bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed
Authors: Trifanescu R , Stavrinides V , Plaha P , Cudlip S , Byrne J V , Ansorge O , Wass J A H , Karavitaki N 
Published: April 2011

ObjectiveTo clarify the outcome of all cases of Rathke's cleft cysts (RCC) treated surgically and followed up in Oxford during a long-term period.Subjects and methodsThe records of all patients with RCC seen in the Department of Endocrinology between January 1978 and June 2009 were reviewed.ResultsA total of 33 patients (20 females, median age 43 years) were identified. At presentation, major visual field defects were detected in 58% of patients and gonadotrophin, ACTH and TSH deficiency in 60, 36 and 36% of patients respectively. Desmopressin treatment was required in 18% of patients. Treatment consisted of cyst evacuation combined with or without biopsy/removal of the wall. Post-operatively, visual fields improved in 83% of patients with impairment, whereas there was no reversal of ACTH or TSH deficiency or of diabetes insipidus. All but one subject had imaging follow-up during a mean period of 48 months (range 2–267). Cyst relapse was detected in 22% of patients at a mean interval of 29 months (range 3–48 months); in 57% of them, the recurrence was symptomatic. Relapse-free rates were 88% at 24-months and 52% at 48-months follow-up. At last assessment, at least quadrantanopia was reported in 19% of patients, gonadotrophin, ACTH and TSH deficiency in 50, 42 and 47% of patients respectively. Desmopressin treatment was required in 39% of patients.ConclusionsIn this study of patients with RCC and long-term follow-up, we showed a considerable relapse rate necessitating long-term monitoring. Surgical intervention is of major importance for the restoration of visual field defects, but it does not improve endocrine morbidity, which in the long-term affects a substantial number of patients.
Hypothalamic involvement and insufficient sex steroid supplementation are associated with low bone mineral density in women with childhood onset craniopharyngioma
Authors: Holmer Helene , Popovic Vera , Ekman Bertil , Follin Cecilia , Siversson Ann Britt , Erfurth Eva Marie 
Published: April 2011

ContextData on bone mineral density (BMD) are lacking in adults with childhood onset (CO)–craniopharyngioma (CP) with hypothalamic damage from the tumor. In patients with CO GH deficiency, BMD increases during GH treatment.ObjectiveThe aims were to evaluate BMD in adults with CO–CPs on complete hormone replacement, including long-term GH and to evaluate the impact of hypothalamic damage on these measures.Design and participantsBMD (dual-energy X-ray absorptiometry), markers of bone turn over, physical activity and calcium intake were assessed in 39 CO–CP adults (20 women), with a median age of 28 (17–57) years, in comparison with matched population controls.ResultsLate puberty induction was recorded in both genders, but reduced androgen levels in females only. Only CP women had lower BMD (P=0.03) at L2–L4, and reduced Z-scores at femoral neck (P=0.004) and L2–L4 (P=0.004). Both genders had increased serum leptin levels (P=0.001), which significantly correlated negatively with BMD at L2–L4 (P=0.003; r=−0.5) and 45% of CP women had Z-score levels ≤−2.0 s.d. Furthermore, 75% of those with a Z-score ≤−2.0 s.d. had hypothalamic involvement by the tumor. Calcium intake (P=0.008) and physical activity (P=0.007) levels were reduced in CP men only. Levels of ostecalcin and crossLaps were increased in CP men only.ConclusionsDespite continuous GH therapy, low BMD was recorded in CO–CP females. Insufficient estrogen and androgen supplementation during adolescence was the main cause, but hypothalamic involvement with consequent leptin resistance was also strongly associated with low BMD in both genders.
Intrapartum-Related Stillbirths and Neonatal Deaths in Rural Bangladesh: A Prospective, Community-Based Cohort Study
Authors: Ellis Matthew , Azad Kishwar , Banerjee Biplob , Shaha Sanjit Kumer , Prost Audrey , Rego Arati Roselyn , Barua Shampa , Costello Anthony , Barnett Sarah 
Published: April 2011

OBJECTIVE:
Using a low-cost community surveillance system, we aimed to estimate intrapartum stillbirth and intrapartum-related neonatal death rates for a low-income community setting.

PATIENTS AND METHODS:
From 2005 to 2008, information on all deliveries in 18 unions of 3 districts of Bangladesh was ascertained by using traditional birth attendants as key informants. Outcomes were measured using a structured interview with families 6 weeks after delivery.

RESULTS:
We ascertained information on 31 967 deliveries, of which 26 173 (82%) occurred at home. For home deliveries, the mean cluster-adjusted stillbirth rate was 26 (95% confidence interval [CI[: 24–28) per 1000 births, and the perinatal mortality rate was 51 per 1000 births (95% CI: 47–55). The NMR was 33 per 1000 live births (95% CI: 30–37). There were 3186 (12.5%) home-born infants who did not breathe immediately. Of these, 53% underwent some form of resuscitation. Of 1435 infants who were in poor condition at 5 minutes (5% of all deliveries), 286 (20%) died; 35% of all causes of neonatal mortality. Of 201 fresh stillbirths, 40 (14%) of the infants had major congenital abnormalities. Our estimate of the intrapartum-related crude mortality rate among home-born infants is 17 in 1000 (95% CI: 16–19), 6 in 1000 stillborn and 11 in 1000 neonatal deaths after difficulties at birth.

CONCLUSIONS:
Difficulty initiating respiration among infants born at home in rural Bangladesh is common, and resuscitation is frequently attempted. Newborns who remain in poor condition at 5 minutes have a 20% mortality rate. Evaluation of resuscitation methods, early intervention trials including antibiotic regimes, and follow-up studies of survivors of community-based resuscitation are needed.
Validating Office-Based Screening for Psychosocial Strengths and Difficulties Among Youths in Foster Care
Authors: Jee Sandra H. , Szilagyi Moira , Conn Anne-Marie , Nilsen Wendy , Toth Sheree , Baldwin Constance D. , Szilagyi Peter G. 
Published: April 2011

OBJECTIVES:To assess the effectiveness of social-emotional screening in the primary care setting for youths in foster care.METHODS:The setting was a primary care practice for all youth in home-based foster care in 1 county. Subjects were youths, aged 11 to 17 years, and their foster parents; both completed a Strengths and Difficulties Questionnaire at well-child visits. The Strengths and Difficulties Questionnaire is a previously validated 25-item tool that has 5 domains: emotional symptoms; conduct problems; hyperactivity/inattention; peer problems; and prosocial behaviors and an overall total difficulties score. We first compared youth versus parent Strengths and Difficulties Questionnaire scores and then assessed the accuracy of these Strengths and Difficulties Questionnaire scores by comparing them in a subsample of youths (n = 50) with results of home-based structured clinical interviews using the Children's Interview for Psychiatric Syndromes.RESULTS:Of 138 subjects with both youth and parent reports, 78% had prosocial behaviors (strengths), and 70% had 1 or more social-emotional problems. Parents reported significantly more conduct problems (38% vs 16%; P &lt; .0001) and total difficulties (30% vs 16%; P = .002) than did youth. The Strengths and Difficulties Questionnaire had better agreement with the Children's Interview for Psychiatric Syndromes (n = 50) for any Strengths and Difficulties Questionnaire–identified problem for combined youth and foster-parent reports (93%), compared with youth report alone (54%) or parent report alone (71%).CONCLUSIONS:Although most youths in foster care have social-emotional problems, most have strengths as well. Youth and foster-parent perspectives on these problems differ. Systematic social-emotional screening in primary care that includes both youth and parent reports can identify youths who may benefit from services.
Acceptance of Pandemic 2009 Influenza A (H1N1) Vaccine in a Minority Population: Determinants and Potential Points of Intervention
Authors: Frew Paula M. , Hixson Brooke , del Rio Carlos , Esteves-Jaramillo Alejandra , Omer Saad B. 
Published: April 2011

OBJECTIVE:
We sought to understand pandemic 2009 influenza A (H1N1) vaccine acceptance in a minority community including correlates of vaccine hesitancy and refusal. We identified intervention points to increase H1N1 vaccine coverage.

PATIENTS AND METHODS:
Minority parents and caregivers of children ≤18 years participated in a cross-sectional survey. Statistical analyses included bivariate correlations, exploratory factor analyses, internal-consistency assessment, and logistic regressions.

RESULTS:
The sample (N = 223) included mostly lower-income (71% [n = 159]) and black (66% [n = 147]) participants. Potential and actual receipt of pediatric H1N1 vaccination was low (36% [n = 80]). Pediatric H1N1 vaccine acceptance was associated with lack of insurance (odds ratio [OR]: 3.04 [95% confidence interval (CI): 1.26–7.37]), perceived H1NI pediatric susceptibility (OR: 1.66 [95% Cl: 1.41–1.95]), child vaccination prioritization in family (OR: 3.34 [95% CI: 1.33–8.38]), believing that H1N1 is a greater community concern than other diseases (OR: 1.77 [95% CI: 1.01–3.09]), believing that other methods of containment (eg, hand-washing, masks) are not as effective as the H1N1 vaccine (OR: 1.73 [95% CI: 1.06–2.83]), and a desire to promote influenza vaccination in the community (OR: 2.35 [95% CI: 1.53–3.61]).

CONCLUSIONS:
We found low acceptance of the H1N1 vaccine in our study population. Perceived influenza susceptibility, concern about H1N1 disease, and confidence in vaccinations as preventive methods were associated with vaccine acceptance. Physician support for HIN1 vaccination will aid in increasing immunization coverage for this population, and health departments are perceived as ideal community locations for vaccine administration.
Attitudes and Beliefs of Parents Concerned About Vaccines: Impact of Timing of Immunization Information
Authors: Vannice Kirsten S. , Salmon Daniel A. , Shui Irene , Omer Saad B. , Kissner Jennifer , Edwards Kathryn M. , Sparks Robert , Dekker Cornelia L. , Klein Nicola P. , Gust Deborah A. 
Published: April 2011

OBJECTIVES:To determine if giving vaccine-information materials before the 2-month vaccination visit to mothers with concerns about vaccine safety positively changed their attitudes and beliefs about vaccine safety.METHODS:Mothers who indicated concerns about infant vaccinations were recruited from 2 separate sites in Tennessee and California and were given vaccine information at 1 of 3 times: during a prenatal visit; a 1-week postpartum well-child visit; or a 2-month vaccination visit. A separate group of concerned mothers was assigned to be followed longitudinally at all 3 time points and was analyzed separately. The mothers reviewed a new vaccine-information pamphlet and Vaccine Information Statements (VIS) from the Centers for Disease Control and Prevention. Attitudes and beliefs about immunization were assessed both before and after the review of materials with written surveys.RESULTS:A total of 272 mothers with immunization concerns participated in the study. After review of the materials, mothers in all groups were significantly more likely to respond positively to questions and statements supporting the safety and importance of vaccines. Mothers who received this information at earlier visits were not significantly more likely to respond positively than mothers who received the information at the child's 2-month vaccination visit; however, participating mothers did indicate a preference for receiving vaccine information before the first vaccination visit.CONCLUSIONS:Distribution of the vaccine-information pamphlet and Vaccine Information Statements significantly improved attitudes about vaccination regardless of at what visit they were provided. Allowing adequate time to review vaccine information, even if done at the vaccination visit, may benefit concerned mothers.
Cost-effectiveness of Essential Newborn Care Training in Urban First-Level Facilities
Authors: Manasyan Albert , Chomba Elwyn , McClure Elizabeth M. , Wright Linda L. , Krzywanski Sara , Carlo Waldemar A. ,   the Eunice Kennedy Shriver National Institute of Child Health and Human Development Global Network for Women's and Children's Health Research
Published: April 2011

OBJECTIVE:
To determine the cost-effectiveness of the World Health Organization (WHO) Essential Newborn Care (ENC) training of health care providers in first-level facilities in the 2 largest cities in Zambia.

METHODS:
Data were extracted from a study in which the effectiveness of the ENC training was evaluated (including universal precautions and cleanliness, routine neonatal care, resuscitation, thermoregulation, breastfeeding, skin-to-skin care, care of the small infant, danger signs, and common illnesses). The costs to train an ENC instructor for each first-level delivery facility and the costs of salary/benefits for 2 coordinators responsible for maintenance of the program were recorded in 2005 US dollars. The incremental costs per life gained and per disability-adjusted life-year averted were calculated.

SETTING:
A 5-day ENC training-of-trainers was conducted in Lusaka, Zambia, to certify 18 college-trained midwives as ENC instructors. The instructors trained all clinic midwives working in their first-level facilities as part of a before-and-after study of the effect of ENC training on early neonatal mortality conducted from Oct 2004 to Nov 2006.

RESULTS:
All-cause 7-day (early) neonatal mortality decreased from 11.5 per 1000 to 6.8 per 1000 live births after ENC training of the clinic midwives (relative risk: 0.59; 95% confidence interval: 0.48–0.77; P &lt; .001; 40 615 births). The intervention costs were $208 per life saved and $5.24 per disability-adjusted life-year averted.

CONCLUSIONS:
ENC training of clinic midwives who provide care in low-risk facilities is a low-cost intervention that can reduce early neonatal mortality in these settings.
A Cluster-Randomized Evaluation of a Responsive Stimulation and Feeding Intervention in Bangladesh
Authors: Aboud Frances E. , Akhter Sadika 
Published: April 2011

OBJECTIVES:
The goal of this study was to determine if a responsive stimulation and feeding intervention improved developmental and nutritional outcomes compared with a regular information-based parenting program. The hypothesis was that mothers in the intervention would exhibit better parenting skills and children would exhibit better developmental and nutritional outcomes than controls.

METHODS:
A cluster-randomized field trial was conducted with 302 children aged 8 to 20 months and their mothers in rural Bangladesh who were randomly assigned according to village to 1 of 3 groups. The control mothers received 12 informational sessions on health and nutrition. The intervention groups received an additional 6 sessions delivered by peer educators who included modeling and coached practice in self-feeding and verbal responsiveness with the child during play. A second intervention group received, along with the sessions, 6 months of a food powder fortified with minerals and vitamins. Developmental outcomes included the Home Observation for Measurement of the Environment (HOME) Inventory, mother-child responsive talk, and language development. Nutritional outcomes included weight, height, self-feeding, and mouthfuls eaten. We used analysis of covariance to compare the 3 groups at the posttest and at follow-up, covarying the pretest levels and confounders.

RESULTS:
At follow-up, responsive stimulation-feeding groups had better HOME inventory scores, responsive talking, language, mouthfuls eaten, and hand-washing. Micronutrient fortification resulted in more weight gain.

CONCLUSIONS:
A brief behavior-change program that focused on modeling and practice in stimulation and feeding was found to benefit children's nutrition and language development. Micronutrients benefited children's weight but not length.
Birth Weight, Postnatal Weight Change, and Risk for High Blood Pressure Among Chinese Children
Authors: Bowers Katherine , Liu Gongshu , Wang Ping , Ye Tao , Tian Zhen , Liu Enqing , Yu Zhijie , Yang Xilin , Klebanoff Mark , Yeung Edwina , Hu Gang , Zhang Cuilin 
Published: April 2011

BACKGROUND:
It is hypothesized that a physiological predisposition toward hypertension results from a combination of intrauterine growth restriction or overgrowth and excessive postnatal weight gain. Previous studies were conducted largely in Western countries however the hypothesis may also be relevant in developing countries where metabolic disorders are increasing.

OBJECTIVE:
We investigated the association of birth weight and postnatal weight gain with hypertension among Chinese children.

METHODS:
A population based study was conducted among 15 600 children aged 3 to 6 years from Tianjin, China. Weight was expressed as z scores. Postnatal weight gain was defined as changes in z scores from birth to 3 to younger than 4 years, 4 to younger than 5 years, and 5 to 6 years. Hypertension was defined as greater than the 90th percentile of either systolic or diastolic blood pressure. Logistic regression-derived odds ratios and 95% confidence intervals were generated to estimate the association between birth weight and postnatal weight gain with hypertension risk in childhood.

RESULTS:
Birth weight was positively associated with childhood hypertension in boys and girls (odds ratios [95% confidence interval] comparing extreme quartiles [high versus low] were 5.67 [3.83–8.39] and 2.58 [3.83–8.39], respectively). Postnatal weight gain was positively associated with hypertension and the association did not significantly vary by birth size for gestational age.

CONCLUSIONS:
Greater birth weight or postnatal weight gain was associated with increased childhood hypertension risk, suggesting that intrauterine growth and postnatal weight gain may have implications on health during childhood.
Racial/Ethnic Disparities in Risk of Early Childhood Mortality Among Children With Congenital Heart Defects
Authors: Nembhard Wendy N. , Salemi Jason L. , Ethen Mary K. , Fixler David E. , DiMaggio Angela , Canfield Mark A. 
Published: April 2011

BACKGROUND:Infants with congenital heart defects (CHDs) have increased risk of childhood morbidity and mortality. However, little is known about racial/ethnic differences in early childhood mortality.PATIENTS AND METHODS:We conducted a retrospective cohort study with data from the Texas Birth Defect Registry on 19 530 singleton, live-born infants with a CHD and born January 1, 1996, to December 31, 2003, to non-Hispanic (NH) white, NH black, and Hispanic women. Texas Birth Defect Registry data were linked to Texas death records and the National Death Index to ascertain deaths between January 1, 1996, and December 31, 2005. Kaplan-Meier survival estimates were computed, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated from multivariable Cox-proportional hazard regression models to determine the effect of maternal race/ethnicity on mortality for selected CHD phenotypes.RESULTS:After adjusting for covariates, compared with NH white children, NH black children had increased early childhood mortality risk for transposition of the great arteries (HR: 2.04 [95% CI: 1.40–2.97]), tetralogy of Fallot (HR: 1.85 [95% CI: 1.09–3.12]), pulmonary valve atresia without ventricular septal defect (VSD) (HR: 2.60 [95% CI: 1.32–5.12]), VSD (HR: 1.56 [95% CI: 1.19–2.03]), and atrial septal defect (HR: 1.34 [95% CI: 1.08–1.66]). Hispanic children had higher mortality risk for pulmonary valve atresia without VSD (HR: 1.76 [95% CI: 1.06–2.91]) and hypoplastic left heart syndrome (HR: 1.51 [95% CI: 1.13–2.02]).CONCLUSIONS:We provide evidence that supports racial/ethnic disparities in early childhood mortality among infants with CHDs. Identifying infants with the greatest risk of early childhood mortality will facilitate development of interventions and policies to mitigate these risks.
The Social Environment and Suicide Attempts in Lesbian, Gay, and Bisexual Youth
Authors: Hatzenbuehler Mark L. 
Published: April 2011

OBJECTIVE:
To determine whether the social environment surrounding lesbian, gay, and bisexual youth may contribute to their higher rates of suicide attempts, controlling for individual-level risk factors.

METHODS:
A total of 31 852 11th grade students (1413 [4.4%] lesbian, gay, and bisexual individuals) in Oregon completed the Oregon Healthy Teens survey in 2006–2008. We created a composite index of the social environment in 34 counties, including (1) the proportion of same-sex couples, (2) the proportion of registered Democrats, (3) the presence of gay-straight alliances in schools, and (4) school policies (nondiscrimination and antibullying) that specifically protected lesbian, gay, and bisexual students.

RESULTS:
Lesbian, gay, and bisexual youth were significantly more likely to attempt suicide in the previous 12 months, compared with heterosexuals (21.5% vs 4.2%). Among lesbian, gay, and bisexual youth, the risk of attempting suicide was 20% greater in unsupportive environments compared to supportive environments. A more supportive social environment was significantly associated with fewer suicide attempts, controlling for sociodemographic variables and multiple risk factors for suicide attempts, including depressive symptoms, binge drinking, peer victimization, and physical abuse by an adult (odds ratio: 0.97 [95% confidence interval: 0.96–0.99]).

CONCLUSIONS:
This study documents an association between an objective measure of the social environment and suicide attempts among lesbian, gay, and bisexual youth. The social environment appears to confer risk for suicide attempts over and above individual-level risk factors. These results have important implications for the development of policies and interventions to reduce sexual orientation–related disparities in suicide attempts.
Genome-Phenome Linkages in Human Population Surveys, with Special Emphasis on the Health and Retirement Survey
Authors: Singer Burton 
Published: April 2011

Abstract
We review a diversity of genome-wide association studies (GWAS) with particular emphasis on precision in specifying phenotypes. This implies that examination of any specific phenotype involves considering the likely genetic contributions to it from the entire genome. We consider a variety of phenotypes specifiable with data from the Health and Retirement Survey (HRS). However, evidence from other large population studies is also incorporated as part of the process of developing and refining pathway representations from the genome thru a hierarchy of intermediate endpoints to behavioral, cognitive, and economic phenotypes. Any causal modeling focused on genome-phenotype connections must, of necessity, include consideration of intermediate endpoints (endophenotypes) as mediators of such associations. We also discuss metabolic and gene expression consequences of gene-environment interactions as a next research step beyond GWAS, not only for HRS but also for an integrated set of human population surveys that can provide much more statistical power than any one of them used alone. A variety of concrete examples based on physiological, psychological, sociological, and economic outcomes are carried along throughout our discussion.