Growth Velocity Research Articles

Nutritional status as predictors for quality of life among caregivers of children with severe cerebral palsy.

Individuals with severe cerebral palsy (CP) often experience various health issues, including feeding difficulties, which can adversely affect their nutritional status and caregivers' quality of life, e.g., more time spent for feeding rather than own selfcare. This study aimed to determine the prevalence of poor nutritional status among individuals with severe CP and explore its role as predictors for caregivers' quality of life. This cross-sectional study was conducted in a government hospital (Cheras Rehabilitation Hospital), Community-Based Rehabilitation (CBR) Program, and Spastic Centre [non-profit organization (NGO)] in Klang Valley, Malaysia. Seventy-one participants with Gross Motor Function Classification System (GMFCS) level IV and V were recruited. Sociodemographic data, health-associated data, and anthropometric data were collected. Caregivers' quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) CP module version 3.0 which included domains such as Movement and Balance, Eating Activities, and School Activities. Most participants were males (60.6%), with 61 classified as level IV in the GMFCS classification. According to the Eating and Drinking Ability Classification System (EDACS), 59 children were at level IV. In total, 40.8% were underweight according to CP growth chart and 49.3% had mid-upper arm circumference (MUAC) readings below the 5th percentile. The lowest scores in the PedsQL CP module version 3.0 were observed in the Daily Activities (5.34±10.87), and School Activities domains (8.15±18.65). Sociodemographic and anthropometric data, including body mass index (BMI)-for-age, MUAC, body fat, triceps, and subscapular skinfold measurement, were predictors for the School Activities domain [F (11, 44)=3.981, P<0.005, R2=0.499]. Poor nutritional status in individuals with severe CP has been shown to negatively impact caregivers' quality of life. Therefore, a multidisciplinary approach involving nutritional intervention is essential to improve dietary provision and the nutritional status of children with CP.

Enhanced structural damage behavior of liquid-filled tank by reactive material projectile impact

A series of ballistic experiments were performed to investigate the damage behavior of high velocity reactive material projectiles (RMPs) impacting liquid-filled tanks, and the corresponding hydrodynamic ram (HRAM) was studied in detail. PTFE/Al/W RMPs with steel-like and aluminum-like densities were prepared by a pressing/sintering process. The projectiles impacted a liquid-filled steel tank with front aluminum panel at approximately 1250 m/s. The corresponding cavity evolution characteristics and HRAM pressure were recorded by high-speed camera and pressure acquisition system, and further compared to those of steel and aluminum projectiles. Significantly different from the conical cavity formed by the inert metal projectile, the cavity formed by the RMP appeared as an ellipsoid with a conical front. The RMPs were demonstrated to enhance the radial growth velocity of cavity, the global HRAM pressure amplitude and the front panel damage, indicating the enhanced HRAM and structural damage behavior. Furthermore, combining the impact-induced fragmentation and deflagration characteristics, the cavity evolution of RMPs under the combined effect of kinetic energy impact and chemical energy release was analyzed. The mechanism of enhanced HRAM pressure induced by the RMPs was further revealed based on the theoretical model of the initial impact wave and the impulse analysis. Finally, the linear correlation between the deformation-thickness ratio and the non-dimensional impulse for the front panel was obtained and analyzed. It was determined that the enhanced near-field impulse induced by the RMPs was the dominant reason for the enhanced structural damage behavior.

Real-world evidence regarding the growth of very premature infants with small for gestational age after birth: a multicenter survey in China

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

Association of Birth Weight Centiles and Gestational Age With Cognitive Performance at Age 5 Years

Birth weight percentiles (BWPs) are often dichotomized at the 10th percentile and show statistically significant association with later cognitive performance, for both preterm and term-born children. However, research testing nonlinear associations between BWPs and cognitive performance is scarce. To investigate culturally invariant, nonlinear associations of BWPs and gestational age with later cognitive performance. In this cohort study, participants with valid neonatal and cognitive data were combined from 4 observational cohorts, including the Millennium Cohort Study, the National Longitudinal Survey of Youth 1979 Child and Young Adult cohort, Growing Up in Ireland, and the Longitudinal Study of Australian Children, with children born between 2000 and 2002, 1980 and 2010, 2007 and 2008, and 2003 and 2004, respectively. Neonatal data were parent reported before age 1 year. At approximately 5 years of age, multiple cognitive tests were performed. Follow-up at 5 years of age was the predominant focus. Data were analyzed July 17, 2023. The parent-reported neonatal data were used to calculate BWPs according to the Fenton growth chart. Scores for IQ were created from multiple measures of cognition, which were z standardized separately within each cohort. Of 30 643 participants (50.8% male), 7.5% were born preterm (before 37 weeks gestation) and 92.5% were term born (between 37 and 42 weeks gestation). In the pooled data using multivariate adaptive regression splines, IQ linearly increased by 4.2 points as BWPs increased from the first to the 69th percentile before completely plateauing. For gestational age, IQ linearly increased by 1.3 points per week up until 32 weeks, with the association reducing to 0.3 points per week after 32 weeks. The association of BWP with IQ was not moderated by gestational age. For term-born infants, the estimated IQ score was only clinically meaningfully lower than average when birth weight was below the third percentile. Consistent results were found when instead using multivariable regression where gestational age and BWPs were categorized into groups. In this cohort study, lower BWPs and gestational age were independently associated with lower IQ. For term-born infants, a cutoff of the third percentile would be more appropriate than the traditionally used 10th percentile when the aim is estimating meaningful cognitive differences.

Identifying underweight in infants and children using growth charts, lookup tables and a novel "MAMI" slide chart: A cross-over diagnostic and acceptability study.

Malnutrition is a leading cause of preventable deaths in infants and children. To benefit from treatment and prevention programmes, malnourished children must first be identified. Low weight-for-age is an anthropometric indicator of malnutrition which is gaining much recent attention because it is particularly effective at identifying children at highest risk of death. However, assessing weight-for-age can be challenging. We aimed to evaluate a novel, low-cost weight-for-age slide chart and compare its performance against two traditional methods. We conducted a cross-over diagnostic study comparing a new "MAMI" slide-chart against traditional growth charts and look-up tables. Participants were health and public health professionals working or studying in the UK. Each acted as their own control, using all three methods but in random order. Under timed conditions, they evaluated hypothetical scenarios, arranged in a random sequence. Each tool's diagnostic accuracy and response rate were compared. User preferences were also recorded. Sixty-two participants took part. Diagnostic accuracy was highest for the MAMI chart: 79%(351/445) correct assessments. Accuracy using look-up tables was 70%(308/438). Growth charts performed worst: 61%(217/353) correct (p-value<0.01). The mean number of scenarios (±SD) correctly identified by each participant in 4-minutes was 3.5(±2.19) using growth charts; 4.97(±2.50) using look-up tables; 5.66(±2.69) using MAMI charts (ANOVA, p-value<0.01). This translates to approximately 53, 75 and 85 correct assessments per participant in an hour for the respective tools. No statistically significant differences were found with participants' years of experience or profession type. Most participants, 43/62(69%), preferred the MAMI chart and reported it to be easier and faster to use than traditional tools. We conclude that weight-for-age assessment is quicker and more accurate using the newly-developed MAMI slide chart as opposed to traditional methods. It should be further field tested in other settings since the potential to improve the efficiency and effectiveness of treatment programmes is great.

Growth hormone therapy for children with Duchenne muscular dystrophy and glucocorticoid induced short stature

ObjectiveTo evaluate the outcome of recombinant human Growth Hormone (rhGH) therapy in patients with Duchene Muscular Dystrophy (DMD) and glucocorticoid treatment with compromised growth. DesignFour DMD patients on Deflzacort 0.6–0.85 mg/kg/day or prednisolone 0.625 mg/kg/day recieved rhGH (0.24 mg/kg/week) for 6–18 months. Primary outcomes were Growth velocity and Height for age Z-scores (Height SD). ResultsGrowth velocity increased from 0 to 3.25 cm/year prior to GH therapy to 3.3–7.8 cm/year over a period of 6–18 months. The typical Height SD decline in DMD was reversed in two patients and blunted in one. No adverse events or deterioration in cardiac or respiratory parameters were associated with the rhGH treatment. ConclusionsrhGH appears to be safe and efficient in promoting growth of patients with glucocorticoid induced growth failure in DMD.

Preece-Baines 1 model validation for cross-sectional data in male soccer players according to maturity status.

The aim of the present study was to compare the Preece-Baines 1 (PB1) model fit between longitudinal and cross-sectional data in male soccer players and to adjust the height growth curve by maturity status. A final sample of 57 male Portuguese soccer players from professional soccer academies was included. Longitudinal height records were measured between 8 and 17 times in each subject from 2-8 years to 14-17 years. Additionally, longitudinal height records were used as cross-sectional data along with 1087 cross-sectional height records taken from 602 Portuguese soccer players. Skeletal age was estimated by Tanner-Whitehouse III method from a left hand-wrist radiograph. Age at peak height velocity (PHV) was estimated by PB1 model for longitudinal and cross-sectional data and by maturity status. No significant differences were found between all the longitudinal estimates of 57 players and the random cross-sectional samples for, S1 parameter and for growth velocity at PHV, at TO, and for age at PHV. The age at PHV in early, on-time, and late maturers were 12.26, 12.9, and 13.58 years, respectively. PB1 adjusted the height growth of Portuguese male soccer players from cross-sectional data, obtaining an estimate PHV very similar to that found from longitudinal data. A maturity time difference of ≈0.6 years was found between the age at PHV of on-time, early, and on-time and late maturity state.

Hemoglobin H Disease and Growth: A Comparative Study of DHbH and NDHbH Patients.

Hemoglobin H disease (HbH), a hemoglobinopathy resulting from abnormal alpha globin genes, is classified into two categories: deletional HbH (DHbH) and non-deletional HbH (NDHbH). The alpha-mutation genotypes exhibit a range of clinical anemias, which differentially impact patient growth. This retrospective study assessed the growth of HbH patients at Siriraj Hospital, Mahidol University. Patients diagnosed with HbH between January 2005 and April 2021 were analyzed using growth standard scores of the Thai Society for Pediatric Endocrinology (2022 version) and BMI-for-age Z scores of the World Health Organization. Growth failure was defined as a patient's height for age exceeding two standard deviations below the mean. Of the 145 HbH patients, 75 (51.7%) had NDHbH, with --SEA/αCSα being the most common genotype (70 patients; 93.3%). The mean baseline hemoglobin level was significantly lower in NDHbH patients than in DHbH patients (8.16 ± 0.93 g/dL vs. 9.51 ± 0.68 g/dL; P < 0.001). Splenomegaly and growth failure prevalences were higher in NDHbH patients (37.3% vs. 0%, with P < 0.001, and 22.7% vs. 8.6%, with P = 0.020, respectively). Multivariable analysis revealed splenomegaly > 3 cm was associated with growth failure (OR = 4.28; 95% CI, 1.19-15.39; P = 0.026). NDHbH patients exhibited lower hemoglobin levels and more pronounced splenomegaly than DHbH patients. Growth failure can occur in both HbH types but appears more prevalent in NDHbH. Close monitoring of growth velocity is essential, and early treatment interventions may be required to prevent growth failure.

Active modulation of competitive nucleation and eutectic growth for refractory Re72.5W27.5 alloy under electrostatic levitation state

The rapid eutectic growth of refractory liquid Re72.5W27.5 alloy was realized under electrostatic levitation state, which attained a maximum undercooling of 510 K (0.16TE). The active modulation of competitive nucleation was achieved by triggered nucleation and spontaneous nucleation respectively. For triggered nucleation between 107 and 454 K undercooling, anomalous eutectic grew primarily from the liquid alloy in the first recalescence, which was followed by lamellar eutectic growth epitaxially in the second recalescence. However, for spontaneous nucleation in the undercooling range of 366–510 K, σ dendrite became the primary phase in the first recalescence. The solidification mode of remaining liquid varied from lamellar eutectic to only (Re) phase as alloy undercooling increased beyond the critical value of 426 K. Once liquid undercooling exceeded 474 K, only σ phase prevailed in the whole solidifying process. It was found that the growth velocities for anomalous eutectic and σ dendrite both displayed power laws versus liquid undercooling. But anomalous eutectic exhibited a faster growth kinetics than σ dendrite in their coexistent undercooling regime of 366–454 K. Furthermore, the Vickers hardness decreased with undercooling in the case of triggered nucleation, whereas it increased for spontaneous nucleation because the harder σ dendrite had larger volume fraction with enhanced undercooling. The maximum Vickers hardness attained 1679 HV corresponding to the highest undercooling.

On estimation of growth velocity of films during magnetron sputtering

On estimation of growth velocity of films during magnetron sputtering

Effect of Undercooling on the Microstructure and Mechanical Properties of Hyper-eutectic Ni–Sn Alloy

In this study, container-less solidification of hyper-eutectic Ni–Sn alloy has been performed by using the electromagnetic levitation technique. The effect of undercooling on the formed microstructure and on the mechanical properties have been investigated. Growth velocities were determined by high-speed video-imaging of the solidification process. A step change in the growth velocities that are increasing with increasing undercooling is observed. This aligns with an observed first change in the microstructure between low and intermediate undercoolings. At the lower undercoolings, a pro-eutectic Ni3Sn phase along with lamellar eutectic structure in the inter-dendritic region is found. At intermediate undercooling of 100–150 K, a divorced eutectic microstructure is observed whereas at undercoolings above 165 K α-Ni precipitates are observed within β-Ni3Sn dendrites. Microhardness testing revealed higher strength for the lamellar phase as compared to the non-lamellar phase. Nano-indentation has been performed to determine the hardness and strength of individual phases in the microstructure.

Body surface area is a predictor of maturity status in school children and adolescents

BackgroundGenerally, Body surface area (BSA) changes significantly during growth and maturation. These increases portend a possible relationship between body size as determined by BSA with maturational status in children and adolescents.ObjectiveTo determine the relationship between maturity status (MS) obtained by non-invasive anthropometric methods and body surface area (BSA) in children and adolescents of both sexes in a regional population of Chile. Additionally, we sought to verify the type of linear or nonlinear relationship between MS and BSA in both sexes.MethodsA descriptive (cross-sectional) study was designed in 950 children and adolescents of both sexes (539 males and 411 females). The age range ranged from 6.0 to 17.9 years. Anthropometric measurements were evaluated: body weight, standing height, sitting height. MS was assessed by means of two non-invasive anthropometric techniques. Both techniques predict peak years of growth velocity (APHV) through a regression equation for each sex. BSA (m2) was estimated by means of the Haycock equation.ResultsThe R2 in the linear model is relatively lower (R2 = 0.80 to 0.89 in males and 0.74 to 0.66 in females) in relation to the nonlinear quadratic model (R2 = 0.81 in males and 0.76 to 0.69). The quadratic nonlinear quadratic model reflected an adequate fit (RMSE) for the data set, being in men (RMSE = 1.080 and 1.125), while in women (RMSE = 1.779 and 1.479).ConclusionBSA is positively associated with MS determined by two non-invasive methods in Chilean children and adolescents: The nonlinear quadratic model was a better fit to the data distribution. The results suggest the use of BSA as a possible predictor of maturity status in Chilean youth.

Upaya Meningkatkan Minat Baca Siswa SD melalui Literasi Digital

Interest in reading can grow by itself in each individual, by getting used to reading activities, each individual will have broader knowledge. Reading is one of the means to learn about the world that you want to know, helps students to learn various knowledge, adds information and can also add to students' vocabulary that they did not know before. Thus reading is very important for students. This reading activity is an activity that can improve HR. In writing this article, the author uses the literature study method. which this method is to collect a number of books, library data, read and review the materials and sources of information that have been collected. The author collects data sourced from journals, scientific articles, and literature reviews that contain concepts written by researchers. Interest is an attitude that exists within a person or as special attention to certain things, this is formed because of the desire and feeling of happiness that arises from within a person. Interest in reading comes gradually, like a growth chart. Based on the results of the research and discussion, it can be concluded that the reading interest of elementary school children is currently still low. Efforts to increase students' interest in reading can be done by utilizing technology, namely the use of digital literacy. besides that increasing students' interest in reading can also be influenced by internal or external factors, then in an effort to increase students' interest in reading, teachers and parents also play an important role in fostering motivation and increasing interest in reading from within these students.

Does urban growth mean the loss of greenness? A multi-temporal analysis for Chinese cities

Urban growth is recognized as the conversion of vegetated surface to built-up surface. However, there is still no consensus about the urbanization-induced dynamic of vegetation greenness in view of existing literatures. In this study, we aimed to empirically investigate whether urban growth mean the loss of vegetation greenness. We selected 340 Chinese cities as the study areas, relied on consistent multi-temporal remotely sensed data and adopted linear regression analysis, annual growth area, Tail-Sen slope and Mann-Kendall models. Results show that although vegetation greening generally lagged behind urban growth in the monitoring period, a tendency of their consistent speeding up can be observed over time. By categorizing four forms and four trends of vegetation greenness dynamics related to urban growth, we revealed the diversity of Chinese cities. The former focused on the velocity of urban growth and vegetation greenness dynamics within newly urbanized area in three phases, i.e., 2003–2008, 2008–2013 and 2013–2018. The latter focused on the interannual trends of vegetation greenness dynamics among the previously existing and newly urbanized areas. The key finding is that, in over 85 % of the cities, we measured an increase of vegetation greenness along with urban growth. In addition, our detailed results allow quantifying the impact of urbanization in Chinese cities on vegetation protection and sustainable development.

Efficacy and Safety of Triptorelin 3-Month Formulation in Chinese Children with Central Precocious Puberty: A Phase3, Open-Label, Single-Arm Study.

Triptorelin is available as 1- and 3-month prolonged-release (PR) formulations; at the time of the study, only the former was approved for central precocious puberty (CPP) in China. This study assessed the efficacy and safety of the triptorelin 3-month PR formulation in Chinese children with CPP. In this 12-month, prospective, open-label, multicentre, single-arm study (NCT04736602), Chinese children (mean age [standard deviation (SD)], 7.6 ± 0.8years) with CPP received triptorelin pamoate 15mg on day1 and at months 3, 6 and 9. The primary endpoint was the proportion with luteinizing hormone (LH) suppression (stimulated peak LH ≤ 3IU/L after gonadotropin-releasing hormone [GnRH] stimulation) at month 3. Secondary endpoints included changes from baseline in hormone levels and clinical parameters, as well as safety assessments. Overall, 32 children were enrolled, including three boys. LH suppression to prepubertal levels (≤ 3IU/L) after GnRH stimulation was observed in 100%, 93.5% and 93.5% of participants at months 3, 6 and 12, respectively. Basal and peak LH and follicle-stimulating hormone levels were substantially suppressed at months 3, 6 and 12, and most participants showed sex hormone suppression. At months 6 and 12 respectively 92.9% and 89.3% of girls had stable breast development, and all boys had stable genital development. There was a decrease in mean growth velocity from baseline (8.96cm/year) to months 3, 6 and 12 (8.07, 5.24 and 6.94cm/year, respectively). The mean difference between bone and chronological age decreased from baseline (2.85years) to month 12 (2.39years). In girls, uterine length was stable or reduced at month 12; in boys, testicular volume was reduced. Triptorelin was well tolerated. The triptorelin 3-month PR formulation demonstrated similar efficacy to that previously reported in non-Chinese patients with CPP and had an acceptable safety profile. This supports triptorelin 3-month PR as a viable option for Chinese children with CPP.

Therapeutic effect of recombinant human growth hormone on children with growth hormone deficiency and different pituitary developmental conditions: a prospective study

To investigate the therapeutic effect of recombinant human growth hormone (rhGH) on children with growth hormone deficiency (GHD) and different pituitary developmental conditions. A prospective study was performed on 90 children with GHD who were admitted to Xuchang Maternity and Child Health Hospital from June 2020 to December 2021. According to pituitary height on the median sagittal plane, they were divided into three groups: pituitary dysplasia group (n=45), normal pituitary group (n=31), and enlarged pituitary growth group (n=14). The changes in body height, growth velocity, height standard deviation score and serum levels of insulin-like growth factor binding protein-3 (IGFBP-3) and insulin-like growth factor-1 (IGF-1) were examined after treatment in the above three groups, and the differences of the above indices before and after treatment were compared among the three groups. After treatment, all three groups had significant increases in body height, growth velocity, height standard deviation score, and the serum levels of IGFBP-3 and IGF-1 (P<0.05). Compared with the normal pituitary group, the pituitary dysplasia group and the enlarged pituitary growth group had significantly higher values in terms of the differences in body height, growth velocity, height standard deviation score, IGF-1, and IGFBP-3 before and after treatment (P<0.05). There was no significant difference in the incidence rate of adverse reactions among the three groups (P>0.05). In GHD children with different pituitary developmental conditions, rhGH can promote bone growth and increase body height, especially in children with pituitary dysplasia and pituitary hyperplasia, with good safety.

Stunting and wasting in neurological Wilson disease: Role of copper, zinc, and insulin-like growth factor-I.

Copper (Cu) and zinc (Zn) are important trace elements for the growth and development of children. In Wilson disease (WD), impaired Cu metabolism may affect growth. This study was conducted to evaluate the height and weight of children with neurological WD and correlate these with serum Cu, Zn, and insulin-like growth factor-I (IGF-I). This prospective cohort study was conducted in a tertiary care teaching institute. Children with neurologic WD were included. The height, weight, and body-mass index of each child were measured and categorized according to the revised national growth chart. Serum Cu, Zn, calcium, alkaline phosphatase, albumin, thyroid-stimulating hormone, and urinary-Cu were measured. Serum IGF-1 was measured by enzyme-linked immunosorbent assay. The relationship between height and weight with trace elements and IGF was analyzed using parametric or non-parametric tests. There were 52 children (5-18 years) with neurologic WD. Thirty-six (69.2%) children had normal height, 12 (23.1%) were tall, and 4 (7.7%) were stunted. Forty-six (88.5%) children had normal weight and six (11.5%) children were underweight. IGF-1 correlated with height, weight, duration of treatment, and serum Zn level. About 15.4% of children had stunting and/or wasting, which was associated with low levels of serum IGF-I, Zn, and calcium. Stunting and/or wasting occurs in 15.4% of children with neurologic WD and is associated with reduced serum IGF-I, Zn, and calcium concentration. Adjunctive Zn and calcium treatment may help in achieving normal growth.

The impact of different growth charts on birthweight prediction: obstetrical ultrasound vs magnetic resonance imaging

The estimation of fetal weight (EFW) by fetal magnetic resonance imaging (MRI) is a simple and rapid method, with a high sensitivity to predict birthweight (BW) in comparison to ultrasound (US). Several national and international growth charts are currently in use but there is substantial heterogeneity among these charts due to: variations in the selected populations from which they were derived, different methodologies and statistical analysis of data. The purpose of this study was to compare the performance of MRI and US for the prediction of BW using three commonly used fetal growth charts: INTERGROWTH-21st (IG-21) project, World Health Organization (WHO), and Fetal Medicine Foundation (FMF). Data derived from a prospective, single center, blinded cohort study that compared the performance of MRI and US between 36+0/7 to 36+6/7 weeks of gestation (WG) for the prediction of BW ≥ 95th percentile was reanalyzed. EFW were categorized as > or < 5th, > or < 10th, > or < 90th, and > or < 95th percentile according to the three growth charts. BW was similarly categorized according to the BW standards of each chart. The performances of US and MRI for the prediction of BW < 5th, < 10th, > 90th, and > 95th percentile using the different growth charts were compared. Data were analysed with R software version 4.1.2. The comparison of sensitivity and specificity was done by McNemar and exact binomial tests. A p-value < 0.05 was considered as statistically significant. 2378 women were eligible for final analysis. US and MRI were performed at a median gestational age of 36+3/7 WG, delivery occurred at a median gestational age of 39+3/7 WG, and median BW was 3380 grams. The incidences of BW < 5th and < 10th percentiles were highest with the FMF chart and lowest with the IG-21 chart, whereas the incidences of BW > 90th and > 95th percentiles were lowest with the FMF chart and highest with the IG-21 chart. The sensitivity of MRI with an EFW > 95th percentile in the prediction of BW > 95th percentile was significantly higher than that of US across the three growth charts, however, its specificity was slightly lower than that of US. In contrast, the sensitivity of MRI with an EFW <10th percentile for predicting BW <10th percentile was significantly lower than US in the IG-21 and FMF charts, whereas the specificity and positive predictive value (PPV) of MRI were significantly higher than US for the three charts. Findings for the prediction of BW > 90th percentile were close to those of BW > 95th percentile, and findings for the prediction of BW < 5th percentile were close to those of BW < 10th percentile. The sensitivity of MRI is superior to US for the prediction of large for gestational age (LGA) fetuses and inferior to US for the prediction of small for gestational age (SGA) fetuses across the three different growth charts. The reverse is true for the specificity of MRI in comparison to the specificity of US.

Sex non-specific growth charts and potential clinical implications in the care of transgender youth.

The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) created separate growth charts for girls and boys because growth patterns and rates differ between sexes. However, scenarios exist in which this dichotomizing "girls versus boys" approach may not be ideal, including the care of non-binary youth or transgender youth undergoing transitions consistent with their gender identity. There is therefore a need for growth charts that age smooth differences in pubertal timing between sexes to determine how youth are growing as "children" versus "girls or boys" (e.g., age- and sex-neutral, compared to age- and sex-specific, growth charts). Employing similar statistical techniques and datasets used to create the CDC 2000 growth charts, we developed age-adjusted, sex non-specific growth charts for height, weight, and body mass index (BMI), and z-score calculators for these parameters. Specifically, these were created using anthropometric data from five US cross-sectional studies including National Health Examination Surveys II-III and National Health and Nutrition Examination Surveys I-III. To illustrate contemporary clinical practice, we overlaid our charts on CDC 2000 girls and boys growth charts. 39,119 youth 2-20 years old (49.5% female; 66.7% non-Hispanic White; 21.7% non-Hispanic Black) were included in the development of our growth charts, reference ranges, and z-score calculators. Respective curves were largely superimposable through around 10 years of age after which, coinciding with pubertal onset timing, differences became more apparent. We conclude that age-adjusted, sex non-specific growth charts may be used in clinical situations such as transgender youth in which standard "girls versus boys" growth charts are not ideal. Until longitudinal auxological data are available in these populations, our growth charts may help to assess a transgender youth's growth trajectory and weight classification, and expectations surrounding these.

Head Circumference is Relatively Larger Than Size: A Novel Screening Tool for Infants With Sagittal Craniosynostosis

Background: The efficacy of minimally invasive techniques for addressing isolated sagittal craniosynostosis decreases with age; thus, timely referral is critical. We sought to identify a screening tool using data from well-child visits. We hypothesized that many infants with sagittal craniosynostosis, but no macrocephaly based on growth chart plotting, in fact have a relative macrocephaly. Methods: All infants with CT and surgically/pathologically confirmed isolated sagittal craniosynostosis were identified. Growth chart data was collected (head circumference (HC), weight, crown-to-toe-length, and World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) percentiles and deviation ( z-scores)). Relative macrocephaly was defined as head circumference &gt;2SD from size (weight and/or length). Results: Initial pilot screen indicated that WHO growth chart data has utility as a screening tool. Subsequent retrospective case-control study with area under the curve (AUC) analysis revealed that HC:length ratio ≥0.71 is indicative of isolated sagittal craniosynostosis as young as 1 week of age, while HC:length ratio ≥0.67 represents the maximization of sensitivity (0.89) and specificity (1.00) as early as 2 weeks old. Prospective internal validation with logistic regression demonstrated that at ages 1 to 2 months greater discriminatory value HC:length ratio was observed. Conclusions: When length is added to head circumference as a screening tool we may identify an abnormal growth pattern beginning as early as 1 week. This represents an opportunity to design an automated alert easily programed into the electronic medical records and may prompt pediatricians to refer patients to craniofacial surgeons early.