique can extract leg motion by temporal template matching with a model defined by forced coupled oscillators as the basis. The (biometric) signature is derived from Fourier analysis of the variation in the motion of the thigh and lower leg. In fact, the mapping between these gait modes clusters better than the original signatures (of which running is the more potent) and can be used for recognition purposes alone, or to buttress both of the signatures. Moreover, the two signatures can be made invariant to gait mode by using the new mapping.
Trends in overweight and obesity prevalence in Dutch, Turkish, Moroccan and Surinamese South Asian children in the Netherlands

Objective: To determine trends in the prevalence of overweight and obesity in children in The Hague (the Netherlands) from 1999 through 2007. Design: Population-based study of a series of cross-sectional assessments of height and weight from electronic health records. Setting: Child Health Care (Municipal Health Service), The Hague. Participants: 50 961 children aged 3–16 years, with Dutch (59%), Turkish (17%), Moroccan (13%) or Surinamese South Asian (11%) ethnicity, representative of the four major ethnic groups in The Hague, with 85 234 weight and height measurements recorded in 1999–2007. Main outcome measures: (Trends in) the prevalence of overweight (excluding obesity) and obesity as defined by the International Obesity Taskforce cut-off points, using logistic regression with year as independent variable. Results: From 1999 through 2007 there was a decrease in the prevalence of overweight in Dutch girls from 12.6% to 10.9% (OR 0.96; 95% CI 0.95 to 0.98) and an increase in Turkish boys from 14.6% to 21.4% (OR 1.08; 95% CI 1.04 to 1.11). Obesity prevalence rose significantly in Turkish boys from 7.9% to 13.1% (OR 1.04; 95% CI 1.01 to 1.06) and in Turkish girls from 8.0% to 10.7% (OR 1.04; 95% CI 1.01 to 1.08). Dutch boys, and Moroccan and Surinamese South Asian boys and girls showed no significant trends. Conclusions: The declining prevalence of overweight in Dutch girls may indicate reversal of previous trends in the Netherlands. However, in Turkish children overweight prevalence and obesity is high and increasing. Further public health action is necessary, especially for Turkish children.
QUESTION 2. Does nephrocalcinosis in ex-premature babies cause long-term renal problems?

A 2 year old born 26 weeks premature presents to you in the neonatal follow-up clinic. Among the usual ventilatory requirements at birth, he also had a persistent patent ductus arteriosus which was treated with loop diuretics for 4 weeks. As a result, he developed nephrocalcinosis. His mother is asking you what the long-term implications are for her child’s kidney function. In preterm babies with nephrocalcinosis (patients) does nephrocalcinosis or renal calcification (intervention) cause renal dysfunction, hypertension or persistent renal ultrasound scan abnormalities (outcome)? ### Secondary sources Cochrane Library, Best Evidence, Clinical Evidence: no relevant articles found. ### Primary sources Online search performed on 16 June 2008 using National Library for Health (www.library.nhs.uk) in AMED, BNI, EMBASE, HMIC, MEDLINE, PsycINFO and CINAHL with no limits, using the following terms: 1. nephrocalcinosis.ti,ab 2. (renal AND calcinosis). ti,ab 3. (renal AND dysfunction). ti,ab 4. hypertension.ti,ab 5. proteinuria.ti,ab 6. 1 OR 2 7. 3 OR 4 OR 5 8. 6 AND 7 Three hundred and thirty-nine results were obtained and independently assessed by the two authors, seven of which were relevant.1 2 3 4 5 6 7 Nephrocalcinosis …
Extremely preterm births: end-of-life decisions in European countries

Objective To explore the influence of end-of-life decisions (EoL-D) on survival and mortality data in the light of differences reported among European countries. Design We collected the published data of several epidemiological studies: Epicure, Epipage, Epibel and the Norwegian study performed in the UK, France, Belgium and Norway, respectively. The data concerning the Epibel and Norwegian studies are considered for a preliminary analysis, while the data relating to the Epicure and Epipage studies are compared based on the total published data. The statistical analysis was performed through the class of generalised linear models, and more specifically, through log-linear models. The data considered were the number of babies who died in neonatal intensive care units after active withdrawal classified according to the country and gestational age. Results The probability of death after active withdrawal was significantly higher at 22 and 24 weeks' gestational age compared with week 25, when considering both countries (OR, 2.35 and 1.29, respectively). For the week 230→6, the probability of death after active withdrawal was not significant; however, it is relevant when considering the OR (1.31). When considering the country, there was a higher probability of death after active withdrawal in France than in the UK, or alternatively, with the assumed baseline French parameter, in the UK, there was a lower probability of death after active withdrawal, with a significant OR=0.69. Conclusions The attitude towards EoL-D could in part explain the differences in survival data of extremely preterm infants and should be taken in mind when comparing international survival rates.
Prevention of doxorubicin-induced alopecia by scalp hypothermia: relation to degree of cooling

SIR,-There have been articles (27 March, p 972) and correspondence (1 May, p 1335) in the medical journals in the past few months concerning the prescription of opioid drugs (such as Physeptone (methadone) and Diconal (dipipanone and cyclizine)) to addicts in private practice, whether by consultants or general practitioners, or by general practitioners under their NHS contractual obligations. Drug dependence treatment clinics, as a routine, check with the drugs branch of the Home Office, to which all opioid addicts should be notified, whether a new patient has attended another clinic or doctor outside a clinic. These data (the last doctor or clinic attended) are given on the acknowledgment of notification form routinely sent by the Home Office. On learning that a patient has attended another clinic or doctor, drug dependence clinics get in touch with the previous treater to find out the method of treatment and to make sure that treatment is not still continuing and thus avoid double prescribing (a situation devoutly to be desired by many such patients). It has recently emerged that some private doctors on learning about previous treatment at clinics or elsewhere do not feel themselves under any obligation to contact the previous treater. They take the view that this would be a breach of confidentiality and that the patient has the right to prohibit such a contact if he so wishes. Furthermore, it seems that the Home Office, which is very alive to such matters of confidentiality, would be unlikely to adopt a system of informing clinics that their patients have gone for treatment elsewhere. It appears to be for the doctors themselves to satisfy themselves that there is no double prescribing. This situation is unsatisfactory. There is no way by which a clinic doctor can be sure that a patient for whom he is prescribing opioid drugs is not taking-amounts of the same drug or drugs prescribed elsewhere. It would be my opinion that any doctor who prescribes opioid drugs to patients whom he knows have attended clinics or other doctors without checking with such doctors that they are no longer prescribing is prescribing irresponsibly. They are thus liable to be dealt with under the appropriate regulations. If I am right in this it might be helpful for the Home Office to alert such doctors to their responsibilities in this field of practice. P H CONNELL
Changes in heart rate in the first minutes after birth

The normal range of heart rate (HR) in the first minutes after birth has not been defined. Objective To describe the HR changes of healthy newborn infants in the delivery room (DR) detected by pulse oximetry. Study Design All inborn infants were eligible and included if a member of the research team attended the birth. Infants were excluded if they received any form of medical intervention in the DR including supplemental oxygen, or respiratory support. HR was measured using a pulse oximeter (PO) with the sensor applied to the right hand or wrist immediately after birth. PO data (oxygen saturation, HR and signal quality) were downloaded every 2 sec and analysed only when the signal had no alarm messages (low IQ signal, low perfusion, sensor off, ambient light). Results Data from 468 infants with 61 650 data points were included. Infants had a mean (range) gestational age of 38 (25–42) weeks and birth weight 2970 (625–5135) g. At 1 min the median (IQR) HR was 96 (65–127) beats per min (bpm) rising at 2 min and 5 min to 139 (110–166) bpm and 163 (146–175) bpm respectively. In preterm infants, the HR rose more slowly than term infants. Conclusions The median HR was <100 bpm at 1 min after birth. After 2 min it was uncommon to have a HR <100 bpm. In preterm infants and those born by caesarean section the HR rose more slowly than term vaginal births.
The International Headache Society Classification of Migraine Headache-A Call for Substantiating Data

This paper proves conclusively that there is no scientific basis for the International Classification of Headache Disorders (ICHD) criteria for the diagnosis of migraine (MI). There are no data supporting the choice of diagnostic criteria, and where data do exist, they contradict the ICHD criteria. The Classification Committee (CC) of the International Headache Society (IHS) is called upon to revise the criteria according to the extensive available data.
Serotype-specific pneumococcal antibody concentrations in children treated for acute leukaemia

Children treated for acute leukaemia are at increased risk of infection with Streptococcus pneumoniae. The basis for this may include low levels of pneumococcal antibody but this has not been well studied. The authors measured serotype-specific pneumococcal IgG antibody concentrations in children treated for acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) ≥6 months after completion of standard-dose chemotherapy. Pneumococcal serotype-specific IgG antibody concentrations were low. None of the subjects had protective concentrations against all the heptavalent-pneumococcal conjugate vaccine serotypes. There was no significant difference in antibody concentrations between subjects with ALL and AML (p≥0.05). Children treated for ALL and AML generally have non-protective antibody concentrations against S pneumoniae. There is significant morbidity associated with pneumococcal disease in this patient group and strategies for vaccination are required.
Management and outcome of vein of Galen malformation

Objective To describe our experience of treating children with vein of Galen aneurysmal malformation (VGM) in a single UK centre between 2003 and 2008. Method Retrospective review of case notes and neuroimaging. Results 33 children were seen (26 neonates, seven infants), of whom 28 underwent endovascular treatment. Four were not offered treatment as they had evidence of severe diffuse brain injury at presentation; treatment was deferred in another who subsequently died. Seven children died (two of whom had endovascular treatment). Of the survivors (all treated), 13 (39%) are neurodevelopmentally intact, seven (21%) have mild neurodevelopmental impairment and the remaining six (18%) have significant neurological impairment. The authors were not able to identify clinical or radiological parameters which strongly predicted outcome. Of note, two children with initially low Bicêtre scores were neurologically intact after successful embolisation. Conclusion The outlook for children with VGM is significantly better since the advent of endovascular treatment. Decisions about the appropriateness and timing of treatment should be taken by an experienced multidisciplinary team.