Final Height Research Articles

Transient Isolated, Idiopathic Growth Hormone Deficiency-A Self-Limiting Pediatric Disease with Male Predominance or a Diagnosis Based on Uncertain Criteria? Lesson from 20 Years' Real-World Experience with Retesting at One Center.

In the majority of children with growth hormone (GH) deficiency (GHD), normal GH secretion may occur before the attainment of final height. The aim of the study was to assess the incidence of persistent and transient GHD and the effectiveness of recombined human GH (rhGH) therapy in children with isolated, idiopathic GHD with respect to the moment of therapy withdrawal and according to different diagnostic criteria of GHD. The analysis included 260 patients (173 boys, 87 girls) with isolated, idiopathic GHD who had completed rhGH therapy and who had been reassessed for GH and IGF-1 secretion. The incidence of transient GHD with respect to different pre- and post-treatment criteria was compared together with the assessment of GH therapy effectiveness. The incidence of transient GHD, even with respect to pediatric criteria, was very high. Normal GH secretion occurred before the attainment of near-final height. Application of more restricted criteria decreased the number of children diagnosed with GHD but not the incidence of transient GHD among them. Poor response to GH therapy was observed mainly in the patients with normal IGF-1 before treatment, suggesting that their diagnosis of GHD may have been a false positive. Further efforts should be made to avoid the overdiagnosis GHD and the overtreatment of patients.

Fabrication of 3D Polycaprolactone Macrostructures by 3D Electrospinning.

Building 3D electrospun macrostructures and monitoring the biological activities inside them are challenging. In this study, 3D fibrous polycaprolactone (PCL) macrostructures were successfully fabricated using in-house 3D electrospinning. The main factors supporting the 3D self-assembled nanofiber fabrication are the H3PO4 additives, flow rate, and initial distance. The effects of solution concentration, solvent, H3PO4 concentration, flow rate, initial distance, voltage, and nozzle speed on the 3D macrostructures were examined. The optimal conditions of 4 mL/h flow rate, 4 cm initial nozzle-collector distance, 14 kV voltage, and 1 mm/s nozzle speed provided a rapid buildup of cylinder macrostructures with 6 cm of diameter, reaching a final height of 16.18 ± 2.58 mm and a wall thickness of 3.98 ± 1.01 mm on one perimeter with uniform diameter across different sections (1.40 ± 1.10 μm average). Oxygen plasma treatment with 30-50 W for 5 min significantly improved the hydrophilicity of the PCL macrostructures, proving a suitable scaffold for in vitro cell cultures. Additionally, 3D images obtained by synchrotron radiation X-ray tomographic microscopy (SRXTM) presented cell penetration and cell growth within the scaffolds. This breakthrough in 3D electrospinning surpasses current scaffold fabrication limitations, opening new possibilities in various fields.

Surface diffusion effects on the system and the film properties of a Ziff–Gulari–Barshad type growth model

Surface diffusion stands as a fundamental process influencing the dynamics and thermodynamics of surface reactions, playing a pivotal role in the behavior of heterogeneous catalysis and thin film growth. To enhance our understanding, we extend the Ziff-Gulari-Barshad (ZGB) growth model by incorporating the diffusion of reactants involved in film formation. Initially, in the realm of heterogeneous catalysis, we compare our findings with an extended ZGB model that accounts for reactant diffusion. We analyze the shift in phase transition positions, induced by diffusion, in comparison to the original ZGB model. Subsequently, we integrate the film growth aspect. Across all examined cases, diffusion fails to adequately preserve the dynamic features of the extended ZGB model, resulting in poisonous states. Our conclusion underscores the dual impact of diffusion: firstly, it diminishes the film growth rate relative to the diffusionless scenario, and secondly, its effective influence on the final film height is evident only when considering hops in different layers. This assertion is validated through computations where diffusion with hops in different layers is either permitted or prohibited.

Link between obesity and growth in children and adolescents

Background: The increasing prevalence of childhood obesity is a global problem. Childhood obesity is associated with an increased risk of several metabolic complications such as insulin resistance, impaired glucose tolerance, and type 2 diabetes mellitus (T2DM). Moreover, childhood obesity plays a significant role in growth patterns.Current Concepts: Growth during childhood and adolescence is influenced by multiple factors, including genes, hormones, and environmental aspects. Excess adiposity can influence growth velocity and final adult height owing to changes in several hormonal parameters such as insulin, leptin, and ghrelin.Discussion and Conclusion: Obese children typically exhibit a tall stature during the prepubertal and pubertal periods, which resolves later in adolescence. In addition, increased obesity in children precedes advancements in skeletal maturation and leads to earlier onset of puberty. Although potential mechanisms have been hypothesized, those underlying the putative association between childhood obesity and growth remain unclear. Further studies are required to gain insight into the mechanisms underlying the growth patterns in children and adolescents with obesity.

Radiographic Study of Transcrestal Sinus Floor Elevation Using Osseodensification Technique with Graft Material: A Pilot Study.

This pilot study aimed to evaluate the level of implant success after transcrestal sinus floor elevation (tSFE) using the osseodensification technique (OD) combined with beta-tricalcium phosphate (β-TCP) by analyzing clinical and radiographic results. Moreover, the increase in bone height was analyzed immediately after surgery, 3 months after, and before loading by taking standardized radiographic measurements. Thirteen patients, four males and nine females, with a mean age of 54.69 ± 5.86 years, requiring the placement of one implant in the upper posterior maxilla, with a residual bone height of <8 mm and a minimum bone width of 5 mm, participated in the study. The bone gain data was obtained using cone-beam computed tomography (CBCT) immediately after surgery and twelve months after the placement. The correlation between initial and final bone height with implant stability was also assessed. The results were analyzed using SPSS 23 software (p < 0.05). The results of the study indicated a 100% implant success rate after a follow-up period of twelve months. Preoperative main bone height was 5.70 ± 0.95 mm. The osseodensification technique allowed a significant increase of 6.65 ± 1.06 mm immediately after surgery. After a twelve-month follow-up, a graft material contraction of 0.90 ± 0.49 mm was observed. No correlation was observed between the bone height at the different times of the study and the primary stability of the implant. Considering the limitations of the size sample of this study, the osseodensification technique used for transcrestal sinus lift with the additional bone graft material (β-TCP) may provide a predictable elevation of the maxillary sinus floor, allowing simultaneous implant insertion with adequate stability irrespective of bone height limitations.

Levels of fat for potential consumption of juvenile Ambystoma mexicanum axolotls: Lipid levels

Objective: The present study focused on the effect of different lipid levels on growth (weight and length) and survival in juvenile Ambystoma mexicanum. Design/methodology/approach: Four diets with the same 45% protein level and different lipid levels: 6, 8, 10 and 12% were tested for a period of 81 days. For the preparation of the diets, two key ingredients were used, such as fishmeal and fish oil, these as protein base and lipid source. The experiment consisted of placing six organisms per experimental unit in tubs with 40 L of water for a period of 81 days; period during which four biometrics were performed, the organisms were fed every 48 hours to the weight of their biomass. The digestibility of the diets, initial and final height, initial and final weight, weight gained, weight gained per day, specific growth rate, survival, Fulton index and protein efficiency rate were recorded. Results: At the end of the experiment, significant differences (p &gt; 0.05) were observed in the growth and survival of the axolotls in the diets of 8, 10 and 12% lipids. Limitations on study/implications: A wider range of lipid levels could not be tested, due to the number of individuals available for the experiment. Findings/conclusions: According to the data obtained in this study, it is recommended to include a level of 45% protein and 8% lipids in the diets of juvenile Ambystoma mexicanum, for their better development and nutrition.

Sodium Chloride Tolerance during Germination and Seedling Stages of Tomato (Solanum lycopersicum L.) Lines Native to Mexico

Tomato is considered moderately sensitive to salinity, which detracts from the quality and yield of its fruit; therefore, wild populations have been used as a genetic resource. The aim of this research was to identify lines derived from wild tomato populations with tolerance to salinity during the germination and seedling stages. During germination, 52 wild lines and 2 commercial hybrids (Imperial®, Reserva®) were subjected to treatment with 150 mM and 0 mM NaCl and evaluated. The test was carried out for 20 days in a germination chamber with constant darkness, a temperature of 25 ± 2 °C and relative humidity conditions of 80 ± 4%. At the seedling stage, 22 wild tomato lines with the best performance in the germination test and 2 commercial hybrids (Imperial®, Topanga®) were evaluated for 12 days in a floating raft system. Concentrations of 175 mM and 0 mM of NaCl were used. During germination, the saline condition decreased the germination percentage (65.2%), speed of germination (88.2%), steam length (72.5%), root length (46.56%), number of normal plants (59.5%), stem dry matter (68.78%), root dry matter (61.99%), and total dry matter (67.1%). At the seedling stage, this condition decreased (p &lt; 0.05) the aerial part dry matter (46.37%), leaf area (59.35%), root length (42.43%), final plant height (40.24%), and growth rate (71.42%). Seventeen tolerant genotypes were identified in one of the two developmental stages, while one genotype showed tolerance in both stages. These results indicate that there are different response mechanisms in each developmental stage. Native tomatoes play an important role in the identification of tolerant genotypes since they can be used as genetic resources for obtaining commercial genotypes with salt tolerance.

Growth Hormone Therapy in a Child with Fetal Alcohol Syndrome: Personal Experience with Literature Review

Introduction: Fetal alcohol syndrome (FAS) is associated with a positive maternal history of drinking during pregnancy and the presence of characteristic dysmorphic features due to alcohol teratogenic effect. No evidence is yet available regarding the use of growth hormone (GH) for children with FAS for whom GH deficiency has not been confirmed. Case Presentation: We have highlighted an improvement in auxological parameters of a child with FAS and normal GH stimulation tests, using a GH dosage similar to that used in idiopathic GH deficit, without side effects. Conclusion: GH therapy in children with FAS may lead to an improvement in growth rate and an increase in final height, although, this condition is not included in the specific recommendations for use of GH. Prolonged follow-up and prospective studies are needed to evaluate long-term efficacy and monitor any possible onset of side effects.

The effect of methylphenidate on the dopamine and growth hormone response to exercise in children with attention-deficit hyperactivity disorder

PurposeTo assess the growth hormone (GH) and Dopamine (DA) response to exercise in children with attention-deficit hyperactivity disorder (ADHD) with and without methylphenidate (MP). We hypothesized that the GH and DA response to the exercise with MP would be siginicantly lower. MethodsTwenty children participated in the study (12 males and 8 females, age range 9–13 years). Ten with ADHD and 10 controls. Participants with ADHD performed an exercise test twice, with and without MP while controls performed one exercise test. Blood samples for GH and DA were collected before, at peak, 30 and 60 min after the end of exercise. ResultsCompared to controls, children with ADHD with and without MP, had a significantly lower GH (P < .002) and DA (P < .01) responses to exercise. In participants with ADHD, a significantly greater GH response (p < .04) to exercise was found when MP administered to the children before exercise, yet this response was still significantly lower than controls. ConclusionsGH and DA excretion after an exercise challenge in children with ADHD is impaired. MP slightly attenuates the GH blunted response. This may link ADHD with growth impairment in some children and explain previous findings indicating that the final adult height is usually not compromised in children with ADHD treated with MP. The combined exercise and stimulant treatment therapeutic effects needs to be further explored.Trial registration number: NCT00945971

Automatic height measurement of central serous chorioretinopathy lesion using a deep learning and adaptive gradient threshold based cascading strategy

Accurately quantifying the height of central serous chorioretinopathy (CSCR) lesion is of great significance for assisting ophthalmologists in diagnosing CSCR and evaluating treatment efficacy. The manual measurement results dominated by single optical coherence tomography (OCT) B-scan image in clinical practice face the dilemma of weak reference, poor reproducibility, and experience dependence. In this context, this paper constructs two schemes: Scheme Ⅰ draws on the idea of ensemble learning, namely, integrating multiple models for locating starting key point in the height direction of lesion in the inference stage, which appropriately improves the performance of a single model. Scheme Ⅱ designs an adaptive gradient threshold (AGT) technique, followed by the construction of cascading strategy, which involves preliminary location of starting key point through deep learning, and then employs AGT for precise adjustment. This strategy not only achieves effective location for starting key point, but also significantly reduces the large appetite of deep learning model for training samples. Subsequently, AGT continues to play a crucial role in locating the terminal key point in the height direction of lesion, further demonstrating its feasibility and effectiveness. Quantitative and qualitative key point location experiments in the height direction of lesion on 1152 samples, as well as the final height measurement display, consistently conveys the superiority of the constructed schemes, especially the cascading strategy, expanding another potential tool for the comprehensive analysis of CSCR.

Effects of non-uniform wavy ribs on flow and heat transfer characteristics of turbine blade cooling channel

Aiming at the problem of reduced heat transfer performance and uneven distribution along the ribbed channel in aero-engine turbine blades, the influence mechanism of rib height, rib angle and fillet radius on the flow and heat transfer characteristics of wavy rib cooling channel under different inlet Reynolds numbers is analyzed by experimental and numerical methods. The research illustrates that the non-uniform change of the rib height has the most profound influence on the heat transfer performance of the ribbed channel. Schemes featuring larger initial and final rib heights demonstrate superior heat transfer performance and uniformity, with the friction factor primarily determined by the maximum rib height. The optimal rib height variation scheme shows a 22.6 % increase in overall Nu/Nu0, with only a 6 % reduction in heat transfer evenness. The non-uniform variation of rib angle and fillet radius mainly affects the local heat transfer and friction factor. Increasing Reynolds number, the distribution of friction factor of the large rib height scheme changes more drastically. At a large Reynolds number (Re = 40000), the enhanced heat transfer in the middle and rear sections of the channel due to the larger rib angle and fillet radius comes at the cost of increased pressure loss.

Implication of Pappalysins and Stanniocalcins in the Bioavailability of IGF-I in Children With Type 1 Diabetes Mellitus.

Anomalies in the growth hormone (GH)/insulin-like growth factor (IGF) axis, are common in children with type 1 diabetes mellitus (T1DM), even in those reaching a normal or near-normal final height. However, concentrations of the IGF bioavailability regulatory factors (pappalysins [PAPP-As] and stanniocalcins [STCs]) have not been reported in children with T1DM. To determine serum concentrations of PAPP-As and STCs in children at diagnosis of T1DM and after insulin treatment and the correlation of these factors with other members of the GH/IGF axis, beta-cell insulin reserve, auxology, and nutritional status. A single-center prospective observational study including 47 patients (59.5% male), with T1DM onset at median age of 9.2 years (interquartile range: 6.3, 11.9) was performed. Blood and anthropometric data were collected at diagnosis and after 6 and 12 months of treatment. At 6 and 12 months after T1DM diagnosis, there was improvement in the metabolic control (decrease in glycated hemoglobin [HbA1c] at 12 months -3.66 [95% CI: -4.81, -2.05], P = .001), as well as in body mass index SD and height SD (not statistically significant). STC2 increased (P < .001) and PAPP-A2 decreased (P < .001) at 6 and 12 months of treatment onset (P < .001), which was concurrent with increased total IGF-I and IGF-binding protein concentrations, with no significant modification in free IGF-I concentrations. HbA1c correlated with PAPP-A2 (r = +0.41; P < .05) and STC2 (r = -0.32; P < .05). Implementation of insulin treatment after T1DM onset modifies various components of the circulating IGF system, including PAPP-A2 and STC2. How these modifications modulate linear growth remains unknown.

Growth Hormone Therapy: Comparison of Short- and Long-Term Outcomes between Children with Growth Hormone Deficiency and Small for Gestational Age

Introduction: Direct comparisons of both short-term and long-term auxological outcomes of growth hormone therapy (GHT) between growth hormone deficiency (GHD) and small for gestational age (SGA) are scarce. Methods: One hundred three patients with GHD and 53 patients with SGA treated at our tertiary center were investigated. Short-term and long-term outcomes were compared between these groups using multivariable linear regression models with adjustment for age, sex, and height at therapy start, also allowing for sex-specific group comparisons. Results: Mean delta height standard deviation scores (SDS) after 1 year of treatment were significantly higher in GHD (0.90, CI: 0.82–0.99) compared to SGA (0.67, CI: 0.54–0.79) (p = 0.003) with no sex difference. As expected, the mean increase in height SDS at final height (FH) was significantly higher in GHD (2.21, CI: 2.00–2.42) compared to SGA (1.05, CI: 0.75–1.35) (p < 0.001), leading to a target height corrected FH of −0.39 SDS (CI: −0.62 to −0.15) in GHD and −1.22 SDS (CI: −1.57 to −0.87) in SGA (p < 0.001). Girls with GHD had a better long-term outcome, as did boys with SGA when compared to the respective opposite sex. The cut-off of delta height of 0.5 SDS during the first year had a low sensitivity to detect long-term non-responders. We found a relation between short-term and long-term outcomes in GHD but not in SGA (adjusted R2 = 0.66 vs. 0.01). Conclusion: In contrast to GHD, we observed practically no relationship between 1st-year and long-term outcomes in SGA patients treated with GH.

Growth after pediatric kidney transplantation: a 25-year study in a pediatric kidney transplant center.

Growth failure is one of the major complications of pediatric chronic kidney disease. Even after a kidney transplant (KT), up to 50 % of patients fail to achieve the expected final height. This study aimed to assess longitudinal growth after KT and identify factors influencing it. A retrospective observational study was performed. We reviewed the clinical records of all patients who underwent KT for 25 years in a single center (n=149) and performed telephone interviews. Height-for-age and body mass index (BMI)-for-age were examined at KT, 3months, 6months, 1 year, and 5 years post-transplant and at the transition to adult care. We evaluated target height, disease duration before KT, need and type of dialysis, recombinant human growth hormone pretransplant use, nutritional support, glomerular filtration rate (GFR), and cumulative corticosteroid dose. At transplant, the average height z-score was-1.38, and height z-scores showed catch-up growth at 6months (z-score-1.26, p=0.006), 1 year (z-score-1.15, p<0.001), 5 years after KT (z-score-1.08, p<0.001), and on transition to adult care (z-score-1.22, p=0.012). Regarding BMI z-scores, a significant increase was also detected at all time points (p<0.001). After KT, GFR was significantly associated with height z-score (p=0.006) and BMI z-score (p=0.006). The height in transition to adult care was-1.28 SD compared to the target height. Despite the encouraging results regarding catch-up growth after KT in this cohort, results remain far from optimum, with a lower-than-expected height at the time of transition.

Pubertal Suppression in Early Puberty Followed by Testosterone Mildly Increases Final Height in Transmasculine Youth.

Treatment for transmasculine youth (TMY) can involve testosterone treatment and is sometimes preceded by gonadotropin-releasing hormone agonist (GnRHa) treatment for puberty blockade. GnRHas can increase final height in birth-assigned females with central precocious puberty. Maximizing final adult height (FAH) is an important outcome for many TMY. Our objective was to determine how GnRHa treatment before testosterone impacts FAH. Retrospective cohort study at 5 US transgender health clinics. Participants were 32 TMY treated with GnRHas in early to midpuberty before testosterone (GnRHa + T group) and 62 late/postpubertal TMY treated with testosterone only (T-only group). The difference between FAH minus midparental target height (MPTH) was +2.3 ± 5.7 cm and -2.2 ± 5.6 cm in the GnRHa + T and T-only groups, respectively (P < .01). In the GnRHa + T group, FAH was 1.8 ± 3.4 cm greater than predicted adult height (PAH) (P < .05) and FAH vs initial height (IH) z-score was 0.5 ± 1.2 vs 0.16 ± 1.0 (P < .05). After adjusting for patient characteristics, each additional month of GnRHa monotherapy increased FAH by 0.59 cm (95% CI 0.31, 0.9 cm), stage 3 breast development at start of GnRHa was associated with 6.5 cm lower FAH compared with stage 2 (95% CI -10.43, -2.55), and FAH was 7.95 cm greater in the GnRHa + T group than in T-only group (95% CI -10.85, -5.06). Treatment with GnRHa in TMY in early puberty before testosterone increases FAH compared with MPTH, PAH, IH, and TMY who only received testosterone in late/postpuberty. TMY considering GnRHas should be counseled that GnRHas may mildly increase their FAH if started early.

Optimal final adult height achieved by low-dose recombinant human growth hormone therapy.

Thailand has been administering the recombinant human growth hormone (rhGH) treatment for >20 years. Due to limited resources being available, efforts have been directed toward utilizing rhGH at the lowest feasible dose. However, there is currently a lack of evidence in terms of the efficacy and outcomes. To evaluate the auxological outcomes of growth hormone (GH) treatment and the GH secretion ability after reaching final adult height (FAH) and discontinuing rhGH. Data of 40 patients were retrospectively reviewed. The clinical characteristics, auxological data, and results of biochemical and endocrine investigations before and during rhGH treatment were evaluated. In addition, GH retesting was performed in 24 patients using the insulin tolerance test. Twenty patients (50%) had complete growth hormone deficiency (GHD), defined as peak stimulated GH level <5 ng/mL, and the remaining patients had partial GHD. Most patients were male (n = 25, 62.5%). The mean age at which rhGH was initiated was 8.9 years. Patients with partial GHD received a higher dose of rhGH than those with complete GHD (30.9 µg/kg/d vs. 26.2 µg/kg/d, P = 0.02). Patients with complete and partial GHD reached FAH at height standard deviation scores (SDSs) of -0.65 and -1.47, respectively. The factors associated with obtaining a good clinical response in terms of height gain included peak-stimulated GH level, age of puberty, and age of discontinuing rhGH. After completing the rhGH treatment, 13 of the 24 patients showed normal GH secretion. Patients with multiple pituitary hormone deficiency (MPHD) were likely to have persistent GHD through adulthood (n = 8, 88.9%). This study has demonstrated that the use of low-dose rhGH could result in healthy populations achieving optimal FAHs. Patients with MPHD might not require retesting as they were likely to have persistent GHD. The results obtained in this research highlight the benefits of the treatment. This treatment can be applied in resource-limited countries.

Sedimentation kinetics of kaolinitic and illitic clay: Impact of cation valence, ionic concentration, and water content

Investigating the sedimentation of clay in saline water was extensively studied because of its wide applications in engineering. This study investigated the impact of cation valence, ionic concentration, and water content on sedimentation behavior of kaolinitic and illitic clays through batch sedimentation tests for the comprehensive understanding of clay particle association and elapsed time for the transition of settling regimes from initial hindered settling to zone settling. The quantitative representation of observed settling curves was achieved using four fitted parameters in batch sedimentation model, which represented the shape of settling curves and the boundary of the initial hindered, zone, and consolidation settling regimes. In addition, the obtained settling velocity from the settling curves provided the fraction of clay particles and the size of clay flocs. The observed settling curves, trends of fitted parameters, and the estimated size of clay flocs shown in this study implied that the type of clay particle association (face-to-face aggregation or edge-to-face flocculation), settling velocity, final interface height, and boundary between initial hindered and zone settling are function of clay mineralogy, water content, cation valence, and ionic concentration.

Bone mineral density in adults growth hormone deficiency with different ages of onset: a real-world retrospective study.

Bone mineral density (BMD) impairment is one of the critical factors for long-term quality of life in adults growth hormone deficiency (AGHD). This study aims to investigate the annual changes in BMD in AGHD patients with different ages of onset and to identify predicting factors that influence BMD. AGHD patients (n = 160) with available data for 4 years follow-up from a major tertiary medical center in China were retrospectively included (110 [68.8%] childhood-onset, 119 [74.4%] male). BMD of the axial bone (including total hip, neck of femur, and L1-4) derived from dual X-ray absorptiometry and final height were investigated at the first visit, 12 months, 24 months, 36 months, and 48 months thereafter. Low BMD was defined as Z-score ≤ -2. The prevalence of low BMD was 30.0% at baseline and 12.5% at 4 years of follow-up. The CO AGHD group presented a significantly lower BMD than the AO AGHD group at the baseline (P = 0.009). In contrast, the CO AGHD group had significantly greater median annual BMD change than the AO AGHD group (0.044 vs. -0.0003 g/cm2/year in L1-4, P < 0.001), indicating a significant difference in the overall BMD trend between CO and AO groups. Childhood-onset (odds ratio [OR] 0.326, P = 0.012), low serum testosterone (OR 0.847; P = 0.004) and FT4 (OR 0.595; P = 0.039) level were independent risk factors for BMD loss. The annual changes of BMD show a different pattern in AGHD patients with varying ages of onset. Patients with CO AGHD have a lower bone mass, and in general, appropriate replacement therapy is necessary for long-term bone health in AGHD patients.

Allocation of reservoirs sites for runoff management towards sustainable water resources: Case study of Harirud River Basin, Afghanistan

The intensification of drought conditions in arid and semi-arid regions coupled with the growing population increased water demands (domestic, and irrigation). It signifies the importance of addressing the pressing need for sustainable water resource management. Seventeen criteria spanning topographical, hydrological, geological, environmental, and socio-economic categories, were used for dam site suitability analysis for Harirud River Basin, Afghanistan. Weighted Linear Combination (WLC) model and Geographic Information System (GIS) were employed to perform multi-criteria analysis (MCA) method. The results revealed that the final suitability map exposed 12.31 % highly suitable, 21.0 % moderately suitable, and 66.68 % non-suitable sites, totaling 125.8 km, 214.6 km, and 681.4 km, respectively. Segmentation accuracy assessment was utilized to evaluate the existing dam’s accuracies. The study revealed that accuracies of 84.65 % for the Salma Dam and 88.08 % for the Pashdan Dam were achieved, respectively. Six new dams, along with the existing two, formed the series of eight dams. The dam series were optimized for the total annual runoff of (1,600,000,000 m3), and the final dam heights were determined as follows: 107.5 m, 42 m, 100 m, 23.9 m, 30 m, 18 m, 23.44 m, and 22.65 m for dams (1 to 8), respectively. The study underscores the methodology's superiority in site suitability analysis and runoff optimization, while recommending future focus on observational data and higher-resolution digital elevation model (DEM) files for enhanced precision, environmental impact assessment, climate change considerations, social and economic implications, improved data resolution, and transboundary cooperation.

Factors that Influence Stunting in the Maratua District of Berau, Indonesia

Highlights:1. This study investigated the factors contributing to stunting in a remote area, which has not received sufficient attention from key stakeholders.2. The findings of this study can serve as a reference for the government in addressing stunting through intervention strategies that incorporate paternal roles to improve children's nutritional status. AbstractStunting is a community health problem with significant impacts. The estimated prevalence rate of stunting was 24.4% in Indonesia and 25.7% in the Berau Regency. Stunting is a growth disorder caused by chronic malnutrition during the first 1,000 days of life. It is characterized by a height-for-age Z-score below -2 standard deviations from the child growth standards median of the World Health Organization, an insufficient growth rate, and a reduced potential final height. The contributing factors to stunting include maternal variables, as mothers are the primary caregivers. The objective of this study was to determine the factors for stunting and specifically investigate if there is a relationship between maternal employment and stunting in the Maratua District of Berau, Indonesia. This study used a cross-sectional research design. The sample size was determined using the Sample Size Calculator from the World Health Organization for a two-sided test (α = 0.05; β = 0.2; p1 = 0.63; p2 = 0.25; 95% CI). The data were collected from the nutrition report and anthropometric measurements at Maratua Primary Healthcare Center. The research was carried out at the Integrated Health Posts (Pos Layanan Terpadu/ Posyandu) in the Maratua District. The toddlers (n = 56) were examined with their parental consent. Toddlers with overnutrition, obesity, and acute infectious diseases were excluded from this study. The data were processed using Chi-square and Fisher tests (p &lt; 0.05). In the analysis, no significant relationship was found between stunting and maternal employment. However, the results revealed that fathers who were not fishermen had a 6.3 times greater risk of having stunted toddlers compared to fathers who worked as fishermen. Fathers with a junior high school degree showed a 6.1 times higher risk of having stunted toddlers than fathers with different educational levels. In conclusion, stunting in the Maratua District is associated with the fathers' educational attainment and employment.