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This study endeavors to establish comprehensive normal reference ranges and Z score formulas for ductus venosus (DV) flow velocity parameters and calculated waveform indices across different gestational ages in low-risk fetuses. Furthermore, we aim to validate the predictive capabilities of these Z score calculation formulas in fetuses with diverse right heart diseases.8,953 singleton low-risk fetuses and 70 fetuses diagnosed with different types of right heart diseases were retrospectively enrolled. The DV blood flow velocities during the cardiac cycle (ventricular systolic wave velocity [S], ventricular diastolic wave velocity [D], atrial contraction wave velocity [A], and time-averaged maximum velocity [Tamx]) and calculated waveform indices (preload index [PLI], peak velocity index [PVI], pulsatility index [PI], S/A, and S/D) were obtained. Ninety low-risk fetuses were randomly selected as the control group to verify the predictive value of the Z score model for fetuses with different types of right heart diseases.As gestational age increased (16–39 weeks), the mean values of S, D, A, and Tamx progressively increased; conversely, the mean values of PLI, PVI, PI, and S/A decreased, respectively, and the median value of S/D remained stable. The Z score-transformed A, PLI, PVI, PI, and S/A could serve as predictors of overall right heart diseases. Different DV Doppler parameter Z scores exhibited varying predictive values for different subtypes of right heart diseases.Normal reference ranges and corresponding Z score calculation formulas for DV hemodynamic parameters were established, which have demonstrated significant diagnostic values in identifying right heart diseases. [ABSTRACT FROM AUTHOR]

Abstract Background Among various growth parameters, liver and spleen size is an important parameter used for the evaluation of patients with certain disorders and abnormalities in these organs. Aim To determine the normal dimensions for the liver, spleen, and kidney in Egyptian infants, children, and adolescents from birth to 18 years. Methods This cross-sectional randomized study was conducted on 1861 Egyptian infants, children, and adolescents from birth to 18 years for the establishment of Z score reference of liver, spleen, and kidney parameters. Results Egyptian children of both sexes (51.5% boys and 48.5% girls) from birth to 18 years old were studied. Then Z scores reference for liver, spleen, and kidney parameters for both sexes were represented in detailed tables and graphs. There was no statistically significant difference between both sexes, so we used unisex tables and graphs (P > 0.05). Conclusions Determination of pathologic changes in the size of the liver, spleen, and kidney necessitates knowing the normal range of dimensions for these organs. So, our study established a Z score chart for normal values of liver, spleen, and kidney size for children and adolescents from birth to 18 years.

Background: Testicular volume is a marker of male pubertal development. Various clinical conditions and their treatments may influence testicular growth. Objectives: To create ruler‐based age‐dependent pubertal testicular volume references that enable calculation of standard deviation (SD) scores. Materials and Methods: Study cohort comprised 65 boys who attended clinical examination twice a year from the age of 8.5 years until the attainment of final testicular size. Forty‐nine (75.4%) boys completed the follow‐up and 16 (24.6%) boys dropped out before the attainment of final post‐pubertal testicular size. At each follow‐up visit testicular size was measured with a ruler, orchidometer, and ultrasonography. LMS or LMSP method served as the technique for creating reference growth curves for testicular volumes. Using the novel references for ruler measurements, development of SD scores was assessed in a cohort of boys with unilateral cryptorchidism. Results: Reference growth curves were constructed separately for ruler, orchidometer, and ultrasonography measurements. Median orchidometer volume of 4 mL, marker of male pubertal onset, occurred at the age of 11.7 years, whereas +2SD curve surpassed 4 mL at 10.2 years and −2SD curve at 13.7 years. Modeled ages at the attainment of 4 mL testicular volume based on ruler measurements were 9.7 years for +2SD curve, 11.5 years for median curve, and 13.6 years for −2SD curve. Ultrasonography‐based volume of 1.3 mL corresponded with the median modeled orchidometer‐based volume of 4 mL. In boys with unilateral cryptorchidism, ruler‐based SD scores decreased during puberty in undescended testes, but not in descended testes. Discussion and Conclusion: The present study provides reference values for pubertal testicular volume measured with a ruler enabling an age‐dependent assessment of testicular size. Comparison with measurements by an orchidometer and ultrasonography is also presented. [ABSTRACT FROM AUTHOR]

The present study is on "Financial Health of Muthoot Finance Limited" and it was based on the secondary data.Secondary data was retrieved from reports, documents, and profile. Financial stability of Muthoot Finance Limited has calculated by the Altman "Z" score evaluation. All the accounting ratios (activity, leverage, liquidity) are merged to form a single AccountingAngle. Edwin I Altman combined anumber of accounting ratios (Liquidity, Leverage, activity and profitability) to forman index of the profitability, which was an effective indicator of corporateperformance in predicting bankruptcy. Moving in this manner,an assessment of the financial situation covering the years 2018--2023 with the use of MDA, or multiple discriminant analysis. [ABSTRACT FROM AUTHOR]

Background: Among various growth parameters, liver and spleen size is an important parameter used for the evaluation of patients with certain disorders and abnormalities in these organs. Aim: To determine the normal dimensions for the liver, spleen, and kidney in Egyptian infants, children, and adolescents from birth to 18 years. Methods: This cross-sectional randomized study was conducted on 1861 Egyptian infants, children, and adolescents from birth to 18 years for the establishment of Z score reference of liver, spleen, and kidney parameters. Results: Egyptian children of both sexes (51.5% boys and 48.5% girls) from birth to 18 years old were studied. Then Z scores reference for liver, spleen, and kidney parameters for both sexes were represented in detailed tables and graphs. There was no statistically significant difference between both sexes, so we used unisex tables and graphs (P > 0.05). Conclusions: Determination of pathologic changes in the size of the liver, spleen, and kidney necessitates knowing the normal range of dimensions for these organs. So, our study established a Z score chart for normal values of liver, spleen, and kidney size for children and adolescents from birth to 18 years. [ABSTRACT FROM AUTHOR]

Background:Monitoring response to highly active antiretroviral therapy (HAART) in HIV infected children using both laboratory and physical growth parameter is important. But monitoring laboratory parameters could sometimes be challenging in resource-poor settings as the machines used for these measurements may not always be functional or the required technical expertise be available especially in rural areas. Hence, changes in weight-for-age (WAZ), height-for -age (HAZ) and body mass indexfor age (BAZ) Z scores during clinic follow-up visits with or without changes in absolute CD4 count, could be used instead of viral load measurements as indicators of response to HAART in children. Objectives: To determine the effect in children of treatment with HAART - on changes in physical growth using WAZ, HAZ and BAZ and on changes in CD4 count using absolute CD4 count. Methods: Data on demographic/ clinical variables, viral load, absolute CD4 count, and weight and height measurements done at enrolment and at follow-up visits for 72 eligible children < 15 years who were consecutively enrolled into HAART were analysed Results: After nine months of HAART, the median absolute CD4 count increased by 28.2% and median WAZ increased by 28.6%. The reduction in the proportion of children with moderate malnutrition (WAZ < -2) from time of HAART commencement to nine months after HAART, was by 61.5% in those without severe immune suppression (SIS) and by 50% in those with SIS Conclusion: This study showed that WAZ and absolute CD4 count changes could be useful for monitoring response to HAART in resource –limited settings.

Recent guidelines for spirometry interpretation recommend both race-neutral reference equations and use of z score thresholds to define severity of airflow obstruction. How does the transition from race-specific to race-neutral equations impact severity classifications for patients with COPD when using % predicted vs z score thresholds, and do changes in severity correspond to clinical risk? This retrospective cohort study included Black and White patients with COPD and available spirometry from the Johns Hopkins Health System. Global Lung Function Initiative (GLI) 2012 (race-specific) equations and GLI Global (race-neutral) equations were used to determine FEV 1 % predicted and z score values. Patients were classified as having mild, moderate, or severe disease according to % predicted or z score thresholds. Associations between a change in severity classification from race-specific to race-neutral with COPD exacerbations and all-cause hospitalizations were evaluated using logistic regression. This cohort included 13,324 patients, of whom 9,232 patients (69.3%) were White (mean age, 65.7 years) and 4,092 patients (30.7%) were Black (mean age, 61.1 years). More Black than White patients showed a change in severity classification between approaches when using % predicted thresholds (20.2% vs 6.1%; P <.001), but not with z score thresholds (12.6% vs 12.3%; P =.68). An increased severity classification with a race-neutral approach was associated with increased risk of exacerbation when using z score thresholds (OR, 2.34; 95% CI, 1.51-3.63), but not when using % predicted thresholds (OR, 1.08; 95% CI, 0.61-1.93). A decreased severity classification with a race-neutral approach was associated with lower risk of exacerbation with both % predicted (OR, 0.49; 95% CI, 0.28-0.87) and z score (OR 0.67; 95% CI, 0.50-0.90) thresholds. The proportions of Black and White individuals reclassified were similar with z score thresholds, and changes in severity corresponded to clinical risk with z scores. These results support recent recommendations for use of race-neutral equations and z score thresholds for spirometry interpretation. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: A common complication of thalassemia is secondary osteoporosis. This study aimed to assess the prevalence and factors associated with low BMD in thalassemic patients. Method: This is a cross-sectional study. Eligible patients were males aged within 18-49 years or premenopausal women diagnosed with thalassemia in Chiang Mai University Hospital between July 2021 and July 2022. The diagnosis of low BMD by dual-energy x-ray absorptiometry (DXA) was defined as a Z-score of -2.0 SD or lower in either the lumbar spine or femoral neck. Clinical factors associated with low BMD were analyzed using a logistic regression model. Results: Prevalence of low BMDwas 62.4% from 210 patientswith a mean age of 29.7 ± 7.6 years. The predominant clinical characteristics of low BMD thalassemia patients were being female, transfusion-dependent (TDT) and a history of splenectomy. From multivariable analysis, the independent variables associated with low BMD were transfusion dependency (odds ratio, OR 2.36; 95%CI 1.28 to 4.38; p=0.006) and body mass index (BMI) (OR 0.71; 95%CI 0.61 to 0.82; p<0.001). Among patients with low BMD, we observed a correlation between a Z-score with low IGF-1 levels (b=-0.42; 95% CI -0.83 to -0.01; p=0.040), serum phosphate levels (b=0.40; 95% CI 0.07 to 0.73; p=0.016) and hypogonadism (b=-0.48, 95% CI -0.91 to -0.04, p=0.031). Conclusion: This study found a prevalence of low BMD in 62.4% of subjects. Factors associated with low BMD were TDT and BMI. Within the low BMD subgroup, hypogonadism, serum phosphate and low serum IGF-1 levels were associated with a lower Z-score. [ABSTRACT FROM AUTHOR]

In our study, it was observed that the EPR signals of table sugar irradiated with gamma rays at 3 kGy, 5 kGy, 10 kGy increased in proportion to the increasing dose. The fading in the signals was investigated by taking into account the peak-to-peak heights (Ipp) in the EPR spectra of table sugar. The stability of radicals was monitored by performing EPR measurements on sugar samples irradiated with high doses of gamma rays (Co-60) on 29.06.2020, 23.03.2021, 28.06.2021, 05.08.2021. Suitability evaluation was made with Z score, which is a statistical test to determine fading. It was observed that there was almost no loss in the EPR signals of sugar for 14 months. Also table sugar; Similarities have been shown by comparing the EPR spectra of the fruits used in the TS EN 13708 Foodstuffs - Standard for determining whether foodstuffs containing crystal sugars are irradiated by ESR spectroscopy. Thanks to these similarities, it has been suggested that fruits can also be used as dosimeters, depending on the sugar they contain.

OBJECTIVES Ascending aortic aneurysms pose a different risk to each patient. We aim to provide personalized risk stratification for such patients based on sex, age, body surface area and aneurysm location (root versus ascending). METHODS Root and ascending diameters, and adverse aortic events (dissection, rupture, death) of ascending thoracic aortic aneurysm patients were analysed. Aortic diameter was placed in context vis-a-vis the normal distribution in the general population with similar sex, age and body surface area, by conversion to z scores. These were correlated of major adverse aortic events, producing risk curves with 'hinge points' of steep risk, constructed separately for the aortic root and mid-ascending aorta. RESULTS A total of 1162 patients were included. Risk curves unveiled generalized thresholds of z  = 4 for the aortic root and z  = 5 for the mid-ascending aorta. These correspond to individualized thresholds of less than the standard criterion of 5.5 cm in the vast majority of patients. Indicative results include a 75-year-old typical male with 2.1 m2 body surface area, who was found to be at increased risk of adverse events if root diameter exceeds 5.15 cm, or mid ascending exceeds 5.27 cm. An automated calculator is presented, which identifies patients at high risk of adverse events based on sex, age, height, weight, and root and ascending size. CONCLUSIONS This analysis exploits a large sample of aneurysmal patients, demographic features of the general population, pre-dissection diameter, discrimination of root and supracoronary segments, and statistical tools to extract thresholds of increased risk tailor-made for each patient. [ABSTRACT FROM AUTHOR]

The problem of testing a common parameter of several independent continuous populations is considered. Among all tests, Fisher's combined test is the most popular one and is routinely used in applications. In this article, we propose an alternative method of combining the p-values of independent tests using chi-square scores, referred to as the inverse chi-square test. The proposed test is as simple as other existing tests. We compare the powers of the combined tests for (i) testing a common mean of several normal populations, (ii) testing the common coefficient of variation of several normal populations, (iii) testing the common correlation coefficient of several bivariate normal populations, (iv) testing the common mean of several lognormal populations and (v) testing the common mean of several gamma distributions. Our comparison studies indicate that the inverse chi-square test is a better alternative combined test with good power properties. An illustrative example with real-world data is given for each problem. [ABSTRACT FROM AUTHOR]

This study analyzes bankruptcy patterns and their influence on the on-field success of seven prominent European football clubs traded on their countries' respective stock exchanges. During the period between 2008 and 2020, the current study reveals how these clubs perform financially benchmarked against respective well-established bankruptcy scores. By using Altman's Z score (Altman, 1968), Springate's S score (Springate, 1978), and Zmijewski's X score (Zmijewski, 1984), we are analyzing the financial stability of football clubs and how it impacts the on-field results and success of these football clubs. This paper concludes that most clubs show bankruptcy tendencies, which affect their sporting success. [ABSTRACT FROM AUTHOR]

Criminality is an act of violating the values and norms of society that causes a lot of harm. Much of the criminal data is often just a collection of data that has no information. Analysis of crime data is key in efforts to reduce crime rates that provide an overview of the incidence of crime, patterns, levels of vulnerability, and the level of security of an area. This research proposes data analysis that provides an understanding of crime using data mining techniques, especially the K-means cluster method, both traditional and with principal component analysis (PCA) dimension reduction. Before the PCA process, the values are transformed first with Z score normalization. From the processing through the davies bouldin index (DBI) performance test with 3 clusters, it is concluded that traditional K-means produces a DBI Index value of 0.019 and K-means PCA of 0.299. Meanwhile, to see the optimal cluster, several iterations were performed and resulted in the most optimal DBI index of 4 clusters in K-means of 0.014 and K-means PCA of 0.172. From the performance test value, it means that in the context of clustering the traditional criminal K-means data is declared more optimal than K-means PCA. [ABSTRACT FROM AUTHOR]

In community-based studies, mid-upper arm circumference (MUAC) appears to be a superior predictor of childhood under nutrition than many other anthropometric indicators. This study aimed to evaluate the nutritional status of children aged 2-5 years using mid-upper arm circumference (MUAC) cut-off values recommended by the World Health Organization in 2007. The present study was a cross-sectional study carried out in randomly selected 44 ICDS canters in Maynaguri Block, Jalpaiguri District, West Bengal, India. Children aged 24 – 60 months (Boys - 499 and Girls - 522) from three (Rajbanshi, Nama Shudra, Nashya Seikh) ethnic communities. Significant age variation was found among boys (F = 14.777; p< 0.001) and girls (9.465; p< 0.001). The overall percentage of moderate and severe undernourished girls (moderate – 25.67%; severe – 5.75%) is higher than the boys (moderate – 24.85 %; severe – 5.41%). Chi-square analysis shows a statistically significant relationship of under nutrition with age, birth weight, ethnicity, birth order, number of siblings, bath place, fuel of cooking, income level and Asiaspecific maternal BMI level. Comparison with international studies reveals that the prevalence of under nutrition in the present study is higher than the children of Malaysia, Cameroon, Nepal, Nigeria and Pakistan. In the context of India, the present study reported a higher prevalence of under nutrition than the children of Midnapur South 24 Pargana of West Bengal, children of Odisha and Bihar. [ABSTRACT FROM AUTHOR]

In community-based studies, mid-upper arm circumference (MUAC) appears to be a superior predictor of childhood under nutrition than many other anthropometric indicators. This study aimed to evaluate the nutritional status of children aged 2-5 years using mid-upper arm circumference (MUAC) cut-off values recommended by the World Health Organization in 2007. The present study was a cross-sectional study carried out in randomly selected 44 ICDS canters in Maynaguri Block, Jalpaiguri District, West Bengal, India. Children aged 24 – 60 months (Boys - 499 and Girls - 522) from three (Rajbanshi, Nama Shudra, Nashya Seikh) ethnic communities. Significant age variation was found among boys (F = 14.777; p< 0.001) and girls (9.465; p< 0.001). The overall percentage of moderate and severe undernourished girls (moderate – 25.67%; severe – 5.75%) is higher than the boys (moderate – 24.85 %; severe – 5.41%). Chi-square analysis shows a statistically significant relationship of under nutrition with age, birth weight, ethnicity, birth order, number of siblings, bath place, fuel of cooking, income level and Asia-specific maternal BMI level. Comparison with international studies reveals that the prevalence of under nutrition in the present study is higher than the children of Malaysia, Cameroon, Nepal, Nigeria and Pakistan. In the context of India, the present study reported a higher prevalence of under nutrition than the children of Midnapur South 24 Pargana of West Bengal, children of Odisha and Bihar.

BackgroundA common complication of thalassemia is secondary osteoporosis. This study aimed to assess the prevalence and factors associated with low BMD in thalassemic patients.MethodThis is a cross-sectional study. Eligible patients were males aged within 18–49 years or premenopausal women diagnosed with thalassemia in Chiang Mai University Hospital between July 2021 and July 2022. The diagnosis of low BMD by dual-energy x-ray absorptiometry (DXA) was defined as a Z-score of -2.0 SD or lower in either the lumbar spine or femoral neck. Clinical factors associated with low BMD were analyzed using a logistic regression model.ResultsPrevalence of low BMD was 62.4% from 210 patients with a mean age of 29.7 ± 7.6 years. The predominant clinical characteristics of low BMD thalassemia patients were being female, transfusion-dependent (TDT) and a history of splenectomy. From multivariable analysis, the independent variables associated with low BMD were transfusion dependency (odds ratio, OR 2.36; 95%CI 1.28 to 4.38; p=0.006) and body mass index (BMI) (OR 0.71; 95%CI 0.61 to 0.82; p

Abstract Background In all studies conducted so far, there was no report about the correlation between excessive gestational weight gain (GWG) and the risk of preeclampsia (PE) in multiparas, especially considering that multiparity is a protective factor for both excessive GWG and PE. Thus, the aim of this retrospective cohort study was to determine whether GWG of multiparas is associated with the increased risk of PE. Methods This was a study with 15,541 multiparous women who delivered in a maternity hospital in Shanghai from 2017 to 2021, stratified by early-pregnancy body mass index (BMI) category. Early-pregnancy body weight, height, week-specific and total gestational weight gain as well as records of antenatal care were extracted using electronic medical records, and antenatal weight gain measurements were standardized into gestational age-specific z scores. Results Among these 15,541 multiparous women, 534 (3.44%) developed preeclampsia. The odds of preeclampsia increased by 26% with every 1 z score increase in pregnancy weight gain among normal weight women and by 41% among overweight or obese women. For normal weight women, pregnant women with preeclampsia gained more weight than pregnant women without preeclampsia beginning at 25 weeks of gestation, while accelerated weight gain was more obvious in overweight or obese women after 25 weeks of gestation. Conclusions In conclusion, excessive GWG in normal weight and overweight or obese multiparas was strongly associated with the increased risk of preeclampsia. In parallel, the appropriate management and control of weight gain, especially in the second and third trimesters, may lower the risk of developing preeclampsia. Graphical Abstract

Kawasaki disease (KD) occurs in young children, has an unknown etiology, and can cause such life-threatening complications as coronary artery aneurysm. A mouse model using Lactobacillus casei cell wall extract (LCWE) with intraperitoneal injection was established for KD years ago. Histological examination of coronary artery lesions indicated features similar to those of vascular lesions of patients with KD. Since animals must be sacrificed during histological examination, the longitudinal survey of coronary artery lesions (CALs) is difficult. The aim of this study was to survey the vasculitis status of the coronary artery and the carotid artery in a KD mouse model. Method: LCWE was intraperitoneally injected into 5-week-old male C57BL/6 mice to induce CALs. We studied the longitudinal status of the carotid and coronary arteries and analyzed the Z-score of coronary artery diameter. Results: Carotid artery wall thickness (day 7) and diameter (day 14) significantly increased in the LCWE group with a dose-dependent effect (p < 0.05). Aortic diameter and wall thickness demonstrated significant increases on day 28 and day 7, respectively (p < 0.05). Carotid artery outer diameter and wall thickness were positively associated with coronary artery diameter on day 28 (p < 0.01). Coronary artery diameter significantly increased in the LCWE group after day 7 (p < 0.05). The percentage of Z > 3.0 indicated was more than 80% in the high-dose LCWE group and 0% in the control group. Conclusions: This report is the first to use coronary artery Z-score in a mouse model of KD by echocardiography and to find a positive association between carotid artery and coronary artery diameter. [ABSTRACT FROM AUTHOR]

Objective: Cleft lip and palate are the most common congenital anomalies of the head and neck region. According to studies, 13.5% of children under 5 years of age were reported to be underweight. When compared with the global data, this ratio was found to be higher in patients with isolated cleft lip, isolated cleft palate, and cleft lip with cleft palate. This study aimed to evaluate the frequency of malnutrition in isolated Veau type 1 and type 2 cleft palate in an institutional patient group. Material and Methods: Patients with isolated Veau type 1 and type 2 cleft palate who were operated between November 2019 and February 2022 were included in the study. The age (month), height (centimeters), and weight (kilograms) of the patients were noted one day before the surgery, and Z scores were calculated for malnutrition assessment. Result: A total of 40 patients were included in this study. The mean age of the patients was 16.82±2.73 months (7-48 months). Fourteen patients were male whereas 26 patients were female. Malnutrition was not observed in nine patients. Eight patients had chronic mild malnutrition, 5 patients had chronic moderate malnutrition and 13 patients had chronic severe malnutrition. In addition, chronic mild obesity was observed in two patients, chronic moderate obesity was observed in two patients, and chronic severe obesity was observed in one patient. In total, malnutrition was observed in 65% of the patients. Conclusion: One of the most important problems in patients with cleft palate is feeding. Inadequate nutrition predisposes to malnutrition in the preoperative period. To prevent this situation, the patients should be referred for prompt professional nutritionist care and early follow-up. [ABSTRACT FROM AUTHOR]

Abstract Background To analyze the real-world growth pattern of very premature infants (VPI) with small for gestational age (SGA) after birth by using the ΔZ value of weight at discharge. Methods The clinical data were collected from 28 hospitals in China from September 2019 to December 2020. They were divided into the EUGR(Extrauterine Growth Restriction) and the non-EUGR group according to the criterion of ΔZ value of weight at discharge

Background: There is interplay of genetic and environmental factors in determining the weight, height and body structure of children. Hence it is important to know the role of genetic factor in determining height, weight and Body Mass Index (BMI) of children. Aim and Objectives: To know the prevalence of malnutrition among under five children; to assess correlation between anthropometry of parents and anthropometry of under five children; and to assess the quality and quantity of diet consumed by under five children. Material and Methods: Present study was a cross sectional study, done among 270 children aged between 1-4 years registered at Anganawadi. Information on sociodemographic variables and anthropometry of under five children and their parents was collected after taking parents' consent. Percentages and correlation coefficient were used to find correlation between anthropometry of parents and children (height, weight and BMI), level of significance was taken at p < 0.05. Results: Our study showed that 22.96% of children were under nourished, 1.48% stunted and 84.7% wasted. As per the mid arm circumference, mean was 12.02 ± 1.27, 8.1% were severely malnourished and 29.3% moderately. Parents' height was positively correlated with height of children and it was statistically significant with p < 0.05. Parents' weight and fathers' BMI also showed positive correlation but it was not statistically significant. Mothers' BMI was not correlated with BMI of children. Conclusion: Our study found that about 23% of children were under nourished. Parent's height was positively correlated with children's height.

ObjectiveTo investigate the factors influencing the catch-up growth of 12-months low birth weight infants in Suyu District of Suqian City during the period of COVID-19 prevention and control.MethodsAll 301 low birth weight infants were selected with clustered sampling from the database under authorized use， who made their regular check-ups and follow-ups to 12 months in Suyu District of Suqian City from January 2020 to May 2021. Data were collected on infants’ basic information， their birth situation and their weight upon birth and at 12 months， while maternal situation during pregnancy and the infants’ postnatal feeding and diseases were investigated with a questionnaire. Z scores were calculated. All infants were divided into the catch-up growth group and the uncompleted catch-up growth group according to whether the △Z score was ≥0.67. The influencing factors were analyzed for catch-up growth of the low birth weight infants during the period of COVID-19 prevention and control.ResultsThere were statistically significant differences in the rate of small for gestational age， preterm birth， intrauterine growth retardation， postnatal nutrition enhancement and feeding mode between the two groups. The results in the multifactor logistics regression analysis showed that intrauterine growth retardation （OR=0.070， 95%CI： 0.015‒0.327） was an obstacle factor for catch-up growth， while postnatal fortified nutrition （OR=6.518， 95%CI 1.215‒34.955） was a promoting factor for catch-up growth.ConclusionThere is catch-up growth in postnatal weight among most of the low birth weight infants. Postnatal fortified nutrition is beneficial to catch-up growth， while intrauterine growth retardation may induce uncompleted catch-up growth.

Abstract A common problem in meta-analyses is the unavailability of mean and standard deviation (SD). Unfortunately, only having values of the median, interquartile range (IQR), or range cannot be directly utilized for meta-analysis. Although some estimation and conversion methods have been proposed in the past two decades, there were no published and user-friendly tools developed based on multiple scenarios of missing SD. Therefore, this study aimed to provide a collection of possible circumstances of missing sample means or SD with solutions for teaching and research. A total of 10 common circumstances of missing SD or mean could have available statistics of p value, t value, z score, confidence interval, standard error, median, IQR, and range. Teachers and investigators can use relevant formulas for finding the sample mean and SD according to the available circumstance. Due to the complicated computations, our team provides a free available spreadsheet. With ever-evolving statistical methods, some formulas may be further improved in the future; therefore, it is recommended to involve statisticians in evidence-based practice or systematic reviews.

Background : The availability of nomograms is crucial for the correct interpretation of pediatric and neonatal echocardiograms. Echocardiographic Z-score applications/websites use Western nomograms as reference, which may not be an appropriate standard for gauging Indian neonates. Currently available Indian pediatric nomograms either have not included neonates or have not been specifically designed for neonates. This gross underrepresentation of neonates renders available nomograms unreliable for use as standards for comparison. Objectives : The objective of this study was to collect normative data for the measurement of various cardiac structures using M-Mode and two-dimensional (2D) echo in healthy Indian neonates and to derive Z-scores for each measured parameter. Methods : Echocardiograms were performed on healthy term neonates (within first 5 days of life). Birth weight and length were recorded, and body surface area was calculated using Haycock's formula. Twenty M-mode and 2D-echo parameters were measured (including left ventricular dimensions, atrioventricular valves, and semilunar valves' annuli sizes, pulmonary artery and branches, aortic root, and arch). Results : We studied 142 neonates (73 males) with a mean age of 1.83 ± 1.12 days and mean birth weight of 2.89 ± 0.39 Kg. Regression equations with linear, logarithmic, exponential and square root models were tested to select the best model of fit for the relationship between birth weight and each echocardiographic parameter. Scatter plots and nomogram charts with Z-scores were prepared for each echocardiographic parameter. Conclusions : Our study provides nomograms with Z-scores for term Indian neonates weighing between 2 kg and 4 kg at birth, within first 5 days of life, for a set of echocardiographic parameters that are frequently used in clinical practice. This nomogram has poor predictability for babies at extremes of birth weight. There is a need for further indigenous studies to include neonates at extremes of weight, both term, and preterm.

Background: To analyze the real-world growth pattern of very premature infants (VPI) with small for gestational age (SGA) after birth by using the ΔZ value of weight at discharge. Methods: The clinical data were collected from 28 hospitals in China from September 2019 to December 2020. They were divided into the EUGR(Extrauterine Growth Restriction) and the non-EUGR group according to the criterion of ΔZ value of weight at discharge < –1.28. Results: This study included 133 eligible VPI with SGA. Following the criterion of ΔZ value, the incidence of EUGR was 36.84% (49/133). The birth weight, the 5-min Apgar score, and the proportion of male infants in the EUGR group were lower (P < 0.05). The average invasive ventilation time, cumulative duration of the administration of antibiotics, blood transfusion time, blood transfusion ratio, and total days of hospitalization were significantly higher in the EUGR group (P < 0.05). In the EUGR group, several factors exhibited higher values (P < 0.05), including the initiation of enteral feeding, the volume of milk supplemented with human milk fortifier (HMF), the duration to achieve complete fortification, the cumulative duration of fasting, the duration to achieve full enteral feeding, the length of parenteral nutrition (PN), the number of days required to attain the desired total calorie intake and oral calorie intake, as well as the age at which birth weight was regained. The average weight growth velocity (GV) was significantly lower in the EUGR group (P < 0.001). The incidences of patent ductus arteriosus with hemodynamic changes (hsPDA), neonatal necrotizing enterocolitis (NEC) stage≥ 2, late-onset sepsis (LOS), and feeding intolerance (FI) in the EUGR group were higher (P < 0.05). Multivariate logistic regression analysis showed that birth weight, male, and GV were the protective factors, while a long time to achieve full-dose fortification, slow recovery of birth weight, and NEC stage ≥2 were the independent risk factors. Conclusion: SGA in VPI can reflect the occurrence of EUGR more accurately by using the ΔZ value of weight at discharge. Enhancing enteral nutrition support, achieving prompt and complete fortification of breast milk, promoting greater GV, reducing the duration of birth weight recovery, and minimizing the risk of NEC can contribute to a decreased occurrence of EUGR. Trial registration: CHICTR, ChiCTR1900023418. Registered 26/05/2019, http://www.chictr.org.cn. [ABSTRACT FROM AUTHOR]

Proficiency testing is the use of interlaboratory comparisons to assess the ability of a laboratory to perform a particular test or measurement competently and demonstrate the reliability of the results generated. To achieve this goal, the international standard ISO 13528:2022 presents four performance statistics and one of them is the z score. Some researchers have proposed an alternative approach for proficiency testing scheme interpretation based on an analysis of variance method. This short communication presents residual analysis to choose an appropriate analysis of variance model for proficiency testing interpretation when the assigned value is obtained by consensus value among participants. The analysis of variance approach was compared with z score to assess the performance of interlaboratory comparison for determining the amount of NOx present in vehicle emissions. Preliminary results indicate that the conclusions obtained by both methodologies differ for one of the participating laboratories. This occurs due to violation of the homoscedasticity assumption which is not considered when using the z score. On the other hand, residual analysis can provide such information and feasible generalized least squares can deal with heteroscedasticity. [ABSTRACT FROM AUTHOR]

Background: There is interplay of genetic and environmental factors in determining the weight, height and body structure of children. Hence it is important to know the role of genetic factor in determining height, weight and Body Mass Index (BMI) of children. Aim and Objectives: To know the prevalence of malnutrition among under five children; to assess correlation between anthropometry of parents and anthropometry of under five children; and to assess the quality and quantity of diet consumed by under five children. Material and Methods: Present study was a cross sectional study, done among 270 children aged between 1-4 years registered at Anganawadi. Information on sociodemographic variables and anthropometry of under five children and their parents was collected after taking parents' consent. Percentages and correlation coefficient were used to find correlation between anthropometry of parents and children (height, weight and BMI), level of significance was taken at p < 0.05. Results: Our study showed that 22.96% of children were under nourished, 1.48% stunted and 84.7% wasted. As per the mid arm circumference, mean was 12.02 ± 1.27, 8.1% were severely malnourished and 29.3% moderately. Parents' height was positively correlated with height of children and it was statistically significant with p < 0.05. Parents' weight and fathers' BMI also showed positive correlation but it was not statistically significant. Mothers' BMI was not correlated with BMI of children. Conclusion: Our study found that about 23% of children were under nourished. Parent's height was positively correlated with children's height. [ABSTRACT FROM AUTHOR]

COVID-19 is a pandemic disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The study area, Tamilnadu, is a southern state in India. The present study demonstrates the significance of mapping in identifying the risk zones of COVID-19 disease by taking a study of COVID-19 cases in Tamilnadu state. The main objective of the study was to identify the risk zone of COVID-19 disease in the first wave of Tamilnadu through geospatial mapping. Data on COVID-19 cases collected during March 2020 to March 2021 month wise in all 37 districts (unit area) of Tamilnadu in two-month interval wise was analysed. The study is based on secondary sources from respective office in Tamilnadu. Z-score techniques were used for standardizing data. Correlation analysis provided a measure of correlation between COVID-19 and working population. Location Quotient analysis aided the identification of COVID-19 risk zones in Tamilnadu. Present study indicates tertiary workers are more vulnerable to COVID-19 disease. [ABSTRACT FROM AUTHOR]

A common problem in meta-analyses is the unavailability of mean and standard deviation (SD). Unfortunately, only having values of the median, interquartile range (IQR), or range cannot be directly utilized for meta-analysis. Although some estimation and conversion methods have been proposed in the past two decades, there were no published and user-friendly tools developed based on multiple scenarios of missing SD. Therefore, this study aimed to provide a collection of possible circumstances of missing sample means or SD with solutions for teaching and research. A total of 10 common circumstances of missing SD or mean could have available statistics of p value, t value, z score, confidence interval, standard error, median, IQR, and range. Teachers and investigators can use relevant formulas for finding the sample mean and SD according to the available circumstance. Due to the complicated computations, our team provides a free available spreadsheet. With ever-evolving statistical methods, some formulas may be further improved in the future; therefore, it is recommended to involve statisticians in evidence-based practice or systematic reviews. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Financial Politic & Economic Reviews / Finans Politik & Ekonomik Yorumlar is the property of Journal of Financial Politic & Economic Reviews / Finans Politik & Ekomomik Yorumlar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background The use of systemic steroids for 6+ weeks in children is associated with decreased bone mineral content (BMC) and density (BMD). However, the effects of a shorter duration of use on BMD are unknown. Purpose To determine the effect of the use of systemic steroids for 2–6 weeks on BMD and BMC in pediatric patients. Methods Twenty-five pediatric patients (21 with tuberculosis, 2 with systemic juvenile idiopathic arthritis, 1 with inflammatory bowel disease, 1 with autoimmune hemolytic anemia) who received systemic steroids for 2–6 weeks and 25 age- and sexmatched controls were enrolled. BMC, BMD, and z scores of the whole body (WB), lumbar spine (LS), nondominant distal radius (DR), and total body less the head (TBLH) were determined by dual-energy x-ray absorptiometry at baseline, the end of steroid therapy or 6 weeks (whichever was earlier; first follow-up), and at the end of 3 months from baseline (second follow-up) in patients and at baseline in controls. The values were adjusted for confounding variables. Continuous and categorical variables were compared using Student t test and the chi-square test or Fisher exact test, respectively. Pairwise comparisons employed Bonferroni correction. Results Statistically significant decreases in BMC, BMD, and all z scores were observed. BMC declined by 5.37%, 2.08%, 1.82%, and 2.27%, and 11.42%, 3.75%, 3.34%, and 4.17% for WB, LS, DR, and TBLH, respectively, at the first and second follow-ups, respectively. Similarly, BMD declined by 2.01%, 2.31%, 2.18%, and 1.70% and 4.59%, 3.76%, 3.14%, and 3.50% for the WB, LS, DR, and TBLH, respectively, at the first and second follow-ups, respectively. A significant negative correlation was found among bone densitometric parameters, duration, and cumulative dose. Conclusion The use of systemic steroids for 2–6 weeks in pediatric patients decreased the BMD and BMC of trabecular and cortical bones, an effect that persisted after discontinuation.

Electrolytic conductivity is recognized as one of the parameters to determine water quality. An accurate measurement of electrolytic conductivity of wastewater before dumping it into the environment is crucial to prevent water pollution. Therefore, the ability of laboratories in conducting accurate and comparable measurements of electrolytic conductivity is important to guarantee the measurement results. The measurement quality of the laboratories can be determined by participating in a proficiency testing (PT) conducted by accredited PT provider. In 2018, Chemical Metrology Laboratory, Indonesian Institute of Sciences (LIPI), as a PT provider, conducted a PT for electrolytic conductivity measurement with synthetic wastewater as the PT test item. It was prepared from cations and anions commonly found in natural wastewater. A total of 25 participants from Indonesian testing laboratories reported their electrolytic conductivity measurements. These results were then evaluated using a standardized performance statistic of z score, z′ score, En score and ζ (zeta) score. There were 20 laboratories having satisfactory results evaluated using both z score and z′ score, while only 14 laboratories were considered having a successful performance evaluated using En score and ζ score. The evaluation results show that the participants already have the ability to measure the electrolytic conductivity value but some of them still need improvement in estimating the uncertainty. [ABSTRACT FROM AUTHOR]

No studies have assessed differences between the Japanese and Z score criteria in the echocardiographic detection sensitivity of coronary artery (CA) abnormalities using large-scale data containing samples from multiple facilities engaged in daily clinical practices of Kawasaki disease (KD). We analyzed data from the 25th Japanese nationwide KD survey, which identified 30,415 patients from 1357 hospitals throughout Japan during 2017–2018. Hospitals were classified according to their use of Z score criteria. We assessed differences in hospital and patient background factors and compared the prevalence of CA abnormalities among groups using the Z score criteria. Multivariable logistic regression analyses were performed to evaluate differences in the detection sensitivity for CA abnormalities. The Z score criteria were more likely to be utilized in larger hospitals with more pediatricians and cardiologists. Even after controlling for potential confounders, detection sensitivities by the Z score criteria were significantly higher than by the Japanese criteria in patients with CA dilatations (adjusted odds ratio (95% confidence interval) 1.77 (1.56–2.01)) and aneurysms (1.62 (1.17–2.24)). No significant difference was found in patients with giant CA aneurysms. Compared with the Japanese criteria, the Z score criteria were significantly more sensitive for detecting patients with CA dilatations regardless of age, and for those with CA aneurysms only in patients aged ≤ 1 year. Our results indicate that differences in the detection sensitivity for CA abnormalities between the Z score and the Japanese criteria were dependent on the CA size and patient age. [ABSTRACT FROM AUTHOR]

Background : The availability of nomograms is crucial for the correct interpretation of pediatric and neonatal echocardiograms. Echocardiographic Z-score applications/websites use Western nomograms as reference, which may not be an appropriate standard for gauging Indian neonates. Currently available Indian pediatric nomograms either have not included neonates or have not been specifically designed for neonates. This gross underrepresentation of neonates renders available nomograms unreliable for use as standards for comparison. Objectives : The objective of this study was to collect normative data for the measurement of various cardiac structures using M-Mode and two-dimensional (2D) echo in healthy Indian neonates and to derive Z-scores for each measured parameter. Methods : Echocardiograms were performed on healthy term neonates (within first 5 days of life). Birth weight and length were recorded, and body surface area was calculated using Haycock's formula. Twenty M-mode and 2D-echo parameters were measured (including left ventricular dimensions, atrioventricular valves, and semilunar valves' annuli sizes, pulmonary artery and branches, aortic root, and arch). Results : We studied 142 neonates (73 males) with a mean age of 1.83 ± 1.12 days and mean birth weight of 2.89 ± 0.39 Kg. Regression equations with linear, logarithmic, exponential and square root models were tested to select the best model of fit for the relationship between birth weight and each echocardiographic parameter. Scatter plots and nomogram charts with Z-scores were prepared for each echocardiographic parameter. Conclusions : Our study provides nomograms with Z-scores for term Indian neonates weighing between 2 kg and 4 kg at birth, within first 5 days of life, for a set of echocardiographic parameters that are frequently used in clinical practice. This nomogram has poor predictability for babies at extremes of birth weight. There is a need for further indigenous studies to include neonates at extremes of weight, both term, and preterm. [ABSTRACT FROM AUTHOR]

Copyright of Jurnal Ekonomi Syariah Teori dan Terapan is the property of Universitas Airlangga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Proficiency testing schemes by interlaboratory comparisons are used to determine the performance of individual laboratories for specific tests or measurements. The international standard ISO 13528:2015 provides a description of statistical methods used for achieving this goal; one of these methods is the z score. The standard allows each participant to choose a measurement method and this can lead to inhomogeneity between participant variance known as heteroscedasticity. The ISO 13528:2015 standard does not mention heteroscedasticity in its statistical procedures. This paper describes a new approach, based on residuals analysis, to assess the performance of an interlaboratory comparison for determining the presence of benzoic acid in orange juice. The results indicate that the conclusions (using z scores) and the proposed approach are different for some laboratories. This occurs due to violation of the homoscedasticity assumption. The z score procedure does not consider this assumption violation while residual analysis can provide such information. Feasible generalized least squares allow one to deal with non-homoscedasticity. [ABSTRACT FROM AUTHOR]

Financial distress is one of the leading reasons for corporate default, foreclosure, and subsequent bankruptcy. Traditionally accounting information-based models have been used to identify the financially distressed firms. Inaccurate identification results in type-I and type- II errors. These errors are attributable to the elements of conservatism and prudence within the accounting information. Enclosure of market information into these models may reduce the quantum of errors and improve the existing ability of these models to accurately identify the financially distressed firms. This study has infused the Corporate Social Responsibility information into the Altman Z-Score. The enclosure has been made using additive index methodology, resulting in formation of a Composite Default Index. 161 non- financial firms listed on the Pakistan Stock Exchange have been taken as the sample over the study period of 2010-2016. The accuracy of Composite default Index has been found significantly better as compared to the Z-Score Default Index as the type-I and type-II errors are reduced by 41% and 132% respectively. This study has implication for the corporate regulators, practitioners, stakeholders and researchers in form of providing a better mechanism to identify the financially distressed firms, future studies may consider other forms of market information and the accounting information-based models to improve upon the same, further.

Kawasaki disease, an acute systemic vasculitis affecting children, is the leading cause of acquired heart disease in developed countries. This vasculitis has a predilection for the coronary artery, and coronary artery abnormalities are the main criteria for its diagnosis. The diagnosis of coronary abnormalities has historically been based on dichotomous criteria, but recent guidelines have accepted the body surface area-adjusted z score system to define coronary abnormalities and classify coronary artery aneurysms. Z score systems have improved risk classifications of coronary aneurysms and improved correlations with clinical prognosis. However, the discrepancy of calculated z scores according to the formula has been noticed in the application of the z score system, which is possibly related to the diagnosis of coronary artery abnormalities. This variability was greater in larger coronary aneurysm dimensions. A careful choice of the z score formula and its consistent use is needed in clinical applications. [ABSTRACT FROM AUTHOR]

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A total of 15,267 pregnancies were tested by NIPT in this study. Grey zone (z score: 2.58 ∼ 4 and −4∼−2.58) was set for screening out aneuploidy 21, 18 and 13. Cases with z score located in the grey zone were retested starting from DNA extraction. The chi-squared test and/or the Fisher's exact test were used to compare variables. One hundred and eight screening-positive samples in the first run of NIPT were common trisomies 21 (N = 83), trisomies18 (N = 13) or trisomies 13 (N = 12), with PPVs of 87.18%, 76.92%, and 30% respectively. For the cases in the grey zone, most of them (67.15%, 184/274) were reported with Z score of Chromosome 21 in the grey zone and 176 were reclassified as negative by the second run of NIPT; while 3 cases reclassified as trisomy 21 and 1 case reclassified as trisomy 13 were finally confirmed by karyotyping analysis, with PPV 25% and 20% respectively. The grey zone and the second run of NIPT in this study showed that the grey zone and second run NIPT approach was able to accurately help categorise cases as negative and positive. Invasive diagnosis is recommended to prevent false negative aneuploidies for samples located in the special z score scope of 2.58–3 for two runs of NIPT. What is already known on this subject? Grey zone was widely used in NIPT. The performance of grey zone of clinical samples on Illumina HiSeq 2000 instrument has been reported, and the performance of grey zone on some mainstream sequencers with simulated samples has also been summarised. Reported treatments for samples located in the grey zone in NIPT usually included being classified into 'unclassified' or 'no call' followed by following up and/or karyotyping analysis. What do the results of this study add? This study investigated the performance of the grey zone on Ion Proton DA8600 with clinical samples; and it present an alternative treatment for samples in grey zone that reclassified them as negative or positive by the second run of sequencing. What are the implications of these findings for clinical practice and/or further research? Our own data for the performance of the grey zone in the cfDNA assay on the semiconductor sequencing platform might provide raw materials for other researchers' meta-analysis, cohort study, or other studies. Details of Z score distributions of chromosomes in grey zone, results of the second run of NIPT for samples in the grey zone, and false negative samples in the grey zone would help lab technicians better analyse the NIPT results and help doctors to improve genetic counselling. [ABSTRACT FROM AUTHOR]

Objective: To investigate the underlying causes of false positives in NIPT of fetal sex chromosomal aneuploidies using fetal cell‐free DNA from maternal plasma. Methods: In the present study, we focus on a cohort of 23,984 pregnancy cases with NIPT. Karyotyping and FISH analysis were employed to verify the NIPT detected false‐positive results of fetal sex chromosomal aneuploidies, and a comparative CNV sequencing on positive and negative NIPT cases was uniquely performed to elucidate the underlying causes. Results: A total of 166 cases (0.69%) were identified as fetal sex chromosomal abnormalities, while 84 cases were found to be false‐positive results possibly associated with maternal X chromosomal aneuploidies (n = 8), maternal X chromosomal structural abnormalities (n = 1), maternal CNVs (n = 4) as well as known placental mosaicism (n = 1). Furthermore, our study showed that the maternal chromosome CNV between 1–1.6 Mb was associated with false‐positive NIPT results in sex chromosomal abnormalities. Conclusion: Our research demonstrated the spectrum of factors causing false positives in NIPT of fetal sex chromosomal abnormalities based on a large cohort. The effective maternal CNV size cut‐off identified in our study could integrate into bioinformatics algorithms for reducing the false‐positive rate, however, further investigation is necessary to confirm this. [ABSTRACT FROM AUTHOR]

Background: Non-invasive prenatal screening (NIPS) is a highly sensitive and specific screening test to detect fetal chromosomal abnormalities. The primary objective of this study was to evaluate the NIPS as an effective method for prenatal detection of aneuploidies in both high-risk and low-risk pregnancies. Methods: In current study, we performed NIPS in 32,394 pregnancies, out of which results were available in 32,361 (99.9%) of them. Illumina sequencing was performed for NIPS screening. Hypothesis Z test was used to classify fetal autosomal aneuploidy of T21, T18, and T13. Karyotyping was performed to determine the true negative and true positive NIPS results. Results: Among the 32,361 confirmed samples, 164 cases had positive results and 32197 cases had negative results. Of these positive cases, 116 cases were trisomy 21, 34 cases were trisomy 18 and 14 cases were trisomy 13. No false negative results were found in this cohort. The overall sensitivity and specificity were 100% and 99.91%, respectively. There was no significant difference in test performance between the 7,316 high-risk and 25,045 low-risk pregnancies, (sensitivity, 100% vs 100% (P>0.05); specificity, 99.96% vs 99.95% (P > 0.05)). Factors contributing to false-positive results included fetal copy number variants (CNVs), fetal mosaicism and typically producing Z scores between 3 and 4. Moreover, we analyzed NIPS whole-genome sequencing to investigate the Single Nucleotide Polymorphisms (SNPs) associations with drug response or risk of disease. As compare to the 1000g East Asian genome data, the results revealed a significant difference in 7,285,418 SNPs variants of Shanxi pregnant women including 19,293 clinvar recorded variants and 7,266,125 non-clinvar recorded. Conclusions: Our findings showed that NIPS was an effective assay that may be applied as routine screening for fetal trisomies in the prenatal setting. In addition, this study also provides an accurate assessment of significant differences in 7,285,418 SNPs variants in Shanxi pregnant women that were previously unavailable to clinicians in Shanxi population. [ABSTRACT FROM AUTHOR]

Introduction: Beta‐blockers are prescribed for many pregnant women with heart disease, but whether there is a dose‐dependent effect on fetal growth remains to be examined. We aimed to investigate if antenatal beta‐blocker use and dose were associated with delivering a small‐for‐gestational‐age infant among women with heart disease. Material and methods: Our cohort included women with heart disease who delivered at Oslo University Hospital between 2006 and 2015. Maternal heart disease was classified into modified WHO risk scores. Women with beta‐blocker treatment were dichotomized into whether they had been treated with a low or high dose based on clinical factors. We compared the risk of delivering a small‐for‐gestational‐age infant in women exposed to high doses, low doses, or with no exposure to antenatal beta‐blockers while adjusting for severity of maternal heart disease in logistic regression models. Results: Of a total of 540 pregnancies among women with heart disease, 163 (30.2%) were exposed to beta‐blocker treatment. The majority were treated with metoprolol (86.5%). Almost twice as many babies in the beta‐blocker group were small‐for‐gestational‐age, compared with the non‐exposed group (19.8 vs 9.5%, P < 0.001). Women using a high‐dose beta‐blocker had a five‐fold increased risk of delivering a small‐for‐gestational‐age infant compared with non‐exposure (adjusted odds ratio [aOR] 4.89, 95% confidence interval [CI] 2.22–10.78, P < 0.001). Women using a low dose of beta‐blocker had a two‐fold increased risk of delivering a small‐for‐gestational‐age infant; however, the confidence interval included the null (aOR 1.75, 95% CI 0.83–3.72, P = 0.143). Results when restricting the analyses to metoprolol showed the same pattern, but with attenuation of risks. Conclusions: We found a five‐fold increased risk of delivering a small‐for‐gestational‐age infant in women with heart disease treated with a high dose of beta‐blocker, and a two‐fold increased risk among those treated with a low dose, showing an apparent dose–response relation. Close monitoring of fetal growth is warranted among women with heart disease treated with beta‐blockers. As drug therapy in pregnancy concerns both mother and fetus, an optimum balance for both should be the goal. [ABSTRACT FROM AUTHOR]

Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The use of systemic steroids for 6+ weeks in children is associated with decreased bone mineral content (BMC) and density (BMD). However, the effects of a shorter duration of use on BMD are unknown. Purpose: To determine the effect of the use of systemic steroids for 2-6 weeks on BMD and BMC in pediatric patients. Methods: Twenty-five pediatric patients (21 with tuberculosis, 2 with systemic juvenile idiopathic arthritis, 1 with inflammatory bowel disease, 1 with autoimmune hemolytic anemia) who received systemic steroids for 2-6 weeks and 25 age- and sexmatched controls were enrolled. BMC, BMD, and z scores of the whole body (WB), lumbar spine (LS), nondominant distal radius (DR), and total body less the head (TBLH) were determined by dual-energy x-ray absorptiometry at baseline, the end of steroid therapy or 6 weeks (whichever was earlier; first follow-up), and at the end of 3 months from baseline (second follow-up) in patients and at baseline in controls. The values were adjusted for confounding variables. Continuous and categorical variables were compared using Student t test and the chi-square test or Fisher exact test, respectively. Pairwise comparisons employed Bonferroni correction. Results: Statistically significant decreases in BMC, BMD, and all z scores were observed. BMC declined by 5.37%, 2.08%, 1.82%, and 2.27%, and 11.42%, 3.75%, 3.34%, and 4.17% for WB, LS, DR, and TBLH, respectively, at the first and second follow-ups, respectively. Similarly, BMD declined by 2.01%, 2.31%, 2.18%, and 1.70% and 4.59%, 3.76%, 3.14%, and 3.50% for the WB, LS, DR, and TBLH, respectively, at the first and second follow-ups, respectively. A significant negative correlation was found among bone densitometric parameters, duration, and cumulative dose. Conclusion: The use of systemic steroids for 2-6 weeks in pediatric patients decreased the BMD and BMC of trabecular and cortical bones, an effect that persisted after discontinuation. [ABSTRACT FROM AUTHOR]

Background: This study aimed to generate a Z score calculation model for coronary artery diameter of normal children and adolescents to be adopted as the standard calculation method with consensus in clinical practice., Methods: This study was a retrospective, multicenter study that collected data from multiple institutions across South Korea. Data were analyzed to determine the model that best fit the relationship between the diameter of coronary arteries and independent demographic parameters. Linear, power, logarithmic, exponential, and square root polynomial models were tested for best fit., Results: Data of 2,030 subjects were collected from 16 institutions. Separate calculation models for each sex were developed because the impact of demographic variables on the diameter of coronary arteries differs according to sex. The final model was the polynomial formula with an exponential relationship between the diameter of coronary arteries and body surface area using the DuBois formula., Conclusion: A new coronary artery diameter Z score model was developed and is anticipated to be applicable in clinical practice. The new model will help establish a consensus-based Z score model., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2024 The Korean Academy of Medical Sciences.)