human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: RATIONALE Apnea of prematurity is a common condition that is usually treated with caffeine , an adenosine receptor blocker that has powerful influences on the central nervous system . However , little is known about the long-term effects of caffeine on sleep in the developing brain . OBJECTIVES We hypothesized that neonatal caffeine use result ed in long-term abnormalities in sleep architecture and breathing during sleep . METHODS A total of 201 ex-preterm children aged 5 - 12 years who participated as neonates in a double-blind , r and omized , controlled clinical trial of caffeine versus placebo underwent actigraphy , polysomnography , and  parental sleep question naires . Co primary outcomes were total sleep time on actigraphy and apnea-hypopnea index on polysomnography . MEASUREMENTS AND MAIN RESULTS There were no significant differences in primary outcomes between the caffeine group and the placebo ( adjusted mean difference of -6.7 [ 95 % confidence interval ( CI ) = -15.3 to 2.0 min ] ; P = 0.13 for actigraphic total sleep time ; and adjusted rate ratio [ caffeine/placebo ] for apnea-hypopnea index of 0.89 [ 95 % CI = 0.55 - 1.43 ] ; P = 0.63 ) . Polysomnographic total recording time and total sleep time were longer in the caffeine group , but there was no difference in sleep efficiency between groups . The percentage of children with obstructive sleep apnea ( 8.2 % of caffeine group versus 11.0 % of placebo ; P = 0.22 ) or elevated periodic limb movements of sleep ( 17.5 % in caffeine group versus 11 % in placebo group ) was high , but did not differ significantly between groups . CONCLUSIONS Therapeutic neonatal caffeine administration has no long-term effects on sleep duration or sleep apnea during childhood . Ex-preterm infants , regardless of caffeine status , are at risk for obstructive sleep apnea and periodic limb movements in later childhood Background : Few studies have prospect ively investigated whether early-life exposures are associated with pre-adolescent eating attitudes . Objective : The objective of this study is to prospect ively investigate associations of parental smoking , alcohol use , marital status , measures of maternal satisfaction , self-reported parental body mass index ( BMI ) and clinical ly measured childhood BMI , assessed between birth and 6.5 years , with problematic eating attitudes at 11.5 years . Methods : Observational cohort analysis nested within the Promotion of Breastfeeding Intervention Trial , a cluster-r and omised trial conducted in 31 maternity hospitals and affiliated polyclinics in Belarus . Our primary outcome was a Children ’s Eating Attitudes Test ( ChEAT ) score ⩾22.5 ( 85th percentile ) , an indicator of problematic eating attitudes . We employed multivariable mixed logistic regression models , which allow inference at the individual level . We also performed instrumental variable ( IV ) analysis using parents ’ BMI s as instruments for the child ’s BMI , to assess whether associations could be explained by residual confounding or reverse causation . Subjects : Of the 17 046 infants enrolled between 1996 and 1997 across Belarus , 13 751 ( 80.7 % ) completed the ChEAT test at 11.5 years . Results : In fully adjusted models , overweight children at age 6.5 years had a 2.14-fold ( 95 % confidence interval ( CI ) : 1.82 , 2.52 ) increased odds of having ChEAT scores ⩾85th percentile at age 11.5 years , and those who were obese had a 3.89-fold ( 95 % CI : 2.95 , 5.14 ) increased odds compared with normal-weight children . Children of mothers or fathers who were themselves overweight or obese were more likely to score ⩾85th percentile ( P for trend ⩽0.001 ) . IV analysis was consistent with a child ’s BMI causally affecting future eating attitudes . There was little evidence that parental smoking , alcohol use , or marital status or maternal satisfaction were associated with eating attitudes . Conclusion : In our large , prospect i ve cohort in Belarus , both parental and childhood overweight and obesity at 6.5 years were associated with pre-adolescent problematic eating attitudes 5 years later Objective : To examine maternal intake of a mildly alcoholic beverage ( pulque ) during pregnancy and lactation , and its potential effect on postpartum child growth and attained size . Design : A prospect i ve cohort study that followed mothers ( during pregnancy and lactation ) and their offspring ( from birth to approximately 57 months of age ) . Setting : Six villages in rural , central Mexico . Subjects : Subjects are 58 mother – child pairs .  Pulque intake  was measured as part of a dietary assessment that was conducted for 2days/month during pregnancy and early lactation . Results : Most mothers consumed pulque during pregnancy ( 69.0 % ) and lactation ( 72.4 % ) . Among pulque drinkers , the average ethanol intake was 125.1 g/week during pregnancy and 113.8 g/week during lactation . Greater pulque intake during lactation , independent of intake during pregnancy , was associated with slower weight and linear growth from 1 to 57 months , and smaller attained size at 57 months . Low-to-moderate pulque  intake during pregnancy , in comparison to either nonconsumption or heavy intake , was also associated with greater stature at 57 months . Conclusions : Pulque intake during lactation may have adversely influenced postnatal growth in this population . Public health interventions are urgently needed in Mexico to reduce heavy intake of pulque by pregnant and lactating women , and to replace intake with foods that provide the vitamins and minerals present in the traditional alcoholic beverage OBJECTIVE : Many motivated new mothers fail to reach public health goals for breastfeeding , highlighting the need to identify risk factors . Because having a family history of alcoholism is associated with blunted prolactin responses to an alcohol challenge in nonlactating individuals , this study aim ed to identify associations in family history of alcoholism , prolactin , and breastfeeding behaviors in lactating women . METHODS : This was a 2-day experimental study that used within-subject alcohol or control beverage consumption and between-subject family history of alcoholism factors . The participants were non – alcohol-dependent lactating women ; 7 were family history – positive ( FHP ) for alcohol dependence , and 21 were family history – negative ( FHN ) .  Consumption of 0.4 g/kg alcohol or nonalcoholic beverage occurred in separate r and omized sessions , followed by use of a breast pump . Basal and suckling-induced prolactin , blood alcohol concentrations , milk yield , self-reported drug effects , neophobia , and breastfeeding patterning were measured . RESULTS : Although no group differences in alcohol pharmacokinetics were detected , FHP women exhibited blunted prolactin to breast stimulation after drinking the control and alcohol beverage and felt more of the stimulant-like effects of alcohol than did FHN women . FHP women reported more frequent daily breastfeeding than did FHN women . CONCLUSIONS : This is the first evidence that family history of alcoholism is associated with a blunted magnitude , rapidity , and duration of the prolactin response to breast stimulation and an alcohol challenge in lactating women . More frequent breastfeeding by FHP women suggests behavioral compensation for perceived and /or actual poor lactation . Alcohol did not enhance lactational performance , further disputing the lore that alcohol is a galactagogue Previous studies and animal evidence have suggested a relationship between parental  tobacco or alcohol use and the  risk  of some  childhood cancers , including  neuroblastoma .  A case-control study was conducted to investigate the relationship between  parental tobacco smoking , alcohol consumption , and risk of neuroblastoma .  Cases were children diagnosed with neuroblastoma over the period 1992 - 1994 at Children 's Cancer Group and Pediatric Oncology Group institutions throughout the United States and Canada . One matched control was selected using r and om-digit dialing . Information on parental smoking and drinking history was obtained from 504 case and 504 control parents by telephone interview . Overall , there was no consistent pattern of association with parental smoking and alcohol consumption . For example , both maternal smoking and drinking during the period from 1 month before pregnancy through breastfeeding had adjusted odds ratios ( ORs ) of 1.1 [ 95 % confidence interval ( CI ) , 0.8 - 1.4 ] . There was no association with paternal smoking ( OR , 1.2 ; 95 % CI , 0.8 - 1.6 ) or paternal drinking 1 month before conception ( OR , 1.0 ; 95 % CI , 0.7 - 1.4 ) . There was no consistent increase in risk by the amount of smoking or drinking during any time period relative to pregnancy . There was no suggestion of an increased risk when only one parent smoked . Smoking or drinking among both parents did not jointly increase the risk of neuroblastoma in their offspring . The child 's age at diagnosis , stage , or MYCN oncogene amplification status did not material ly alter the OR estimates . It is concluded that the results from this study do not indicate any evidence for a relationship between neuroblastoma and parental tobacco or alcohol use Objectives : Breast-feeding is the recommended form of nutrition for the first 6 months . This target is unmet , however , in most industrialized regions . We evaluated aspects of breast-feeding in a cohort of mother – baby dyads . Methods : Breast-feeding practice s in 555 mother – baby dyads were prospect ively studied for 24 months ( personal interview at birth and 7 structured telephone interviews ) . Results : Of the babies , 71.3 % were fully breast-fed on discharge from maternity hospitals and 11.9 % were partially breast-feed . Median breast-feeding duration was 6.93 ( interquartile range 2.57–11.00 ) months ; for full ( exclusive ) breast-feeding 5.62 ( interquartile range 3.12–7.77 ) months ; 61.7 % received supplemental feedings during the first days of life . Breast-feeding duration in babies receiving supplemental feedings was significantly shorter ( median 5.06 months versus 8.21 months , P < 0.001 ) . At 6 months , 9.4 % of the mothers were exclusively and 39.5 % partially breast-feeding . Risk factors for early weaning were early supplemental feedings  ( odds ratio [ OR ] 2.87 , 95 % CI 1.65–4.98 ) , perceived milk insufficiency ( OR 7.35 , 95 % CI 3.59–15.07 ) , low breast-feeding self-efficacy ( a mother 's self-confidence in her ability to adequately feed her baby ) ( OR 3.42 , 95 % CI 1.48–7.94 ) , lower maternal age ( OR 3.89 , 95 % CI 1.45–10.46 ) , and lower education level of the mother ( OR 7.30 , 95 % CI 2.93–18.20 ) . Conclusions : The recommended full breast-feeding duration of the first 6 months of life was not reached . Sociodemographic variables and factors directly related to breast-feeding practice s play an important role on breast-feeding duration /weaning in our region . Underst and ing risk factors will provide insights to give better support to mothers and prevent short- and long-term morbidity following early weaning OBJECTIVE To determine which dietary practice s and sociodemographic factors are associated with iron deficiency anaemia ( IDA ) and iron deficiency ( ID ) in hospitalized New Zeal and children . METHODOLOGY A prospect i ve study of children 8 - 23 months of age hospitalized with an acute illness from 1997 to 1999 . Iron deficiency was defined as abnormal values for two out of three of serum ferritin ( < 10 micro g/L ) , serum iron saturation ( < 10 % ) and red cell distribution width ( > 14.5 % ) . Iron deficiency anaemia ( IDA ) was defined as ID + serum haemoglobin concentration < 110 g/L. Those with IDA or ID were compared separately with those who were not iron deficient . RESULTS Three hundred and ninety-one children were enrolled . Two hundred and twenty had IDA , 73 had ID and 98 were not iron deficient . In a multivariate analysis , those children who had a diagnosis of pneumonia ( odds ratio 4.43 , 95 % CI 1.49 , 13.13 ) were Pacific ( odds ratio 6.31 , 95 % CI 2.14 , 18.63 ) , were currently drinking breast milk ( odds ratio 10.22 , 95 % CI 2.95 , 35.42 ) , had a mother who restricted her meat intake during pregnancy ( odds ratio 4.40 , 95 % CI 1.53 , 12.64 ) or lived in a household with more than three children ( odds ratio 7.42 , 95 % CI 1.88 , 29.34 ) were at increased risk of IDA . Those children who were Pacific ( odds ratio 5.44 , 95 % CI 1.37 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: RATIONALE Apnea of prematurity is a common condition that is usually treated with caffeine , an adenosine receptor blocker that has powerful influences on the central nervous system . However , little is known about the long-term effects of caffeine on sleep in the developing brain . OBJECTIVES We hypothesized that neonatal caffeine use result ed in long-term abnormalities in sleep architecture and breathing during sleep . METHODS A total of 201 ex-preterm children aged 5 - 12 years who participated as neonates in a double-blind , r and omized , controlled clinical trial of caffeine versus placebo underwent actigraphy , polysomnography , and  parental sleep question naires . Co primary outcomes were total sleep time on actigraphy and apnea-hypopnea index on polysomnography . MEASUREMENTS AND MAIN RESULTS There were no significant differences in primary outcomes between the caffeine group and the placebo ( adjusted mean difference of -6.7 [ 95 % confidence interval ( CI ) = -15.3 to 2.0 min ] ; P = 0.13 for actigraphic total sleep time ; and adjusted rate ratio [ caffeine/placebo ] for apnea-hypopnea index of 0.89 [ 95 % CI = 0.55 - 1.43 ] ; P = 0.63 ) . Polysomnographic total recording time and total sleep time were longer in the caffeine group , but there was no difference in sleep efficiency between groups . The percentage of children with obstructive sleep apnea ( 8.2 % of caffeine group versus 11.0 % of placebo ; P = 0.22 ) or elevated periodic limb movements of sleep ( 17.5 % in caffeine group versus 11 % in placebo group ) was high , but did not differ significantly between groups . CONCLUSIONS Therapeutic neonatal caffeine administration has no long-term effects on sleep duration or sleep apnea during childhood . Ex-preterm infants , regardless of caffeine status , are at risk for obstructive sleep apnea and periodic limb movements in later childhood Background : Few studies have prospect ively investigated whether early-life exposures are associated with pre-adolescent eating attitudes . Objective : The objective of this study is to prospect ively investigate associations of parental smoking , alcohol use , marital status , measures of maternal satisfaction , self-reported parental body mass index ( BMI ) and clinical ly measured childhood BMI , assessed between birth and 6.5 years , with problematic eating attitudes at 11.5 years . Methods : Observational cohort analysis nested within the Promotion of Breastfeeding Intervention Trial , a cluster-r and omised trial conducted in 31 maternity hospitals and affiliated polyclinics in Belarus . Our primary outcome was a Children ’s Eating Attitudes Test ( ChEAT ) score ⩾22.5 ( 85th percentile ) , an indicator of problematic eating attitudes . We employed multivariable mixed logistic regression models , which allow inference at the individual level . We also performed instrumental variable ( IV ) analysis using parents ’ BMI s as instruments for the child ’s BMI , to assess whether associations could be explained by residual confounding or reverse causation . Subjects : Of the 17 046 infants enrolled between 1996 and 1997 across Belarus , 13 751 ( 80.7 % ) completed the ChEAT test at 11.5 years . Results : In fully adjusted models , overweight children at age 6.5 years had a 2.14-fold ( 95 % confidence interval ( CI ) : 1.82 , 2.52 ) increased odds of having ChEAT scores ⩾85th percentile at age 11.5 years , and those who were obese had a 3.89-fold ( 95 % CI : 2.95 , 5.14 ) increased odds compared with normal-weight children . Children of mothers or fathers who were themselves overweight or obese were more likely to score ⩾85th percentile ( P for trend ⩽0.001 ) . IV analysis was consistent with a child ’s BMI causally affecting future eating attitudes . There was little evidence that parental smoking , alcohol use , or marital status or maternal satisfaction were associated with eating attitudes . Conclusion : In our large , prospect i ve cohort in Belarus , both parental and childhood overweight and obesity at 6.5 years were associated with pre-adolescent problematic eating attitudes 5 years later Objective : To examine maternal intake of a mildly alcoholic beverage ( pulque ) during pregnancy and lactation , and its potential effect on postpartum child growth and attained size . Design : A prospect i ve cohort study that followed mothers ( during pregnancy and lactation ) and their offspring ( from birth to approximately 57 months of age ) . Setting : Six villages in rural , central Mexico . Subjects : Subjects are 58 mother – child pairs .  Pulque intake  was measured as part of a dietary assessment that was conducted for 2days/month during pregnancy and early lactation . Results : Most mothers consumed pulque during pregnancy ( 69.0 % ) and lactation ( 72.4 % ) . Among pulque drinkers , the average ethanol intake was 125.1 g/week during pregnancy and 113.8 g/week during lactation . Greater pulque intake during lactation , independent of intake during pregnancy , was associated with slower weight and linear growth from 1 to 57 months , and smaller attained size at 57 months . Low-to-moderate pulque  intake during pregnancy , in comparison to either nonconsumption or heavy intake , was also associated with greater stature at 57 months . Conclusions : Pulque intake during lactation may have adversely influenced postnatal growth in this population . Public health interventions are urgently needed in Mexico to reduce heavy intake of pulque by pregnant and lactating women , and to replace intake with foods that provide the vitamins and minerals present in the traditional alcoholic beverage OBJECTIVE : Many motivated new mothers fail to reach public health goals for breastfeeding , highlighting the need to identify risk factors . Because having a family history of alcoholism is associated with blunted prolactin responses to an alcohol challenge in nonlactating individuals , this study aim ed to identify associations in family history of alcoholism , prolactin , and breastfeeding behaviors in lactating women . METHODS : This was a 2-day experimental study that used within-subject alcohol or control beverage consumption and between-subject family history of alcoholism factors . The participants were non – alcohol-dependent lactating women ; 7 were family history – positive ( FHP ) for alcohol dependence , and 21 were family history – negative ( FHN ) .  Consumption of 0.4 g/kg alcohol or nonalcoholic beverage occurred in separate r and omized sessions , followed by use of a breast pump . Basal and suckling-induced prolactin , blood alcohol concentrations , milk yield , self-reported drug effects , neophobia , and breastfeeding patterning were measured . RESULTS : Although no group differences in alcohol pharmacokinetics were detected , FHP women exhibited blunted prolactin to breast stimulation after drinking the control and alcohol beverage and felt more of the stimulant-like effects of alcohol than did FHN women . FHP women reported more frequent daily breastfeeding than did FHN women . CONCLUSIONS : This is the first evidence that family history of alcoholism is associated with a blunted magnitude , rapidity , and duration of the prolactin response to breast stimulation and an alcohol challenge in lactating women . More frequent breastfeeding by FHP women suggests behavioral compensation for perceived and /or actual poor lactation . Alcohol did not enhance lactational performance , further disputing the lore that alcohol is a galactagogue Previous studies and animal evidence have suggested a relationship between parental  tobacco or alcohol use and the  risk  of some  childhood cancers , including  neuroblastoma .  A case-control study was conducted to investigate the relationship between  parental tobacco smoking , alcohol consumption , and risk of neuroblastoma .  Cases were children diagnosed with neuroblastoma over the period 1992 - 1994 at Children 's Cancer Group and Pediatric Oncology Group institutions throughout the United States and Canada . One matched control was selected using r and om-digit dialing . Information on parental smoking and drinking history was obtained from 504 case and 504 control parents by telephone interview . Overall , there was no consistent pattern of association with parental smoking and alcohol consumption . For example , both maternal smoking and drinking during the period from 1 month before pregnancy through breastfeeding had adjusted odds ratios ( ORs ) of 1.1 [ 95 % confidence interval ( CI ) , 0.8 - 1.4 ] . There was no association with paternal smoking ( OR , 1.2 ; 95 % CI , 0.8 - 1.6 ) or paternal drinking 1 month before conception ( OR , 1.0 ; 95 % CI , 0.7 - 1.4 ) . There was no consistent increase in risk by the amount of smoking or drinking during any time period relative to pregnancy . There was no suggestion of an increased risk when only one parent smoked . Smoking or drinking among both parents did not jointly increase the risk of neuroblastoma in their offspring . The child 's age at diagnosis , stage , or MYCN oncogene amplification status did not material ly alter the OR estimates . It is concluded that the results from this study do not indicate any evidence for a relationship between neuroblastoma and parental tobacco or alcohol use Objectives : Breast-feeding is the recommended form of nutrition for the first 6 months . This target is unmet , however , in most industrialized regions . We evaluated aspects of breast-feeding in a cohort of mother – baby dyads . Methods : Breast-feeding practice s in 555 mother – baby dyads were prospect ively studied for 24 months ( personal interview at birth and 7 structured telephone interviews ) . Results : Of the babies , 71.3 % were fully breast-fed on discharge from maternity hospitals and 11.9 % were partially breast-feed . Median breast-feeding duration was 6.93 ( interquartile range 2.57–11.00 ) months ; for full ( exclusive ) breast-feeding 5.62 ( interquartile range 3.12–7.77 ) months ; 61.7 % received supplemental feedings during the first days of life . Breast-feeding duration in babies receiving supplemental feedings was significantly shorter ( median 5.06 months versus 8.21 months , P < 0.001 ) . At 6 months , 9.4 % of the mothers were exclusively and 39.5 % partially breast-feeding . Risk factors for early weaning were early supplemental feedings  ( odds ratio [ OR ] 2.87 , 95 % CI 1.65–4.98 ) , perceived milk insufficiency ( OR 7.35 , 95 % CI 3.59–15.07 ) , low breast-feeding self-efficacy ( a mother 's self-confidence in her ability to adequately feed her baby ) ( OR 3.42 , 95 % CI 1.48–7.94 ) , lower maternal age ( OR 3.89 , 95 % CI 1.45–10.46 ) , and lower education level of the mother ( OR 7.30 , 95 % CI 2.93–18.20 ) . Conclusions : The recommended full breast-feeding duration of the first 6 months of life was not reached . Sociodemographic variables and factors directly related to breast-feeding practice s play an important role on breast-feeding duration /weaning in our region . Underst and ing risk factors will provide insights to give better support to mothers and prevent short- and long-term morbidity following early weaning OBJECTIVE To determine which dietary practice s and sociodemographic factors are associated with iron deficiency anaemia ( IDA ) and iron deficiency ( ID ) in hospitalized New Zeal and children . METHODOLOGY A prospect i ve study of children 8 - 23 months of age hospitalized with an acute illness from 1997 to 1999 . Iron deficiency was defined as abnormal values for two out of three of serum ferritin ( < 10 micro g/L ) , serum iron saturation ( < 10 % ) and red cell distribution width ( > 14.5 % ) . Iron deficiency anaemia ( IDA ) was defined as ID + serum haemoglobin concentration < 110 g/L. Those with IDA or ID were compared separately with those who were not iron deficient . RESULTS Three hundred and ninety-one children were enrolled . Two hundred and twenty had IDA , 73 had ID and 98 were not iron deficient . In a multivariate analysis , those children who had a diagnosis of pneumonia ( odds ratio 4.43 , 95 % CI 1.49 , 13.13 ) were Pacific ( odds ratio 6.31 , 95 % CI 2.14 , 18.63 ) , were currently drinking breast milk ( odds ratio 10.22 , 95 % CI 2.95 , 35.42 ) , had a mother who restricted her meat intake during pregnancy ( odds ratio 4.40 , 95 % CI 1.53 , 12.64 ) or lived in a household with more than three children ( odds ratio 7.42 , 95 % CI 1.88 , 29.34 ) were at increased risk of IDA . Those children who were Pacific ( odds ratio 5.44 , 95 % CI 1.37 
    Output:
    