Z-score Values Research Articles

Clustering of Districts Based on Infrastructure Indicators Using K-Means And Average Linkage Methods

Aceh Jaya is one of the districts in Aceh Province that has great potential in various sectors, such as agriculture, plantations, and tourism. In the Aceh Jaya District Development Plan (RPK) Book 2023-2026, it is stated that the unequal distribution of infrastructure development in Aceh Jaya District in 2023-2026 has resulted in low investment competitiveness and decreased economic performance. Because of these conditions, this study clusters regions in Aceh Jaya District based on infrastructure indicators so that groups of sub-districts are obtained based on the level of infrastructure development. The method used in this study is clustering analysis by comparing it with two clustering methods, namely K-means and average linkage, which are validated based on the silhouette coefficient value to see which cluster is the best. The results obtained are the Kaiser-Mayer-Olkin (KMO) value of 0.611, which indicates that the sample is representative of a total of eight variables; for the zscore value, there is no outlier data, which means that the data of the eight infrastructure variables can be used entirely. Meanwhile, the clustering results using the K-Means method resulted in 3 clusters, and with the Average Lingkage method resulted in 2 clusters. This means that Aceh Jaya District can be clustered into 2 clusters, as seen from the silhouette coefficient value of 0.736. The conclusion that can be drawn from this research is that infrastructure development has not been evenly distributed in the 9 existing sub-districts, so that strategies and priorities are needed in infrastructure development in Aceh Jaya Regency.

Evaluating the Impact of Urban Encroachment and Land Cover Changes on World Cultural Heritage Site Taxila: A Spatio-Temporal Analysis from 1990 to 2024

Rapid global urbanization during the late 20th and early 21st centuries has induced substantial land cover changes, posing significant threats to the United Nations Educational, Scientific and Cultural Organization’s (UNESCO) World Heritage Sites. In this study, we investigated the spatio-temporal change in urban development in response to land use transformations in the world cultural heritage site (CHS) of Taxila, Pakistan, to check the possible threats faced by the site. Land transfer matrices were used to assess the land cover change (LCC) between 1990 and 2024. Support vector machine and Getis–Ord Gi techniques were employed for LCC classification and spatial pattern interpretation, respectively, which were later evaluated by the high spatial resolution imagery of KH-9 (Keyhole-9), Google Earth Pro and Gaofen-2. The results indicate a significant increase in built-up area from 23.68 km2 to 78.5 km2, accompanied by a substantial rise in bare land from 8.56 km2 to 26.5 km2 between 1990 and 2024, which is quite irregular. LCC transformations were notable, with 13.1 km2 of cropland and 44.8 km2 vegetation being converted into 4.4 km2 of built-up area and 14.5 km2 into bare land during the 1990 to 2024 period. Getis–Ord Gi analysis observed a high Z-score value and showed low to high clustering patterns in the proximity of the Sarakhola and Bhir Mound sites from 1990 to 2024. Furthermore, high spatial resolution imagery indicates the loss of the core zone of the Sarakhola site from 0.0168 to 0.0032 km2 from 2004 to 2024, which was the major threat to its outstanding universal venue (OUV) status. The findings of the current study indicate that the CHS under study is facing an alarming situation for conservation due to rapid urban development and encroachment. Therefore, local government should strictly implement the heritage law and revisit their policies to promote conservation efforts to maintain the authenticity and integrity of this world CHS.

P0275 The Impact of Sarcopenia on Clinical Outcomes in Pediatric Crohn’s Disease

Abstract Background Sarcopenia, the age-related progressive loss of muscle mass and strength, affects up to 50% of adults with Crohn’s Disease (CD) and is related to major clinical outcomes. However, data on children is scarce. We investigated whether sarcopenia at the diagnosis impacts the outcomes of children with CD. Methods Retrospective, single-center, case-control study of newly diagnosed children with CD undergoing magnetic resonance (MR) within one month from the diagnosis, from 2011 to 2022. Sarcopenia was assessed by measuring total psoas muscle area (tPMA) at L3-L4 level on the MR and defined as z-score values ≤2 standard deviations. Sarcopenic and nonsarcopenic children were compared for the risk of disease flares, IBD-related hospitalization, complications, need for step-up treatment, and courses of steroids over a 2-year follow-up. Results Seventy-eight children were included (mean age 11.7 years, 41% females), 46 (59%) sarcopenic and 32 (41%) nonsarcopenic. Sarcopenic children presented at the diagnosis with higher serum levels of total cholesterol (140 ± 28 mg/dL vs. 105.6 ± 27 mg/dL, p=0.009) as well as LDL and HDL cholesterol (77 ± 26 vs. 57.7 ± 24. 4 mg/dL, p=0.03 and 42.8 ± 9.2 vs 36 ± 8 mg/dL, p=0.02, respectively). The risk of clinical relapse was higher in sarcopenic vs nonsarcopenic patients at 6 [21.7% vs. 0%, OR 8.6 (95% CI 1.2-96.2), p=0.004] and 12 months [34.7% vs. 6.6%, OR 7.4 (95% 1.6-34.4), p=0.005]. Additionally, the risk of steroid use was higher in sarcopenic vs. nonsarcopenic children at 12 months [34.7% vs. 13.3%, OR 3.4 (95% CI 1.1-10.3), p=0.06]. Kaplan Meier analysis showed lower survival free from relapses in sarcopenic vs nonsarcopenic patients [Log Rank p=0.004, HR 2.8 (95%CI 1.3-5.7)]. Multivariate logistic regression analysis identified sarcopenia as an independent predictor of relapse risk [OR (95%CI)142 (2.1-470), p=0.051]. Conclusion The presence of sarcopenia at the diagnosis seems to increase the risk of unfavorable outcomes, specifically clinical relapses in the first year of diagnosis. An altered lipid profile may indicate an increased risk of reduced muscle mass children, highlighting the need for targeted nutritional and therapeutic interventions

A method for HDAC activity screening in postmortem human brain. A proof-of-concept study with antipsychotics.

Histone deacetylase (HDAC) density and activity are altered in different brain disorders. Antipsychotic drugs (APs) might modulate HDAC activity in brains of schizophrenia subjects. HDAC activity assay amenable for enzyme kinetics and HDAC inhibitor (HDACi) screening studies in postmortem human brain samples. The optimization and characterization work involved several steps. The nucleosolic subcellular fraction and total protein amount needed for an optimal HDAC activity on Boc-Lys(Ac)-AMC substrate were characterized. Signal-to-noise ratio (1.8) and Z-score values (0.82) were indicators of the assay quality. Inhibition studies with non-selective (belinostat, vorinostat, valproic acid) and selective (apicidin, MS275, romidepsin, tacedinaline and EX527) HDACis showed that the optimized assay detected class I HDAC activity. The obtained IC50 values were similar to those previously reported, proving the assay reliability. We used the optimized assay to study the effect of APs on HDAC activity. Inhibition studies with APs in postmortem human brain, together with enzyme kinetic studies in brains of rats chronically treated with APs observed no modulation of class I HDAC activity. This study describes the optimization of a reliable and cost efficient HDAC activity assay for its use in postmortem human brain samples. The assay does not depend on antibody specificity and it is valid for enzyme kinetic studies and for the screening of new potential class I HDACis. We optimized and characterized an assay to measure HDAC activity in postmortem human brain samples. We did not observe any modulatory effect of APs on HDAC activity.

Assessment of Atrial Size, Shape, and Contractility in Growth-Restricted and Small-for-Gestational-Age Fetuses.

The size, shape, and contractility of the heart's atrial chambers have not been evaluated in fetuses with growth restriction (FGR) or who are small-for-gestational-age (SGA) as defined by the Delphi consensus protocol. This study aimed to examine the atrial chambers using speckle tracking analysis to identify any changes that may be specific for either growth disturbance. Sixty-three fetuses were evaluated with an estimated fetal weight <10th percentile who were classified as FGR or SGA based on the Delphi consensus protocol. The atrial cardiac cycle was defined as end-diastole, end-systole, and end-diastole, equivalent to ventricular end-systole, end-diastole, and end-systole. The atrial size, shape, and contractility were computed from 24 transverse segments and one length measurement identified from speckle tracking analysis of the endocardium at end-diastole and end-systole. The z-score for each atrial measurement was computed using the mean and standard deviation equations from a control group of 200 fetuses. The z-score values were compared between the control and FGR/SGA fetuses as well as between FGR and SGA fetuses using the Kruskal-Wallis test. A P-value of <.05 was considered significant. Of the 63 fetuses with an estimated fetal weight (EFW) <10th percentile, 60% (38/63) were classified as FGR and 40% (25/63) as SGA. The following abnormal atrial measurements were unique to FGR fetuses: decreased end-diastolic left atrial (LA) area, decreased LA base and mid-chamber end-diastolic width, decreased LA base sphericity index, decreased right atrial (RA) mid-chamber sphericity index, decreased LA ejection volume, and decreased LA emptying volume. The following were unique to the SGA fetuses: Increased RA mid-chamber length, decreased LA fractional area change, decreased RA reservoir strain, decreased RA basal-apical length fractional shortening, and decreased LA base width transverse fractional shortening. The significant difference was an increased LA mid-chamber length in the SGA fetuses. Fetuses with an EFW <10th percentile who are classified as either SGA or FGR demonstrate unique abnormalities of atrial size, shape, and contractility, thus allowing the examiner to differentiate between FGR and SGA fetuses.

Exploring the Laws of Developmental Direction Using a Documented Skeletal Collection.

Many human growth studies note a trend of differential variation in limb segment lengths, where distal elements show greater variability than their proximal counterparts. This has been attributed to their developmental sequence, where bones further from the head develop later and are more impacted by fluctuating growth conditions. We aimed to explore limb dimensions within this framework, known as the laws of developmental direction, in children (0.09-11.75 years) from a documented skeletal collection of low socioeconomic status. Z-scores were generated for diaphyseal length measurements of six limb bones. Differences between mean z-score values of the limbs, as well as of the proximal and distal segments of each limb, were assessed using paired samples t-tests. The lower limb was significantly more stunted in growth relative to the upper limb (p ≤ 0.001), as was the distal segment of the upper limb relative to the proximal segment (p ≤ 0.001). In contrast, the distal segment of the lower limb was significantly less stunted in growth relative to the proximal segment (p ≤ 0.001). The findings of increased sensitivity in the lower limb relative to the upper limb and in the distal segment of the upper limb relative to its proximal segment are consistent with the laws of developmental direction. However, the finding of greater sensitivity in the proximal segment of the lower limb relative to the distal segment does not align with the theorized developmental gradient. These results reveal the complexity of human growth and developmental plasticity in response to biocultural factors.

THE EFFECTIVENESS OF GROUP COUNSELING COGNITIVE RESTRUCTURING TECHNIQUES TO REDUCE FEAR OF MISSING OUT (FOMO) IN ADOLESCENT SOCIAL MEDIA USERS IN BAYUNG LENCIR

Fear of missing out (FoMO) is the behavior of actively accessing social media, continuous access that disturbs the subject, causing feelings of laziness, delays in scheduled activities and concerns about not knowing interesting events that other people are doing. The purpose of this study was to determine the level of fear of missing out (FoMO) in adolescent social media users and the extent to which cognitive restructuring technique group counseling is effective in reducing fear of missing out (FoMO) in adolescent social media users. This type of research is quantitative with an experimental method and uses a one group pretest posttest research design. The population in this study was 77 adolescents with research samples taken using purposive sampling techniques from the results of the pretest treatment, namely 8 people. Furthermore, for data collection techniques, researchers used questionnaires and data analysis techniques were carried out through the Wilcoxon test. The results showed that there was a decrease in the posttest score (high and medium categories with a mean value of 57.5) compared to the pretest results (high and medium categories with a mean value of 75.12). From the data analysis using the Wilcoxon test, it shows that the Zscore value &lt;0.05 with a Zscore value of -2.533, so it can be concluded that group counseling with cognitive restructuring techniques is effective in reducing fear of missing out in adolescents who use social media.

Assessment of Undernutrition Among Under-Five Children by Using Composite Index of Anthropometric Failure (CIAF)

Undernutrition is acknowledged as a significant public health concern across many developing nations. Anthropometric measures serve as crucial tools for estimating the extent of undernutrition in children globally. The Composite Index of Anthropometric Failure (CIAF), offers a comprehensive assessment of undernutrition, aggregating various anthropometric indices to identify single or multiple anthropometric failures in children under five. This study aims to evaluate the prevalence of undernutrition using anthropometric measures and CIAF among urban slum children. Conducted as a cross-sectional community-based investigation in the slum areas of Sambalpur District, Odisha, India, the study employed standard procedures to measure height and weight anthropometrically. Age-sex-specific Z-score values for weight-for-age, height-for-age, and weight-for-height were calculated. A Z-score below -2.00 for any anthropometric index was indicative of undernourishment. The prevalence of undernutrition was determined using the standard CIAF classification. The study found an overall prevalence of wasting, underweight, stunting, and CIAF at 22.4%, 34.7%, 40.7%, and 58%, respectively. Sex-specific prevalence rates for wasting (23.9% vs. 20.9%), underweight (37.3% vs. 32.2%), stunting (39.9% vs. 41.5%), and CIAF (60.1% vs. 56%) exhibited statistically non-significant differences between boys and girls (p &gt; 0.05). Notably, the investigation highlighted the CIAF's utility as it revealed a higher magnitude of undernutrition compared to conventional anthropometric measures.

Analisis Financial Distress Menggunakan Metode Altman Z-Score Pada PT Sepatu Bata Tbk Periode 2021-2023

PT Sepatu Bata Tbk is one of the companies listed on the IDX which is engaged in the footwear industry and produces various types of leather shoes and sandals. The company's finances began to deteriorate in 2020, and continues to this day. In its latest financial report, Bata posted losses for four consecutive years. The research objectives to be achieved in this study are to determine the analysis of the level of bankruptcy using the Altman Z-Score method at PT Sepatu Bata Tbk for the 2021-2023 period. The analysis technique used in this study is to use the Altman Z-Score model. in 2021 a Z-Score value of 2.55 was obtained. With an assessment criterion of 1.81 &lt; 2.55 &lt; 2.99, which means that PT Sepatu Bata Tbk is in the gray area category. From this study, it was found that in 2022, a Z-score value of 1.64 was obtained with an assessment criterion of 1.64 &lt; 1.81, which means that PT Sepatu Bata Tbk is in the bankrupt category. While in 2023, a Z-score value of 0.48 was obtained with an assessment criterion of 0.48 &lt; 1.81, which means that PT Sepatu Bata Tbk is in the bankrupt category. PT Sepatu Bata Tbk in 2021 has an X1 ratio of 0.1815. In 2022 the value of the X1 ratio of PT Sepatu Bata Tbk decreased, namely 0.0121. Then in 2023 the X1 ratio value decreased again, namely -0.0847. The decrease in the X1 ratio value of PT Sepatu Bata Tbk every year is caused by the unstable value of current assets, current debt, and total assets of PT Sepatu Bata Tbk. Ratio X3 of PT Sepatu Bata Tbk in 2021 has a value of -0.297. In 2022 the X3 ratio also has a value of -0.09. In 2023 the value of the X3 ratio of PT Sepatu Bata Tbk decreased, namely -0.27. The minus value in the X3 ratio of PT Sepatu Bata is because the company suffered losses in those 3 years. From the research it can be concluded that PT Sepatu Bata Tbk for the period 2021-2023 using the Altman Z-score model, the results obtained in 2021 PT Sepatu Bata Tbk is in a gray area, which means that the company is in an unhealthy financial condition and is not bankrupt either. Meanwhile, in 2022 and 2023 PT. Sepatu Bata Tbk is in bankrupt condition, which means that the company's financial condition is not healthy

Nutritional status of tribal and non-tribal school-going children in rural Bangladesh: A comparative study

BackgroundInadequate nutrition of school-going children is a major concern in Bangladesh, and it can negatively affect their productivity. It is important to consider the food pattern, socio-cultural, and economic differences between tribal (T) and non-tribal (NT) communities in Bangladesh when evaluating their nutritional status. This study aimed to investigate the nutritional status of school-going children in the rural area of Rajshahi district’s High Barind Tract (HBT) region of Bangladesh. Additionally, we compared the nutritional status between T and NT school-going children in the same area.MethodsThis was a cross sectional household study. Data were collected from T and NT households in the HBT region in the Rajshahi district of Bangladesh, from January to June of 2019. A total of 500 (T 81, NT 419) school-going children aged 6–13 years were selected as samples using mixed sampling, including convenience sampling (non-probability) and simple random sampling (probability) methods. Nutritional status was assessed using body mass index-for-age z-score (BAZ) and height-for-age z-score (HAZ) according to WHO guidelines. Thinness was defined as BAZ < -2SD and stunting as HAZ < -2SD. Descriptive statistics, Z-proportional test, and logistic regression model were used to analyze the effect of selected independent variables on nutritional status of T and NT children.ResultsAmong school-going children, 15.20% were suffering from thinness (T 12.30% and NT 15.80%) and 17.80% stunting (T 13.60% and NT 18.60%), respectively. The difference in thinness (p > 0.05) and stunting (p > 0.05) were not significant between T and NT. The distribution of BAZ and HAZ of T and NT children were normally distributed, and were positioned negatively compared to the WHO standards. The logistic model identified the following factors for thinness: (i) mother with non-or-primary education (aOR = 1.89, 95% CI: 1.05–3.43, p < 0.05), (ii) underweight mother (aOR = 3.86, 95% CI: 1.48–10.06, p < 0.01), and (iii) underweight father (aOR = 4.12, 95% CI: 1.50-11.29, p < 0.01). For stunting, the factors were: (i) mother as a housewife (aOR = 2.79, 95% CI: 1.16–6.71, p < 0.05), (ii) father working as labour (aOR = 1.77, 95% CI: 1.01–3.278, p < 0.05), (iii) severe food insecurity in the household (aOR = 2.37, 95% CI: 1.23–4.54, p < 0.05), and (iv) children playing outside regularly more than 2 h (aOR = 2.19, 95% CI: 1.31–3.67, p < 0.01).ConclusionIn rural Bangladesh, the nutritional status of T and NT school-going children did not show significant defferences. However, the mean z-score values for both groups of children were lower than the WHO standard, indicating that both communities have poor nutritional status.

Risk Factors for Adjacent Vertebral Fractures Following Cement Vertebroplasty: The Clinical Significance of Multiple Preexisting Vertebral Compression Fractures.

A retrospective cohort study. The study retrospectively analyzed the factors associated with the development of adjacent vertebral fractures. Adjacent vertebral fractures (AVF) may occur following cement vertebroplasty, and several risk factors have been reported with controversies. A total of 123 patients, with a mean age of 79.2 years, who underwent single-level vertebroplasty were included in the investigation. We systematically collected data encompassing baseline demographics, osteoporosis parameters, surgical details, radiologic measurements, and Hounsfield unit (HU) values in the lumbar spine. Subsequently, univariable, followed by multivariable logistic regression analyses, were employed to identify the risk factors of AVFs. Thirty of 123 patients had AVFs within 6 months following vertebroplasty. The AVF group exhibited a higher percentage of multiple preexisting vertebral compression fractures (P=0.006), a greater volume of injected cement (P=0.032), and a more pronounced reduction in local kyphosis (P=0.007). Multivariable logistic regression analysis revealed multiple preexisting vertebral compression fractures and a reduction in local kyphosis exceeding 8 degrees were independent risk factors for AVFs (P=0.008 and 0.003, respectively), with odds ratios of 3.78 (95% confidence interval: 1.41-10.12) and 4.16 (95% CI: 1.65-10.50), respectively. Subgroup analysis showed that patients with multiple preexisting vertebral compression fractures (VCFs) had significantly lower bone mineral density Z-score, T-score, and HU values compared with those without preexisting VCFs (P<0.05). Conversely, there were no significant differences in T-score or HU values between patients with no VCFs and those with a single VCF. This study demonstrated that both bone strength and local alignment are key factors associated with adjacent vertebral fractures. Specifically, having multiple preexisting vertebral compression fractures and a reduction in local kyphosis exceeding 8 degrees are independent risk factors. The presence of more than one previous vertebral compression fracture serves as a significant clinical indicator of advanced bone density reduction in patients with osteoporosis, offering a quick and straightforward method for identifying high-risk patients. Patients exhibiting these risk factors should be monitored more closely for favorable clinical outcomes. Level III-retrospective nonexperimental study.

Comparison of the Effect of Selective Serotonin and Norepinephrine Reuptake Inhibitors on Bone Mineral Density with Selective Serotonin Reuptake Inhibitors and Healthy Controls

Purpose: This study investigated the association between selective serotonin reuptake inhibitor (SSRI) and selective serotonin and norepinephrine reuptake inhibitor (SNRI) use and the risk of decreased bone mineral density in postmenopausal women.Methods: Sixty-three patients diagnosed with GAD (Generalized Anxiety Disorder) were treated with venlafaxine or duloxetine from the SNRI group, and sixty patients treated with SSRIs were enrolled. Social demographic features, the Hamilton Anxiety Scale (HAS) results, and the Hamilton Depression Scale (HDS) scores of all the patients were assessed. The BMD (bone mineral density) of the patients was measured by dual-energy X-ray absorptiometry (DXA) at the femoral and lumbar regions. The BMD of the patients was compared with that of 40 healthy controls.Results: Bone measurements in the SNRI and SSRI users were similar to those of the healthy controls. However, osteopenic values were observed in the SSRI users, while normal bone density was found in the SNRI users. Also, the bone mineral densities were compared between patients using duloxetine and venlafaxine with healthy controls, showing similar T-score and Z-score values with no significant differences compared to the control group. However, while the lumbar region T-scores of those using duloxetine were within normal values, they were within the osteopenia range of venlafaxine and healthy controls.Conclusion: SNRIs may have a lower risk of developing osteoporosis than SSRIs. Of the SNRIs, duloxetine appears to be safer than venlafaxine. Further randomized controlled studies are warranted to determine whether SNRI use is risky.

Waist circumference as a parameter in school-based interventions to prevent overweight and obesity - a systematic review and meta-analysis

BackgroundPreventing childhood obesity remains an important public health issue worldwide. Since visceral fat in particular is understood as an important risk factor for many chronic diseases, waist circumference is recommended as a measurement parameter for global obesity surveillance. This systematic review and meta-analysis focused on waist circumference as an outcome parameter for studies of school-based interventions to prevent overweight and obesity.MethodsA systematic literature search was conducted at the end of 2019 in nine data bases, including Medline and Embase, in order to identify relevant studies evaluating interventions in schools aimed at preventing obesity. Eligibility criteria admitted randomised and non-randomised controlled trials. After screening titles, abstracts and full texts, the data of the identified studies were systematically extracted. Risk of bias was assessed according to study type with the appropriate Cochrane Risk of Bias Tool. The review gives a qualitative overview over all included studies structured by extracted data. Separate meta-analyses were done for the outcome mean difference in change in waist circumference, measured in cm or reported as z-score value, using an inverse variance random-effects model due to study design.ResultsA total of 2421 publications were screened based on titles, abstracts and full texts. Complemented by results of a former systematic literature search 44 studies were identified for inclusion, comprising a total of 39.837 participants (age range: 6 to 18 years). Nearly half of the studies were conducted in Europe, two-thirds combined diet and exercise-based interventions. Likewise two thirds of the studies were conducted as cluster-randomised trials. Most of the reported effects favoured the experimental groups, indicating the basic effectiveness of school-based measures. Based on reported data, only one third of the studies could be included in the meta-analyses. For the difference in mean change of the outcome parameter waist circumference measured in cm (95% CI), we found a pooled effect estimate of -0.95 (-1.87; -0.46). For the difference in mean change of the outcome parameter waist circumference reported as z-score value (95% CI), the pooled effect estimate was -0.10 (-0.15; -0.05). Both effect estimates were in favour of the experimental group. The overall effect sizes were small with a p-value < 0.05.ConclusionsPooled effect estimates were small but in favour of the experimental groups. The same applies to the majority of the effects reported in the included studies. The included cluster of randomised controlled trials demonstrated an especially sound methodological standard. The possibility of achieving larger effects in studies of preventive interventions and health promotion is limited. Schools can only realise their full potential in preventing overweight and obesity in children and adolescents if they are accompanied by measures in other areas of the obesogenic environment.

Growth Parameters and Prevalence of Obesity in PKU Patients and Peers: Is This the Right Comparison?

One of the main objectives of Phenylketonuria (PKU) management is represented by optimising the growth trend under restricted protein diet regimen. The data on long-term growth in PKU children are limited and mostly based on earlier studies. The data for this twelve-year longitudinal study were collected from 34 PKU children and 37 healthy peers, whose auxological parameters were taken at 7 time-points over the follow-up. The weight-for-length ratio (WLR) z-score and body mass index (BMI) z-score were considered according to age. Prevalence of overweight/obesity was evaluated at last assessment. The median BMI z-score of PKU children was normal and not statistically different from that of controls on all the seven time-point assessments. Their distributions tended to be wider than those of peers, with the upper limit exceeding the normal range since 12 months old, with a peak specifically at 3 years of age. In controls, there was a tendency to approach the BMI z-score values of overweight in later childhood. The prevalence of overweight was comparable (29% vs. 25%, p: 0.78) between the two groups at last assessment, and obese subjects (3/37) were only detected in the control group. In this study, we report data from a long-term follow-up on growth, highlighting that the median BMI z-score of PKU children was normal and not statistically different from that of controls. Also, the prevalence of obesity at 12 years of age was overlapping. However, the high prevalence of overweight children in the general population may explain the lack of difference and does not reassure about patients' nutritional risk.

Laboratory performances during proficiency tests for the analysis of active substances in pesticide formulations during 2021–2023

During the period 2021–2023, the Italian National Institute of Health (ISS) organised, in collaboration with the Italian Health Ministry, proficiency testing (PTs) for about 22 Italian and other EU laboratories involved in the monitoring programmes for Plant Protection Products (PPPs). The aim of the PTs was to determine the amount of active ingredient in various formulations of PPPs. Overall, the type of formulations to be analysed were soluble concentrate (SL), suspension concentrate (SC), capsule suspension (CS), emulsion water oil (EW), soluble water granule (SG), dustable powder (DP), water dispersible granule (WDG) and emulsion concentrate (EC). In 2021, the ISS organised PTs for the determination of Imazamox, Fenhexamid and Trinexapac-ethyl in three different PPPs as soluble concentrate (SL), suspension concentrate (SC), and capsule suspension (CS), respectively. In 2022, PTs for the determination of Bentazone, Spinosad and Tau-Fluvalinate were organised. For this PTs, commercial PPPs were obtained from the Italian market as SC, emulsion oil water (EW) and soluble water granule (SG). In 2023, the PT was organised to determine the active ingredient Trifloxystrobin, Deltamethrin and Cyprodinil in the commercial product as water dispersible granule (WDG), dustable powder (DP) and emulsion concentrate (EC), respectively. Homogeneity and stability, performed for all PT samples, fulfilled the acceptability criteria. The Jarque–Bera test was used to verify the hypothesis of normality of the data distributions before to calculate the z-score values. Laboratory performances, expressed in terms of z-scores, were satisfactory for almost all participants for all substances.

12455 Bone Mineral Density Improvement After Resolution Of Endogenous Cushing Syndrome

Abstract Disclosure: C. Plessias: None. N. Charoenngam: None. T. Rittiphairoj: None. T. Suenghataiphorn: None. T. Srikulmontri: None. P. Wattanachayakul: None. M. Kurt: None. Bone Mineral Density Improvement After Resolution of Endogenous Cushing Syndrome: a Meta-analysis and meta-regression Patients with endogenous Cushing syndrome (eCS) are known to have decreased bone mineral density (BMD) and are prone to fragility fractures. Treatment of eCS have been shown in multiple studies to result in improvement in BMD. However, the degree of BMD improvement after resolution of eCS remains inadequately explored due to limited sample sizes in existing studies. Through systematic review, meta-analysis, and meta-regression techniques, we aimed to identify all available evidence to evaluate BMD improvement after resolution of eCS. Potentially eligible studies were identified from the PubMed and EMBASE databases from inception to February 2024, utilizing a search strategy incorporating terms related to "Bone mineral density" and "Cushing syndrome". Eligible studies must include adult or pediatric patients diagnosed with any form of eCS, encompassing Cushing disease (CD), adrenal adenoma, mild autonomous cortisol secretion or ectopic ACTH-secreting tumors, who received treatment resulting in CS resolution. These studies must either present lumbar spine (LS) or femoral neck (FN) BMD measurements in the form of T-score, Z-score or actual BMD values before and after CS resolution, or report mean differences (MD) of BMD, or provide individual BMD data. Point estimates with corresponding standard errors were extracted from each study and combined using the generic inverse variance method. Meta-regression analysis was utilized to explore the impact of time after resolution of eCS on BMD improvement.A total of 5,085 records were identified from the databases. After systematic review, 14 studies, including a total of 386 patients, were deemed eligible for analysis. The meta-analysis demonstrated that resolution of eCS resulted in statistically significantly improvement of LS BMD (pooled MD: Z-score: +0.76, 95%CI 0.50 – 1.02, I2 76%; T-score: +0.87, 95%CI 0.55 – 1.19, I2 78%; actual BMD: +0.092 g/cm2, 95%CI 0.060 – 0.124, I2 74%) and FN BMD (pooled MD: Z-score: +0.54, 95%CI 0.32 – 0.76, I2 75%; T-score: +0.38, 95%CI 0.25 – 0.51, I2 0%; actual BMD: +0.041 g/cm2, 95%CI 0.021 – 0.062, I2 0%). The meta-regression analysis revealed a statistically significant association between follow-up time and improvements in LS T-score BMD (predicted LS T-score improvement = 0.42 + 0.062 × year, p = 0.027) and FN Z-score BMD (predicted FN Z-score improvement = 0.35 + 0.037 × year, p = 0.003), but not with LS Z-score and FN T-score.In summary, our study presents the extent of improvement in LS and FN BMD following the resolution of eCS based on all available data in the literature. These findings have clinical significance as they offer guidance for management of osteoporosis following the resolution of eCS. Presentation: 6/3/2024

Machine learning tools used for mapping some immunogenic epitopes within the major structural proteins of the bovine coronavirus (BCoV) and for the in silico design of the multiepitope-based vaccines.

BCoV is one of the significant causes of enteritis in young calves; it may also be responsible for many respiratory outbreaks in young calves. BCoV participates in the development of bovine respiratory disease complex in association with other bacterial pathogens. Our study aimed (1) to map the immunogenic epitopes (B and T cells) within the major BCoV structural proteins. These epitopes are believed to induce a robust immune response through the interaction with major histocompatibility complex (MHC class II) molecules (2) to design some novel BCoV multiepitope-based vaccines. The goal is achieved through several integrated in silico prediction computational tools to map these epitopes within the major BCoV structural proteins. The final vaccine was constructed in conjugation with the Choleratoxin B toxin as an adjuvant. The tertiary structure of each vaccine construct was modeled through the AlphaFold2 tools. The constructed vaccine was linked to some immunostimulants such as Toll-like receptors (TLR2 and TLR4). We also predicted the affinity binding of these vaccines with this targeted protein using molecular docking. The stability and purity of each vaccine construct were assessed using the Ramachandran plot and the Z-score values. We created the in silico cloning vaccine constructs using various expression vectors through vector builder and Snap gene. The average range of major BCoV structural proteins was detected within the range of 0.4 to 0.5, which confirmed their antigen and allergic properties. The binding energy values were detected between -7.9 and -9.4 eV and also confirmed their best interaction between our vaccine construct and Toll-like receptors. Our in silico cloning method expedited the creation of vaccine constructs and established a strong basis for upcoming clinical trials and experimental validations. Our designed multiepitope vaccine candidates per each BCoV structural protein showed high antigenicity, immunogenicity, non-allergic, non-toxic, and high-water solubility. Further studies are highly encouraged to validate the efficacy of these novel BCoV vaccines in the natural host.

Determination of Cortisol Hormone from Sweat Samples and Interpretation with Microcontroller

Cortisol, known as the body's stress hormone, regulates metabolism, inflammation, and the immune system. It affects various bodily systems such as the nervous, immune, cardiovascular, respiratory, reproductive, and musculoskeletal systems. Normal sweat cortisol levels range from 8 to 142 ng/ml, with elevated levels indicating stress (200 ng/ml in women, 500 ng/ml in men). This study focuses on colorimetric cortisol analysis using a microfluidic layer to collect sweat samples. Samples are mixed with a specific color reagent. Cortisol levels are quantitatively analyzed using Z-Score values and RGB channel density via photographs taken with the ESP 32 module. The aim is to determine cortisol levels, aiding in diagnosing conditions like Cushing's syndrome and Addison's Disease, leveraging wearable technology. The developed system integrates a microcontroller into the wearable microfluidic system for cortisol measurements throughout the day. Data is displayed and recorded on a computer for streamlined cortisol monitoring. The blue tetrazolium method used offers stable colors and rapid reactions (10 minutes). The Limit of Detection (LOD) is 0.3 ug/mL, with a detection limit of 1.1 ug/mL. Combined with the ESP 32 Cam module, the system detects cortisol concentrations from 0.8 – 60 ug/mL.

Kebijakan Cash Holding Pada Perusahaan Sektor Consumer Cyclicals di Indonesia

This research aims to determine the effect of cash flow, dividends, market to book ratio, net working capital, leverage and Z-score on cash holding in consumer cyclicals sector companies listed on the Indonesia Stock Exchange for the 2018-2022 period. The type of data used is quantitative data sourced from secondary data. The population is consumer cyclical sector companies listed on the Indonesia Stock Exchange from 2018 to 2022. The sampling technique used purposive sampling and 23 companies were obtained as samples. The research results show that cash flow, market to book ratio, net working capital have a significant and positive effect on cash holding. High cash flow indicates that cash inflow is greater than cash outflow, thus allowing the company to hold cash and use it to finance its operational activities. The market to book ratio indicates investment opportunities for the company, opens up easy access to capital markets and allows for easy acquisition of additional funds. Excess funds saved by the company will increase cash holdings. An increase in net working capital indicates an increase in cash balances because companies with high liquidity will generally hold large amounts of cash. On the other hand, the Z-score shows a significant and negative influence on cash holding. A high Z-score value indicates that the company is in a safe zone and does not need to hold a lot of cash because its financial condition is stable. Meanwhile, dividends and leverage do not show a significant influence on cash holding.

Individual-specific metabolic network based on 18F-FDG PET revealing multi-level aberrant metabolisms in Parkinson's disease.

Metabolic network analysis in Parkinson's disease (PD) based on 18F-FDG PET has revealed PD-related metabolic patterns. However, alterations at the systemic metabolic network level and at the connection level between different brain regions still remain unknown. This study aimed to explore metabolic network alterations at multiple network levels among PD patients using an individual-specific metabolic network (ISMN) approach. 18F-FDG-PET images of patients with PD (n = 34) and healthy subjects (n = 47) were collected. Healthy subjects were further separated into reference group (n = 28) and control group (n = 19) randomly. Standardized uptake value normalized by lean body mass ratio (SULr) maps was calculated from the PET images. ISMNs were constructed based on SULr maps for PD patients and controls with reference to the reference group. Comparisons of nodal and edge features were performed between PD and control groups. Correlation analysis was conducted between multilevel network properties and clinical scales in PD group. A linear classifier was trained based on nodal or edge features to distinguish PD from controls. The distance from each patient's ISMN to the group-level difference network showed a negative correlation with Hoehn and Yahr stage (r = -0.390, p = .023). Eight nodes from ISMN were identified which exhibited significantly increased nodal degree in PD patients compared to controls (p < .05). Eleven edges were observed which demonstrated significant distinctions in Z-score values in comparisons to the control group (p < .05). Furthermore, the nodal and edge features showed comparable performances in PD diagnosis compared to the traditional SULr values, with area under the receiver operating characteristic curve larger than 0.91. The proposed ISMN approach revealed systemic metabolic deviations, as well as nodal and edge distinctions in PD, which might be supplementary to the existing findings on PD-related metabolic patterns.