bluuebunny/crossref_metadata_2025_split huggingface dataset:
The epidemiology of childhood eczema: II. Statistical analyses to identify independent early predictors
Authors: Peters Tim J. , Golding Jean 
Published: April 2008

Summary. Amongst a nationally representative sample of singletons born in one week of April 1970 for whom information was available, 12.3% were reported by their mothers as having developed eczema at some time before their fifth birthday. Data from both the birth and the five‐year follow‐up surveys have been analysed to identify the independent early predictors of this (reported) condition in 11 920 children.Using an initial set of possible predictors suggested by previous analyses of these data, the dominant risk characteristics have been identified as: a positive maternal history of eczema; a positive maternal history of asthma or hay fever; higher parental educational qualifications and the mother originating from the West Indies or Africa. There were also increased risks for children of mothers born in England (relative to the rest of the United Kingdom) and for children of mothers who used contraceptives in the 18 months prior to the index pregnancy.There was no protective effect of breast‐feeding even among children whose mothers had a history of allergy.
Is perinatal mortality still a good indicator of perinatal care?
Authors: Field D.J. , Smith Heather , Mason Elizabeth , Milner A.D. 
Published: April 2008

SummaryThe increasing influence of very immature infants on perinatal mortality rates (PMR) led us to question the usefulness of this parameter in assessing perinatal care. To examine this further we have compared the incidence of perinatal asphyxia amongst mature babies (greater than or equal to 35 weeks gestation) for two geographically‐defined populations of over 500 000 people. Both areas have a teaching hospital‐based maternity service and comparable perinatal mortality rates. The incidence of severe post‐asphyxia1 encephalopathy showed a marked excess in one population (1.93 vs 0.61 per 1000 births), which was not obviously explicable. Taken in conjunction with the figures for stillbirth in labour, this represented a 2.8 times greater risk for either fetal death in labour or severe asphyxia1 insult. It would appear that perinatal mortality rates do not accurately reflect important differences in those perinatal outcomes most likely to be affected by perinatal care.
The Christchurch Child Development Study: a review of epidemiological findings
Authors: Fergusson D.M. , Horwood L.J. , Shannon F.T. , Lawton J.M. 
Published: April 2008

SummaryThe Christchurch Child Development Study is a longitudinal study of a birth cohort of 1265 New Zealand children who have been studied over an 11‐year period using data from multiple sources including parental interview, medical records, teacher questionnaires and direct testing of children. The article provides a review of the major lines of epidemiological research examined in the Study. These include: breast feeding and child health; parental smoking and child health; the effects of low level lead exposure; childhood asthma; nocturnal bladder control; the effects of early hospital admission; the distribution of child health services; and the consequences of private medical insurance. In addition a number of general topics (sample attrition, measurement error, individual differences and causal inference) relating to longitudinal designs are discussed briefly. It is concluded that the longitudinal design is a powerful and cost‐effective method of gathering data for general paediatric epidemiological purposes but that research in this area would benefit from an increased use of emerging methods of statistical modelling.
Acute abdominal pain and appendicitis in north east Thailand
Authors: Chatbanchai W. , Hedley A.J. , Ebrahim S.B.J. , Areemit S. , Hoskyns E.W. , de Dombal F.T. 
Published: April 2008

Summary. In a survey of emergency admissions to hospital in rural Thailand, acute appendicitis was the commonest cause of acute abdominal pain. Estimates of the incidence of appendicitis, in two series comprising a total of 356 patients, at 3.2 and 3.7 per 10000 population per year, were relatively high compared with reports from other warm climate countries. In comparison with 1825 cases in studies sponsored by the Organisation Mondiale de Gastroenterologie (OMGE), Thai patients with acute appendicitis were older, presented late and experienced more complications than those in 14 other countries. In Khon Kaen only 2–3% of the cases were children aged 0–9 years, compared with 9–26% in the OMGE series. In patients admitted to hospital with acute abdominal pain in Thailand, acute appendicitis was diagnosed more often than non‐specific abdominal pain. The converse was true in the OMGE series. This may reflect the longer distances travelled to hospital by many patients and delays between onset of symptoms and admission to hospital. Acute appendicitis was the commonest definitive diagnosis in both series.This survey indicates that relatively high rates of acute appendicitis may occur in populations eating traditional diets. The results are consistent with the recently described hypothesis of an infective aetiology and increases in appendicitis rates may be expected in people born since the introduction of improvements in environmental sanitation. Further studies are needed to examine trends in the incidence of appendicitis in populations eating traditional diets with both high and low fibre content and to investigate the significance of changing social and environmental factors.
Secular trends of sudden infant death syndrome in Norway 1967–1988: application of a method of case identification to Norwegian registry data
Authors: Oyen Nina , Irgens Lorentz M. , Skjærven Rolv , Morild Inge , Markestad Trond , Rognum Torleiv Ole 
Published: April 2008

Summary. In Norway, towards the end of the 1980s, sudden infant death syndrome (SIDS) was the most frequent cause of infant death. Both SIDS and the total post‐perinatal mortality rates had increased. This paper presents a procedure for identifying SIDS from death certificates. Supplemented with additional information, a database was established to evaluate secular trends of SIDS and for further analytical research. The Medical Birth Registry of Norway comprises 1.3 million births from 1967 to 1988. Of these, 5447 infants died in the post‐perinatal period. The cause of death was reviewed by an expert panel and 1984 cases of SIDS were retrieved.Low maternal age, higher birth order, male gender, and lower birthweight were confirmed as risk factors for SIDS. In 1988, the rate for SIDS and for total post‐perinatal deaths reached 2.69 and 5.02 per 1000 infants at risk. The incidence of SIDS increased 2.2 times from the period 1967–1971 to the period 1987–1988. Adjusted for maternal age, birth order, and birthweight, the odds ratio was 3.1. The increase is due to factors not yet accounted for. Adjusted mortality rates for the other post‐perinatal deaths were not different from the crude rates.
Does maternal behaviour influence the risk of perinatal death in Jamaica?
Authors: Greenwood Rosemary , McCaw‐Binns Affette 
Published: April 2008

Summary. Features of behaviour of mothers of singleton perinatal deaths collected over the 12‐month period from 1 September 1986 to 31 August 1987 were compared with 9919 mothers of singleton infants born in September and October 1986 and surviving the first week of life, as part of the Jamaican Perinatal Mortality Survey.For perinatal deaths as a whole, and in the presence of maternal age and social and environmental features, logistic regression analyses showed that the following were independently related with higher risk of mortality: (1) deliberately trying to get pregnant; (2) ever having used Depo Provera; (3) not drinking alcohol in pregnancy; and (4) smoking cigarettes in pregnancy. There were no associations with coital frequency, ever using the contraceptive pill or smoking ganja (cannabis).Deaths were classified using the Wigglesworth scheme, and separate analyses carried out for the three major groups ‐ antepartum fetal deaths, deaths from immaturity and deaths from intrapartum asphyxia. Antepartum fetal deaths were at increased risk if (1) mothers were deliberately trying to get pregnant or (2) they had ever used Depo Provera. Deaths from immaturity were not associated with any health behaviour variables. Deaths from intrapartum asphyxia were more likely if (1) the mother was deliberately trying to get pregnant or (2) she had never used an intrauterine contraceptive device.
Antenatal and perinatal care in Jamaica: do they reduce perinatal death rates?
Authors: McCaw‐Binns Affette , Greenwood Rosemary , Ashley Deanna , Golding Jean 
Published: April 2008

Summary. Information concerning 9919 singleton pregnancies delivered in Jamaica in the 2‐month period of September and October 1986 and surviving the early neonatal period were compared with 1847 singleton perinatal deaths occurring in the 12‐month period from 1 September 1986 to 31 August 1987, classified according to the Wigglesworth schema.Logistic regression was used to assess features of antenatal and intrapartum care that were associated with the different groups of perinatal death after taking account of environmental, maternal and medical factors.In Jamaica, 67% of all mothers took iron during pregnancy. These mothers appeared to have a lower risk of perinatal death. This does not appear to be an artefact related to the gestation at which the mother delivers, and was particularly associated with antepartum fetal deaths.Commencement of antenatal care in the first trimester appeared to reduce the risk of all perinatal deaths, and for intrapartum asphyxia in particular. It is speculated that the mechanism may involve early detection and treatment of anaemia and syphilis.Quality of perinatal care available in the area of residence, as measured by the presence of consultant obstetricians and a paediatric consultant unit, is shown to be significantly related to a reduction in deaths from intrapartum asphyxia, but it appeared not to be related to antepartum fetal deaths.
The contribution of twins to perinatal mortality in Jamaica
Authors: Ashley Deanna , Samms‐Vaughan Maureen , Greenwood Rosemary , Golding Jean 
Published: April 2008

Summary. The Jamaican Perinatal Mortality Survey collected data that have been used in this paper to estimate: (1) the rate of multiple deliveries on the island; (2) the way in which this varies with demographic features; and (3) the causes of perinatal mortality among twins on the island.The survey consisted of two phases: a study of all births in the months of September and October 1986 (the cohort months) and a study of all perinatal deaths in the 12 months from 1 September 1986 to 31 August 1987.Among the 10408 pregnancies in the cohort months, 99(1.0%) were multiple pregnancies. The twinning rate showed statistically significant trends with maternal age and parity but no association with social factors.Among the 2020 perinatal deaths occurring in the 12‐month period, 173 (8.6%) were twins, with particularly high contribution to the Wigglesworth group ‘deaths from immaturity’. Mortality rate of twins was significantly lower if mothers resided in areas where there were good obstetric and paediatric facilities.
Assessment of risk of perinatal death in Jamaica
Authors: Greenwood Rosemary , Ashley Deanna 
Published: April 2008

Summary. Data from the Jamaican Perinatal Mortality Survey had been used to create a statistical model using logistic regression.1 From this a simple additive scoring system to predict perinatal death was devised and tested on the 2 cohort months of the study.The score had a theoretical range of 0–28 points, with the higher the score, the greater the likelihood of a perinatal death. For a cut‐point of 7, sensitivity was 43% and specificity 84%. A cut‐point of 8 resulted in 27% sensitivity and 94% specificity. Higher cut‐points resulted in much reduced sensitivity but enhanced specificity (e.g. cut‐point 10: 11% sensitivity, 99% specificity).However, it is likely that these estimates are optimistically high, and to achieve unbiased estimates of sensitivity and specificity the score needs to be tested on a sample of the population from which it was not derived before implementation takes place. Meanwhile, the cut‐off level for implementation will depend on appropriate resources available.
The changing pattern of cerebral palsy in Avon
Authors: MacGillivray Ian , Campbell Doris M. 
Published: April 2008

Summary. The overall rate of cerebral palsy excluding post‐neonatal cases, has remained relatively constant, varying between 1.93 and 2.27 per 1000 births over the 20‐year period between 1969 and 1988 in Avon. The rate of the subgroup of spastic cerebral palsy varied from 1.40 to 1.78 per 1000 births over the same time period.In singletons the corresponding figures were 1.80‐2.17 per 1000 births and 1.28‐1.67 per 1000 births, and in multiple births the figures were 7.12‐8.80 per 1000 births and 7.12‐8.44 per 1000 births. Although the overall rates have remained fairly constant there was an increase in incidence in the later years among children with low birthweight and short gestation.
Antenatal antecedents of moderate and severe cerebral palsy
Authors: Palmer Lyle , Blairt Eve , Petterson Beverly , Burton Paul 
Published: April 2008

Summary. Aetiological relationships between cerebral palsy, preterm birth, small‐for‐gestational‐age (SGA) birth and selected feto‐maternal factors were investigated in a case‐control study of all moderate and severe cerebral palsy cases born in Western Australia between 1980 and 1986 (n= 215). Cases were individually matched to three controls of the same gender and plurality born in the same year. Two of the controls were matched to the index cases for gestational age, one of which was also matched for birthweight.Pre‐eclampsia and urinary tract infections were not significantly associated with cerebral palsy. The significant association of antepartum haemorrhage with cerebral palsy was accounted for by its associations with preterm birth. Congenital malformations and non‐cerebral palsy neurological disorder were significantly associated with cerebral palsy; these associations were only partially accounted for by adjusting for preterm birth and small‐for‐gestational‐age birth.This study shows that some of the risk of cerebral palsy associated with the antenatal antecedents of some common feto‐maternal factors is mediated through preterm birth, confirming the importance of interrelationships between antenatal antecedents in the aetiology of some cerebral palsy.Perinatal and post‐neonatal causes now account for only around 20% of all cerebral palsy. Future reductions in cerebral palsy incidence may therefore depend on acquiring greater knowledge of inter‐relationships between antenatal antecedents.
Discriminating between pore‐filling load and bed‐structure load: a new porosity‐based method, exemplified for the river Rhine
Authors: FRINGS ROY M. , KLEINHANS MAARTEN G. , VOLLMER STEFAN 
Published: April 2008

AbstractSediments contained in the river bed do not necessarily contribute to morphological change. The finest part of the sediment mixture often fills the pores between the larger grains and can be removed without causing a drop in bed level. The discrimination between pore‐filling load and bed‐structure load, therefore, is of practical importance for morphological predictions. In this study, a new method is proposed to estimate the cut‐off grain size that forms the boundary between pore‐filling load and bed‐structure load. The method evaluates the pore structure of the river bed geometrically. Only detailed grain‐size distributions of the river bed are required as input to the method. A preliminary validation shows that the calculated porosity and cut‐off size values agree well with experimental data. Application of the new cut‐off size method to the river Rhine demonstrates that the estimated cut‐off size decreases in a downstream direction from about 2 to 0·05 mm, covariant with the downstream fining of bed sediments. Grain size fractions that are pore‐filling load in the upstream part of the river thus gradually become bed‐structure load in the downstream part. The estimated (mass) percentage of pore‐filling load in the river bed ranges from 0% in areas with a unimodal river bed, to about 22% in reaches with a bimodal sand‐gravel bed. The estimated bed porosity varies between 0·15 and 0·35, which is considerably less than the often‐used standard value of 0·40. The predicted cut‐off size between pore‐filling load and bed‐structure load (Dc,p) is fundamentally different from the cut‐off size between wash‐load and bed‐material load (Dc,w), irrespective of the method used to determine Dc,p or Dc,w. Dc,w values are in the order of 10−1 mm and mainly dependent on the flow characteristics, whereas Dc,p values are generally much larger (about 100 mm in gravel‐bed rivers) and dependent on the bed composition. Knowledge of Dc,w is important for the prediction of the total sediment transport in a river (including suspended fines that do not interact with the bed), whereas knowledge of Dc,p helps to improve morphological predictions, especially if spatial variations in Dc,p are taken into account. An alternative to using a spatially variable value of Dc,p in morphological models is to use a spatially variable bed porosity, which can also be predicted with the new method. In addition to the morphological benefits, the new method also has sedimentological applications. The possibility to determine quickly whether a sediment mixture is clast‐supported or matrix‐supported may help to better understand downstream fining trends, sediment entrainment thresholds and variations in hydraulic conductivity.
Interaction between seroreactivity to microbial antigens and genetics in Crohn’s disease: is there a role for defensins?
Authors: Lakatos P. L. , Altorjay I. , Mándi Y. , Lakatos L. , Tumpek J. , Kovacs A. , Molnar T. , Tulassay Z. , Miheller P. , Palatka K. , Szamosi T. , Fischer S. , Papp J. ,   the Hungarian IBD Study Group, Papp M. 
Published: April 2008

AbstractAntibodies against different microbial epitopes are associated with disease phenotype, may be of diagnostic importance and may reflect a loss of tolerance in Crohn’s disease (CD). Recently, an association was reported between the presence of these antibodies and mutations in pattern receptor genes. Our aim was to investigate whether mutations in various genes other than NOD2/CARD15 or TLR4 associated with CD (NOD1/CARD4, DLG5 and DEFB1) may influence the presence of antibodies against bacterial proteins and carbohydrates in a Hungarian cohort of CD patients. Three hundred and seventy‐six well‐characterized, unrelated, consecutive CD patients (male/female: 191/185, age at onset: 29.1 ± 12.9 years, duration: 7.9 ± 11.7 years) were investigated. Sera were assayed for anti‐Omp, anti‐Saccharomyces cerevisiae antibodies (ASCAs) immunoglobulin (Ig) A and IgG, and antibodies against a mannan epitope of S. cerevisiae (gASCA), laminaribioside (ALCA), chitobioside (ACCA), and mannobioside (AMCA). NOD1/CARD4, DLG5 and DEFB1 variants were tested by polymerase chain reaction–restriction fragment length polymorphism, and DEFB1 was genotyped in a subgroup of 160 patients. Detailed clinical phenotypes were determined by reviewing the patients’ medical charts. The carriage of DEFB1 20A variant alleles less frequently led to antiglycan positivity compared with patients without (29.6% vs 46.2%, OR: 0.49, 95% CI: 0.25–0.97), regardless of disease location or behavior. Similar tendency was observed for DEFB1 44G (present: 21.6% vs absent: 10.2%, P = 0.06) and ALCA. A gene or serology dosage effect was not observed. However, no association was found between the DEFB1 G52A, DLG5 R30Q, and NOD1/CARD4 E266K variants and any of the serology markers. We found that variants in human β‐defensin 1 gene are inversely associated with antiglycan antibodies, further confirming an important role for innate immunity in the pathogenesis of CD.
Do patients with heart failure appropriately undergo invasive procedures post‐myocardial infarction? Results from a prospective multicentre study
Authors: Tobing D. , French J. , Varigos J. , Meehan A. , Billah B. , Krum H. ,   the post‐MI audit group
Published: April 2008

AbstractBackground:  The degree of adherence to guideline recommendations that patients following myocardial infarction (MI) with congestive heart failure (CHF) undergo early angiography, and angioplasty if indicated, is unknown.Methods:  We prospectively evaluated the use of invasive procedures in patients with segment‐elevation myocardial infarction (STEMI), non‐STEMI and CHF, admitted in 1 month to 16 Australian hospitals.Results:  Of 475 post‐MI patients (248 (52.2%) with STEMI), 112 (23.6%) had CHF, (57 (23.0%) with STEMI). Patients with CHF, compared with those without CHF, were older (67.8 vs 63.2 years; P = 0.002) and were more often women (34 vs 24%, P = 0.03), but had similar rates of other risk factors. Compared with post‐MI patients without CHF, patients with CHF had fewer invasive procedures: angiography 72.3% versus 85.1% (P = 0.002) and angioplasty 33.9% versus 52.9% (P < 0.001) (12 (2.5%) patients underwent coronary surgery in‐hospital); and among STEMI patients (angiography 72.3% CHF vs 89.5% no CHF [P < 0.001]; angioplasty 50.9% CHF vs 69.1% no CHF [P = 0.011]); these differences remained significant after adjustment for clinical covariates. Of the 121 (25.5%) post‐MI patients aged ≥75 years, compared with those <75 years, the frequencies of angiography and angioplasty procedures were 66.1% versus 87.6% (P < 0.001) and 33.9% versus 53.4% (P < 0.001), respectively; 66% of the elderly with, and without, CHF had angiography.Conclusion:  The presence of CHF post‐MI resulted in lower rates of use of angiography and angioplasty, which was not explained by lower procedure rates in the elderly. As these guideline‐recommended procedures may improve survival in patients with CHF post‐MI, future strategies should aim to enhance their use.
Early continence outcomes of posterior musculofascial plate reconstruction during robotic and laparoscopic prostatectomy
Authors: Nguyen Mike M. , Kamoi Kazumi , Stein Robert J. , Aron Monish , Hafron Jason M. , Turna Burak , Myers Robert P. , Gill Inderbir S. 
Published: April 2008

Associate EditorAsh TewariEditorial BoardRalph Clayman, USAInderbir Gill, USARoger Kirby, UKMani Menon, USAOBJECTIVESTo detail the technique and evaluate in a preliminary study the effectiveness of posterior reconstruction of Denonvilliers’ musculofascial plate (PRDMP) in enhancing early continence after robotic and laparoscopic radical prostatectomy (RP).PATIENTS AND METHODSThirty‐two consecutive patients having robotic or laparoscopic RP with PRDMP (group 1). Thirty previous patients not having PRDMP were compared as historical controls (group 2). Continence, as measured by patient self‐reporting of the number of pads used/24 h, was assessed at 3 days and 6 weeks after catheter removal, by telephone interview. ‘Continent’ was defined as the use of none or one pads, ‘moderate incontinence’ as two pads, and ‘severe incontinence’ as more than two pads. Intraoperative transrectal ultrasonography (TRUS) was used to measure the membranous urethral length before and after PRDMP.RESULTSAt 3 days after catheter removal, more patients in group 1 were continent than in group 2 (34% vs 3%, P = 0.007). At 6 weeks continence was again better in group 1 (56% vs 17%, P = 0.006). The mean length of the membranous urethra on TRUS measured before RP, after RP but before the musculofascial suture, and afterward, was 15.6, 12 and 14 mm, respectively. Thus, reconstruction restored the length of the transected membranous urethra by a mean of 2 mm.CONCLUSIONSPRDMP during robotic and laparoscopic RP leads to improved maintenance of membranous urethral length and significantly higher early continence rates.