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Background: The objective was to determine whether infant neurobehavior measured at five post-gestational weeks could predict social and communicative behavior (SCB) through five and eight years. Methods: Infant neurobehavior was assessed using the Neonatal Intensive Care Unit Network Neurobehavioral Scale, and SCB was measured using the Social Responsiveness Scale (SRS). Adjusted linear regression with generalized estimating equations were employed to estimate the association between infant neurobehavior and SCB. Interaction terms and stratification were used to identify potential effect modification by autism spectrum disorder risk factors. Results: The analyses include n = 214 and n = 227 participants who were examined at 5 weeks and followed to 4/5 and 8 years, respectively. Adjusting for maternal age, race, parity, and education as well as gestational age, only the Neonatal Intensive Care Unit Network Neurobehavioral Scale summary score of "attention" (measured at mean 43.9 gestational weeks) was inversely associated with total SRS T-score through 5 years. However, in analyses stratified by maternal age, the inverse association between "attention" and SCB was significant, but only among offspring of women of advanced maternal age (=35 y); in addition, higher scores of "excitability," "lethargy," and "arousal" were associated with increased total SRS T scores among women of advanced maternal age. The associations were no longer statistically significant at 8 years. Conclusions: Newborns with lower scores on the attention subscale (determined by an ability to localize and track animate and inanimate objects) were more likely to demonstrate deficits in SCB. In addition, infants with increased excitability, lethargy, or increased arousal were more likely to have impaired SCB that persisted through 5 years, but not at 8 years of age. Further work is necessary to identify specific aspects of infant neurobehavior that may affect childhood SCBs.

Executive functioning (EF) abilities develop through childhood, but this development can be impacted by various psychosocial environmental influences. Using longitudinal data from the Health Outcome and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort study, we examined if psychosocial environmental factors were significant predictors of EF development. Study participants comprised 271 children and their primary caregivers (98.5% mothers) followed from birth to age 12. We identified four distinct EF developmental trajectory groups comprising a consistently impaired group (13.3%), a descending impairment group (27.7%), an ascending impairment group (9.95%), and a consistently not impaired group (49.1%). Higher levels of maternal ADHD and relational frustration appear to be risk factors for increased EF difficulty over time, while higher family income may serve as a protective factor delaying predisposed EF impairment. Important intervention targets might include teaching positive and effective parenting strategies to mothers whose children are at risk for EF dysfunction. [ABSTRACT FROM AUTHOR]

Applying Bandura's reciprocal determinism model, differences in math and science experiences influenced by individual, gender, and school variables were investigated within 1,368 elementary students who attended 21 Catholic schools. Math and science were evaluated positively and favored more than other academic subjects. However, advantages were found for boys by lowered math anxiety levels and favoring of math, and for large schools by lowered math anxiety levels and higher student ratings of science. No advantages were found for small schools. However, school poverty rate appeared to have a confounding effect on school size. Discussion is presented pertaining to the specific need to study Catholic school systems regarding student perceptions in light of distinguishing Catholic school factors. (Contains 7 tables.)

Context: Most individuals with Turner syndrome (TS) require estrogen for pubertal induction. Current estrogen dosing guidelines are based on expert consensus opinion. Objective: Evaluate whether current international guidelines for estrogen dosing during pubertal induction of individuals with TS result in normal uterine growth. We hypothesized that uterine size in individuals with TS who reached adult estrogen dosing is smaller than in mature females without TS. Methods: Cross-sectional study of patients with TS at the Cincinnati Center for Pediatric and Adult Turner Syndrome Care. Twenty-nine individuals (age 15-26 years) with primary ovarian insufficiency who reached adult estrogen dosing (100 µg of transdermal or 2 mg of oral 17β-estradiol) were included. Comparison of uterine measurements with a published sample of 292 age-appropriate (age 15-20 years) controls without TS. Uterine length, volume, and fundal–cervical ratio (FCR) were measured. Clinical information (karyotype, Tanner staging for breast development, laboratory data) was extracted from an existing institutional patient registry. Results: There was no evidence of compromise of the uterine size/configuration in the TS cohort compared with the controls; in fact, uterine length, mean 7.7 cm (±1.3) vs 7.2 cm (±1.0) (P = .03), and volume, mean 60.6 cm3 (±26.6) vs 50.5 cm3 (±20.5) (P = .02), were both larger in individuals with TS. Conclusion: Current international guidelines for hormone replacement using 17β-estradiol in individuals with TS appear adequate to allow for normal uterine growth by the end of pubertal induction. [ABSTRACT FROM AUTHOR]

Flag football is promoted as a safer alternative to tackle football. This may be 1 reason why participation rates have risen by 39% over the past 3 years. Despite rising participation, epidemiologic research on sport-specific injuries and associated relative risk is lacking. To prospectively document the epidemiology of injuries in youth flag football. Descriptive epidemiology study. Regional and national youth flag football tournaments. Athletes (N = 1939; 1744 boys and 195 girls), ages 6 to 12 years. An athletic trainer prospectively monitored the athletes for sport-related injury and exposures. Athlete risks of injury and injury rates were calculated overall and by sex. Injury characteristics were reported for the total population and by sex. Forty-seven injuries to unique individuals were recorded in 1939 athletes with a total of 9228 athlete-exposures (AEs). The overall risk of injury was 2.4% (95% CI = 1.79%, 3.21%), with an overall injury rate of 5.1 per 1000 AEs (95% CI = 3.75, 6.77). Of the 47 injuries, 36 occurred in boys (8365 AEs), and 11 occurred in girls (863 AEs). A higher risk in girls was evidenced by both the injury risk ratio (2.73; 95% CI = 1.41, 5.30) and injury rate ratio of 2.96 (95% CI = 1.51, 5.82). The most common injury sites were the head/face/neck (n = 15, 31.9%), followed by the ankle/foot (n = 9, 19.1%). The most frequent types of injury were contusion (55.3%), sprain/subluxation (14.9%), and general trauma (10.6%); 74.5% of all injuries resulted from direct impact. Although the competition injury rate for youth flag football was lower than the values from studies reporting comparable tackle football data, the frequencies by body part, type, and mechanism were similar. Given that most injuries were related to some form of impact and predominantly contusions, adopting minimal protective equipment or padding may reduce the numbers of these injuries. [ABSTRACT FROM AUTHOR]

Background: Persons with stroke often have difficulty achieving target heart rate (HR) during graded exercise testing (GXT), which is known to limit test sensitivity for detecting clinically relevant cardiac conditions. A novel Recumbent Stepper 3‐minute (RS 3Min) "all out" test may increase sensitivity of stress testing after stroke. Objective: To determine the feasibility of adding the RS 3Min test after GXT among persons after stroke. Design: A within‐participant, nonrandomized, repeated measures design. Setting: Rehabilitation research laboratory and cardiovascular stress laboratory Participants: Fifteen participants with chronic stroke (56.7 ± 9.6 years; 6.4 ± 4.3 years post stroke; 8 male). Interventions: All participants randomly completed (1) a symptom‐limited treadmill GXT and (2) a symptom‐limited RS GXT followed by RS 3Min critical power test. Main Outcome Measures: HR, ratings of perceived exertion, oxygen consumption, respiratory exchange ratio, and power output measured continuously during each test. Blood pressure measured every 2 minutes and or immediately post exercise. P value set at p <.05 from omnibus test for a significant difference among protocols. Results: The RS 3Min test had a significantly higher rate of achieving target HR compared to the RS GXT (9/14 vs 4/14, p =.02) and was not significantly different from the treadmill GXT (9/14 vs 5/14, p =.09). Minimum power output during the RS 3Min was significantly higher than peak power output during the RS GXT (110 ± 41 W vs. 84 ± 22 W, p =.02) with 12/15 participants reaching a VO2 plateau. Conclusions: Although additional studies with randomized designs are needed, a novel RS 3Min "all out" test appears to be a promising method for enhancing test sensitivity in cardiovascular screening after stroke, while providing a potentially valid measure of critical power. [ABSTRACT FROM AUTHOR]

Objective: Excessive gestational weight gain (GWG) has been associated with autism spectrum disorder (ASD). This study sought to examine whether familial susceptibility for autism, intensity of ASD‐related behaviors, or prepregnancy BMI influences the association of GWG with ASD‐related behaviors. Methods: Using data from the Early Autism Risk Longitudinal Investigation (EARLI) study (n = 136), a familial enriched cohort of mothers who had a previous child with ASD, and the Health Outcomes and Measures of the Environment (HOME) study (n = 253), a general population cohort, gestational age and prepregnancy BMI category‐specific GWG z scores were calculated. Caregivers completed the Social Responsiveness Scale (SRS) to assess the presence and severity of ASD‐related traits in children aged 3 to 8 years. Using quantile regression, the association between GWG z scores and ASD‐related behaviors in children was estimated. Results: In HOME, among mothers who had overweight or obesity prepregnancy BMI values, GWG z scores and SRS scores were positively associated in children with more ASD‐related traits (higher SRS scores), but not in children with fewer ASD‐related traits. Similar patterns were observed in EARLI among mothers with prepregnancy obesity. Conclusions: GWG may be associated with autism‐related behaviors among children who have a greater predisposition to these behaviors and who have mothers with prepregnancy overweight or obesity. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) affects ∼10% of U.S. adolescents. Abdominal obesity is the most prevalent component and may indicate MetS risk in adolescents undergoing weight loss surgery. Assess MetS risk/severity and its association with abdominal obesity (measured by sagittal abdominal diameter, SAD) before and after weight loss surgery in adolescents to determine whether SAD predicts MetS risk in this population. Data were collected in the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study at 5 sites (U.S. children's hospitals) performing weight-loss surgery in adolescents. The current study is a secondary analysis of these data. We examined data collected presurgery through 5 years postsurgery. MetS risk/severity was defined using the MetS severity z score (MetS-z), and MetS prevalence was determined using age-appropriate criteria. Association between SAD and MetS-z was evaluated with an adjusted linear mixed model. Among 228 individuals (75% female, 72% White), mean age 16.5 years and body mass index (BMI) 53 kg/m2, 79% met MetS criteria pre-urgery. MetS-z (1.5) and SAD (32cm) were correlated (r = 0.6, P <.0001) presurgery, and both improved significantly at 6 months, 1, and 5 years postsurgery, remaining highly correlated at each timepoint. SAD predicted MetS-z (β = 0.118; 95% CI, 0.109, 0.127) after adjustment for age, visit, surgery type, and caregiver education. Abdominal obesity is a key MetS risk marker in youth undergoing weight loss surgery. Both SAD and Met-z measures may be useful for MetS risk assessment and tracking postsurgery changes in this population, but more research is needed to identify effective lifestyle interventions targeting abdominal obesity. • Metabolic syndrome (MetS) is prevalent in adolescents undergoing bariatric surgery • Abdominal obesity is strongly associated with MetS risk in this population • Major reductions in MetS risk and abdominal obesity persist 5 years postsurgery • Interventions targeting abdominal obesity may reduce MetS risk in youth [ABSTRACT FROM AUTHOR]

Using data from the National Longitudinal Study of Adolescent Health, this study examined the associations among family bonding factors and the initiation of smoking by race/ethnicity and age group among nonsmokers at Wave 1. Overall, 18% of the sample initiated smoking by Wave 2. For younger African-American and Hispanic youths, high maternal satisfaction with the relationship was significantly protective of smoking initiation. For older Hispanics, high parental presence and high parent-family connectedness were protective against smoking initiation, while lack of awareness about the adolescent's whereabouts was a risk factor for initiation in both younger and older Caucasians, and in the older Hispanics. Our results underscore the importance of maintaining high levels of family bonding with the adolescent throughout early and late adolescence in order to decrease tobacco initiation. (Contains 3 tables.)

During adolescence, cognitive abilities increase robustly. To search for possible related structural alterations of the cerebral cortex, we measured neuronal soma dimension (NSD = width times height), cortical thickness and neuronal densities in different types of neocortex in post-mortem brains of five 12-16 and five 17-24 year-olds (each 2F, 3M). Using a generalized mixed model analysis, mean normalized NSD comparing the age groups shows layer-specific change for layer 2 (p less than 0.0001) and age-related differences between categorized type of cortex: primary/primary association cortex (BA 1, 3, 4, and 44) shows a generalized increase; higher-order regions (BA 9, 21, 39, and 45) also show increase in layers 2 and 5 but decrease in layers 3, 4, and 6 while limbic/orbital cortex (BA 23, 24, and 47) undergoes minor decrease (BA 1, 3, 4, and 44 vs. BA 9, 21, 39, and 45: p = 0.036 and BA 1, 3, 4, and 44 vs. BA 23, 24, and 47: p = 0.004). These data imply the operation of cortical layer- and type-specific processes of growth and regression adding new evidence that the human brain matures during adolescence not only functionally but also structurally. (Contains 1 table and 6 figures.)