Humerus Length Research Articles

In utero effects of opioids on fetal growth

Background Studies indicate antenatal opioid use is associated with birth size deficits, as evidenced by reductions in birth weight and head circumference. However, there remains a limited understanding of how early this growth restriction occurs, and what specific parameters are affected. This novel study evaluated global and specific growth deficits associated with prenatal opioid exposure between 18–22 weeks’ gestation as assessed during anatomy ultrasounds. Methods Pregnant women who completed an anatomy ultrasound were identified via electronic medical records from a large academic obstetric practice. The study group used opioids, with tobacco and/or marijuana use permitted (n = 41). The control group could have used tobacco and/or marijuana, but not opioids (n = 308). Neither group had alcohol or other drug exposure. Records were reviewed for medical history and ultrasound size parameters, coded as percentiles for gestational age. Results Demographics and medical histories were compared with several significant differences noted. After controlling for these differences, significant (p < 0.05) growth deficits were identified in opioid-exposed fetuses. Specifically, reductions >10 percentile points were observed in head circumference, biparietal diameter, and humerus length for opioid-exposed fetuses compared to controls. Additionally, intrauterine growth restriction (IUGR) was diagnosed five times more often. Femur length was significantly reduced in opioid-exposed fetuses prior to adjustment for confounding (p = .016), but this reduction was not significant (p = .072) after controlling for background differences. Estimated fetal weight (p = .274) and abdominal circumference (p = .633) were not significantly different between exposure groups. Conclusion Fetal opioid exposure predicted various bone growth deficits during routine anatomy ultrasound, indicating the effects of opioid exposure on size deficits may be evident as early as 18–22 weeks’ gestation. These findings may also suggest that in utero opioid exposure negatively impacts bone growth specifically rather than weight or fat/muscle mass. Additional studies with larger sample sizes may also reveal significantly reduced femur length, further supporting a negative impact on bone growth. Future studies evaluating bone health and immune function in children after antenatal opioid exposure may help clarify this specific effect of opioids on bone development.

Fetal Humeral Diaphyseal Length in the Second Trimester - A Radiographic Observational Study among Indian Population.

The present study was performed to provide a normal reference range for humerus diaphysis length at the second trimester of pregnancy in an Indian population. This cross-sectional study was performed on 25 radiographs of aborted normal human fetuses of gestational age (GA) between 13th and 28th weeks. The radiographs were used to measure the maximum length of the humerus using a vernier calliper. Data were collected, tabulated, and statistically analyzed. The mean diaphyseal length of humerus at the fourth lunar month was 22.18 ± 6.59 mm, and at the seventh lunar month, it was 41.39 ± 10.08 mm. Simple linear regression analysis shows a strongly significant linear relationship of humerus length with GA, biparietal diameter, head circumference, and abdomen circumference. We have provided a normal reference range for humerus diaphysis length at the second trimester of pregnancy in an Indian population.

Preoperative estimation of humerus intramedullary nail length using clinical landmarks

PurposeIntramedullary interlocking nailing is one of the accepted methods of treating humerus diaphyseal fractures. Appropriate nail length and diameter are of paramount importance to achieve a stable fracture fixation. Estimating the nail length can be as challenging in certain cases as it is important. This study aims to provide an easy-to-use formula utilizing clinical measurements from contra lateral arm to accurately estimate humeral nail length. MethodsThis descriptive cross-sectional study was conducted at 3 tertiary care hospitals in Mangalore, India. Patients above the age of 18 years coming to the outpatient department with elbow, shoulder or arm complaints requiring radiological investigation from July 2021 to July 2022 were included. Patients with fractures or dislocations of upper limbs, malunited or non-united fractures of upper limbs, congenital or developmental deformities and patients with open growth plates were excluded. Patients’ variables (like age and gender), radiological humerus length and contralateral arm clinical measurements were recorded. An independent samples t-test was used for univariate analysis, and linear regression analysis was done to estimate the desired nail length using the clinical measurement of the humerus (cm) in both genders separately. The significance level was set at p < 0.05. ResultsOur study included 204 participants of which 108 were male and 96 were female. The formula for predicting humeral nail length in males is (−2.029) + (0.883 × clinical measurement). The formula for females is 1.862 + (0.741 × clinical measurement). A simplified formula to determine humeral nail length is 0.9 clinical length – 2 cm (in males) and 0.7 × clinical length + 2 cm (in females). ConclusionTo improve the stability of fixation with intramedullary nails it is imperative to select the appropriate nail length. There have been studies that devised reliable methods of determining nail lengths in the tibia and femur using preoperative clinical measurements. A similar clinical method of determining humeral nail length is lacking in the literature. Our study was able to correlate radiological lengths of the humerus medullary canal with clinical measurements performed using anatomical landmarks to arrive at a formula. This allows for a reliable and easy nail length determination preoperatively.

Anatomic consideration of the radial nerve in relation to humeral length for unilateral external fixation: a retrospective study using magnetic resonance imaging findings in korean

BackgroundThis study aimed to present a safe zone for distal pin insertion for external fixation using magnetic resonance imaging (MRI) images.MethodsAll patients who took at least one upper arm MRI from June 2003 to July 2021 were searched via a clinical data warehouse. For measuring the humerus length, proximal and distal landmarks were set as the highest protruding point of the humeral head and lowermost margin of ossified bone of the lateral condyle, respectively. For children or adolescents with incomplete ossification, the uppermost and lowermost ossified margin of the ossification centers were set as proximal and distal landmarks respectively. The anterior exit point (AEP) was defined as the location of the radial nerve exiting the lateral intermuscular septum to the anterior humerus and distance between the distal margin of the humerus and AEP was measured. The proportions between the AEP and full humeral length were calculated.ResultsA total of 132 patients were enrolled for final analysis. The mean humerus length was 29.4 cm (range 12.9–34.6 cm). The mean distance between the ossified lateral condyle and AEP was 6.6 cm (range 3.0–10.6 cm). The mean ratio of the anterior exit point and humeral length was 22.5% (range 15.1–30.8%). The minimum ratio was 15.1%.ConclusionA percutaneous distal pin insertion for humeral lengthening with an external fixator may be safely done within 15% length of the distal humerus. If pin insertion is required more proximal than distal 15% of the humeral shaft, an open procedure or preoperative radiographic assessment is advised to prevent iatrogenic radial nerve injury.

Development and Validation of a Small for Gestational Age Screening Model at 21-24 Weeks Based on the Real-World Clinical Data.

Small for gestational age (SGA) is a condition in which fetal birthweight is below the 10th percentile for the gestational age, which increases the risk of perinatal morbidity and mortality. Therefore, early screening for each pregnant woman is of great interest. We aimed to develop an accurate and widely applicable screening model for SGA at 21-24 gestational weeks of singleton pregnancies. This retrospective observational study included medical records of 23,783 pregnant women who gave birth to singleton infants at a tertiary hospital in Shanghai between 1 January 2018 and 31 December 2019. The obtained data were nonrandomly classified into training (1 January 2018 to 31 December 2018) and validation (1 January 2019 to 31 December 2019) datasets based on the year of data collection. The study variables, including maternal characteristics, laboratory test results, and sonographic parameters at 21-24 weeks of gestation were compared between the two groups. Further, univariate and multivariate logistic regression analyses were performed to identify independent risk factors for SGA. The reduced model was presented as a nomogram. The performance of the nomogram was assessed in terms of its discrimination, calibration, and clinical usefulness. Moreover, its performance was assessed in the preterm subgroup of SGA. Overall, 11,746 and 12,037 cases were included in the training and validation datasets, respectively. The developed SGA nomogram, comprising 12 selected variables, including age, gravidity, parity, body mass index, gestational age, single umbilical artery, abdominal circumference, humerus length, abdominal anteroposterior trunk diameter, umbilical artery systolic/diastolic ratio, transverse trunk diameter, and fasting plasma glucose, was significantly associated with SGA. The area under the curve value of our SGA nomogram model was 0.7, indicating a good identification ability and favorable calibration. Regarding preterm SGA fetuses, the nomogram achieved a satisfactory performance, with an average prediction rate of 86.3%. Our model is a reliable screening tool for SGA at 21-24 gestational weeks, especially for high-risk preterm fetuses. We believe that it will help clinical healthcare staff to arrange more comprehensive prenatal care examinations and, consequently, provide a timely diagnosis, intervention, and delivery.

A Whey-Based Diet Can Ameliorate the Effects of LPS-Induced Growth Attenuation in Young Rats.

Chronic inflammation in childhood is associated with impaired growth. In the current study, a lipopolysaccharide (LPS) model of inflammation in young rats was used to study the efficacy of whey-based as compared to soy-based diets to ameliorate growth attenuation. Young rats were injected with LPS and fed normal chow or diets containing whey or soy as the sole protein source during treatment, or during the recovery period in a separate set of experiments. The body and spleen weight, food consumption, humerus length, and EGP height and structure were evaluated. Inflammatory markers in the spleen and markers of differentiation in the EGP were assessed using qPCR. The LPS led to a significant increase in the spleen weight and a decrease in the EGP height. Whey, but not soy, protected the animals from both effects. In the recovery model, whey led to increased EGP height at both 3 and 16 d post treatment. The most affected region in the EGP was the hypertrophic zone (HZ), which was significantly shortened by the LPS treatment but enlarged by whey. In conclusion, LPS affected the spleen weight and EGP height and had a specific effect on the HZ. Nutrition with whey protein appeared to protect the rats from the LPS-induced growth attenuation.

Calf circumferences in fetuses and neonates with and without talipes equinovares. A prospective cohort study.

Children and adults with talipes equinovarus (TEV) have smaller calves and shorter feet compared to non-affected controls. Do these changes have a prenatal onset? A prospective cohort study (January 2020-July 2021) was conducted with serial ultrasonographic measurements at 20 and 28weeks gestation and measurements directly and 6weeks after birth. Calf circumference and width, foot length and length of humerus, ulna, radius, femur, tibia and fibula were measured in TEV and were compared to a control population. Calculated sample size necessitated a minimal population of 10 cases with TEV and 50 controls. Twenty cases with TEV and 62 controls were included. Fetal calf circumference (p<0.001) and width (p<0.001) were smaller in the TEV group in comparison to the control group, which persisted after birth. Growth in foot length (p<0.001) and calf width (p 0.003) declined prenatally over time. The bone lengths and upper leg circumference were not smaller or shorter in TEV compared to controls. This prospective cohort study demonstrated the prenatal onset of reduced calf and foot size in fetuses with TEV from 20weeks and onwards, which persists directly after birth. To investigate whether reduction in circumference initiates TEV or is caused by TEV, further examination is needed.

Identification of Selection Signatures and Loci Associated with Important Economic Traits in Yunan Black and Huainan Pigs.

Henan Province is located in central China and rich in domestic pig populations; Huainan (HN) pigs are one of three Henan indigenous breeds with great performance, including early maturation, strong disease resistance and high meat quality. Yunan (YN) black pigs are a typical, newly cultivated breed, synthesized between HN pigs and American Duroc, and are subjected to selection for important traits, such as fast growth and excellent meat quality. However, the genomic differences, selection signatures and loci associated with important economic traits in YN black pigs and HN pigs are still not well understood. In this study, based on high-density SNP chip analysis of 159 samples covering commercial DLY (Duroc × Landrace × Large White) pigs, HN pigs and YN black pigs, we performed a comprehensive analysis of phylogenetic relationships and genetic diversity among the three breeds. Furthermore, we used composite likelihood ratio tests (CLR) and F-statistics (Fst) to identify specific signatures of selection associated with important economic traits and potential candidate genes. We found 147 selected regions (top 1%) harboring 90 genes based on genetic differentiation (Fst) in the YN-DLY group. In the HN-DLY group, 169 selected regions harbored 58 genes. In the YN-HN group, 179 selected regions harbored 77 genes. In addition, the QTLs database with the most overlapping regions was associated with triglyceride level, number of mummified pigs, hemoglobin and loin muscle depth for YN black pigs, litter size and intramuscular fat content for HN pigs, and humerus length, linolenic acid content and feed conversion ratio mainly in DLY pigs. Of note, overlapping 14 tissue-specific promoters' annotation with the top Fst 1% selective regions systematically demonstrated the muscle-specific and hypothalamus-specific regulatory elements in YN black pigs. Taken together, these results contribute to an accurate knowledge of crossbreeding, thus benefitting the evaluation of production performance and improving the genome-assisted breeding of other important indigenous pig in the future.

Largest-known fossil penguin provides insight into the early evolution of sphenisciform body size and flipper anatomy

AbstractRecent fossil discoveries from New Zealand have revealed a remarkably diverse assemblage of Paleocene stem group penguins. Here, we add to this growing record by describing nine new penguin specimens from the late Paleocene (upper Teurian local stage; 55.5–59.5 Ma) Moeraki Formation of the South Island, New Zealand. The largest specimen is assigned to a new species, Kumimanu fordycei n. sp., which may have been the largest penguin ever to have lived. Allometric regressions based on humerus length and humerus proximal width of extant penguins yield mean estimates of a live body mass in the range of 148.0 kg (95% CI: 132.5 kg–165.3 kg) and 159.7 kg (95% CI: 142.6 kg–178.8 kg), respectively, for Kumimanu fordycei. A second new species, Petradyptes stonehousei n. gen. n. sp., is represented by five specimens and was slightly larger than the extant emperor penguin Aptenodytes forsteri. Two small humeri represent an additional smaller unnamed penguin species. Parsimony and Bayesian phylogenetic analyses recover Kumimanu and Petradyptes crownward of the early Paleocene mainland NZ taxa Waimanu and Muriwaimanu, but stemward of the Chatham Island taxon Kupoupou. These analyses differ, however, in the placement of these two taxa relative to Sequiwaimanu, Crossvallia, and Kaiika. The massive size and placement of Kumimanu fordycei close to the root of the penguin tree provide additional support for a scenario in which penguins reached the upper limit of sphenisciform body size very early in their evolutionary history, while still retaining numerous plesiomorphic features of the flipper.UUID: https://zoobank.org/15b1d5b2-a5a0-4aa5-ba0a-8ef3b8461730

Training in the Initial Range of Motion Promotes Greater Muscle Adaptations Than at Final in the Arm Curl.

The effects of ROM manipulation on muscle strength and hypertrophy response remain understudied in long-term interventions. Thus, we compared the changes in strength and regional muscle hypertrophy after training in protocols with different ranges of motion (ROM) in the seated dumbbell preacher curl exercise using a within-participant experimental design. Nineteen young women had one arm randomly assigned to train in the initial ROM (INITIALROM: 0°-68°; 0° = extended elbow) while the contralateral arm trained in the final ROM (FINALROM: 68°-135°), three times per week over an eight-week study period. Pre- and post-training assessments included one repetition maximum (1RM) testing in the full ROM (0°-135°), and measurement of biceps brachii cross-sectional area (CSA) at 50% and 70% of humerus length. Paired t-tests were used to compare regional CSA changes between groups, the sum of CSA changes at 50% and 70% (CSAsummed), and the strength response between the training protocols. The INITIALROM protocol displayed a greater CSA increase than FINALROM protocol at 70% of biceps length (p = 0.001). Alternatively, we observed similar increases between the protocols for CSA at 50% (p = 0.311) and for CSAsummed (p = 0.111). Moreover, the INITIALROM protocol displayed a greater 1RM increase than FINALROM (p < 0.001). We conclude that training in the initial angles of elbow flexion exercise promotes greater distal hypertrophy of the biceps brachii muscle in untrained young women. Moreover, the INITIALROM condition promotes a greater dynamic strength increase when tested at a full ROM compared to the FINALROM.

Three-dimensional-printed porous prosthesis for the joint-sparing reconstruction of the proximal humeral tumorous defect.

Background: Tumorous bone defect reconstructions of the proximal humerus with joint sparing is a challenge. Numerous reconstruction methods have been proposed but the proximal residual humerus is commonly sacrificed because of its extremely short length. To preserve the proximal humerus and improve clinical outcomes, we designed a three-dimensional (3D) printed uncemented prosthesis with a porous structure to treat tumorous bone defects of the proximal humerus. Methods: Our analysis included seven patients treated between March 2018 and July 2019. A 3D model was established, and related data were obtained, including the diameter of the humeral head, the resection length, and the residual length. A prosthesis was designed and fabricated based on these data. Functional and oncologic outcomes were recorded, and complications and osseointegration were evaluated. Results: The mean age of the patients was 20.3years, and the median follow-up period was 26months. The lengths of the residual proximal humerus were 17.9mm on average. All the patients had preserved humeral heads and most of the rotator cuff was intact. The average postoperative range of motion (ROM) of the affected shoulder was 83.8°; flexion was 82.5°, extension was 43.8°, and adduction was 16.3°. The average Musculoskeletal Tumor Society score (MSTS) was 94.3%. Good osseointegration was observed on the interface between the bone and prosthesis. Conclusion: A 3D printed porous prosthesis with cone-like structures successfully achieved joint-sparing reconstruction of proximal humeral tumorous defects with satisfying functional outcomes. The preservation of the rotator cuff and humeral head plays an essential role in the function of the shoulder joint.

Normal Fetal Growth Profile at 10-41 Weeks of Gestation - An Update Based on 10225 Normal Singleton Pregnancies and Measurement of the Fetal Parameters Using 3D Ultrasound.

To construct new growth charts and tables for the following fetal growth parameters: biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC), abdominal transverse diameter (ATD), abdominal sagittal diameter (ASD), abdominal circumference (AC), femur length (Fe), tibia length (Ti), fibula length (Fi), humerus length (Hu), radius length (Ra), and ulna length (Ul). This prospective study was conducted at a level III ultrasound center as a population-based cross-sectional study on 10 225 normal singleton pregnancies with a gestational age between 10 and 41 completed weeks. Gestational age was confirmed in all cases by an ultrasound examination with crown-rump measurement before 10 weeks of gestation. All examinations were performed with 3 D probes. BPD, OFD, ATD, and ASD were measured as outer-to-outer measurements (skin-to-skin) after identifying the exact biometric planes by 3 D multiplanar display. HC was computed using the formula . For AC the approximate elliptical formula AC = (ATD+ASD)/2 × 3.142 was used. Measurements of the limb bones included the entire ossified shaft. Based on a nonlinear regression model for the age-specific mean values, distribution-free reference ranges were calculated for the parameters BPD, OFD, HC, ATD, ASD, AC, Fe, Ti, Fi, Hu, Ra and Ul. The new reference ranges were compared with our reference ranges published in 1996 as well as with different reference charts published by other authors. 3 D ultrasound allows a controlled demonstration of all fetal planes required for exact biometric measurements. The fetal growth profile including the 12 biometric parameters gives a precise overview of normal or abnormal fetal growth.

Update Reference Charts: Fetal Biometry between the 15th and 42nd Week of Gestation.

This study was designed to establish new reference charts for BPD (biparietal diameter), OFD (occipitofrontal diameter), HC (head circumference), CM (cisterna magna), TCD (transverse cerebellar diameter), PCV (posterior cerebral ventricle), AC (abdominal circumference), FL (femur length), and HL (humerus length) and extend known charts to 42 weeks of gestation. These new charts were compared to studies carried out by Snijders and Nicolaides, the INTERGROWTH 21st Project, and the WHO Fetal Growth Charts. In this retrospective cross-sectional single-center study of 12,972 low-risk pregnancies, biometric data between the 15th and 42nd weeks of gestation were evaluated. Only one examination per pregnancy was selected for statistical analysis. Descriptive analysis for the 5th, 50th, and 95th quantile was performed for each parameter as listed above. Regression models were used to fit the mean and the SD at each gestational age. Initially the reference curves for BPD, OFD, HC, AC, FL, and HL show a linear increase, which changes into a cubic increase towards the end of pregnancy. The results of this study show statistically noticeable differences from the percentile curves of the studies listed above. The percentile curves in this study differ from the commonly used ones. The presented standard curves can be used as a reference in prenatal diagnostics.

Métodos clínicos de avaliação dinâmica e quantitativa do complexo ombro e escápula: uma revisão de escopo

ABSTRACT The shoulder joint has the greatest range of motion and is the most susceptible to dysfunction. Dynamic and quantitative evaluations of this region provide better information for the clinic but the choice of the method depends on its measurement properties. This study aimed to identify the existing methods of quantitative dynamic evaluation of the shoulder and scapula complex, in a clinical context for the general population, identifying the measurement properties and outcomes of each method. The scoping review included in vivo studies, with samples without a specific clinical condition and involving applicable methods in a clinical context. We identified evaluated outcome, measurement method, and its measurement properties. We selected 29 studies that investigated 12 measurement methods, and evaluated their validity and reliability for 17 different outcomes. Most studies (n=21) addressed the position of the shoulder and the scapula and the derivative outcomes, using mainly the units of inertial measurement (n=5) and inertial magnetic measurement (n=6) as evaluation methods. The outcomes with valid and reliable methods were: shoulder joint range; scapula and shoulder motion range; muscle activity; shoulder joint center; humerus length; torque-time curve; functional performance; scapular dyskinesia; external shoulder rotators force; shoulder joint functionality and range; initial scapular movement; scapula and shoulder position; and shoulder angular velocity.

Construction of a digital fetus library for radiation dosimetry.

Accurate estimations of fetal absorbed dose and radiation risks are crucial for radiation protection and important for radiological imaging research owing to the high radiosensitivity of the fetus. Computational anthropomorphic models have been widely used in patient-specific radiation dosimetry calculations. In this work, we aim to build the first digital fetal library for more reliable and accurate radiation dosimetry studies. Computed tomography (CT) images of abdominal and pelvic regions of 46 pregnant females were segmented by experienced medical physicists. The segmented tissues/organs include the body contour, skeleton, uterus, liver, kidney, intestine, stomach, lung, bladder, gall bladder, spleen, and pancreas for maternal body, and placenta, amniotic fluid, fetal body, fetal brain, and fetal skeleton. Nonuniform rational B-spline (NURBS) surfaces of each identified region was constructed manually using 3D modeling software. The Hounsfield unit values of each identified organs were gathered from CT images of pregnant patients and converted to tissue density. Organ volumes were further adjusted according to reference measurements for the developing fetus recommended by the World Health Organization (WHO) and International Commission on Radiological Protection. A series of anatomical parameters, including femur length, humerus length, biparietal diameter, abdominal circumference (FAC), and head circumference, were measured and compared with WHO recommendations. The first fetal patient-specific model library was developed with the anatomical characteristics of each model derived from the corresponding patient whose gestational age varies between 8 and 35 weeks. Voxelized models are represented in the form of MCNP matrix input files representing the three-dimensional model of the fetus. The size distributions of each model are also provided in text files. All data are stored on Zenodo and are publicly accessible on the following link: https://zenodo.org/record/6471884. The constructed fetal models and maternal anatomical characteristics are consistent with the corresponding patients. The resulting computational fetus could be used in radiation dosimetry studies to improve the reliability of fetal dosimetry and radiation risks assessment. The advantages of NURBS surfaces in terms of adapting fetal postures and positions enable us to adequately assess their impact on radiation dosimetry calculations.

The association between first-trimester omega-3 fatty acid supplementation and fetal growth trajectories

Prenatal omega-3 fatty acid supplementation, particularly docosahexaenoic acid and eicosapentaenoic acid, has been associated with greater birthweight in clinical trials; however, its effect on fetal growth throughout gestation is unknown. This study aimed to examine the association between first-trimester docosahexaenoic acid and eicosapentaenoic acid supplementation and growth trajectories of estimated fetal weight and specific fetal biometrics measured longitudinally from the second trimester of pregnancy to delivery. In a multisite, prospective cohort of racially diverse, low-risk pregnant women, we used secondary data analysis to examine fetal growth trajectories in relation to self-reported (yes or no) first-trimester docosahexaenoic acid and eicosapentaenoic acid supplementation. Fetal ultrasonographic measurements, including abdominal circumference, biparietal diameter, femur length, head circumference, and humerus length, were measured at enrollment (8-13 weeks) and up to 5 follow-up visits. Estimated fetal weight and head circumference-to-abdominal circumference ratio (a measure of growth symmetry) were calculated. Fetal growth trajectories were modeled for each measure using a linear mixed model with cubic splines. If significant differences in fetal growth trajectories between groups were observed (global P<.05), weekly comparisons were performed to determine when in gestation these differences emerged. Analyses were adjusted for maternal sociodemographics, parity, infant sex, total energy consumption, and diet quality score. All analyses were repeated using dietary docosahexaenoic acid and eicosapentaenoic acid intake, dichotomized at the recommended cutoff for pregnant and lactating women (≥0.25 vs <0.25 g/d), among women who did not report supplement intake in the first trimester of pregnancy were repeated. Among 1535 women, 143 (9%) reported docosahexaenoic acid and eicosapentaenoic acid supplementation in the first trimester of pregnancy. Overall, first-trimester docosahexaenoic acid and eicosapentaenoic acid supplementation was associated with statistically significant differences (P-value <.05) in fetal growth trajectories during pregnancy. Specifically, estimated fetal weight was larger among women with docosahexaenoic acid and eicosapentaenoic acid supplementation than among those without supplementation (global P=.028) with significant weekly differences in median estimated fetal weight most apparent between 38 to 41 weeks of gestation (median estimated fetal weight difference at 40 weeks of gestation, 114 g). Differences in fetal growth trajectories for abdominal circumference (P=.003), head circumference (P=.003), and head circumference-to-abdominal circumference ratio (P=.0004) were also identified by supplementation status. In weekly comparisons, docosahexaenoic acid and eicosapentaenoic acid supplement use was associated with larger median abdominal circumference (changed from 2 to 9 mm) in midpregnancy onward (19 to 41 weeks), larger median head circumference between 30 to 33 weeks of gestation, and smaller median head circumference-to-abdominal circumference ratio in the second and third trimesters of pregnancy. There was no specific weekly difference in fetal femur length or humerus length by docosahexaenoic acid and eicosapentaenoic acid supplementation. First-trimester dietary sources of docosahexaenoic acid and eicosapentaenoic acid among women with no first-trimester docosahexaenoic acid and eicosapentaenoic acid supplementation (n=1392) were associated with differences in fetal biparietal diameter (P=.043), but not other metrics of fetal growth. At the recommended dietary docosahexaenoic acid and eicosapentaenoic acid levels compared with below-recommended levels, biparietal diameter was larger between 38 to 41 weeks of gestation. In this racially diverse pregnancy cohort, first-trimester docosahexaenoic acid and eicosapentaenoic acid supplementation was associated with significant increases in fetal growth, specifically greater estimated fetal abdominal circumference in the second and third trimesters of pregnancy.

Risk factors for hardware-related complications after extra-articular distal humerus fracture fixation using an anatomical locking plate.

We aimed to identify the incidence and risk factors of hardware-related complications in patients treated with anatomical locking plate fixation for extra-articular distal humerus fractures. From 2013 to 2020, patients with extra-articular distal humerus fractures who underwent open reduction and internal fixation with an extra-articular distal humerus locking plate (EADHP) were retrospectively reviewed and categorized according to the presence/absence of hardware-related complications. Hardware-related complications were defined as the occurrence of skin prominence on the plate and discomfort in activities of daily living. Patient demographics, the lateral condylar angle, lateral body length, shaft-condylar angle of the humerus, and plate length were analyzed. Of the 29 patients, 10 (34%) did not develop hardware-related complications (group A), whereas 19 (66%) did (group B). Patient demographics did not differ between the groups. However, the number of patients who underwent hardware removal was significantly greater in group B (16/19) than in group A (4/10; p = 0.032). Radiologic assessment revealed no significant difference in the lateral condylar or shaft-condylar angle. However, the lateral body length was greater in group A than in group B (44.5 ± 4.8 vs. 39.5 ± 3.7, p = 0.007). The plate length significantly differed between the groups. Twelve of 19 (63%) patients in group B received short-hole plates (six holes), while nine of ten (90%) patients in group A received long-hole plates (eight holes). In the multivariable analysis, the lateral body length of the distal humerus (p = 0.047, odds ratio = 0.734, 95% confidence interval: 0.542-0.996) and plate length (p = 0.036, odds ratio = 0.076, 95% confidence interval: 0.542-0.996) were associated with hardware-related complications. Most patients developed hardware-related complications, particularly with short plates, mainly because of the narrow lateral body length of the distal humerus. Surgeons should be careful to secure EADHP in the appropriate position, especially when short plates are used in patients with narrow lateral body length.

The Influence of Parents’ Education on Growth Pattern of Children Aged 5-12 Years From Kazaure Emirate, Jigawa State, Nigeria

Anthropometry is defined as the measurements of different parts of the body and is widely used in surveys as an indicator of nutritional and health status. Studies revealed that large number of socio-economic variables are associated with the physical development of children. These variables consist of parental profession, income, education, birth order, family size, and urbanization. Materials used for the study were Stadiometer, non-elastic measuring tape, Skin fold caliper. The study involved a cross-sectional survey comprising of 863 pupils randomly selected from public primary schools in Kazaure emirate. The subjects were noted for sex and age. A stadiometer was used to measure height to the nearest 0.1 cm and weight to the nearest 0.5 kg. A non-elastic measuring tape was used for the measurement of head, neck, chest, mid upper arm, hip, waist and calf circumferences to the nearest 0.1cm respectively. A Harpenden skin fold caliper was used for the measurement of biceps and triceps skin fold thicknesses to the nearest 0.1 mm respectively. The study participants were apparently healthy public primary school pupils aged between 5 - 12years, from Kazaure Emirate and ofHausa ethnic group (parents and grandparents are Hausa). Based on lack of parents’ formal education, males had higher values of neck circumference (NC) and chest circumference (CTC) than females with statistical difference at p&lt;0.05. However,females had higher values ofcephalic index (CI) than males with statistical difference at p&lt;0.05.Based on the level of education of parents (primary, secondary and tertiary education), males had higher values of height (HT), weight (WT), BMI, head circumference (HDC), NC, CTC, waist circumference (WC) and calf circumference (CC) than females with statistical difference at p&lt;0.05. However, females showed higher mean values of triceps skinfold thickness (TSF) and hip circumference (HC) than males with statistical difference at p&lt;0.05. Males had higher values ofhead length (HDL), head breadth (HDB), facial length (FL) and facial breadth (FB) than females with statistical difference at p&lt;0.05. Conversely, females showed higher mean value ofcephalic index (CI) than males with statistical difference at p&lt;0.05.Males had higher values of right humerus length (RHML), left humerus length LHML), right ulna length (RUL), left ulna length (LUL), right radial length (RRL), left radial length (LRL), right hand length (RHNL), left hand length (LHNL), right hand breadth (RHNB) and left hand breadth (LHNB) than females with statistical difference at p&lt;0.05. Males had higher values of right tibial length (RTBL), left tibial length (LTBL), right fibula length (RFBL), left fibula length (LFBL), right foot length (RFTL), left foot length (LFTL), right foot breadth (RFTB) and left foot breadth (LFTB) than females with statistical difference at p&lt;0.05.

Early pregnancy PM2.5 exposure and its inorganic constituents affect fetal growth by interrupting maternal thyroid function

Early pregnancy is crucial for fetal growth. Maternal thyroid hormone is critical for fetal growth and can be disturbed under exogenous exposure. However, it's uncertain whether exposure to PM2.5 and inorganic constituents during early pregnancy can affect TH and fetal growth. We focused on the associations of early-pregnancy PM2.5 and inorganic constituents with fetal growth and maternal THs. PM2.5 concentration was estimated using a satellite-based spatiotemporal model. Fetal biparietal diameter (BPD), head circumference (HC), femur length (FL), and humerus length (HL) were measured by ultrasonography at median 15.6, 22.2, and 33.1 gestational weeks. Levels of 28 PM2.5 constituents were measured in a sub-group of 329 pregnancies. Maternal serum free thyroxine (fT4), free triiodothyronine, and thyroid-stimulating hormone levels were measured at 14 weeks of gestation. Mixed-effect models and multiple linear regression were applied to evaluate the associations of PM2.5 and its constituents with fetal growth measures. Mediation analysis was used to examine the mediating role of the THs. Results showed that each 10 μg/m3 increase in PM2.5 was associated with 0.20 mm reductions in BPD (95%CI: 0.33, −0.01), 0.27 mm decreases in FL (95%CI: 0.40, −0.13), and 0.36 decreases in HL (95%CI: 0.49, −0.23). Per 10 μg/m3 increment in PM2.5 was correlated with 5.82% decreases in the fT4 level (95% CI: 8.61%, −2.96%). FT4 accounted for 14.3% of PM2.5 exposure-induced change in BPD at first follow-up. Al (β = −2.91, 95%CI: 5.17, −0.66), Si (β = −1.20, 95%CI: 2.22, −0.19), K (β = −3.09, 95%CI: 5.41, −0.77), Mn (β = −47.20, 95%CI: 83.68, −10.79) and Zn (β = −3.02, 95%CI: 5.55, −0.49) were associated with decreased fetal BPD, especially in first follow-up. Zn (β = −38.12%, 95% CI: 58.52%, −8.61%) was also associated with decreased fT4 levels. Overall, early pregnancy exposure to PM2.5 and its constituents was associated with fetal growth restriction and decreased maternal fT4 levels might mediate the effect of PM2.5.

Incidence and Skeletal Features of Developmental Cervical and Lumbar Spinal Stenosis.

Cross-sectional study. To report the prevalence and relationship of developmental cervical and lumbar spinal stenosis (DCSS and DLSS) with the bone parameters of the skull and extremities. DCSS and DLSS are found occasionally in daily practice. DCSS and DLSS can cause compressive myelopathy, radiculopathy, and cauda equina syndrome; however, data on their prevalence and correlation with skull and skeletal extremity profiles is scarce. A cross-sectional measurement study of 293 whole-body dried-bone samples was conducted. We measured the anteroposterior (AP) and transverse diameter of the fourth to sixth cervical vertebrae (C4-C6) and third to fifth lumbar vertebrae (L3-L5). Stenosis of the cervical spine and lumbar spine was defined as an AP diameter of <12 mm and <13 mm, respectively. We also measured the skull circumference, the AP and transverse diameters of the foramen magnum, the inner and outer inter distances between the left and right orbital bones, the humerus length, and the femoral length. Kruskal-Wallis and post hoc analyses were used in the statistical analyses. The age was 22-93 years. DCSS was found in 59 (20.1%) and DLSS in 28 (9.6%). Twelve samples had both DCSS and DLSS (development spinal stenosis, DSS). When compared to the "no spinal stenosis sample," DSS (-), DCSS and DSS had a significantly smaller skull circumference, the transverse diameter of the foramen magnum, and inner and outer distance between the orbital bone (p<0.05). There was no significant difference in humeral length, femoral length, or AP diameter of the foramen magnum. DCSS was correlated with a small skull, a small transverse diameter of the foramen magnum, and a small orbital bone. A small skull was strongly associated with a small cervical canal. DLSS, on the other hand, was unrelated to either a small cervical canal or a small skull.