Growth Percentiles Research Articles

The prevalence of malnutrition and growth percentiles for urban South African children

BackgroundLow- and middle-income countries (LMIC) are experiencing a double-burden of malnutrition characterised by high prevalence of both under- and over-nutrition. We set out using data from the mixed-longitudinal Birth-to-Twenty Plus (Bt20+) birth cohort, to evaluate the patterns of malnutrition and growth in a large South African (SA) city by; (i) assessing the prevalence of undernutrition from birth to 5 years of age and overweight and obesity from ages 2 to 21 years in black and white, male and female children, and (ii) determining percentiles for height, weight, BMI, waist and hip circumferences and comparing the centiles to American and Dutch references.MethodsHeight, weight, waist and hip circumferences were measured on urban black and white SA children from the Bt20+. A total of 3273 children born between April and June 1990 in the Greater Johannesburg Metropolitan area were included in the cohort. Z-scores were derived using the WHO 2006 child growth standards (0–5 years), for defining stunting, underweight and wasting. The International Obesity Task Force (IOTF) references were used to define overweight and obesity. Percentiles were developed using the lambda mu sigma (LMS) method and compared to American and Dutch references.ResultsBlack children were consistently shorter and black males lighter than white children and American references. The prevalence of stunting peaked at 2 years and was significantly higher in males than females and in black than white children. Black females had a greater prevalence of overweight and obesity than black males from 10 to 17 years. The percentiles for black females for weight and BMI were similar to those of South African white and American references but both black and white South African females had lower waist circumferences than American references.ConclusionThe growth percentiles show that young South African urban black females are experiencing general but not central obesity due to a secular change which is faster in weight than height. High levels of undernutrition persist alongside high levels of over-nutrition with adolescence being a critical period for the upsurge in obesity in females. Early intervention is needed to combat the rise in obesity.

85. Cortical Thickness and Subcortical Volume Trajectories Across the Lifespan: Data From 14,600 Healthy Individuals Aged 6-90 Years

Background: Age is a critical determinant of brain morphometry. We formed the Lifespan Working group of the Enhancing Neuroimaging Genetics through Meta-Analysis(ENIGMA) Consortium to perform a large-scale analysis of cortical thickness data across more than 79 samples and14,600 healthy individuals aged 6-90 years. Methods: We used fractional polynomial (FP) regression to characterize age-related trajectories in brain morphometry. Normalized growth centiles were constructed using the para-metric Lambda, Mu, and Sigma (LMS) method. Inter-individual variability was analyzed using meta-analysis and one-way analysis of variance. Results: The volume of subcortical regions followed an inverted U-shaped trajectory while cortical thickness in almost all regions decreased during the first two to three decades of life and showed an attenuated or plateaued slope afterwards. Exceptions were the entorhinal, anterior cingulate and temporopolar cortices that followed attenuated age-related U-shaped trajectories. Age and its FP combinations explained up to 48% variance in morphometry. Sample, strength of the MRI scanner magnetic field and FreeSurfer version jointly accounted for a median of 17% of the variance. Conclusions: Our results could shed light on the uncertainties about age-related developmental trajectories of cortical thickness. The estimated centile values will provide scientists and clinicians with more efficient tools to detect brain morphological deviations and their association with behavioral, cognitive and clinical outcomes

Translating Standardized Effects of Education Programs Into More Interpretable Metrics

Evaluators report effects of education initiatives as standardized effect sizes, a scale that has merits but obscures interpretation of the effects’ practical importance. Consequently, educators and policymakers seek more readily interpretable translations of evaluation results. One popular metric is the number of years of learning necessary to induce the effect. We compare years of learning to three other translation options: benchmarking against other effect sizes, converting to percentile growth, and estimating the probability of scoring above a proficiency threshold. After enumerating the desirable properties of translations, we examine each option’s strengths and weaknesses. We conclude that years of learning performs worst, and percentile gains performs best, making it our recommended choice for more interpretable translations of standardized effects.

Final Height and Endocrine Complications in Patients with β-Thalassemia Intermedia: Our Experience in Non-Transfused Versus Infrequently Transfused Patients and Correlations with Liver Iron Content.

Backgroundβ-thalassemia intermedia (TI) spans a wide spectrum of severity and carries higher morbidity than previously recognized, including extramedullary hematopoiesis, leg ulcers, gallstones, thrombosis, secondary heart failure, pulmonary hypertension, skeletal deformity, growth retardation and endocrine abnormalities, such as diabetes mellitus, hypothyroidism, osteoporosis, and hypogonadism.ObjectivesTo evaluate the final height and the endocrine complications encountered in young adult patients with TI followed at Hematology Section, Doha (Qatar) in relation to liver iron content in non-transfused versus infrequently transfused TI patients.Patients and MethodsThis retrospective cohort study was performed on 28 young adults with TI who were randomly selected from the Hematology Clinic of the Hematology Section, National Centre for Cancer Care and Research, Hamad Medical Corporation of Doha (Qatar).Eligibility criteria for this retrospective analysis included TI patients diagnosed by complete blood count, hemoglobin electrophoresis and young adult age ( ≥ 18 years).Group 1 included nine patients who did not receive any blood transfusion, and Group 2 included 19 patients who infrequently received blood transfusions.Data recorded from charts included demographic characteristics (gender, date of birth, ethnicity), disease and treatment characteristics (e.g., transfusion frequency, history of chelation therapy, and splenectomy), auxological and pubertal data [growth percentiles and pubertal stages, and body mass index (BMI)], laboratory data and target organ complications (including endocrinopathies and liver disease). Iron overload was assessed by direct (liver iron content; LIC) and indirect methods (SF), and bone mass index (BMA) by dual-energy X-ray absorptiometry (DXA).ResultsShort stature [Final Height (Ht) SDS < −2] occurred in 25% of patients with no difference between the two groups of patients. Insulin growth factor 1 (IGF-1) SDS was low in 35.7 % of patients with no statistical difference among the two groups. Impaired fasting blood glucose occurred in 17.8% of patients, diabetes mellitus in 25% and hypogonadotropic hypogonadism in 10.7% of them. Morning cortisol was low in one patient. No thyroid or hypo-parathyroid abnormalities were detected in any patient. Liver iron content (LIC) > 15 mg/g dry weight and SF > 2,000 ng/mL were detected in 75% of the patients. The values resulted significantly higher in the transfused group (Group 2). High liver enzyme level (ALT) was detected in 42.8 % of patients, and the values were significantly higher in the transfused group (Group 2). Total and fetal Hb was significantly higher in group 1 versus group 2. Osteopenia was diagnosed in 14.3% of patients. Females had significantly better final height SDS, higher IGF-1 SDS, lower LIC and fasting blood glucose level compared to males. Significant correlations were found between Ht-SDS and IGF-1 SDS; LIC and SF, level; ALT and LIC, SF levels. Total and fetal Hb did not correlate significantly with Ht-SDS or IGF-1 level.ConclusionsA significant number of TI patients have high LIC, short stature and endocrine disorders. Patients who require occasional transfusions have more liver iron overload and higher hepatic dysfunction. Females appear to attain a better final adult height and have higher IGF1-SDS versus males. Our data emphasize the need for long term surveillance for identification of organ-specific risk factors and early disease manifestations. We also recommend close monitoring of endocrine and other complications, according to the international guidelines.

SUN-454 Rationale and Methods for a Phase II Trial Evaluating Osilodrostat in Pediatric Patients with Cushing's Disease

Background: Cushing’s disease (CD) is a rare disease associated with significant morbidity and mortality, with 2-5 new cases per million per year, of which 10% occur in children (Stratakis CA. Endocrinol Metab Clin North Am 2012;41:793-803). In children, CD presents with a combination of weight gain and slowed linear growth. First-line surgery is the treatment of choice for most patients, with a success rate of 60-98% in pediatric patients if performed by an expert pituitary surgeon (Keil MF. J Clin Endocrinol Metab 2013;98:2667-78). When surgery is not successful, patients require additional pharmacologic interventions, which are currently limited in children. Osilodrostat is a potent oral 11β-hydroxylase inhibitor in clinical development for the treatment of CD. This Phase II, multicenter, open-label, non-comparative study will evaluate the pharmacokinetics (PK), pharmacodynamics and safety/tolerability of osilodrostat in patients aged 6-<18 years with Cushing’s disease (clinicaltrials.gov identifier: NCT03708900). Methods: This single-arm study will enroll 12 evaluable patients aged 6-<18 years with confirmed CD for whom pituitary surgery is not an option, for whom surgery has failed, or who are awaiting surgery. CD will be confirmed by the clinical criteria of decreasing growth percentiles with increasing weight (defined by height SDS <0, BMI SDS >0, and a strong clinical suspicion of CD), an abnormal low-dose dexamethasone suppression test, measurable morning ACTH levels, and two 24-hour UFC measurements >1.3 x ULN. This study consists of two phases: a 12-week core phase and an optional 9-month extension period for patients who obtain a clinical benefit from osilodrostat as judged by the investigator. The primary objective is to assess the PK (Cmax and Ctrough) of osilodrostat during the 12-week core study. A secondary objective is to assess the proportion of patients with normal mean UFC (mUFC; determined from two 24-hour UFC samples) at weeks 6 and 12. Other secondary objectives include: assessment of safety and tolerability up to week 12 of the core phase and up to month 12 of the extension phase; assessment of efficacy up to month 12. The starting dose of osilodrostat will be 1 mg once daily and 1 mg twice daily for patients weighing <60 kg and ≥60 kg, respectively. The dose may be titrated based on mUFC response. PK parameter estimates will be calculated by pooling individual plasma osilodrostat concentration-time data and analyzed using non-compartmental analysis. Conclusion: This Phase II, multicenter, open-label, non-comparative study will be the first study of osilodrostat in pediatric patients with CD. The results of this study may allow further clinical development of osilodrostat in children with CD.

The impact of lacto-ovo-/lacto-vegetarian and vegan diets during pregnancy on the birth anthropometric parameters of the newborn

Introduction: The data in the literature on the appropriateness of vegetarian diets during pregnancy and the impact on the birth anthropometric parameters of the newborn are divergent and conflicting. The aim of the present study is to compare the birth anthropometric parameters of three groups of children distinguished according to the dietary pattern followed by their mothers during pregnancy. Moreover, the second aim is to study the cultural inference of vegetarianism.Materials and methods: Between September 2017 and May 2018, from the Pediatric Service of the Campus Bio-Medico University Hospital of Rome and vegetarian-oriented societies, detailed information have been provided to all mothers who showed interest in participating in the study. More than 100 mothers gave their consent, but in consideration of the criteria of inclusion and exclusion only 55 with the respective children (for a total of 63 kids) have been enlisted in the study. Based on the dietary pattern followed by women during pregnancy, the participants have been divided into three groups: vegan group, lacto-ovo-/lacto-vegetarian group, and omnivorous group. The data necessary for the study have been collected through a questionnaire previously created and sent electronically to 55 enrolled mothers.Results: From our statistical analysis, it has emerged that birth weight, both when expressed in grams and when expressed in growth percentiles, of the vegan mothers’ children is lower than that of the omnivorous mothers’ children. No significant difference has emerged from the comparison for the length, cranial circumference and BMI at birth between the three groups.Conclusion: Although from our study statistically significant differences in birth weight between the vegan group and the omnivorous one has emerged, the values of this anthropometric parameter were all included within the physiological range decided by the experts in the field. From this, it emerges that the planning of any type of diet with experts in the field is indispensable to ensure a physiological development of the fetus, but given the limited number of participants we cannot draw unequivocal and certain conclusions on this subject.

Growth curves of myopia-related parameters to clinically monitor the refractive development in Chinese schoolchildren

PurposeTo produce a clinical model for the prediction of myopia development based on the creation of percentile curves of axial length in school-aged children from Wuhan in central China.MethodsData of 12,554 children (6054 girls and 6500 boys) were collected and analyzed for the generation of the axial length growth curves. A second data set with 226 children and three yearly successive measurements was used to verify the predictive power of the axial length growth percentile curves. Percentile curves were calculated for both gender groups and four age groups (6, 9, 12, and 15 years). The second data set was used to verify the efficacy of identifying the refractive error of the children using the axial length curves, based on their spherical refractive error from the third visit.ResultsFrom 6 to 15 years of age, all percentiles showed a growth trend in axial length, except for the percentiles below the first quartile, which appear to stabilize after the age of 12 (− 0.10; 95%CI, − 0.36–0.16; P = 0.23 for girls; − 0.16; 95%CI, − 0.70–0.39; P = 0.34 for boys); however, the growth continued for the remaining 75% of cases. The second data set showed that the likelihood of suffering high myopia (spherical refractive error ≤− 5.00D) during adolescent years increased when axial length values were above the first quartile, for both genders.ConclusionsThe data from the current study provide a tool to observe the annual growth rates of axial length and can be considered as an approach to predict the refractive development at school ages.

Standardizing test scores for a target population: The LMS method illustrated using language measures from the SCALES project.

BackgroundCentile curves and standard scores are common in epidemiological research. However, standardised norms and centile growth curves for language disorder that reflect the entire UK local school population do not exist.MethodsScores on six language indices assessing receptive and expressive functioning of children were obtained from the SCALES population survey. Monolingual English speaking participants were aged between five and nine years. Children who attended special schools at study intake, or who were learning English as an additional language were excluded. We constructed language norms using the LMS method of standardisation which allows for skewed measurements. We made use of probability weights that were produced from a two-step logistic model. Distributions of estimated standard scores from an intensively assessed sub-population and from the full population were contrasted to demonstrate the role of weights.ResultsNon-overlapping centile curves and standardised scores at each age were obtained for the six language indices. The use of weights was essential at retrieving the target distribution of the scores. An online calculator that estimates standardised scores for the measures was constructed and made freely available.ConclusionsThe findings highlight the usefulness and flexibility of the LMS method at dealing with the standardisation of linguistic and educational measures that are sufficiently continuous. The paper adds to the existing literature by providing population norms for a number of language tests that were calculated from the same group of individuals.

The impact of teacher–student relationships and classroom engagement on student growth percentiles of 7th and 8th grade students

AbstractThe study examined the extent that teacher–student relationships (TSR) influenced basic psychological needs, engagement, and student growth using the self‐systems process model as a framework using structural equation modeling. Based on prior research, it was hypothesized that context (TSR) influenced self (basic psychological needs), which influenced action (engagement), and consequently, influenced outcome (student score and grade point average‐GPA). The findings of the study supported prior research that a TSR positively influenced levels of engagement in the classroom and, consequently, student outcomes as measured by classroom grade point average (GPA) and standardized assessment results. Using an identical methodological setup that substituted student growth percentiles (SGP) for scale scores, it was determined that TSR, basic psychological need satisfaction, and level of engagement do not influence SGP. Implications and potential contributions are discussed.

Variation In Health Spending Growth For The Privately Insured From 2007 To 2014.

We examined the growth in health spending on people with employer-sponsored private insurance in the period 2007-14. Our analysis relied on information from the Health Care Cost Institute data set, which includes insurance claims from Aetna, Humana, and UnitedHealthcare. In the study period private health spending per enrollee grew 16.9percent, while growth in Medicare spending per fee-for-service beneficiary decreased 1.2percent. There was substantial variation in private spending growth rates across hospital referral regions (HRRs): Spending in HRRs in the tenth percentile of private spending growth grew at 0.22percent per year, while HRRs in the ninetieth percentile experienced 3.45percent growth per year. The correlation between the growth in HRR-level private health spending and growth in fee-for-service Medicare spending in the study period was only 0.211. The low correlation across HRRs suggests that different factors may be driving the growth in spending on the two populations.

Evaluation of short stature in paediatric age group in rural medical college

Evaluation of short stature in paediatric age group in rural medical college - IJMPO- Print ISSN No: - 2581-4699 Online ISSN No:- 2581-4702 Article DOI No:- 10.18231/2581-4702.2018.0036, IP International Journal of Medical Paediatrics and Oncology-IP Int J Med Paediatr Oncol

Developmental delay: identification and management at primary care level.

Developmental delays are common in childhood, occurring in 10%-15% of preschool children. Global developmental delays are less common, occurring in 1%-3% of preschool children. Developmental delays are identified during routine checks by the primary care physician or when the parent or preschool raises concerns. Assessment for developmental delay in primary care settings should include a general and systemic examination, including plotting growth centiles, hearing and vision assessment, baseline blood tests if deemed necessary, referral to a developmental paediatrician, and counselling the parents. It is important to follow up with the parents at the earliest opportunity to ensure that the referral has been activated. For children with mild developmental delays, in the absence of any red flags for development and no abnormal findings on clinical examination, advice on appropriate stimulation activities can be provided and a review conducted in three months' time.

Influence of gratification behavior on early childhood caries and body mass index in preschool children.

Early childhood caries (ECC) and obesity are becoming major public health problems in children. Apart from biological and social risk factors, gratification response, a psychological behavior, may also have a large influence on body mass index (BMI) and occurrence of ECC in preschool children. The study aimed to ascertain the impact of delayed gratification as a behavioral risk factor for the occurrence of ECC and obesity in preschool children of age 5-6 years. Comparative cross-sectional study. Fifty children with ECC (Group I) and 50 caries-free children (Group II) were included to participate in a task similar to the famous Stanford marshmallow experiment to assess their ability to delay gratification. BMI was calculated by obtaining the biometric measures of height and weight. Body weight status was determined using BMI for age percentile growth charts revised by the Indian Academy of Pediatrics, 2015. Children's caries experience and BMI status were associated with their gratification response. Statistical analysis was performed using Fisher's exact test and Chi-square test. Higher percentage of children with ECC delayed their gratification (54%) than caries free (40%). Children who exhibited instant gratification (37%) had a higher BMI when compared to those who delayed their gratification (25%). Children with ECC were more self-controlled, and children with high BMI were more impulsive. Hence, delayed gratification for cariogenic reward is a behavioral risk factor for ECC, whereas instant gratification is an alarming risk factor for higher BMI in preschool children.

Leucine for the Treatment of Transfusion Dependence in Patients with Diamond Blackfan Anemia

▪Diamond Blackfan anemia (DBA) is a rare, inherited bone marrow failure syndrome characterized by anemia, congenital anomalies and a predisposition to cancer. The patients usually present during infancy or early childhood, but can also present in adulthood. In the majority of cases DBA is due to a mutation in a small or large ribosomal protein (RP) subunit leading to RP haploinsufficiency. The only treatments for the anemia of DBA are red cell transfusions (accompanied by iron chelation), oral corticosteroid therapy or stem cell transplantation. Pospisilova et al. (Haematologica 2007; 92(5):e66-67) reported one complete and two partial erythroid responses after the use of the branched chain amino acid L-leucine in 6 select patients. In skeletal muscle, leucine supplementation can upregulate components of the protein synthetic machinery, including ribosomal proteins, promoting protein translation. Mouse and fish models of DBA respond with amelioration of anemia to L-leucine. We therefore proposed to study the effect of L-leucine on transfusion dependence and growth in subjects with DBA.Methods: The primary objectives were to determine the feasibility of administering L-leucine in subjects with DBA who are red cell transfusion-dependent and to determine the efficacy of L-leucine to produce a hematologic and growth response. The secondary objective was to determine the safety profile of L-leucine. Twelve study sites were involved in this multi-center, Phase I/II study with an anticipated accrual of 50 subjects. A dose of 700 mg/M2 orally three times per day for 9 months was used. Inclusion criteria included age > 2 years, the diagnosis of DBA and transfusion dependence with adequate kidney and liver function. Response was evaluated at 9 months with Complete Response (CR) defined as no further transfusions required and Hb >9; Partial Response (PR): Hb < 9 gm/dL with an increase in reticulocyte count and transfusion interval; and No Response (NR): no change in transfusion needs, Hb or reticulocyte count . Growth percentiles were evaluated at baseline and at completion of 9 months of treatment and the growth velocity change was calculated.Results: The study opened July 2014 and closed February 2017; 55 subjects were consented; 12 were screen failures; 43 subjects were evaluable. There were 21 males; the median age was 9 years 1 month (2 years 5 months - 46 years 1 month). There were no untoward side effects experienced by any subject that were attributable to the L-leucine. Two subjects had an erythroid CR and 1 subject had a PR. The CRs occurred at 1 month and 3 months after start of L-leucine. The subject with PR had an elevated reticulocyte count but was not able to maintain a Hb >9 gm/dL without a transfusion and thus was not transfusion independent. Of the 30 subjects with growth potential who received L-leucine 10 experienced a positive growth velocity change at 9 months of therapy compared to baseline. At a median age of 7.5 years, the mean pre-leucine height percentile was 27 +/- 17.9 and the post-leucine height percentile was 35 +/- 19.9 (p <0.01). The mean weight percentile pre-leucine was 35.4 +/- 26.6 versus the post-Leucine weight percentile of 38.4 +/- 28.1.Conclusions: The administration of L-leucine is safe. L-leucine administration resulted in an erythroid response in 7% of subjects and an increased growth velocity in 33% of growing subjects. Based upon extrapolation from animal models, it is likely that this dose was suboptimal. We hypothesize that higher doses of L-leucine will lead to hematologic responses in more subjects who are transfusion dependent. The potential benefit of added growth in children with DBA may improve final adult height. DisclosuresGlader:Agios: Consultancy, Research Funding.

The Role of School Adaptation and Self-Concept in Influencing Chinese High School Students' Growth in Math Achievement.

A longitudinal designed research study was conducted to provide empirical evidence regarding the influences of three dimensions of students’ school adaptation on their math achievement growth over the first year of high school. These dimensions included learning adaptation, stress management, and personal communication. Student math achievement growth was measured using the student growth percentile (SGP) score. Structural equation modeling (SEM) was used to test for the possible mediating role of self-concept behind those three relationships. Based on the model comparison, it was discovered that school adaptation significantly and positively influences student math achievement growth via mediating effects of student academic self-concept, as opposed to showing a direct impact on students. The findings of this study have important implications for educators and parents to aid students in their pursuit of academic success.

First Ukrainian Growth References for Height, Weight, and Body Mass Index for Children and Adolescents Aged 7 to 18 Years.

Introduction. To date, growth centiles of children and adolescents have not been created in Ukraine. Therefore, the aim of this study was to construct reference growth charts for height, weight, and body mass index (BMI) of Ukrainian school-aged children and to compare them with World Health Organization references from 2007 for children's BMI. Material and Methods. Among the representative sample of 13,712 students (aged 7 to 18 years) who were included in this study, 6,582 (48%) were boys and 7,130 (52%) were girls. Assessments of height, body mass, and BMI of participants were performed. Reference charts were developed using LMS models within the ChartMaker lms program. Results. We present first growth references for height, weight, and body mass index for Ukrainian children and adolescents aged 7 to 18 years. The younger Ukrainian pediatric population (7-13 years) was heavier than population reported in the multiethnic WHO references, while the older (13-18 years) had lower body weight comparing to the same references from WHO. Conclusions. The constructed reference growth charts are a benchmark for following secular trends in Ukraine and are also an optimal clinical tool for health care. We recommend national implementation of the Ukrainian reference growth charts for anthropometric measurements.

Intrauterine Fetal Growth Delay During Late Pregnancy After Maternal Gastric Bypass Surgery.

To investigate intrauterine fetal growth development and birth anthropometry of fetuses conceived after maternal gastric bypass surgery. Longitudinal cohort study describing longitudinal growth estimated by ultrasound on 43 singleton pregnancies after gastric bypass compared to 43 BMI-matched controls. In fetuses after maternal gastric bypass surgery, growth percentiles decreased markedly from the beginning of the second trimester until the end of the third trimester (decrease of 3.1 fetal abdomen circumference percentiles (95 %CI 0.9-5.3, p = 0.007) per four gestational weeks). While in the second trimester, fetal anthropometric measures did not differ between the groups, the mean abdomen circumference percentiles appeared significantly smaller during the third trimester in offspring of mothers after gastric bypass (mean difference 25.1 percentiles, p < 0.001). Similar tendencies have been observed in estimated fetal weight resulting in significantly more SGA offspring at delivery in the gastric bypass group. In children born after maternal gastric bypass surgery, weight percentiles (32.12th vs. 55.86th percentile, p < 0.001) as well as placental weight (525.2 g vs. 635.7 g, p < 0.001) were significantly reduced compared to controls. In fetuses conceived after maternal gastric bypass, intrauterine fetal growth distinctively declined in the second and third trimester, most prominently observed in fetal abdomen circumferences. Birth weight and placental weight at birth was significantly lower compared to BMI-matched controls, possibly due to altered maternal metabolic factors and comparable to mothers experiencing chronic hunger episodes.

Standard growth and diarrhea-associated growth faltering in captive infant rhesus macaques (Macaca mulatta).

Reference growth studies of captive rhesus macaque infants have not accounted for diarrhea and the potential for growth stunting or growth faltering. Healthy infants without diarrhea could be used to build a standard growth chart and a tool used to detect growth faltering associated with diarrhea. We hypothesized infants who develop diarrhea during the first year of life would experience decreased linear weight gain compared to healthy infants, and we used healthy infants to establish standard growth of male and female infants. We hypothesized the lower 3rd percentile of standard growth would be cut-off criteria used in screening for diarrhea-associated growth faltering. Using a retrospective cohort of 6,510 infant weight records in a multiple linear regression, daily weight gain through the first year of life was determined by sex, housing type, and health status. Male standard growth was 4.1 g/day (95%CI: 4.0-4.2 g/day) in corrals and 4.7 g/day (95%CI: 4.5-4.8 g/day) in shelter housing. Female standard growth was 4.0 g/day (95%CI: 3.8-4.2 g/day) in corrals and 4.4 g/day (95%CI: 4.0-4.7 g/day) in shelter housing. Diarrhea was significantly associated with decreased linear weight gain by up to 34% during the first year of life. Odds of growth faltering of infants, defined as those falling below the 3rd percentile of standard growth, were at least 8.9 higher given a history of diarrhea compared to healthy. The growth faltering cut-off criteria had a sensitivity of at least 53% for males and females to screen for diarrhea in infants between 6 and 12 months in shelters housing. Interinstitutional collaborations of infant rhesus macaque weight records would refine the standard growth charts and cut-off criteria, and additional morphometric data would provide a more nuanced picture of growth stunting.

Different teacher-level effectiveness estimates, different results: inter-model concordance across six generalized value-added models (VAMs)

In this study, researchers compared the concordance of teacher-level effectiveness ratings derived via six common generalized value-added model (VAM) approaches including a (1) student growth percentile (SGP) model, (2) value-added linear regression model (VALRM), (3) value-added hierarchical linear model (VAHLM), (4) simple difference (gain) score model, (5) rubric-based performance level (growth) model, and (6) simple criterion (percent passing) model. The study sample included fourth to sixth grade teachers employed in a large, suburban school district who taught the same sets of students, at the same time, and for whom a consistent set of achievement measures and background variables were available. Findings indicate that ratings significantly and substantively differed depending upon the methodological approach used. Findings, accordingly, bring into question the validity of the inferences based on such estimates, especially when high-stakes decisions are made about teachers as based on estimates measured via different, albeit popular methods across different school districts and states.

Influence of Time Interval from Bariatric Surgery to Conception on Pregnancy and Perinatal Outcomes.

Pregnancy in women submitted to bariatric surgery is increasing. Recommendations for surveillance of these pregnancies have been suggested, but an adequate time interval from surgery to conception, to avoid perinatal negative outcomes, is still controversial. Medical records of pregnancies in women with previous bariatric surgery were retrieved and outcomes were assessed according to three different time thresholds (12, 18 and 24months). The association between time from surgery to conception and the presence of adverse outcomes was analysed. Eighty-six pregnancies were assessed. Weight gain was higher (p = 0.014) and more adequate (p = 0.041) when pregnancy occurred more than 12months after surgery. Foetal growth percentile was lower when pregnancy was achieved before 24months following surgery (p = 0.021). No differences among groups were found in other assessed outcomes (BMI, gestational age at delivery, type of delivery, gestational diabetes, pregnancy hypertensive disease, anaemia, preterm delivery, foetal weight, foetal growth restriction, Apgar score, admission to neonatal intensive unit) in all considered thresholds. No association between time from surgery to conception and the presence of adverse outcomes was found. Despite differences found in maternal weight gain and foetal growth percentile, our study does not support the recommendation to delay pregnancy based on a fixed deadline. Other factors, including a more individualised approach, need to be considered.