bluuebunny/crossref_metadata_2025_split huggingface dataset:
Support for breastfeeding mothers: a systematic review
Authors: Sikorski Jim , Renfrew Mary J. , Pindoria Sima , Wade Angela 
Published: October 2003

SummaryAlthough the benefits of breastfeeding are widely accepted, the effectiveness of different strategies to promote the continuation of breastfeeding once initiated are less clear. The objective of this systematic review was to describe studies comparing standard care with the provision of extra breastfeeding support and to measure its effectiveness. Outcome measures used were rates of cessation of any breastfeeding or exclusive breastfeeding at chosen points in time. Measures of child morbidity and maternal satisfaction were also used when these were reported.Twenty eligible randomised or quasi‐randomised controlled trials were identified, involving 23 712 mother–infant pairs. Extra support had a beneficial effect on the duration of any breastfeeding (RR [95% confidence intervals] for stopping any breastfeeding before the last study assessment up to 6 months 0.88 [0.81, 0.95]; 15 trials, 21 910 women). The effect was greater for exclusive breastfeeding (RR for stopping exclusive breastfeeding before the last study assessment 0.78 [0.69, 0.89]; 11 trials, 20 788 women).Although the point estimates of relative risk were very similar, benefit derived from professional support achieved statistical significance for any breastfeeding (RR 0.89 [0.81, 0.97]; 10 trials, 19 696 women) but not for exclusive breastfeeding (RR 0.90 [0.81, 1.01]; six trials, 18 258 women). Lay support was effective in reducing the cessation of exclusive breastfeeding (RR 0.66 [0.49, 0.89]; five trials, 2530 women) while the strength of its effect on any breastfeeding was less clear (RR 0.84 [0.69, 1.02]; five trials, 2224 women). Professional support in the largest trial to assess health outcomes produced a significant reduction in the risk of gastrointestinal infections and atopic eczema. In two trials with children suffering from diarrhoeal illness, extra support was highly effective in increasing short‐term exclusive breastfeeding rates and reducing recurrence of diarrhoea.This review supports the conclusion that supplementary breastfeeding support should be provided as part of routine health service provision. There is clear evidence for the effectiveness of professional support on the duration of any breastfeeding although the strength of its effect on the rate of exclusive breastfeeding is uncertain. Lay support is effective in promoting exclusive breastfeeding although the strength of its effect on the duration of any breastfeeding is uncertain. Evidence supports the promotion of exclusive breastfeeding as central to the management of diarrhoeal illness in partially breast‐fed infants.
Secular trends of fetal growth in Canada, 1981 to 1997
Authors: Wen Shi Wu , Kramer Michael S. , Platt Robert , Demissie Kitaw , Joseph K. S. , Liu Shiliang , Sauve Reg 
Published: October 2003

SummaryPreterm birth and low birthweight in Canada have shown paradoxical temporal trends, with an increase in preterm birth and a decrease in low birthweight. Mean birthweight has increased in many industrialised countries, despite a recent rise in preterm birth, suggesting a temporal increase in fetal growth (birthweight for gestational age) in Canada. We thus described temporal trends in the distribution of fetal growth from 1981 to 1997, including means and proportions of infants at both the low and high ends of the fetal growth distribution. We used data for singleton live births from Statistics Canada's Canadian Birth Data Base for the years 1981–97 (excluding Ontario and Newfoundland) and analysed temporal trends in birthweight and birthweight‐for‐gestational‐age z‐score as continuous outcomes and the derived dichotomised  outcomes  [i.e.  low  birthweight  (<2500 g),  very  low  birthweight  (<1500 g), small‐for‐gestational‐age (<10th percentile), very small‐for‐gestational‐age (<3rd percentile), high birthweight (>4000 g), very high birthweight (>4500 g), large‐for‐gestational‐age (>90th percentile), and very large‐for‐gestational‐age (>97th percentile)]. The birthweight‐for‐gestational‐age was based on a newly developed population‐based Canadian reference. The results showed that in the overall sample and in a subsample of term and post‐term births, mean birthweight, mean z‐score, rates of high birthweight, very high birthweight, large‐for‐gestational‐age, and very large‐for‐gestational‐age increased whereas rates of low birthweight, very low birthweight, small‐for‐gestational‐age, and very small‐for‐gestational‐age decreased between 1981–83 and 1995–97. The reverse was observed in preterm births. These temporal changes were larger for more extremely distributed measures of fetal growth. For example, compared with 1981–83, the decrease in 1995–97 for very small‐for‐gestational‐age (<3rd percentile) was 38.9%, whereas the decrease for small‐for‐gestational‐age (<10th percentile) was only 29.7%. Corresponding temporal increases were 21.4% for very large‐for‐gestational‐age (>97th percentile) and 15.2% for large‐for‐gestational‐age (>90th percentile). Among infants with gestational age 34–36 weeks, all measures of fetal growth, including the rates for all dichotomous outcomes, decreased in 1995–97 as compared with 1981–83. We conclude that Canadian infants are getting bigger, but only those born at term. The temporal trends for more extremely distributed fetal growth measures are particularly marked.
Childhood malnutrition and its predictors in rural Malawi
Authors: Maleta Kenneth , Virtanen Suvi M. , Espo Merimaaria , Kulmala Teija , Ashorn Per 
Published: October 2003

SummaryWe prospectively followed up a population‐based cohort of 767 rural Malawian children from birth to 36 months to characterise the timing and predictors of malnutrition. Underweight and wasting incidence peaked between 6 and 18 months of age, whereas stunting incidence was highest during the first 6 months of age. After infancy about 40% of the children were underweight, 70% stunted, and about 4% wasted. Small size during the first 3 months of life predicted the incidence of severe underweight (relative risk [95% confidence interval], 1.8 [0.9, 3.4]), severe stunting ( 2.1 [1.3, 3.4]), and moderate wasting (2.0 [1.1, 3.5]). Children with many illness episodes in infancy had a twofold risk for the development of severe underweight and moderate wasting. Severe underweight was further predicted by residence far away from a health facility and moderate wasting by maternal HIV infection. Our conclusion is that the intrauterine period and first 6 months of life are critical for the development of stunting whereas the subsequent year is more critical for the development of underweight and wasting. Strategies combating intrauterine growth retardation, maternal HIV and infant morbidity are likely to reduce the burden of malnutrition in this population.
The effect of caffeine consumption and nausea on the risk of miscarriage
Authors: Giannelli Massimo , Doyle Pat , Roman Eve , Pelerin Margo , Hermon Carol 
Published: October 2003

SummaryEvidence for a harmful effect of caffeine intake on risk of miscarriage (spontaneous abortion) is inconsistent and nausea during pregnancy has been claimed to explain any association seen. The objective of this analysis was to determine whether caffeine consumption both before and during pregnancy influenced the risk of miscarriage in a group of pregnant women in the UK. We examined the association with maternal caffeine intake in a case–control study of 474 nulliparous women. Participants were recruited during the years 1987–89 from the Royal Berkshire Hospital in Reading and from a large group practice situated within the hospital's catchment area. Cases were 160 women with a clinically diagnosed miscarriage and controls were 314 pregnant women attending for antenatal care. Information on coffee/tea/cola consumption and potential confounders was collected by interview and caffeine content was assigned to individual drinks according to published data on caffeine content of beverages. Compared with a maternal caffeine intake of < 151 mg/day, we found evidence that caffeine consumption > 300 mg/day doubled the risk of miscarriage. Adjusted odds ratios were 1.94 [95% CI 1.04, 3.63] for 301–500 mg/day and 2.18 [95% CI 1.08, 4.40] for > 500 mg/day. This effect could not be explained by nausea in pregnancy. Nausea appeared to be strongly independently associated with a reduced risk of miscarriage (test for trend P < 0.0001). There was no evidence that prepregnancy caffeine consumption affected the risk. Our results indicate that high caffeine consumption during pregnancy (>300 mg/day), in particular coffee consumption, is an independent risk factor for increased risk and nausea is an independent protective factor for a lower risk of miscarriage.
Is midwife workload associated with quality of process of care (continuous electronic fetal monitoring [CEFM]) and neonatal outcome indicators? A prospective study in consultant‐led labour wards in Scotland
Authors: Tucker J. , Parry G. , Penney G. , Page M. , Hundley V. 
Published: October 2003

SummaryEvidence for staffing recommendations in labour wards is scant. This study aimed to test association between midwife workload with adjusted process of continuous electronic fetal monitoring (CEFM) and neonatal outcome indicators. This was a prospective workload study in 23 consultant‐led labour wards in Scotland. There were 3489 livebirths during September 2000, and 1561 consecutively delivered women with CEFM case review during the mid‐two weeks. Process measures were: adjusted rates of CEFM, appropriate CEFM, and time to medical response for a serious fetal heart trace abnormality. Neonatal outcome indicators were: Apgar score < 7 at 5 minutes, admission to neonatal unit (NNU) > 48 hours, and neonatal resuscitation. Complete information was available for 99% (2553/2576) of workload time points, 99% (1559) of CEFM process, and 3083 eligible neonates. There were no associations between occupancy or staffing ratios and adjusted CEFM process, Apgar < 7 at 5 minutes (0.98 [0.83, 1.15]) or admission to NNU for > 48 hours (0.97 [0.95, 1.00]). However, there was association between increasing staffing ratios and lower odds of adjusted neonatal resuscitation (excluding bag and mask only) (0.97 [0.94, 0.99]). The direction of effect of increasing workload suggests detriment to outcome indicators, although the size of effect may be small.
Correlated evolution of colour pattern and body size in polymorphic pygmy grasshoppers,Tetrix undulata
Authors: Ahnesjö J. , Forsman A. 
Published: October 2003

AbstractTheory posits that selection on functionally interrelated characters will promote physical and genetic integration resulting in evolution of favourable trait‐value combinations. The pygmy grasshopperTetrix undulata(Orthoptera: Tetrigidae) displays a genetically encoded polymorphism for colour pattern. Colour morphs differ in several traits, including behaviours, thermal biology and body size. To examine if these size differences may reflect phenotypic plasticity of growth and development in response to temperature we used a split brood‐design and reared hatchlings from mothers belonging to different morphs in different thermal environments (warm or cold) until maturity. We found that time to maturity was longer in the cold compared with the warm treatment. In the warm (but not in the cold) treatment time to maturity also varied among individuals born to mothers belonging to different colour morphs. Although low temperature and long development time are normally accompanied by increased body size in ectotherms, our results revealed no difference in size at maturity between individuals reared in the two temperature treatments. There was also an increase (not a decrease) in adult body size with shortened time to maturity across families within each treatment. Taken together, this suggests that body size is canalized against environmental perturbations, and that early maturation does not necessarily trade off against a size‐mediated decrease in fecundity. Heritability of body size was moderate in magnitude. Moreover, body size at maturity varied among individuals belonging to different morphs and was influenced also by maternal colour morph, suggesting that a genetic correlation exists between colour pattern and body size. These findings suggest that different characters have evolved in concert and that the various colour morphs represent different evolutionary strategies, i.e., alternative peaks in a multi‐modal adaptive landscape.
Humoral immune response in relation to senescence, sex and sexual ornamentation in the barn swallow (Hirundo rustica)
Authors: Saino N. , Ferrari R. P. , Romano M. , Rubolini D. , Møller A. P. 
Published: October 2003

Abstract
Performance of animals may decline with age. The effects of senescence, however, may differ between the sexes because of differences in physiology and behaviour. Acquired immunity provides hosts with efficient mechanisms of anti-parasite defence, but the effect of senescence on immunocompetence has never been studied in natural populations. In the barn swallow (Hirundo rustica), primary antibody response to an antigen during one breeding season declined with age in females, while secondary response during the following breeding season declined with age in both sexes. Parasite-mediated sexual selection theory posits that male secondary sexual characters reveal resistance to parasites. Males with large tail ornaments had stronger primary response, retained larger antibody levels until the following year, but did not differ in secondary response compared with short-tailed males, as predicted if ornamentation reflects resistance to parasites. This is the first study showing that immunocompetence declines with age in any vertebrate under natural conditions.
Evidence for bimodal hybrid zones between two species of char (Pisces: Salvelinus) in northwestern North America
Authors: Redenbach Z. , Taylor E. B. 
Published: October 2003

Abstract
Dolly Varden (Salvelinus malma, Pisces: Salmonidae) and bull trout (Salvelinus confluentus) have widely overlapping, but largely parapatric ranges in watersheds in northwestern North America from Washington State to northern British Columbia. Genetic analysis of natural populations using diagnostic molecular markers revealed widespread local sympatry and hybridization with hybrids comprising 0–25% of the local samples. In a detailed analysis of hybridization using four nuclear DNA markers and mitochondrial DNA within the Thutade Lake watershed, northcentral British Columbia, hybrid genotypes constituted up to 9% of the population of juvenile char. There were significant deviations from Hardy–Weinberg, gametic, and cytonuclear equilibria, and local samples showed bimodal frequency distributions of genotypes. Pure parental and inferred backcross genotypes were most common, and F1 and Fn hybrids were comparatively rare. Interspecific hybridization was asymmetrical, with most F1 hybrids (five of six) bearing S. confluentus mtDNA. The introgression of nuclear and mitochondrial alleles was asymmetrical, with S. confluentus mtDNA and Growth Hormone 2 introgressing into S. malma significantly more than either introgression of the three other nuclear loci, or introgression of S. malma alleles into S. confluentus. Substantial prezygotic isolation between the species likely depends on the large body size difference between them in sympatry: S. malma have small bodies and a stream resident life history (12–21 cm adult fork length at maturity), while S. confluentus are larger and adfluvial, i.e., they migrate to Thutade Lake where they grow to maturity before returning to tributary streams to spawn (40–90 cm at maturity). These traits may limit interspecific pairings because of size assortative pairing and size-dependent reproductive habitat use.
Sex choice in plants: facultative adjustment of the sex ratio in the perennial herb Begonia gracilis
Authors: López S. , Domínguez C. A. 
Published: October 2003

Abstract
Sex allocation theory predicts that reproducing individuals will increase their fitness by facultatively adjusting their relative investment towards the rarer sex in response to population shifts in operational sex ratio (OSR). The evolution of facultative manipulation of sex ratio depends on the ability of the parents to track the conditions favouring skewed sex allocation and on the mechanism controlling sex allocation. In animals, which have well-developed sensorial mechanisms, facultative adjustment of sex ratios has been demonstrated on many occasions. In this paper, we show that plants have mechanisms that allow them to evaluate the population OSR. We simulated three different conditions of population OSR by manipulating the amount of pollen received by the female flowers of a monoecious herb, and examined the effect of this treatment on the allocation to male vs. female flowers. A shortage of pollen on the stigmas resulted in a more male-skewed sex allocation, whereas plants that experienced a relatively pollen rich environment tended to produce a more female-skewed sex allocation pattern. Our results for Begonia gracilis demonstrate that the individuals of this species are able to respond to the levels of pollination intensity experienced by their female flowers and adjust their patterns of sex allocation in accordance to the expectations of sex allocation theory.
Flexible mating: cross-pollination affects sex-expression in a marine clonal plant
Authors: Hämmerli A. , Reusch T. B. H. 
Published: October 2003

Abstract
Many functionally hermaphroditic plants have evolved mechanisms to reduce interference between the sex functions and to optimize reproductive output. In addition to physical mechanisms such as the spatial (herkogamy) and temporal (dichogamy) separation of male and female functions, plasticity in sex expression by means of mate-recognition (flexible mating) could be important in plants with variable access to cross-pollen. This applies particularly to clonal plants because of their modular growth form. We experimentally tested for the effects of pollen source and vegetative neighbourhood on instantaneous sex ratio and seed production in the self-compatible clonal marine angiosperm Zostera marina L. To this end, we exposed the (monoecious) flowering shoots to self and cross-pollen and to neighbourhoods of their own and a mix of foreign vegetative shoots. Flowering shoots that had been exposed to cross-pollen showed (1) a significantly lower female/male ratio at peak flowering, evidence for mate-recognition, and (2) a significantly higher seed set by the end of the season. Both effects were independent of the genetic composition of their vegetative neighbourhood. The results suggest that Z. marina maintains a cryptic self-incompatibility system not previously described for angiosperms with sub-aqueous pollination. In Z. marina, and possibly other self-compatible clonal plant species, mate-recognition could be a means of increasing the out-crossing probability for flowering shoots with central positions within their clone.
Environment-dependent inbreeding depression in a hermaphroditic freshwater snail
Authors: Henry P.-Y. , Pradel R. , Jarne P. 
Published: October 2003

Abstract
Inbreeding depression was simultaneously studied under contrasted environments, laboratory and natural conditions, using individuals originating from 14 families of the freshwater snail Physa acuta. Both survival and growth of juveniles showed inbreeding depression under laboratory conditions. The same fitness components were monitored with mature snails either kept under laboratory conditions or released at a natural site and analysed using capture-mark-recapture models. Genetic composition of both samples was similar. Inbreeding depression on survival was highest in the laboratory while strong outbreeding depression was revealed in the field. Thus inbreeding depression may not be always higher under natural conditions, at the opposite of what is commonly assumed. We suggest that inbreeding depression is dependent on metabolic requirements imposed by the environment. Other evidences showing that inbreeding depression is environment-dependent are reviewed. We conclude that genetic models should include both genetic and environmental variance in inbreeding depression for studying mating system evolution.
Diagnostic testing and discharge coding for whooping cough in a children's hospital
Authors: Bonacruz‐Kazzi G , McIntyre P , Hanlon M , Menzies R 
Published: October 2003

Objective:  To evaluate the diagnostic pathways for whooping cough in a large urban paediatric hospital to inform assessment of the relative merits of notification and hospitalization data for measuring pertussis disease burden in Australian children.Methods:  All laboratory requests for Bordetella pertussis (BP) culture or serology between 30 June 1997 and 30 June 1999 were reviewed and cross‐checked against discharge diagnoses with International Classification of Disease (ICD) codes A37.0, 033.0 (whooping cough due to BP) or 37.9, 033.9 (whooping cough due to unspecified organisms). Culture‐positive (CP) cases were defined as a positive culture or polymerase chain reaction for BP. Culture‐negative (CN) cases either fulfilled the current Australian clinical case definition (≥14 days of cough with one or more of paroxysms, whoop, post‐tussive vomiting), or had a cough illness with either positive BP serology or documented contact with an individual coughing for >14 days. In infants <6‐months‐old, a coughing illness with apnoea and negative investigations for other causes was also accepted. Culture positive and CN cases were cross‐referenced with notification data.Results:  During the study period, laboratory tests for BP were performed in 677 children, of whom 230 were hospitalized and 71 (31%) had an eligible ICD code at discharge; 29 were CP, 40 CN, and two (3%) were misclassified. A further 14 CP children were not admitted. Although 61 hospitalized cases (88%) fulfilled notification criteria, including 32 (80%) of CN cases, only 26 (90%) of CP and eight (20%) of CN cases were notified.Conclusions:  Notifications substantially under‐enumerate hospitalized infant cases, especially those without positive laboratory tests. Hospital discharge data add significantly to surveillance for pertussis, particularly in infancy where most severe cases occur.
Systemic aspects of interstitial cystitis, immunology and linkage with autoimmune disorders
Authors: VAN DE MERWE JOOP P. , YAMADA TETSUO , SAKAMOTO YASUKI 
Published: October 2003

Abstract It is recognized that interstitial cystitis (IC) is often associated with a number of diseases such as allergies, irritable bowel syndrome, fibromyalgia, inflammatory bowel disease (Crohn's disease and ulcerative colitis), systemic lupus erythematosus, and Sjögren's syndrome.The prevalence of allergies in IC is reported to be between 40 and 80% of patients. The background of the association is not known and does not seem to be the result of a generalized allergic constitution. Some report that treatment of allergy sometimes has a beneficial effect on bladder symptoms.An increased expression of certain growth factors (PD‐ECGF, FGF, and VEGF) has been found in the bladder of IC patients. In addition, the expression of CD44 was significantly higher in ulcer type IC than in non‐ulcer type. In general, these growth factors are soluble and diffusible under normal conditions but proteoglycans such as CD44 could bind to these growth factors. This may promote the accumulation of growth factors at the sites of inflammation. CD44 expression in ulcer type IC could explain the prolonged and stronger expression of GAG‐binding growth factors that promote inflammation.In the Rotterdam study, a strong association between IC and Sjögren's syndrome is recognized. In this study, 28% of IC patients have definite or probable Sjögren's syndrome. This association is much stronger than is generally recognized. This could be due to difficulties in diagnosing Sjögren's syndrome since a diagnosis usually requires a high index of suspicion.