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Graves' disease is the leading cause of autoimmune hyperthyroidism. Thyroid hormones are an essential element of the endocrine system, playing a pivotal role in the body's development, especially important in children with intensified growth. Disturbance within thyroid tissue certainly affected the whole body. Nowadays, numerous research studies indicate different factors contributing to the onset of the disease; however, the exact pathomechanism of Graves' disease is still not fully understood, especially in the context of immune-related processes. Th1, Th17, and Th22 effector lymphocytes were found to be crucial participants in the disease outcome, as well as in autoimmune diseases. Here, our study aimed at assessing selected effector T lymphocytes, Th1, Th17, and Th22, in newly diagnosed pediatric Graves' disease patients, together with their association with thyroid-related parameters and the potential outcome of disease management. We indicated significant increases in the frequencies and absolute numbers of selected effector lymphocytes in Graves' disease patients. In addition, their mutual ratios, as well as Th1/Th17, Th/Th22, and Th17/Th22, seem to be significant in those diseases. Notably, low Th17/Th22 ratio values were distinguished as potential prognostic factors for normalizing TSH levels in response to methimazole treatment. To sum up, our research determines the crucial contribution of Th1, Th17, and Th22 cells in the pathogenesis of Graves' disease. Moreover, the mentioned subset of T cells is highly likely to play a substantial role in the potential prediction of therapy outcomes. [ABSTRACT FROM AUTHOR]

Background: Linear growth faltering remains a pervasive public health concern that affects many children worldwide. This study aimed to investigate possible maternal factors promoting normal linear growth among children aged 6–23 months of age from impoverished Rwandan households. Methods: We used a three-stage cluster sampling procedure. The study population consisted of children aged six to 23 months and their mothers who lived in the study districts. A structured questionnaire helped to collect data from 807 selected mother-child dyads. The primary outcome variable was height-for-age Z scores. The main predictors were maternal income-generating activity, maternal education, maternal depression, household decision making, number of ANC visits, use of family planning method, types of family planning, and mode of delivery. We used univariate analysis to establish median, frequencies, and percentages. Furthermore, we used the Kruskal-Wallis, Mann-Whitney U, and Spearman rank correlation tests for bivariate analysis. We included in the final model of robust linear regression for multivariate analysis the potential confounding variables identified as significantly associated with the outcome (child age, participation in works for both parents, good handwashing practice, owning a vegetable garden, and the total number of livestock) along with maternal factors. Results: Maternal factors that promoted normal linear growth of children were the presence of maternal income generation activity (β= 0.640 [0.0269 1.253], p value = 0.041), the participation of the mother in the decision-making process of the household (β=0.147 [0.080 0.214], p-value < 0.001), and the higher frequency of consultations with ANC (β=0.189 [0.025 0.354], p-value = 0.024). Additionally, a combination of household decision-making with the number of ANC visits predicted an increase in the linear growth of the child (β=0.032 [0.019 0.045], p-value < 0.001). Conclusion: Maternal factors such as maternal income-generating activity, maternal participation in household decision making, and increased number of ANC visits were found to promote normal child linear growth. These results contribute valuable information to the formulation of interventions and policies to improve child nutrition and growth in the community studied. [ABSTRACT FROM AUTHOR]

Background: Growth references play a crucial role in the screening, evaluation, and surveillance of children, aiding in the early identification of the requirement for diverse growth-promoting interventions. Variations in human growth across distinct ethnic cohorts arise from genetic disparities, lifestyle variances, nutritional diversity, and diverse social and environmental contexts. Consequently, the selection of growth references markedly influences the prevalence of developmental disorders and nutritional imbalances in children. The study aims to assess the growth percentile of children in the north-east of Iran and establish population-specific reference charts for length, weight, and head circumference spanning from birth to 24 months. Methods: This cross-sectional population-based research conducted in the north-east of Iran, from 2016 to 2023. The Data extracted from the electronic health records of Mashhad University of Medical Sciences. All apparently healthy children aged from birth to 24 months who were measured at least once by health staff at the ages of birth,1,2,4,6,7,9,12,15,18,24 months were included. The target population of the study were 479,089 children (96.21%), encompassing 233,565 girls (48.75%) and 245,524 boys (51.25%). Gender-specific percentile curves for length, weight, and head circumference concerning age, as well as weight concerning length, were derived using the GAMLSS approach. Results: From the anthropometric information of 479,089 children (245,524 boys and 233,565 girls), growth charts were constructed. In comparison to the standard WHO chart, Iranian neonates displayed lower weight across all percentiles during the first month after birth, exhibited decreased head circumference at the 3rd percentile, and boys showed reduced length across all percentiles. After this age, Iranian children demonstrated increased weight, length, and head circumference. Conclusions: This research introduces the inaugural large-scale endeavor for indigenous reference charts. Through the noted distinctions from the international reference, the utilization of this novel resource offers the potential to enhance the surveillance of children's growth within the area. Moreover, by accurately assessing growth anomalies such as underweight, stunting, and wasting, it expands the domain of impactful policies in this sphere. Simultaneously, it enables the exploration of the secular trend of children's growth in the forthcoming years. [ABSTRACT FROM AUTHOR]

The aim of this review article is to highlight the consequences of COGHD after the end of linear growth on bone mass and body composition and the opposing beneficial effects of continuing GH replacement in the transition period and young adults. The role of growth hormone in the period of late adolescence and young adulthood is well established, mainly in achieving peak bone mass and a favorable body composition, characterized by muscle mass increase and fat mass reduction. Patients with childhood onset growth hormone deficiency (COGHD), after reaching the adult height, have a reduced bone mineral density and muscle mass with increased fat mass compared to healthy controls. Inadequate body composition is a predictor for cardiovascular risk, while low bone mass in early youth hallmarks the risk of osteoporosis and bone fractures in later life. Cessation of growth hormone replacement (GHr) after completion of growth will lead to delayed peak bone mass and unbalanced body composition with increased abdominal fat deposits. According to numerous clinical studies monitoring the effects of GH treatment on the physical and psychological status of patients with persistent GHD after completion of growth, we suggest continuing this treatment between 16 and 25 years of age. It is advised that GHr in the transition period be administered in intermediate doses between those for the pediatric population and those for the adult population. Usual daily GHr doses are between 0.3 and 0.5 mg but need to be individually optimized, with the aim of maintaining IGF-I in the age-specific normal range. [ABSTRACT FROM AUTHOR]

Background General practitioners (GPs) in Australia have an important role to play in preventing childhood obesity. Activities such as growth monitoring and promotion of healthy behaviours can contribute to obesity prevention efforts; however, the practicalities of how this is done are poorly documented. Objectives Objectives were to understand current attitudes and practices regarding promoting healthy childhood growth and development and preventing childhood obesity in general practice, and identify practical barriers and enablers to routinely incorporating this into general practice based on the observations and personal experiences of general practice staff. Methods A descriptive qualitative study was undertaken with Australian general practice staff. Barriers and enablers underwent thematic analysis and mapped to the ecological model. Results Interviews were conducted with 9 GPs, 4 nurses, and 2 practice managers. Participants agreed that growth monitoring and healthy behaviour promotion should be done for children with a healthy weight. However, the thematic analysis indicated that obesity prevention in clinics is not supported well by the broader general practice system, there are complexities associated with obesity prevention discussions, and the COVID-19 pandemic has intensified challenges in general practice. Two themes for obesity prevention enablers were identified; these related to bridging the implementation gap and the need for changes outside the clinic to support behaviour within the clinic. Ecological model mapping implicated multiple ecological levels for each theme. Conclusion Childhood obesity prevention through growth monitoring and healthy behaviour promotion is relevant to general practice; however, more support is needed to enable implementation and embed these practices day-to-day. [ABSTRACT FROM AUTHOR]

Several evidence gaps exist regarding the use of long-acting polyethylene glycol recombinant human growth hormone (PEG-rhGH) in children with idiopathic short stature (ISS), particularly studies conducted in real-world settings, with long-term follow-up, involving varied dosing regimens, and in comparison with daily rhGH. The study aimed to evaluate the effectiveness, safety, and adherence of once-weekly PEG-rhGH for catch-up growth in children with prepubertal ISS compared to daily rhGH. A real-world retrospective cohort study was conducted in prepubertal children with ISS in China. Children who voluntarily received once-weekly PEG-rhGH or daily rhGH were included and were followed up for 2 years. Ninety-five children were included, 47 received PEG-rhGH 0.2–0.3 mg/kg weekly and 48 received daily rhGH. Outcome measures included effectiveness in catch-up growth, adverse events, and treatment adherence. Height velocity increased significantly in both groups during rhGH therapy. In children who received PEG-rhGH treatment, height velocity was 10.59 ± 1.37 cm/year and 8.75 ± 0.86 cm/year in the first and second year, respectively, which were significantly more than those who received daily rhGH (9.80 ± 1.05 cm/year, P = 0.002, and 8.03 ± 0.89 cm/year, P < 0.001). The height standard deviation score improved at the end of the second year for all children (P < 0.001). However, children who received PEG-rhGH showed more excellent improvement than those with daily rhGH (1.65 ± 0.38 vs. 1.50 ± 0.36, P = 0.001). In children who received PEG-rhGH, lower missed doses were observed than those with daily rhGH (0.75 ± 1.06 vs. 4.4 ± 2.0, P < 0.001). No serious adverse events were observed. Conclusion: PEG-rhGH demonstrated superior effectiveness and adherence compared to daily rhGH in the treatment of children with ISS. The safety profiles were similar between the two treatments. What is Known: • Recombinant human growth hormone (rhGH) has been used to increase adult height in children with idiopathic short stature (ISS), and its safety profile is comparable to other indications for growth hormone treatment. • The use of long-acting rhGH in children with ISS is still an area of uncertainty. What is New: • This 2-year real-world study provides new evidence that PEGylated rhGH (PEG-rhGH) is more effective than daily rhGH in promoting catch-up growth in children with ISS. • PEG-rhGH also demonstrated superior treatment adherence compared to daily rhGH in children with ISS. • The safety profiles of PEG-rhGH and daily rhGH were found to be similar. [ABSTRACT FROM AUTHOR]

Compare the T1 mapping, fat fraction, diffusion and perfusion parameters of the lumbar vertebrae of different age groups to establish normal values for healthy children and observe the trends in these parameters with age. A total of 146 healthy children (0–14 years) were included in this prospective study and underwent 3.0 T lumbar MRI examination. The study cohort was divided into five age groups (Group A ∼ E) according to development milestones in children. T1 mapping, Dixon and IVIM (intravoxel incoherent motion)sequence images were used to measure the parameters of lumbar vertebrae 2–4. The normal values of each parameter were measured and compared across different age groups. The T1 value was negatively correlated with age (r=-0.619, p<0.001). The fat fraction (FF%) was positively correlated with age (r=0.635, p<0.001). There was a negative correlation between the D value and age (r=-0.406, p<0.001). The D∗ value was positively correlated with age (r=0.54, p<0.001). The f value was positively correlated with age (r=0.775, p<0.001). The inflexion points of the T1 value and FF% curves were at approximately 3 years old (36 months).The inflexion points of the IVIM-related parameter curves were approximately 5 years old (60 months). The age-dependent differences in the vertebral body parameters of this pediatric cohort suggest changes in the bone marrow composition and cellular structure of the vertebral body during physiological growth in children. The establishment of normal values of children's lumbar spine can facilitate the clinical study of diseases. • The inflexion point of the T1 value and FF% curves are at 3 years old. • The inflexion points of the IVIM-related parameter curves are at 5 years old. • The normal values of the vertebral bone marrow for healthy children are established. [ABSTRACT FROM AUTHOR]

Short stature (SS) is a condition where children's growth rates are below the 2.5th percentile for their age and gender. Early intervention is vital due to its association with reduced quality of life and mortality. This study examines the understanding of Qassimi parents regarding their child's SS. We surveyed 384 Qassimi parents, including those with growing children and those without children willing to participate. Knowledge scores ranged from 0 to 8, with scores over 4 indicating good knowledge. Most of the study participants were Saudis, females, or holding a university degree. The mean score was 4.44 and almost 47% of respondents demonstrated good knowledge. All the study participants were aware of at least one cause of short stature. Of more than 20 causes of short stature, only 24.3% of the study participants could correctly identify 4 or more causes. Multivariable regression revealed that higher knowledge scores were significantly noted among participants younger than 40 years (p-value: < 0.001), students (p-value: < 0.001), unmarried (p-value: 0.001), and/or having no children (p-values: 0.001). Among respondents with children, individuals with children younger than 12 years had significantly better knowledge (p-value: 0.003). In contrast, knowledge was seemingly independent of gender, level of education, nationality, or family history (p-values: > 0.05). Although the knowledge status is overall moderate, it's recommended to further start public health initiatives and educational programs, while paying special attention to population groups associated with lower knowledge level. [ABSTRACT FROM AUTHOR]

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ABSTRACT Plant‐based diets (PBD) have been reported throughout history, but are increasingly common in current times, likely in part due to considerable emphasis on climate change and human health and wellness. Many dietary organisations around the world endorse well‐planned, nutritionally adequate PBD, which exclude some or all forms of animal‐based foods. However, special attention must be given to patients who follow PBD and also have food allergy (FA), as avoidance may increase the risk of developing nutritional deficiencies, including poor growth in children, weight loss in adults and vitamin and mineral deficiencies. Given the increasing prevalence of both PBD and food allergen avoidance diets, healthcare providers are likely to counsel patients with FA who also follow a PBD. In this review, an overview of PBD in patients with FA is provided, including recent trends, macro‐ and micronutrient needs, and growth for children and weight gain considerations for adults. With regard to a PBD, special attention should be given to ensure adequate fat and protein intake and improving the bioavailability of several minerals such as iron, zinc, iodine, calcium and magnesium, and vitamins such as A, B2, B12 and D. Although the collective data on growth amongst children following a PBD are varied in outcome and may be influenced in part by the type of PBD, growth must be regularly monitored and in adults weight gain assessed as part of any clinical assessment in those people with FA. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Height velocity is considered a key auxological tool to monitor growth, but updated height velocity growth charts are lacking. We aimed to derive new French height velocity growth charts by using a big‐data approach based on routine measurements.We extracted all growth data of children aged 1 month–18 years from the electronic medical records of 42 primary care physicians, between 1 January 1990 and 8 February 2018, throughout the French metropolitan territory. We derived annual and biannual height velocity growth charts until age 15 years by using the Lambda‐Mu‐Sigma method. These new growth charts were compared to the 1979 French and 2009 World Health Organisation (WHO) ones.New height velocity growth charts were generated with 193 124 and 209 221 annual and biannual values from 80 204 and 87 260 children, respectively, and showed good internal fit. Median curves were close to the 1979 French or 2009 WHO ones, but SD curves displayed important differences. Similar results were found with the biannual height velocity growth charts.We produced new height velocity growth charts until age 15 years by using a big‐data approach applied to measurements routinely collected in clinical practice. These updated growth charts could help optimise growth‐monitoring performance. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Gestational age significantly influences children's growth and development. Yet, the effect of postterm birth (gestation beyond 42 weeks) on children's growth outcomes remains underexplored.This study aimed to assess the impact of postterm birth on adverse growth outcomes in children using a nationally representative sample from China.A retrospective cohort study was conducted in China from 1 April 2018, to 31 December 2019. The final analysis included 141,002 children aged 3–6 years from 551 cities. Postterm birth was defined as children with postterm birth at a gestational age of 42 weeks or more. Obesity, overweight and thinness were assessed using body mass index‐for‐age (BMI‐for‐age) z‐scores, based on the World Health Organization (WHO) Child Growth Standards. Generalised additive models were employed to investigate the non‐linear relationship between maternal gestational age and BMI‐for‐age z scores. Poisson regression models and subgroup analyses with forest plots were performed to examine the associations between postterm birth and the risks of obesity, overweight and thinness in children.We included 141,002 mother–child pairs, of whom 7314 (5.2%) children were classified as postterm births. There exists a non‐linear relationship between gestational age and BMI‐for‐age z scores. Children born postterm exhibited a 46% increased risk of obesity, a 27% increased risk of combined overweight/obesity and a 13% increased risk of thinness. Similar associations were observed in most cases when further sensitivity and subgroup analysis were conducted.Postterm birth was associated with elevated risks of obesity, overweight and thinness in children aged 3–6 years, independent of sex. These findings underscore the importance of further research across diverse populations to understand the implications of postterm births on child health outcomes. [ABSTRACT FROM AUTHOR]

Background: Deviations between the determination of bone age (BA) according to Greulich and Pyle (G&P) and chronological age (CA) are common in Caucasians. Assessing these discrepancies in a population over time requires analysis of large samples and low intra-observer variability in BA estimation, both can be achieved with artificial intelligence-based software. The latest software-based reference curve contrasting the BA determined by G&P to the CA of Central European children dates back over two decades. Objective: To examine whether the reference curve from a historical cohort from the Netherlands (Rotterdam cohort) between BA determined by G&P and CA still applies to a current Central European cohort and derive a current reference curve. Materials and methods: This retrospective single-center study included 1,653 children and adolescents (aged 3–17 years) who had received a radiograph of the hand following trauma. The G&P BA estimated using artificial intelligence-based software was contrasted with the CA, and the deviations were compared with the Rotterdam cohort. Results: Among the participants, the mean absolute error between BA and CA was 0.92 years for girls and 0.97 years for boys. For the ages of 8 years (boys) and 11 years (girls) and upward, the mean deviation was significantly greater in the current cohort than in the Rotterdam cohort. The reference curves of both cohorts also differed significantly from each other (P < 0.001 for both boys and girls). Conclusion: The BA of the current Central European population and that of the curve from the Rotterdam cohort from over two decades ago differ. Whether this effect can be attributed to accelerated bone maturation needs further evaluation. [ABSTRACT FROM AUTHOR]

AbstractHuman capital deficits in early childhood in terms of health and cognitive developmental issues are conceptualized as a lurking threat to China’s future economic growth by a growing body of scholarly literature; however, it is unknown whether these deficits persist into adolescence. This study draws upon longitudinal, nationally-representative data from the China Family Panel Studies 2010–2020 to investigate the possibility of recovering from early growth retardation and the potential implications for recovery of related cognitive outcomes. In particular, the paper considers whether there is evidence of cognitive catch-up from early cognitive delays. Based on group-based trajectory models with inverse probability of treatment weighting, this study finds that mid-childhood catch-up growth may mitigate the negative effects of early childhood stunting on early adolescent academic performance. Moreover, children who recover from stunting demonstrate cognitive catch-up in Chinese but not in math. This evidence not only reaffirms the significance of early childhood development but also suggests an opportunity for interventions to avert undernutrition and cognitive deficits after early childhood. [ABSTRACT FROM AUTHOR]

Introduction: Early focal brain injuries lead to long-term disabilities with frequent cognitive impairments, suggesting global dysfunction beyond the lesion. While plasticity of the immature brain promotes better learning, outcome variability across individuals is multifactorial. Males are more vulnerable to early injuries and neurodevelopmental disorders than females, but long-term sex differences in brain growth after an early focal lesion have not been described yet. With this MRI longitudinal morphometry study of brain development after a Neonatal Arterial Ischemic Stroke (NAIS), we searched for differences between males and females in the trajectories of ipsi- and contralesional gray matter growth in childhood and adolescence, while accounting for lesion characteristics. Methods: We relied on a longitudinal cohort (AVCnn) of patients with unilateral NAIS who underwent clinical and MRI assessments at ages 7 and 16 were compared to age-matched controls. Non-lesioned volumes of gray matter (hemispheres, lobes, regions, deep structures, cerebellum) were extracted from segmented T1 MRI images at 7 (Patients: 23 M, 16 F; Controls: 17 M, 18 F) and 16 (Patients: 18 M, 11 F; Controls: 16 M, 15 F). These volumes were analyzed using a Linear Mixed Model accounting for age, sex, and lesion characteristics. Results: Whole hemisphere volumes were reduced at both ages in patients compared to controls (gray matter volume: -16% in males, -10% in females). In ipsilesional hemisphere, cortical gray matter and thalamic volume losses (average -13%) mostly depended on lesion severity, suggesting diaschisis, with minimal effect of patient sex. In the contralesional hemisphere however, we consistently found sex differences in gray matter volumes, as only male volumes were smaller than inmale controls (average-7.5%), mostly in territoriesmirroring the contralateral lesion. Females did not significantly deviate from the typical trajectories of female controls. Similar sex differences were found in both cerebellar hemispheres. Discussion: These results suggest sex-dependent growth trajectories after an early brain lesion with a contralesional growth deficit in males only. The similarity of patterns at ages 7 and 16 suggests that puberty has little effect on these trajectories, and that most of the deviation in males occurs in early childhood, in line with the well-described perinatal vulnerability of themale brain, and with no compensation thereafter. [ABSTRACT FROM AUTHOR]

The golden age of toddlerhood is a crucial time for growth and development that requires special attention. Failure to support children during this time can cause developmental issues that affect their future growth. This study examined whether toddler growth and development interventions prevent developmental disorders. This pre-experimental study used a one-group pre-test/post-test design. The proportional random sample included 70 participants. The respondents' age, occupation, education, use of toddler growth and development stimulation interventions, and health cadres' and mothers' knowledge and skills were variables. Data were analyzed using Wilcoxon and Mann-Whitney. There was a significant increase in health cadres and mothers' knowledge and skills for promoting toddler growth and preventing developmental disorders (P=0.000<0.05). Effective toddler growth and development interventions improve health cadres and mothers' knowledge and skills, preventing developmental disorders in toddlers. These findings suggest that targeted educational programs for health cadres and mothers may reduce developmental disorders and promote healthier growth trajectories for children. [ABSTRACT FROM AUTHOR]

Growth hormone deficiency (GHD) is the most frequent pituitary hormone deficiency in childhood, with an incidence of 1 in 4000–10,000 live births. GHD can be congenital (genetic or due to hypothalamic/pituitary abnormalities) or acquired and can be isolated (IGHD) or associated with other pituitary hormone deficiencies, but most cases are idiopathic. GH stimulation testing is commonly used in the diagnostic workup of GHD, except for some clinical conditions that do not require GH stimulation tests for the diagnosis. Children with GHD receive replacement therapy with daily injections of recombinant human GH (rhGH). RhGH therapy is effective in increasing short-term height gain and adult height in patients with GHD. The safety of long term GH therapy has been confirmed in many large international studies. Recently, long-acting weekly GH formulations have been introduced, showing good efficacy and safety profiles. [ABSTRACT FROM AUTHOR]

We report growth hormone (GH) deficiency due to presumed GH releasing hormone (GHRH) resistance in an adolescent with pseudohypoparathyroidism type 1B (PHP1B) due to paternal uniparental disomy of chromosome 20 (patUPD20). A male patient aged 11 years 10 months with obesity and mild developmental delay was found to have hypocalcemia, hyperphosphatemia, and an elevated parathyroid hormone level. History included muscle cramps and leg pain with activity. Examination showed round facies, short stature, and obesity. He was in puberty and bone age was advanced by > 2 years. Detailed genetic workup, including nucleotide sequence analysis of GNAS exons 1-13 and STX16 , methylation-sensitive multiplex ligation-dependent probe amplification and analysis of several microsatellite markers for chromosome 20, established the diagnosis of PHP1B due to patUPD20. Muscle cramps and hypocalcemia resolved with calcium carbonate, ergocalciferol, and calcitriol treatment. He was short with linear growth deceleration at around age 13 years. Peak GH concentration was insufficient following stimulation testing. Growth velocity improved with human GH treatment. Although rare, resistance to GHRH can occur in PHP1B and patients with this disorder should be evaluated for GH insufficiency if they present with short stature and reduced growth velocity. Treatment with recombinant human GH may improve growth velocity in such patients. [ABSTRACT FROM AUTHOR]

Congenital hypothyroidism (CH) is detected through a newborn screening program in Iran, enabling early detection and prompt treatment. This study addresses the longitudinal growth trajectory of Iranian children with CH and explores associated factors during the first 3 years of life. Data from 1474 children with CH in Isfahan, Iran (2002–2022), were analyzed. Weight, height, and head circumference were measured, and z-scores for age were calculated. Group-based trajectory modeling was applied to distinct growth trajectories. Factors influencing growth patterns, including gender, treatment initiation age, delivery method, parental consanguinity, history of familial hypothyroidism, and thyroid-stimulating hormone (TSH) levels at 3–7 days, were investigated. Thirty-seven percent of children diagnosed with CH faced a delay in weight, while 36.6% experienced stunted height, and 25.7% showed a retardation in head circumference growth. The initiation of treatment, parental consanguinity, and family history of hypothyroidism varied among these groups. Children exhibiting an optimal growth pattern in the initial 3 years of life demonstrated lower average TSH levels. Conclusion: This research emphasizes the complexity of managing CH and stresses the importance of tailoring interventions based on individualized characteristics and the ongoing growth patterns of the children. Future research is required to understand the intricate relationships between growth patterns and various determinants and optimize the growth and developmental outcomes of children with CH. What is Known: • Iran has a higher prevalence of congenital hypothyroidism (CH) with a nationwide screening program. • There are concerns about delayed growth in CH children, but limited research on long-term patterns and contributing factors. What is New: • Distinct patterns in weight, height, and head circumference among children with CH were identified. • Factors such as consanguinity, parental hypothyroidism, and TSH levels impact growth outcomes. • CH management is complicated, and there is a need for individualized interventions. [ABSTRACT FROM AUTHOR]

Background: Children are an important asset for a nation, so the education and care provided must be able to improve the quality of children in the future. Child Protection Law no. 23 of 2002 explains that every child has the right to receive growth and development monitoring without exception. Early detection of deviations in growth and development needs to be done, one of which is by using digital-based growth and development e-Reports. Objective: The e-report product produced can increase efficiency and effectiveness, helping teachers, homeroom teachers, cadres or health workers in managing the SDIDTK program so that valid, practical and effective digital-based e-Report applications can be obtained. Research methods: The research design for the development of digital-based growth and development e-reports was carried out referring to the development of the 4D model which includes define, design, develop and disseminate. Results: There is an influence of perceived usefulness on interest in using the child health e- report application Conclusion: e-Report can be used to check children's health and growth and development at the PAUD unit level to increase the scope of monitoring children's health and SDIDTK [ABSTRACT FROM AUTHOR]

Introduction: In childhood, growth hormone (GH) deficiency (GHD) diagnosis is based on auxological assessment and biochemical provocative tests, whose reliability remains disputed. Recently, several papers have been published on standardising the duration of some tests. The aim of our study was to analyse the possible length reduction of the L‐DOPA provocative test. Methods: We retrospectively investigated the response of GH to L‐DOPA in 256 children, analysing 267 tests (some patients were retested over time for the persistence of severe auxopathy). We studied the same data considering GH peak threshold both at 8 ng/mL (Italian GHD cut‐off) and at 10 ng/mL (international cut‐off). Based on stimulation tests, patients were divided into two groups: GHD and no‐GHD short children. We described the results in the whole population and then clustering for gender and pubertal stage. We termed as index the test stopped at 90 min. Results: The GH peak after L‐DOPA mostly occurred at 60 min. The sensitivity of the index test was the highest, while the specificity was slightly higher using the 8 ng/mL threshold (specificity = 0.68; 95% CI 0.60–0.76) then using the 10 ng/mL threshold (specificity = 0.56; 95% CI 0.47–0.65) at 90 min. The two ROC curves showed moderate performance of the test at 90 min. While the negative predictive value was 100% in both tests, the positive predictive value was slightly better with 10 ng/mL cut‐off. Considering the two groups established by GHD definition and placing a GH threshold at 10 ng/mL, stopping L‐DOPA test time at 90 min would have changed the test result and subsequentially patient's classification in 3/267 of the analysed tests (1.1%), while with the Italian GH threshold value at 8 ng/mL in 7/267 of the tests (2.6%). Conclusions: Our research shows that omitting 120‐min time reduces L‐DOPA test specificity, especially with GHD cut‐off at 10 ng/mL. [ABSTRACT FROM AUTHOR]

Background: One of the problems currently faced by Indonesia is nutritional problems in the form of stunting. Stunting is a disruption in the growth and development of children due to chronic malnutrition and recurrent infections, characterized by their length or height being below the standard. Methods: This descriptive research aimed to describe the condition of stunting in Tegal City and the efforts of the Tegal City government in contributing to the reduction of the stunting rate. Results: This activity has shown good results, this can be seen from the reduction in the stunting rate in Tegal City from 9.94% in 2022 to 8.21% in 2023. The program to reduce stunting rates in Tegal City was established through the formation of the stunting reduction acceleration team (SRAT). Some of the activities carried out by SRAT include sensitive services linked to poverty management program activities, such as providing integrated healthy livable houses, interventions in the use of yard land, expanding family planning acceptors, refining social assistance recipients, and providing access to drinking water and sanitation management. Specific services are carried out by strengthening specific interventions on a provincial scale, enhancing communication and behavior change by strengthening communication and behavior change and planning and monitoring the evaluation of regional apparatus organizations’ program integration. Collaboration with potential partners is also key in accelerating stunting reduction, along with ongoing monitoring and evaluation of performance. This activity has shown positive outcomes, as evidenced by the reduction in the stunting rate in Tegal City from 9.94% in 2022 to 8.21% in 2023. Conclusion: The prevalence of stunted children in Tegal City has decreased. Effective leadership, a strong civil society, and targeting vulnerable communities during the implementation of specific and sensitive nutrition interventions are the main factors that support the achievement of these targets. [ABSTRACT FROM AUTHOR]

Treatment of severe acute malnutrition aims at producing quick catch‐up growth in children to decrease their short‐term mortality risk. The extent to which catch‐up growth is influenced by the amount of energy provided is unclear. This study assessed whether energy provided at admission is associated with catch‐up ponderal growth among children with mid‐upper arm circumference (MUAC) < 115 mm at admission. We conducted a secondary data analysis an operational cohort in Mali. The children were treated with a simplified protocol providing 1000 kcal/day of therapeutic food until MUAC ≥ 115 mm was achieved for two consecutive weeks and 500 kcal/day thereafter until discharge with MUAC ≥ 125 mm for two consecutive weeks. Linear mixed‐effects regression models were fitted to assess the relationship between energy provided at admission (kcal/kg/day) with weight gain velocity (g/kg/day) (primary outcome), change in MUAC ‐for‐age z‐score and change in weight‐for‐age z‐score. Unadjusted models and models adjusted for sex, age, seasonality and MUAC at admission were fitted. Both models included the study site as a random effect. A 10 kcal/kg/day increase in energy provided at admission was associated with increments in all outcomes; for weight gain velocity, the mean (95% CI) increment was 0.340 [0.326, 0.354] g/kg/day and 0.466 [0.446, 0.485] g/kg/day in the unadjusted and adjusted analysis, respectively. A positive relationship exists between energy provided at admission and catch‐up ponderal growth in children with MUAC < 115 mm treated using a simplified protocol. Determining the ideal weight gain rate remains essential for assessing the benefits and risks of increased energy intake during treatment. [ABSTRACT FROM AUTHOR]

Context Several endocrine abnormalities were reported in children with Prader–Willi syndrome (PWS), including hypothyroidism. Growth hormone (GH) treatment may impact the thyroid hormone axis by direct inhibition of T4 or TSH secretion or by increased peripheral conversion of free T4 (FT4) to T3. Objective The objective of this study is to evaluate thyroid function during GH treatment in a large group of children with PWS. Methods Serum FT4, T3, and TSH are measured in a 2-year randomized controlled GH trial (RCT) and 10-year longitudinal GH study (GH treatment with 1.0 mg/m²/day [∼0.035 mg/kg/day]). Results Forty-nine children with PWS were included in the 2-year RCT (median [interquartile range, IQR] age: GH group 7.44 [5.47-11.80] years, control group 6.04 [4.56-7.39] years). During the first 6 months, median (IQR) FT4 standard deviation score (SDS) decreased in the GH group from −0.84 (−1.07 to −0.62) to −1.32 (−1.57 to −1.08) (P <.001) and T3 SDS increased from 0.31 (−0.01-0.63) to 0.56 (0.32-0.79) (P =.08), while in the control group, FT4 and T3 SDS remained unchanged. In our 10-year GH study, 240 children with PWS (median [IQR] age: 1.27 (0.54-4.17) years] were included. Between 2 and 10 years, median (IQR) FT4 SDS remained unchanged, being −0.87 (−0.98 to −0.77) after 2 years and −0.88 (−1.03 to −0.74) after 10 years (P =.13). TSH SDS decreased from −0.35 (−0.50 to −0.21) after 2 years to −0.68 (−0.84 to −0.53) after 10 years (P <.001). Conclusions Our findings suggest that GH treatment decreases FT4 levels, due to increased peripheral conversion of FT4 to T3 in the first months of treatment, but thereafter, FT4 and T3 normalize and remain stable during long-term GH treatment in almost all children and adolescents with PWS. [ABSTRACT FROM AUTHOR]

Context Few reliable markers are available to distinguish transient congenital hypothyroidism (TCH) and permanent congenital hypothyroidism (PCH). Additionally, the differences in growth between TCH and PCH remain unclear. Objective To investigate the growth of children with TCH and PCH and develop a nomogram for early differentiation of these forms. Methods This retrospective study included children with TCH or PCH. The predictive efficacy of the prognostic predictors was analyzed using receiver operating characteristic analysis. Multivariate prediction models were developed. Measurements of growth were compared between groups. Results Patients with TCH had lower initial thyroid-stimulating hormone (TSH) than those with PCH at newborn screening (NBS). The supplementary dose of levothyroxine (L-T4) gradually decreased with age in TCH but not in PCH. The area under the curve (AUC) values of the initial TSH, L-T4 dose at 1 year of age, and L-T4 dose at 2 years of age for distinguishing TCH from PCH were 0.698, 0.71, and 0.879, respectively. The predictive efficacy of the multivariate models at 1 and 2 years of age improved, with AUC values of 0.752 and 0.922, respectively. A nomogram was built based on the multivariate model at 1 year of age. The growth did not differ between children with TCH and those with PCH. However, at 1 year of age, girls with CH exhibited higher z-scores in terms of height and weight than boys with CH. Conclusion TSH at NBS and L-T4 doses during treatment can be used to distinguish between PCH and TCH early in life, and the predictive efficacy can be improved using multivariable models with a visualized nomogram. At 3 years of age, patients with TCH and PCH showed similar growth. [ABSTRACT FROM AUTHOR]

Short stature affects approximately 2.5% of children. Some of them, when diagnosed with growth hormone deficiency (GHD), benefit from recombinant human growth hormone (rhGH) therapy; in others, this treatment is controversial. We aimed to present the clinical characteristics of Polish short stature children in the context of current GHD diagnostic standards, as obtaining more data gives a broader foundation for the potential modifications of diagnostic and therapeutic recommendations. This retrospective analysis was based on a cohort of 277 short stature children divided into two subgroups depending on their peak growth hormone (GH) cutoff level, set at 10 ng/mL: 138 had growth hormone deficiency (GHD) and 137 had normal growth hormone secretion (GHN). These subgroups were then compared based on the extracted clinical data. In the obtained result, no significant differences between the GHD and GHN subgroups were found in any of the variables, including the following: gender distribution, birth weight, bone age delay, height SDS, IGF-1 SDS, vitamin D levels, celiac disease indices, prevalence of hypothyroidism or anemia. As our results point to major clinical similarities between the GHD and GHN children, it seems that distinguishing patients with normal GH secretion from those with deficient GH secretion based on a 10 ng/mL cutoff value might not be clinically relevant. [ABSTRACT FROM AUTHOR]

Alpine skiing performance depends on several qualities, including lower limb strength, power production and flexibility. However, how these physical skills, as well as their relationship, differ between sexes and evolve in growing skiing athletes is still unclear. We analysed sit-and-reach (SR) and three jump test (height and peak power) scores of over 200 alpine ski racers collected across 15 sports seasons. We stratified data among sex and age categories to assess differences and to interpret the relationships between flexibility and jump performance. The mixed models showed a significant age category and sex effect (p < 0.001) for all the flexibility and jump performance scores, with males having higher jump scores but lower SR scores than females, and all performance scores increasing significantly through the age categories. The regressions between SR and the jump scores performed on the whole database were positively significant for the three jump variations (p < 0.001, R 2 ranging from 8.9% to 15.9%), while when the relationship was reanalysed independently in each age–sex group, only some were significant. Both age and sex influenced the performance in the investigated lower limb power and flexibility qualities, along with their relationship. The presented results suggest that lower limb power and flexibility should be longitudinally assessed, as well as their relationship, for training and testing purposes, considering the sex and growth-related modifications. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica 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.)

The purpose of this phenomenological study is to discover the lived experiences of the special education teachers and parents in terms of providing psychosocial support to children with learning disabilities. Five (5) parents of children with learning disabilities (LD) and Five (5) special education teachers were chosen to be interviewed individually. Moreover, this study utilized a qualitative methodology to be able to gather in-depth data into and understanding the phenomenon. The result of this study has shown that majority of the parents of children with learning disabilities and special education teachers collaborate effectively through interaction and exchanging of feedbacks to maintain their engagement with one another and to consistently guide the child towards growth and development. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effect of feeding patterns during the first 6 months on weight development of infants ages 0–12 months. Using monitoring data from the Maternal and Child Health Project conducted by the National Center for Women and Children's Health of the Chinese Center for Disease Control and Prevention from September 2015 to June 2019, we categorized feeding patterns during the first 6 months as exclusive breastfeeding, formula feeding, or mixed feeding. We calculated weight-for-age Z scores (WAZ) according to the World Health Organization's (WHO) 2006 Child Growth Standard using WHO Anthro version 3.2.2. A multilevel model was used to analyze the effect of feeding patterns during the first 6 months on the WAZ of infants ages 0–12 months in monitoring regions. Length of follow-up (age of infants) was assigned to level 1, and infants was assigned to level 2. Characteristics of infants, mothers, and families and region of the country were adjusted for in the model. The average weight of infants ages 0–12 months in our study (except the birth weights of boys who were formula fed or mixed fed) was greater than the WHO growth standard. After we adjusted for confounding factors, the multilevel model showed that the WAZ of exclusively breastfed and mixed-fed infants were statistically significantly higher than those of formula-fed infants (coefficients = 0.329 and 0.159, respectively; P < 0.05), and there was a negative interaction between feeding patterns and age (both coefficients = − 0.020; P < 0.05). Infants who were exclusively breastfed were heavier than formula-fed infants from birth until 12 months of age. Mixed-fed infants were heavier than formula-fed infants before 8 months, after which the latter overtook the former. Infants' weight development may be influenced by feeding patterns during the first 6 months. Exclusive breastfeeding during the first 6 months may be beneficial for weight development of infants in infancy. [ABSTRACT FROM AUTHOR]

This study aimed to determine the relationships between prenatal PM2.5 exposure and childhood growth trajectories during the first 6 years of life. A total of 47,625 pairs of mothers and children were recruited from a prospective birth cohort conducted between 2011 and 2013 in Wuhan, China, and followed for 6 years. We used the group-based trajectory models to classify the population into three trajectory groups: slow growth (n = 13,671, 28.7%), normal growth (n = 29,736, 62.4%), and rapid growth (n = 4218, 8.9%). Multinomial logistic regression models were used to determine the associations of prenatal PM2.5 exposure and childhood growth trajectories. Compared to normal growth trajectory, increased PM2.5 exposure in trimester 1, trimester 2 and the entire pregnancy showed significant associations with an increased risk of the slow growth trajectory but reduced the risk for the rapid growth trajectory, significant association of prenatal PM2.5 exposure with rapid growth trajectory was only observed in the trimester 3. Stratified analyses displayed relatively stronger associations among those mothers with maternal age over 35 years, pre-pregnancy BMI ≥ 25 kg/m2, and previous delivery experience. Prenatal exposure to PM2.5, particularly during the midpoint period of pregnancy, was more likely to have a slow growth trajectory and a lower risk of rapid growth trajectory. Maternal age, pre-pregnancy BMI, and previous delivery experience might modify these associations. [ABSTRACT FROM AUTHOR]

The study evaluated the efficacy of a three-month supplemental feeding intervention in encouraging weight gain among toddlers. Through linear regression analysis, this study aimed to elucidate the relationship between baseline measurements and monthly changes in toddler weight. Secondary data were collected and processed from 180 toddlers who underwent the intervention, covering baseline weight along with monthly measurements. These findings reveal a progressive month to month increase in body weight, as seen from the significant positive coefficients at eachmonth (β1 = 0.003, β2 = 0.204, β3 = 0.674), suggesting that the intervention had a positive and cumulative impact on children’s growth over a three-month period. These results underscore the importance of ongoing support and supplementation to achieve optimal growth outcomes. By measuring the impact of interventions on growth parameters, the study contributes valuable insights to the field, informing future strategies to address malnutrition and promote growth in vulnerable populations. [ABSTRACT FROM AUTHOR]

Background: Improving the minimum acceptable diet (MAD) is essential for ensuring optimal growth and development of children, as well as preventing malnutrition and its consequences. Previous studies in Ethiopia have focused on the magnitude and determinants of a minimum acceptable diet. However, much emphasis was not given to minimum acceptable diet and its associated factors among 6–23 months old children enrolled in Outpatient therapeutic programs (OTP), particularly, in the study area. This study determines the minimum acceptable diet and associated factors among 6–23-month-old children enrolled in OTP. Methods: A community-based cross-sectional study was conducted among 346 randomly selected mothers with children aged 6–23 months who were admitted to the OTP. The data were collected using interviewer-administered structured questionnaires. The data were entered, cleaned, coded into Epidata version 4.6, and exported to SPSS version 26 for further analysis. Multivariate logistic regression was used to assess the determinants of MAD. Results: The overall prevalence of minimum Acceptable diet among children aged 6–23 months enrolled to OTP was 14.5% (95% CI: 12.02-19%). The odds of MAD were 1.9 times higher among children aged 18–23 months compared to children aged 6–11 months (AOR = 1.9, 95% CI ((1.2 3.9). The odds of MAD were 2.9times higher in children whose mothers had a good knowledge on recommended feeding (AOR = 2.9, 95% CI (1.2, 6.35). Mothers who had no formal education were 81% less likely to provide minimum acceptable diets for their children compared to their counterpart.(AOR = 1.94, 95% CI = 1.24, 4.19). Conclusion: The practice of a minimum acceptable diet is inadequate. Nutrition education should be emphasized to improve the mothers' nutrition knowledge regarding infant and young child feeding recommendations, to support mothers in overcoming barriers to feeding their children with adequate diets, and to foster complementary feeding practices for malnourished children. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) and other health authorities recommend breastfeeding for at least 2 years, a practice also supported by Quranic teachings. Despite this, many mothers discontinue breastfeeding earlier than advised. The factors enabling some mothers to continue breastfeeding for 2 years or more are not well understood. Objective: This study aimed to identify factors and outcomes associated with breastfeeding for 2 years or more by evaluating mothers' knowledge, attitudes, and practices (KAP) regarding breastfeeding and weaning, and their impact on children's growth and development. Subjects and Methods: A retrospective comparative KAP study was conducted with mothers of children aged 3-5 years. The study included 353 mothers who breastfed for 18 months or less (Group I: CBF18-) and 150 mothers who breastfed for 24 months or more (Group II: CBF24+). Children's growth was assessed using WHO growth charts, and developmental disorders were evaluated. Results: Mothers in Group II (CBF24+) had significantly higher knowledge, attitudes, and practices scores related to breastfeeding benefits, early exclusive breastfeeding (EBF) for 6 months, and gradual weaning (P<0.05). Their children were less likely to be wasted (P<0.05) and experienced fewer episodes of illness (P<0.05). Developmental disorders like temper tantrums, night terrors, and others were linked to sudden, rather than gradual, weaning (P<0.05), but not to the duration of breastfeeding. Conclusion: Mothers' KAP significantly influences the ability to achieve CBF24+. Developmental disorders may arise from attachment issues due to sudden weaning. Early, intense EBF is predictive of longer breastfeeding and better emotional stability in children. [ABSTRACT FROM AUTHOR]

Existing research on human growth in Mexico is regionally focused, creating a gap in the understanding of growth patterns of children and adolescents at national level and regional variation. The objective of the present study was to characterize the height growth curve of the Mexican population by geographic area and to cluster the states of the Mexican Republic according to their somatic maturation characteristics, based on a national representative sample of boys. Data on age, height, socioeconomic level, and geographic area of 18,219 boys were obtained from the National Health and Nutrition Survey 2012 (ENSANUT) and ENSANUT 2018, carried out in 32 Mexican states. Both surveys had representative samples. Preece–Baines 1 model was applied to fit height growth curves. Biological parameters were estimated; principal component analysis and cluster analysis were performed to group Mexican states based on these biological parameters. The estimated age at peak height velocity (PHV) was 12.3 years in the sample. Significant regional differences in the timing and tempo of PHV among Mexican boys were observed. Boys in the northern region experienced PHV at an earlier age and had a shorter duration of growth compared with boys in the central and southern regions. Boys in the central region had a longer duration of growth and a later age of PHV compared with the boys in the southern region. The cluster that included the southern states of the country showed estimated lower adult height and earlier somatic maturation. A lower height was found in the low and low-middle socioeconomic levels compared with the medium-high and high socioeconomic levels. Future research in Mexico should focus on longitudinal studies to analyse the timing and tempo of growth and maturation, considering the impacts of environmental and genetic factors. Public health strategies should account for geographic variations. [ABSTRACT FROM AUTHOR]

Objectives: The REACT project was designed around two main aims: (1) to assess children's growth and motor development after the COVID‐19 pandemic and (2) to follow their fundamental movement skills' developmental trajectories over 18 months using a novel technological device (Meu Educativo®) in their physical education classes. In this article, our goal is to describe statistical analysis of the longitudinal ordinal motor development data that was obtained from these children using the multilevel ordinal logistic model. Methods: Longitudinal ordinal data are often collected in studies on motor development. For example, children or adolescents might be rated as having poor, good, or excellent performance levels in fundamental movement skills, and such ratings may be obtained yearly over time to assess changes in fundamental movement skills levels of performance. However, such longitudinal ordinal data are often analyzed using either methods for continuous outcomes, or by dichotomizing the ordinal outcome and using methods for binary data. These approaches are not optimal, and so we describe in detail the use of the multilevel ordinal logistic model for analysis of such data from the REACT project. Our intent is to provide an accessible description and application of this model for analysis of ordinal motor development data. Discussion: Our analyses show both the between‐subjects and within‐subjects effects of age on motor development outcomes across three timepoints. The between‐subjects effect of age indicate that children that are older have higher motor development ratings, relative to thoese that are younger, whereas the within‐subject effect of age indicates higher motor development ratings as a child ages. It is the latter effect that is particularly of interest in longitudinal studies of motor development, and an important advantage of using the multilevel ordinal logistic model relative to more traditional methods. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to monitor the cranial parameters of patients with sagittal craniosynostosis. We will mainly focus on the differences between endoscopic and open-surgical treatment and their influence on changes in cranial parameters in patients with craniosynostosis of the sagittal suture. Craniosynostosis has various consequences, including reduced self-confidence and problems fitting in among other children due to craniofacial deformity. Therefore, monitoring aesthetic results of craniosynostosis treatment in pediatric patients is important. Patients and Methods: The sample of patients included in this study comes from patients monitored by the neurosurgeon at the Department of Paediatric Neurosurgery of the National Institute of Child Diseases in Bratislava, Slovakia. Standardized anthropometric methods and tools to monitor cranial dimensions were used. Results: In our study, we noted no differences in aesthetic results between open and endoscopic surgical treatment. However, surgical treatment, regardless of the type of chosen treatment, produced the desired aesthetic results, and these results improved over time. Conclusion: The benefit of the work will be the longitudinal monitoring of the growth of children's cranium, and the evaluation of the effectiveness of surgical treatment in patients with neurocranial growth disorders and the prevention of late consequences of growth disorders. [ABSTRACT FROM AUTHOR]

Nutrition plays a crucial role in the growth of healthy children, and its role is particularly critical in pediatric patients to help increase response to treatment, reduce morbidity and mortality, improve quality of life, and reduce treatment costs. Anthropometric indexes are an integral part of screening and assessment of the nutritional status. The present study aimed to examine the correlation between the mid-upper arm circumference (MUAC) z-score with anthropometric indexes, such as weight and height, in the assessment of the nutritional status of pediatric inpatients. The present cross-sectional study was conducted on 500 pediatrics from 2 to 60 months of age. The nutritional status of all the pediatric patients was assessed using the following metrics: Weight for age, height for age, weight for height, MUAC for age. The nutritional status was then classified based on the z-score according to the WHO 2006 guidelines as follows: Weight/age: underweight (20.8%), overweight and obese (1.8%); weight/height: Wasting (14%), overweight and obese (5.4%); height/age: Stunting (24%), of which severe (10.2%); MUAC z-score: Malnutrition (27.2%), of which severe malnutrition (14.4%), and overweight (1%). The MUAC z-score was strongly associated with weight/height z-score (r=0.608; P<0.001). Thus, the present study demonstrates that it is necessary to use a combination of all three anthropometric indexes, namely weight, height and MUAC to detect early clinical malnutrition, particularly in patients whose weight is affected by fluid status; MUAC is an integral tool for assessing the nutritional status. [ABSTRACT FROM AUTHOR]

Aim: How maternal opioid maintenance treatment (OMT) affects children is under‐researched. This population‐based registry study investigated child growth and somatic health following intrauterine exposure to this treatment. Methods: Children born between 1 March 2011 and 30 May 2021 to mothers who used buprenorphine, buprenorphine‐naloxone, or methadone throughout their pregnancies were followed for 2 years at the Helsinki University Hospital, Finland. Appropriate statistical tests were used to compare the treatment groups. Results: Of the 67 neonates, 52% were male, 96% were born full‐term and 63% were treated for neonatal opioid withdrawal syndrome. Otherwise, the children were predominantly healthy, although relatively small: 22% were small for gestational age, the methadone group children being the smallest. Foetal exposure to maternal methadone treatment, illicit drugs, hepatitis C and smoking were associated with small for gestational age; the former two were also associated with later slower growth, especially head growth and weight gain (p < 0.001). However, 29% were overweight at 2 years. Conclusion: Using child growth as the outcome, we found that buprenorphine‐naloxone and buprenorphine‐monotherapy had equal effects as forms of maternal OMT. Exposure to multiple risk factors may harm foetal and subsequent growth. We recommend long‐term follow‐up of children exposed to maternal OMT. [ABSTRACT FROM AUTHOR]

While randomized, placebo‐controlled, double‐blinded clinical studies are the gold standard for evaluating the efficacy of investigational drugs, the use of placebo in children with achondroplasia should be limited because it provides no clinical benefit while exhausting study participants' treatment window. Recifercept is an investigational drug for treating children with achondroplasia aged 2–10 years. An alternative efficacy evaluation method, instead of a placebo control arm, was employed in the phase II study. Prior to participating in the phase II study, participants completed a natural history (NH) study. Based on the NH data, a multi‐variate linear mixed effects natural disease course model of three anthropometric end points (standing height, sitting height, and arm span) was developed. The model was validated using published growth charts of children with achondroplasia. Subsequently, the model was used to simulate the natural growth trajectories (without any treatment) of the three anthropometric end points for the individuals enrolled in the phase II study. To quantify the efficacy of recifercept, the simulations were compared with the observations post‐recifercept treatment in the phase II study. For all the tested doses of recifercept, at the individual level, the observations were comparable to the simulations at 6 and 12 months post‐recifercept treatment, suggesting no treatment effect. The results contributed to the decision of terminating recifercept clinical development. This work delivers a framework that could eliminate the need for placebo in clinical trials yet provide sufficient evidence for evaluating the efficacy of an investigational drug. [ABSTRACT FROM AUTHOR]

Context The assessment and treatment of children with growth retardation is increasingly complex, and due to availability of targeted genetic sequencing, an ever-expanding number of conditions impeding growth are being identified. Among endocrine-related etiologies of short stature amenable to hormonal treatment, defects in the growth hormone (GH)–insulin-like growth factor I axis remain pre-eminent, with a multiplicity of disorders causing decreased secretion or insensitivity to GH action. Sex steroids in puberty increase epiphyseal senescence and eventual growth plate closure. This is mediated mostly via estrogen receptor (ER)α in males and females, effects that can greatly limit time available for growth. Evidence Acquisition Extensive literature review through PubMed and other search engines. Evidence Synthesis Therapeutic strategies to be considered in peripubertal and pubertal children with disordered growth are here discussed, including daily and weekly GH, low-dose sex steroids, gonadotropin hormone releasing hormone (GnRH) analogues in combination with GH, aromatase inhibitors (AIs) alone and in combination with GH in boys. When used for at least 2 to 3 years, GnRH analogues combined with GH can result in meaningful increases in height. AIs used with GH permit puberty to progress in boys without hindrance, selectively decreasing estrogen, and resulting in taller height. With more than 20 years of cumulative experience in clinical use of these medications, we discuss the safety profile of these treatments. Conclusion The approach of growth retardation in the peripubertal and pubertal years must consider the sex steroid milieu and the tempo of bone acceleration. Treatment of affected children in this period must be individualized. [ABSTRACT FROM AUTHOR]

Background: Growth charts are an important method for evaluating a child's health, growth, and nutritional status. It is essential to monitor the growth of children and adolescents using growth charts. Objectives: To present body mass index (BMI)-for-age references reflecting children's growth in Shanxi. We also compare our new data with growth references of other cities of China and World Health Organization (WHO) growth standards. Methods: A stratified cluster random sampling method was used to recruit 5461 children and adolescents aged 6–17 years. Height and weight were measured and BMI was calculated. The LMS method was used to calculate the percentile values of body mass index by sex and age. Smoothed BMI-for-age growth curves were presented for both sexes and compared with reference data from other cities of China and WHO. Results: BMI centiles increased with age but with different patterns in both boys and girls. The centile curves from the 3rd to the 50th had a slight increase, while a sharp increase was seen from 11 to 17 years in boys and from 6 to 14 years in girls in the higher centiles. In comparison with other cities of China, the values for the 50th percentile are higher than those reported for children from China 2009, Shanghai, Changsha and China 2010 in both sexes. In comparison with WHO growth references, Chinese girls and boys had higher values in all percentiles, whereas curves of girls look roughly the same. The medians for BMI in Shanxi increase linearly from 6 to 17 years in boys. Conclusions: The BMI percentiles of children aged 6–17 years in Shanxi differed significantly from the growth reference curves of other cities of China and WHO. Recommending the provision of BMI reference curves for local children and adolescents to assess their growth and development and monitor their nutritional status. Early detection of overweight and obesity in children provides a scientific basis for the prevention and control of overweight and obesity in children. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion 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.)

Introduction: Childhood stunting remains a pervasive global health issue affecting millions of children, with significant repercussions on their physical and cognitive development. Objective: This study aimed to collect information on dietary guidelines and protein recommendation specifically designed for stunted children. Methods: A systematic review was performed using several databases, including Pubmed, Scopus, and Google Scholar. A literature search was conducted to collect studies on dietary guidelines (keywords: Dietary recommendation OR Dietary Guidelines AND Stunting OR Stunted OR Retarded Growth) and protein recommendation (keywords: protein AND catch-up growth AND stunting AND children OR infant) for stunted children. This review also included a narrative review for additional information. Results: A total of 12 and 9 related articles were included in this systematic review on dietary guidelines and protein intake, respectively. This systematic review shows that protein intake stands out as a critical determinant in stunting, with low intake associated with growth faltering. However, guidelines specifically tailored to manage stunting remain scarce. Current evidence suggests protein’s beneficial role in supporting linear growth, but excessive intake may contribute to obesity risk, highlighting the need for balanced recommendations. Conclusion: This review synthesizes existing knowledge on protein’s role in stunting management, emphasizing the importance of appropriate protein intake in promoting optimal growth while mitigating associated risks. [ABSTRACT FROM AUTHOR]

Copyright of Ciencia y Educación (2707-3378) is the property of Duanys Miguel Pena Lopez 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.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco 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.)

Using household-level panel data and a coarsened exact matching procedure, this paper investigates the relationship between frequent electricity outages and the anthropometric outcomes of children. Specifically, we study the differences in the anthropometric outcomes of children aged under 5 in the Kyrgyz Republic. We find that children living in households with frequent outages have z-scores of height-for-age (HAZ) that are 0.37 units lower compared to the children living in similar households but without frequent outages. We also document that HAZ values of girls are more sensitive toward frequent outages, which indicates a possible presence of gender bias among Kyrgyz households. [ABSTRACT FROM AUTHOR]

Background: Spiritual health is part of the general concept of child health. Considering the effects of spiritual health on the growth and development of children, it is necessary to understand the concept of spiritual health and its dimensions in children. Accordingly, this study explains the dimensions of children’s spiritual health. Methods: This qualitative study was conducted using conventional content analysis. The data was collected through semi-structured interviews with 17 children and 9 researchers and specialists in the field of children’s mental health. Interviews were conducted with an average duration of 30 min. Results: Dimensions of children’s spiritual health with two themes of balanced relationship in 4 categories of relationship with God, relationship with self, relationship with others, and relationship with the environment, and the theme of relationship transcendence in 2 categories of transcendent behaviors and love of God were explained. Conclusion: Regardless of other developmental principles that follow the rule of maturity, the balanced relationship of spiritual health and the relationship transcendence of spiritual health in children did not follow the rule of maturity, and due to the innateness of the themes of balanced relationship and relationship transcendence of spiritual health. These characteristics have existed in children since childhood, regardless of any religious-spiritual measures within the family, and their spiritual health potential has been realized from their potential state. [ABSTRACT FROM AUTHOR]

Bone age assessment is a common diagnostic method used for abnormal growth and development in children. Despite recent significant advancements in convolutional neural network (CNN)-based intelligent bone age assessment in children, there remains room for improvement in assessment accuracy. Studies have indicated that a dual-path network (DPN) can incorporate different features of a CNN and improve the potential of the model to extract critical features compared to a single structural CNN. Attention mechanisms can also contribute to the enhanced ability of the model to extract channel and spatial features. Therefore, we propose a dual attention dual-path network (DADPN) to improve the accuracy of pediatric bone age assessment. DPN serves as a backbone network in DADPN by incorporating residual and dense connections. DPN was modified using two different attention mechanisms while containing gender information to compensate for physiological differences in bone age between males and females. Experiments were performed using this method with the RSNA Pediatric Bone Age Challenge dataset and compared to nine representative bone age assessment methods. This method achieved an optimal assessment accuracy with a mean absolute error (MAE) of 4.76 months. The experimental results suggest that the DADPN can extract the effective features of pediatric hand bone X-ray images and improve bone age assessment accuracy more than other deep learning methods. [ABSTRACT FROM AUTHOR]

This study takes the parent-child game behavior of children aged 3~6 and their parents as the research object, and extracts and summarizes the user behavioral needs of parents and children when they use game-based furniture together by using the questionnaire research method, observation method, and interview method. Based on the KJ method, 16 behavioral demand indicators were compiled by five furniture design students to construct a user behavioral demand system. In addition, AHP and entropy weight method were used to solve the user behavioral demand weights from subjective and objective perspectives in this study. Twenty experts and designers in this research field scored the indicators two by two and solved the subjective weights of user behavioral requirements according to the AHP algorithm. A seven-level Likert scale was used to design the questionnaire and distribute it to the parents of children aged 3–6 to fill in, and the 121 valid questionnaires obtained were used as raw data for entropy weighting to obtain the objective weights of user behavioral needs representing the opinions of interactive game-based furniture users. Finally, with 0.4 as the proportion coefficient of subjective weights, the subjective and objective weights were weighted to get the comprehensive weight value of each demand. The results show that the eight items with higher weights for user behavioral needs include: firm and stable, safe in use, comfortable for both parents and children, holding behavior by human-machine dimensions, able to sit on the ground and play, able to play face-to-face, easy to find for picking up, and sufficient operating space. In general, parent-child interactive game furniture firstly needs to meet the user's needs for safety and comfort, and secondly needs to meet the user's needs for the state of the game posture and the furniture size to meet the needs of the fetching and storage posture and the game space. The fuzzy comprehensive evaluation model established based on these needs can take into account the opinions of design experts and users at the same time and put the needs of children and parents in an equally important position so that the design of children's play furniture can tend to meet the needs of parents and children when they use it together, and to promote parent-child interaction and the healthy growth of children. [ABSTRACT FROM AUTHOR]