Reference Ranges for Arterial Oxygen Saturation, Heart Rate, and Cerebral Oxygen Saturation during Immediate Postnatal Transition in Neonates Born Extremely or Very Preterm.

OBJECTIVE: To define percentile charts for arterial oxygen saturation (SpO2), heart rate (HR), and cerebral oxygen saturation (crSO2) during the first 15 minutes after birth in neonates born very or extremely preterm and with favorable outcome. STUDY DESIGN: We conducted a secondary-outcome analysis of neonates born preterm included in the Cerebral regional tissue Oxygen Saturation to Guide Oxygen Delivery in preterm neonates during immediate transition after birth III (COSGOD III) trial with visible cerebral oximetry measurements and with favorable outcome, defined as survival without cerebral injuries until term age. We excluded infants with inflammatory morbidities within the first week after birth. SpO2 was obtained by pulse oximetry, and electrocardiogram or pulse oximetry were used for measurement of HR. crSO2 was assessed with near-infrared spectroscopy. Measurements were performed during the first 15 minutes after birth. Percentile charts (10th to 90th centile) were defined for each minute. RESULTS: A total of 207 neonates born preterm with a gestational age of 29.7 (23.9-31.9) weeks and a birth weight of 1200 (378-2320) g were eligible for analyses. The 10th percentile of SpO2 at minute 2, 5, 10, and 15 was 32%, 52%, 83%, and 85%, respectively. The 10th percentile of HR at minute 2, 5, 10, and 15 was 70, 109, 126, and 134 beats/min, respectively. The 10th percentile of crSO2 at minute 2, 5, 20, and 15 was 15%, 27%, 59%, and 63%, respectively. CONCLUSIONS: This study provides new centile charts for SpO2, HR, and crSO2 for neonates born extremely or very preterm with favorable outcome. Implementing these centiles in guiding interventions during the stabilization process after birth might help to more accurately target oxygenation during postnatal transition period.

A Pilot Comparative Study between Creatinine- and Cystatin-C-Based Equations to Estimate GFR and Kidney Ultrasound Percentiles in Children with Congenital Anomalies of the Kidney and Urinary Tract.

Congenital anomalies affecting the kidneys present significant challenges in pediatric nephrology, needing precise methods for assessing renal function and guiding therapeutic intervention. Bedside Schwartz formula with the cystatin-C-based Full Age Spectrum formula and Chronic Kidney Disease in Children (CKiD) U 25 formula used in estimating glomerular filtration rate (eGFR) and also to assess if the eGFR in association with kidney length percentiles can be a monitoring parameter for the progression of chronic kidney disease in children with congenital anomalies of the kidney and urinary tract (CAKUT). A total of 64 pediatric patients (median age at diagnostic was 12 months with an interquartile range of 2 to 60) were diagnosed with congenital anomalies in the kidney and urinary tract between June 2018 and May 2023 at "Louis Turcanu" Emergency Hospital for Children in Timisoara, Romania. Baseline characteristics, CAKUT types, associated pathologies, CKD staging, and eGFR using creatinine and cystatin C were analyzed. The mean age at the moment of examination was 116.50 months; (65, 180). Chronic kidney disease staging revealed a predominance of patients in CKD stages G1 and A1. Analysis of eGFR methods revealed a small mean difference between eGFR estimated by creatinine and cystatin C, with a moderate-strong positive correlation observed between the eGFR and ultrasound parameters. Using cystatin-C-based formulas for eGFR, in conjunction with ultrasound measurements, may offer reliable insights into renal function in pediatric patients with congenital anomalies affecting the kidney and urinary tract. However, the economic aspect must be taken into consideration because cystatin C determination is approximately eight times more expensive than that of creatinine. An interdisciplinary approach is crucial for managing patients with CAKUT.

Ocular Biometry Percentile Curves and Their Relation to Myopia Development in Indian Children.

Background: The aim of the present study was to provide ocular biometry percentile values for Indian children between the ages of 6 and 12 and to validate the usefulness of centiles in predicting myopia development. Methods: The study was part of a longitudinal study-the Sankara Nethralaya Tamil Nadu Essilor Myopia Study (STEM), where objective refraction and ocular biometry were measured for children studying in grades 1, 4, and 6 at baseline (2019-2020). These data were used to generate ocular biometry percentile curves (both for axial length (AL) and AL/corneal curvature (AL/CR) ratios). The usefulness of percentile values in predicting myopia development was estimated from follow-up data (2022). Results: The total number of children in the three grades at baseline was 4514 (age range 6 to 12). Boys represented 54% (n = 2442) of the overall sample. The prevalence of myopia at baseline was 11.7% (95% CI from 10.8 to 12.7%) in these three grades. Both the AL and AL/CR ratio centiles showed a linear trend with an increase in AL and AL/CR with increasing grades (p < 0.001) for all percentiles (2, 5, 10, 25, 50, 75, 90, 95, 98, and 99) when stratified by sex. In the follow-up data (n = 377), the 75th and 50th percentiles of the AL/CR ratio had an area under the curve (AUC) of 0.79 and 0.72 to predict myopia onset for grade 4 and 6 children at baseline. Combining baseline AL with the centile shift in follow-up as a predictor increased the AUC to 0.83. Conclusions: The present study has provided centile values specific for Indian children between the ages of 6 and 12 to monitor and intervene where children are at a higher risk of myopia development.

Evaluación de la condición física en poblaciones de 6 a 14 años de México y Cuba

El presente estudio constituye un trabajo trascendente en el área del conocimiento de la condición física y representa el resultado de investigaciones realizadas en la República de Cuba y en los Estados Unidos Mexicanos como respuesta a la solicitud de ambos países. Fue diseñado estadísticamente, para representar datos oficiales y altamente confiables, con el objetivo de conocer el estado de la condición física de las dos naciones y valorar así, el efecto de los programas de Educación Física que se aplican. Se contó con el apoyo de las organizaciones deportivas y de cultura física al conformar los estudios, cuidadosamente tratados en el diseño de muestra, para ello se contó con un equipo de estadísticos especialistas que tuvieron a su cargo el procesamiento de la información. Los datos de este estudio se consideraron limitados para la publicación y una vez desclasificados se dan conocer. Se utilizaron iguales metodologías en su aplicación, lo que resulta una información valiosa para el perfeccionamiento de los planes y programas que en el campo de la Licenciatura en Cultura Física y se brinda una información que, en su comparación, llama a la reflexión de los especialistas de Educación Física, para continuar el perfeccionamiento de estas especialidades, en general.

O presente estudo constitui um trabalho transcendental na área do conhecimento da aptidão física e representa o resultado de uma pesquisa realizada na República de Cuba e nos Estados Unidos Mexicanos em resposta à solicitação de ambos os países. Foi projetado estatisticamente para representar dados oficiais e altamente confiáveis, com o objetivo de conhecer o estado da aptidão física em ambos os países e, assim, avaliar o efeito dos programas de Educação Física aplicados. As organizações esportivas e de cultura física foram apoiadas na elaboração dos estudos, cuidadosamente tratadas no desenho da amostra, com a ajuda de uma equipe de estatísticos especializados que foram responsáveis pelo processamento das informações. Os dados deste estudo foram considerados limitados para publicação e, uma vez desclassificados, são tornados públicos. Foram utilizadas as mesmas metodologias em sua aplicação, o que resulta em informações valiosas para o aprimoramento dos planos e programas no campo da cultura física e fornece informações que, em sua comparação, exigem a reflexão dos especialistas em educação física, a fim de continuar o aprimoramento dessas especialidades em geral.

The present study constitutes a transcendent work in the area of knowledge of physical condition and represents the result of research carried out in the Republic of Cuba and in the United Mexican States in response to the request of both countries. It was designed statistically, to represent official and highly reliable data, with the objective of knowing the state of the physical condition of the two nations and thus evaluating the effect of the Physical Education programs that are applied. It was had the support of sports and physical culture organizations when forming the studies, carefully treated in the sample design, for this it was had a team of specialist statisticians who were in charge of processing the information. The data from this study was considered limited for publication and will be released once declassified. The same methodologies were used in its application, which is valuable information for the improvement of plans and programs in the field of the Bachelor's Degree in Physical Culture and information is provided that, in comparison, calls for reflection by specialists. of Physical Education, to continue the improvement of these specialties, in general.

Disparities with global standards about growth references of mid-upper arm circumference-for-age for Pakistani children aged 6-60 months.

AIM: Growth reference values about mid-upper arm circumference (MUAC) are vital for assessing children's nutritional status. However, Pakistan lacks these reference values and growth charts. This study aims to develop these for children aged 6-60 months and compare them with global standards. METHODS: The data were acquired from the 2018 National Nutrition Survey of Pakistan, which was conducted by the United Nations Children's Fund (UNICEF) during 2018-2019. The final study cohort comprised 57 285 children, with 51% being boys. Percentile values and charts for MUAC-for-age were developed using generalised additive models for location, scale and shape with the Box-Cox power exponential distribution. RESULTS: The mean MUAC was 14.21 cm (±2.07 cm) and 14.13 cm (±2.12 cm) for the boys and girls, respectively. At 60 months of age, the P3 and P97 percentiles for girls were slightly higher than those for boys. The median percentiles of Pakistani children were smaller than the World Health Organisation 2007 standards and with international references. CONCLUSION: We observed disparities in MUAC-for-age growth references among Pakistani children compared to global standards, highlighting regional, age and gender variations. This underscores the need for developing countries like Pakistan to establish their growth references.

"You Are Not Wrong About Getting Strong:" An Insight Into the Impact of Age Group and Level of Competition on Strength in Spanish Football Players.

OBJECTIVE: This study aimed to compare the maximum and rapid force production of Spanish football players and explore the differences between age group and level of competition. METHODS: A cross-sectional study was developed to evaluate the peak force (PF), relative PF, and rate of force development over 250 ms (RFD0-250) during the isometric midthigh pull between groups of football players based on age group (senior vs junior) and level of competition (national vs regional). Using a portable isometric rig, 111 football players performed 2 isometric midthigh-pull trials on a force plate. Two-way analysis of variance with Bonferroni post hoc correction was applied, and statistical significance was set at P ≤ .05. The PF, relative PF, and RFD0-250 0, 25, 50, 75, and 100 percentiles were also calculated and descriptively reported, separated by age group and level of competition. RESULTS: The analysis of variance revealed a significant main effect of the level of competition for the PF (P < .001), relative PF (P = .003), and RFD0-250 (P < .001). There was a significant main effect of age group for the PF (P < .001). There was a significant interaction effect of the age group × level of competition for relative PF (P = .014). National players were stronger than regional players on the PF and RFD0-250 (P < .001). Senior players were stronger than junior players for the PF (P < .001). CONCLUSIONS: Maximum and rapid force production are crucial for Spanish football players as they progress in both level of competition and age group. Practitioners should encourage young football players to prioritize strength development to improve their athletic performance.

Functional fitness benchmark values for older adults: a systematic review.

Introduction: The use of normative values and/or standards of functional fitness in adults is relevant to overall health and well-being. The objectives of the study were: to identify the physical tests of the senior fitness test (SFT) that have been applied since its proposal and to describe the proposed percentiles according to age, sex and country. Methods: A systematic review study was conducted in the Pubmed and Scopus databases. As eligibility criteria, we considered the period from 1999 to 2022 that presented data on SFT test used in the population over 60 years of age and that described normative values through percentiles. MeSH were used as: (1) Physical fitness, Exercise test, Senior Fitness Test, Functional fitness, Cardiorespiratory fitness, (2) older adult, aged, (3) Reference standards, standards, standards of care. Boolean operators "AND" and "OR" were included. Data extracted from the selected studies included: year of publication, country, sample age, sample size, sample sex, fitness component. Results and discussion: Seven studies were identified in five countries (03 in China, 01 in Poland, 01 in Portugal, 01 in Spain and 01 in United States). The age range ranged from 60 to 103 years. The studies were conducted in both sexes. The study with the smallest sample size was by Chung et al. (China) with 944 participants and the largest number of participants was the study by Rikli and Jones in the United States with 7,183 participants. In general, no study was able to complete 100% (8 components) of the tests proposed in the SFT. Normative values were presented through percentile distribution (p10, p50 and p90) organized by age ranges. Males presented better performance in FPF tests than females in all tests. Since the first publication of the SFT until 2022, seven articles have been published in countries such as United States, China (three regional studies), Poland, Portugal and Spain. No study has published the complete battery with its eight components. The percentiles of functional fitness reflect decline with advancing age. Systematic review registration: PROSPERO (CRD42023441294: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023441294).

Does weight influence the course of RSV bronchiolitis in hospitalized infants?

Acute bronchiolitis is among the most common causes of hospitalizations in infants worldwide. Associations between weight and severity of respiratory syncytial virus (RSV) bronchiolitis remain unclear. The aim of this study was to evaluate this association. A single-center, retrospective cohort study of infants aged under 24 months, who were hospitalized between 2018 and 2022 for RSV bronchiolitis. Data from computerized medical records were extracted using the MDclone platform. Participants were divided into three groups according to weight percentiles: underweight (below 5th percentile), normal-weight, and overweight (above 85th percentile). A total of 1936 infants (mean age 6.3 months, 55% males) were included, comprising 274 infants who were underweight, 1470 with normal weight, and 192 with overweight. Underweight infants had a higher rate of admission to the pediatric intensive care unit (PICU) (9.1% vs. 3.5%, P < 0.005) and prolonged length of stay (LOS) in the hospital (3.13 vs. 2.79 days P < 0.001) compared to those with normal weight. Hyponatremia was also more common in the underweight group (23% vs. 15%, P < 0.001). A multivariable model accounting for prematurity and birthweight predicted a relative risk of 2.01 (95% CI 1.13-3.48, P = 0.015) for PICU admission and 1.42 (95% CI 1.17-1.7, P < 0.001) for a prolonged LOS. Being overweight was not associated with a more severe disease.  Conclusion: Underweight infants, hospitalized for RSV bronchiolitis, had a more severe disease course with a higher complication rate, including PICU admission and prolonged LOS. Thus, careful attention and supervision should be given to this subgroup of infants. What is Known: • Established risk factors for severe bronchiolitis include prematurity, BPD, CHD, and compromised immunity. • Abnormal weight status has been associated with an increased risk for morbidity and mortality from infectious diseases, proposedly due to the effects on endocrine and immunologic systems. What is New: • Underweight infants hospitalized with RSV bronchiolitis face an independent risk of PICU admission and prolonged hospital stay. • Conversely, overweight infants did not display associations with severity measures in our study.

Age-related curves of AMH using the Gen II, the picoAMH and the Elecsys assays in women with polycystic ovary syndrome.

CONTEXT: Several challenges still exist to adopt the anti-Müllerian hormone (AMH) as a marker of polycystic ovary morphology (PCOM), as included in the recently updated international guideline. Although different evaluations of age- and assay-specific reference ranges have been published in the last years, these studies have mainly been conducted in normo-ovulatory or infertile women. OBJECTIVE: To develop an age-specific percentile distribution of AMH in patients with polycystic ovary syndrome (PCOS) measured by three different assays. DESIGN: Retrospective cross-sectional study. PATIENTS: 2,725 women aged 20 to 40 years with PCOS diagnosis were included. INTERVENTION (S): Serum AMH measurement by the Gen II (Beckman Coulter), the picoAMH (Ansh Labs), and the Elecsys (Roche) assays. MAIN OUTCOME MEAUSRE (S): Age-specific centile curves for all the assays and correlations between AMH, clinical, hormonal, and ultrasound characteristics. RESULTS: Age-related nomograms for the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of AMH were calculated using the LMS method for all the assays. AMH levels were significantly different between PCOS phenotypes. AMH levels were positive correlated to luteinizing hormone (LH), LH/follicular stimulating hormone (FSH) ratio, testosterone, androstenedione, free androgen index, mean follicular number, and mean ovarian volume. CONCLUSIONS: To our knowledge this is the first study reporting age specific percentile nomograms of serum AMH levels measured by the Gen II, the picoAMH and the Elecsys assays in a large population of PCOS women. These findings may help to interpret AMH levels in PCOS patients and facilitate the use of AMH as a diagnostic tool across age ranges.

ISAK-Based Anthropometric Standards for Elite Male and Female Soccer Players.

This study aimed to provide reference values for anthropometric characteristics of elite male and female soccer players, considering a group of individuals from the general population as controls. The anthropometric profiles of 357 elite soccer players [184 males (age 24.3 ± 4.3 y) and 173 females (age 25.2 ± 5.1 y)] participating in the first Italian league (Serie A) and 363 subjects from the general population [188 males (age 24.2 ± 4.8 y) and 175 females (age 25.0 ± 5.1 y)] were measured according to the guidelines of the International Society for the Advancement of Kinanthropometry (ISAK). Reference percentiles for stature, body mass, circumferences, eight skinfolds (biceps, triceps, subscapular, suprailiac, supraspinal, abdominal, front thigh, and calf), breadths, and somatotype were calculated and stratified by player position and sex. No difference (p > 0.05) was found in age between the two groups. Soccer players showed lower values for the sum of the eight ISAK skinfolds than individuals from the general population of the same sex. This suggests lower adipose tissue, as indicated by a lower endomorphic component. The somatotype was endomorphic mesomorph and mesomorphic endomorph for the male and female individuals from the general population, respectively. The male soccer players were ectomorphic mesomorphs, while the females were balanced mesomorphs, defining a sport-specific morphology. This study provides sex- and role-specific anthropometric standards for elite soccer players. Raw anthropometric reference values may be useful for evaluating body composition without using any predictive equations or assumptions.

Normative Reference Centiles for Sprint Performance in High-Level Youth Soccer Players: The Need to Consider Biological Maturity.

PURPOSE: To compute reference centiles for 5- and 30-m sprint times relative to chronological and skeletal age in youth soccer players. Subsequently, to compare individual's sprint performance scores derived from the chronological and skeletal age reference centiles. METHODS: Sprint times were collected for a sample of male U11 to U19 soccer players (n = 1745 data points). Skeletal age data were available for a subsample (n = 776 data points). Reference centiles were fitted using generalized additive models for location, scale, and shape. Individual z scores relative to chronological and skeletal age reference centiles were computed and compared for each maturity group (late, on-time, early, and very early) using standardized mean differences (SMD). RESULTS: Reference centiles for chronological age increased more rapidly between 10.5 and 15.5 years, while reference centiles for skeletal age increased more rapidly between 13.0 and 16.5 years. Differences in chronological and skeletal z scores for very early (SMD: -0.73 to -0.43) and late (SMD: 0.58 to 1.29) maturing players were small to large, while differences for early (SMD: -0.30 to -0.19) and on-time (SMD: 0.16 to 0.28) were trivial to small. CONCLUSION: Reference centiles provide a valuable tool to assist the evaluation of sprint performance in relation to chronological and skeletal age for talent identification purposes in youth soccer players.

Looking beyond the mean: quantile regression for comparative physiologists.

Statistical analyses that physiologists use to test hypotheses predominantly centre on means, but the tail ends of the response distribution can behave quite differently and underpin important scientific phenomena. We demonstrate that quantile regression (QR) offers a way to bypass some limitations of least squares regression (LSR) by building a picture of independent variable effects across the whole distribution of a dependent variable. We used LSR and QR with simulated and real datasets. With simulated data, LSR showed no change in the mean response but missed significant effects in the tails of the distribution found using QR. With real data, LSR showed a significant change in the mean response but missed a lack of response in the upper quantiles which was biologically revealing. Together, this highlights that QR can help to ask and answer more questions about variation in nature.

Differential effects of growth restriction and immaturity on predicted psychomotor development at 4 years of age in preterm infants.

BACKGROUND: Fetal growth restriction and immaturity are associated with poor neurocognitive development and child psychopathology affecting educational success at school and beyond. However, the differential effects of either obstetrical risk factor on predicted psychomotor development have not yet been deciphered. OBJECTIVE: This study aimed to separately study the impact of growth restriction and that of immaturity on predicted psychomotor development at the preschool age of 4.3 (standard deviation, 0.8) years using birthweight percentiles in a prospective cohort of preterm infants born at ≤37+6/7 weeks of gestation. Differences between small for gestational age newborns with intrauterine growth restriction and those without were described. We examined predicted total psychomotor development score, predicted developmental disability index, calculated morphometric vitality index, and predicted intelligence quotient, Porteus Maze test score, and neurologic examination optimality score in 854 preterm infants from a large prospective screening cohort (cranial ultrasound screening, n=5,301). STUDY DESIGN: This was a prospective cranial ultrasound screening study with a single-center cohort observational design (data collection done from 1984-1988, analysis done in 2022). The study included 5,301 live-born infants, of whom 854 (16.1%) were preterm infants (≤37+6/7 weeks' gestation), and was conducted on the day of discharge of the mother at 5 to 8 days postpartum from a level 3 perinatal center. Predicted psychomotor development, as assessed by the predicted total psychomotor development score, predicted developmental disability index, calculated morphometric vitality index, predicted intelligence quotient, Porteus Maze test score, and neurologic examination optimality score were calculated. We related psychomotor development indices and measures to gestational age in 3 groups of birthweight percentiles (ie, 10%, 50%, and 90% for small, appropriate, and large for gestational age newborns, respectively) using linear regression analysis, analysis of variance, multivariate analysis of variance, and t test procedures. RESULTS: The key result of our study is the observation that in preterm infants born at ≤37+6/7 weeks of gestation, growth restriction as compared with immaturity is the prime risk factor for impairment of overall predicted psychomotor development, intelligence quotient, Porteus Maze test results, and neurologic examination optimality score at the preschool age of 4.3 (standard deviation, 0.8) years (P<.001). This is particularly true for intrauterine growth restriction. These detrimental effects of growth restriction become more prominent with decreasing gestational age (P<.001). As expected, growth restriction in preterm infants born at ≤37+6/7 weeks of gestation was associated with a number of obstetrical risk factors, including hypertension in pregnancy (P<.001), multiple pregnancy (P<.001), pathologic cardiotocography (P=.001), and low pH (P=.007), increased pCO2 (P=.009), and poor pO2 (P<.001) in umbilical arterial blood. Of note, there were no differences in cerebral hemorrhage or white matter damage among small, appropriate, and large for gestational age birthweight percentile groups, suggesting an independent mechanism of brain injury caused by preterm growth restriction resulting in poor psychomotor development. CONCLUSION: Compared with immaturity, growth restriction in preterm infants has more intense detrimental effects on psychomotor development, necessitating improved risk stratification. This finding has implications for clinical management, parental consultation, and early intervention strategies to improve school performance, educational success, and mental health in children. The mechanisms of brain injury specific to growth restriction in preterm infants require further elucidation.

Evaluation of a non-auditory neurocognitive test battery in hearing-impaired according to age.

PURPOSE: Due to the demographic shift, the number of older people suffering from hearing loss and from cognitive impairment increases. Both are closely related and hard to differentiate as most standard cognitive test batteries are auditory-based and hearing-impaired individuals perform worse also in non-auditory test batteries. Therefore, reference data for hearing-impaired are mandatory. METHODS: The computer-based battery ALAcog assesses multiple cognitive domains, such as attention, (delayed) memory, working memory, inhibition, processing speed, mental flexibility and verbal fluency. A data set of 201 bilaterally hearing-impaired subjects aged ≥ 50 (mean 66.6 (SD 9.07)) was analysed. The LMS method, estimated curves for the 10th, 25th, 50th, 75th and 90th percentile were calculated, and classified according to age, starting from the age of 50. RESULTS: Cognitive function shows a decline in all subtests as people age, except for verbal fluency, which remains almost stable over age. The greatest declines were seen in recall and delayed recall and in mental flexibility. Age and hearing ability did not correlate (p = 0.68). However, as people age, inter-subject variability of cognitive test results increases. This was especially the case for inhibition. Cognitive function was not correlated with hearing ability (each p ≥ 0.13). CONCLUSION: The present results make an approach to establish reference data for a comprehensive non-auditory test battery in a large sample of elderly hearing-impaired people which can be used as a simple tool to better contextualise cognitive performance beyond mean and median scores.

Coronary artery calcium score percentiles: data from a single center in Turkey.

PURPOSE: The coronary artery calcium (CAC) score is used in decision-making for preventive medications in patients with borderline clinical risk scores. Both absolute and percentile CAC scores can be used; however, a percentile CAC score is especially useful in young patients and women. The aim of this study is to present CAC score percentiles across age categories in women and men using a large database. METHODS: Bilkent City Hospital database was screened for patients who underwent CAC score measurements between January 2021 and March 2022. Of the 4,487 patients, 546 were excluded due to 1) a history of coronary stent implantation or bypass surgery or 2) missing information regarding a history of revascularization or calcium scores. Therefore, the final study population included 3,941 participants. The percentiles for age categories within each sex were tabulated, and percentile plots were created for each sex using locally weighted scatterplot smoothing regression. RESULTS: The proportion of men included in the study was higher compared with that of women (57.09% vs. 42.91%). The mean age was 52.20 ± 11.11 years, and it was higher in women than in men (54.07 ± 10.47 vs. 50.80 ± 11.37, respectively; P < 0.001). A zero CAC score was observed in 2,381 (60.42%) patients; the percentage was higher in women than in men (68.60% vs. 54.27%; P < 0.001). When the cut-off value for the high-risk category was taken as the 75th percentile, a non-zero CAC score directly assigned a patient into the high-risk category in women aged <55 years and men aged <45 years. Percentile plots were also provided for each sex. CONCLUSION: In this large-scale study, including patients referred for CAC scoring and/or coronary computed tomography angiography, CAC score percentiles were provided for women and men across the selected age categories which may be in therapeutic decision-making. As an approximate rule of thumb, a non-zero CAC score corresponds to the high-risk category in women aged <55 years and in men aged <45 years.

Cohort-Based Reference Values for Serum Ferritin and Transferrin and Longitudinal Determinants of Iron Status in European Children Aged 3-15 Years.

BACKGROUND: Reference values of ferritin and transferrin for European children do not exist. OBJECTIVE: We aimed to provide sex-, age-, and body mass index (BMI)-specific serum ferritin and transferrin reference percentiles of 3-15-y-old children based on cohort data and to investigate determinants of iron status. METHODS: A total of 3390 ferritin and 3416 transferrin measurements from children residing in 8 European countries participating in the IDEFICS/I.Family cohort (https://www.isrctn.com/ISRCTN62310987) at baseline (W0) and 6 y later (W3) were used to estimate percentiles using the generalized additive model for location, scale and shape. Associations of serum ferritin and transferrin concentrations with total iron intake, total iron intake additionally adjusted for vitamin C intake, and iron from heme sources were investigated separately with adjustment for sex, age, country of residence, parental education, usual energy intake and BMI z-score in regression models using cross-sectional and longitudinal data. RESULTS: The age-specific ferritin and transferrin 5th and 95th reference percentiles ranged from 10.9 to 81.1 µg/L and 2.23 to 3.56 g/L, respectively. A deficient iron status was observed in 3% of children at W0 and 7% of children and adolescents at W3, respectively. At both waves, a higher iron intake from heme sources was positively associated with serum ferritin {W0: ß = 3.21 [95% confidence interval (CI): 0.71, 5.71]; W3: ß = 4.48 [95% CI: 2.09, 6.87]}, that is, children consuming one mg more heme iron had a 3.21 and 4.48 µg/L higher ferritin concentration. Adherence to a mainly vegetarian diet was associated with a lower chance for sufficient serum ferritin cross-sectionally at W3 [odds ratio (OR) 0.40 (95% CI: 0.21, 0.81)] and longitudinally [OR 0.35 (95% CI: 0.15, 0.93)]. CONCLUSIONS: Age-, sex-, and BMI-specific reference percentiles of serum ferritin and transferrin concentrations based on cohort data are provided for European children aged 3-15 y and may be used in clinical practice.

Sex- and age-specific normative values of lower extremity muscle power in Italian community-dwellers.

BACKGROUND: Muscle power is associated with health-related parameters. Simple equations were validated to estimate lower extremity muscle power measures based on the time to complete the five-repetition sit-to-stand test. The present study was conducted to provide lower extremity muscle power estimates and produce centile values in a large and relatively unselected population across a wide age spectrum. METHODS: Data were from the Longevity Check-up 7+ (Lookup 7+) project, an ongoing initiative conducted in unconventional settings (e.g., exhibitions, shopping centres and health promotion campaigns) across Italy to foster adoption of healthy lifestyles. Absolute, relative, allometric and specific muscle power measures of the lower extremities were estimated using validated formulas. Cross-sectional centile and normative values for muscle power measures from 18 to 81+ years were produced for the two sexes. Smoothed normative curves for men and women were constructed using the lambda-mu-sigma method. RESULTS: From 1 June 2015 to 31 October 2021, 13 515 participants were enrolled of whom 12 864 were eligible for the present study. Mean age was 55.9 years (standard deviation: 14.8 years; range: 18-98 years), and 7217 (56.%) were women. Absolute, relative, allometric and specific muscle power declined significantly with age. Specific patterns of decline were observed according to sex and muscle power parameter. Absolute muscle power peaked at 41-50 and 31-40 years in men and women, respectively. Afterwards, a decline rate of approximately 12% per decade was observed, regardless of sex. Relative muscle power showed the largest reduction with age, such that it was 40.6% and 46.4% smaller in men and women older than 80, respectively, compared with those aged 18-30 years. Age-related changes in allometric and specific muscle power measures were similar between men and women. CONCLUSIONS: Data from the Lookup 7+ project indicate that lower extremity muscle power estimated using simple equations is significantly associated with age. Sex-specific patterns of decline in absolute and relative muscle power were observed with age. Allometric and specific muscle power declined at a similar rate in men and women.

IGF1 Genetic Polymorphism and the Association between Vitamin D Status and BMI Percentiles in Children.

Both the IGF1 axis and hypovitaminosis D play a role in childhood obesity, either as a cause or a causality. While some studies suggest an interrelation between vitamin D status, IGF1, and obesity, this mechanism remains obscure. The aim of this study, therefore, was to explore associations between four genetic polymorphisms in the IGF1 axis in hypovitaminosis D-related obesity. The study included 116 pre-pubertal Israeli Arab children (52 girls), mean age 9.4 ± 2.6. Serum 25(OH)D was measured and anthropometric measures were obtained. Genomic DNA was extracted from peripheral EDTA-treated anti-coagulated blood using a standard protocol. Genotypes were determined using the Taqman allelic discrimination assay. The IGF genetic score was computed according to the additive genetic score model. A moderate-to-high negative correlation (r = 0.580, p < 0.05) was seen between the vitamin D status and body mass index (BMI) percentile of participants with high GS. Yet, no correlations were seen between vitamin D status and BMI percentile for participants with a low-to-moderate genetic score (GS) (GS ≤ 2). These results suggest that IGF1 genetic scores associated with elevated circulating IGF1 may indicate a tendency toward developing hypovitaminosis D-associated obesity.

Reference Values for Birth Weight in Relation to Gestational Age in Poland and Comparison with the Global Percentile Standards.

INTRODUCTION: Percentiles of birth weight by gestational age (GA) are an essential tool for clinical assessment and initiating interventions to reduce health risks. Unfortunately, Poland lacks a reference chart for assessing newborn growth based on the national population. This study aimed to establish a national reference range for birth weight percentiles among newborns from singleton deliveries in Poland. Additionally, we sought to compare these percentile charts with the currently used international standards, INTERGROWTH-21 and WHO. MATERIALS AND METHODS: All singleton live births (n = 3,745,239) reported in Poland between 2010 and 2019 were analyzed. Using the Lambda Mu Sigma (LMS) method, the Generalized Additive Models for Location Scale, and Shape (GAMLSS) package, smoothed percentile charts (3-97) covering GA from 23 to 42 weeks were constructed. RESULTS: The mean birth weight of boys was 3453 ± 540 g, and this was higher compared with that of girls (3317 ± 509 g). At each gestational age, boys exhibited higher birth weights than girls. The weight range between the 10th and 90th percentiles was 1061 g for boys and 1016 g for girls. Notably, the birth weight of Polish newborns was higher compared to previously published international growth standards. CONCLUSION: The reference values for birth weight percentiles established in this study for Polish newborns differ from the global standards and are therefore useful for evaluating the growth of newborns within the national population. These findings hold clinical importance in identifying neonates requiring postbirth monitoring.

Percentile curves of refractive errors in a Spanish paediatric population

Objective The main objective of this study was to obtain percentile curves of refractive errors in a Spanish paediatric population aged between 3 and 12 years. Materials and method A descriptive, observational and cross-sectional study was conducted, including children aged between 3 and 12 years who did not present with any known ocular and/or systemic diseases. The convenience sampling method was used to select the sample from three schools and one hospital in the Community of Madrid. The refractive error was obtained using a Retinomax K-plus 3 autorefractometer (RTX; Right Mfg. Co. Ltd., Tokyo, Japan). The 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles were calculated using the IBM SPSS Statistics v.24 statistical software (IBM Corporation, Armonk, NY, United States). Results A total of 688 children with a mean age of 7.68 ± 2.17 years were analysed. In the 50th percentile curve, spherical equivalent values started to become myopic at 3 years (SE < –0.50 D) and the 75th percentile curve also turned myopic at 4 years. As a result, it was observed that the spherical equivalent value became more negative with time, starting from the ages indicated above. Therefore, the 90th percentile curve was negative at 11 years. Conclusion Percentile curves of refractive errors in a Spanish paediatric population have been presented for the first time in order to help eyecare professionals detect children with refractive errors at an early age. (AU)