Age-stratified path analyses modeled associations between enteric pathogen reservoirs, transmission pathways and height-for-age z-scores (HAZ) to identify determinants of childhood growth in the Kolkata, India site of the Global Enteric Multicenter Study (GEMS). Models tested direct associations of potential pathogen reservoirs with HAZ at 60-day follow-up in separate moderate and severe diarrhea (MSD) case and control cohorts or indirectly when mediated by enteric infections. In the MSD cohort, rotavirus and typical EPEC (tEPEC) infections among children 0-11 months of age and ST-ETEC infections among children 12-23 months of age were associated with lower HAZ. Handwashing after defecating and before cooking reduced impaired growth through reductions in rotavirus and tEPEC infections. Water storage increased rotavirus and ST-ETEC infection risks, resulting in increased impaired growth, but was reduced with reported child feces disposal. The GII norovirus variant was inversely associated with HAZ among children 12-59 months of age in the control cohort. Reported handwashing before the handling of children reduced GII infections and impaired growth. Boiling water and the disposal of children\'s feces mediated by stored water were positively associated with HAZ. The targeting of pathogen-specific reservoirs and transmission pathways may more effectively improve childhood linear growth in South Asian urban communities.

BACKGROUND: Nutrition has an impact on development and linear growth. However, a few studies examine the connections between children\'s age-standardized height and their nutritional status and diet quality.
OBJECTIVE: This study aimed to find a relationship between dietary consumption and height for age among school students under a web-based Thai school lunch program.
METHODS: Anthropometric data and nutrient consumption were obtained from 24-hour records. Nutrient consumption was calculated using Inmucal. The parent and custodian\'s data were from the electronic health records.
RESULTS: Children\'s heights were not correlated with parents\' heights (P<0.720). Moreover, children with low height-for-age Z-score (HAZ) had significantly lower intakes of minerals (iron, magnesium, and selenium) and vitamins (B6, B12, C, and E). On the other hand, magnesium, selenium, vitamin B12, and vitamin E intakes of the children with normal HAZ were higher than their custodians.
CONCLUSIONS: The Thai school lunch program effectively maintains the normal HAZ of children. Nutritional education in the community is recommended.

BACKGROUND: Childhood stunting remains common in many low-income settings and is associated with increased morbidity and mortality, as well as impaired child development.
METHODS: The main objective of the study was to assess whether home-installed growth charts as well as small-quantity lipid-based nutrient supplements (SQ-LNS) can reduce growth faltering among infants. All caregivers of infants between 2 and 10 months of age at baseline, and at least 6 months old at the beginning of the interventions, in 282 randomly selected enumeration areas in Choma, Mansa and Lusaka districts in Zambia were invited to participate in the study. Cluster randomisation was stratified by district. A software-generated random number draw was used to assign clusters to one of four arms: (1) no intervention (control); (2) home installation of a wall chart that contained a growth monitoring tool along with key messages on infant and young child feeding and nutrition (growth charts only); (3) 30 sachets of SQ-LNS delivered each month (SQ-LNS only) or (4) growth charts+SQ LNS. The primary outcomes were children\'s height-for-age z-score (HAZ) and stunting (HAZ <-2) after 18 months of intervention. Secondary outcomes were haemoglobin (Hb), anaemia (Hb<110.0 g/L), weight-for-height, weight-for-age z-score (WAZ), underweight (WAZ<-2) and child development measured by the Global Scales of Early Development (GSED). Outcomes were analysed intention to treat using adjusted linear and logistic regression models and compared each of the three interventions to the control group. Assessors and analysts were blinded to the treatment-blinding of participating families was not possible.
RESULTS: A total of 2291 caregiver-child dyads across the 282 study clusters were included in the study. 70 clusters (557 dyads) were assigned to the control group, 70 clusters (643 dyads) to growth charts only, 71 clusters (525 dyads) to SQ-LNS and 71 clusters (566 dyads) to SQ-LNS and growth charts. SQ-LNS improved HAZ by 0.21 SD (95% CI 0.06 to 0.36) and reduced the odds of stunting by 37% (adjusted OR, aOR 0.63, 95% CI (0.46 to 0.87)). No HAZ or stunting impacts were found in the growth charts only or growth charts+SQ LNS arms. SQ-LNS only improved WAZ (mean difference, MD 0.17, 95% CI (0.05 to 0.28). No impacts on WAZ were seen for growth charts and the combined intervention. Child development was higher in the growth charts only (MD 0.18, 95% CI (0.01 to 0.35)) and SQ-LNS only arms (MD 0.28, 95% CI (0.09 to 0.46). SQ-LNS improved average haemoglobin levels (MD 2.9 g/L (0.2, 5.5). The combined intervention did not have an impact on WAZ, Hb or GSED but reduced the odds of anaemia (aOR 0.72, 95% CI (0.53 to 0.97)). No adverse events were reported.
CONCLUSIONS: SQ-LNS appears to be effective in reducing growth faltering as well as improving anaemia and child development. Growth charts also show the potential to reduce anaemia and improve child development but do not seem as effective in addressing growth faltering. Further research is needed to better understand reduced effectiveness when both interventions are combined.
BACKGROUND: NCT051204272.

OBJECTIVE: This study aimed to analyze the height growth pattern and the incidence of significant growth deceleration in girls with CPP and EFP on GnRHa treatment, and thereby identify relevant predictors of growth deceleration.
METHODS: The data of 99 girls diagnosed with CPP and 47 girls with EFP were included in this retrospective analysis. The incidence of growth deceleration was calculated in both the first and second years. Multivariate logistic regression analysis was used to identify predictors indicative of growth deceleration.
RESULTS: Growth velocity (GV) trajectories showed gradual decreases to the nadir at 18 months of treatment, and then they recovered till the 24th month of treatment, especially in girls with CPP. Nevertheless, the recovery was significantly greater in the CPP group than EFP. In the first year, no significant difference in the incidence of growth deceleration was found between the CPP group and the EFP group [17.35 vs. 25.53 %, p=0.249]; in the second year, the CPP group had a lower incidence than the EFP group [42.86 vs. 76.92 %, p=0.027]. The multivariate logistic regression analysis suggested that bone age (BA) was an independent predictor of growth deceleration (OR=2.264, 95 % CI: 1.268-4.042, p=0.006). The result of ROC curves showed the cut-off value of BA was 11.05 years.
CONCLUSIONS: GV varies at different periods during GnRHa treatment. GnRHa should be used with more caution for EFP treatment than for CPP. BA can be used to predict the occurrence of growth deceleration during GnRHa treatment.

The aim of this study was to analyze the validity of self-reported anthropometric measurements (weight and height) for classifying the nutritional status of Brazilian adults and elderly people using data from the 2019 National Health Survey (PNS). The PNS sample is made up of permanent private households from all of Brazil\'s federative units and this is a cross-sectional study in which 6,571 records were identified with measured and reported data, with no missing data for one variable being identified when in the presence of another. Validation was carried out with 6,381 data after removing atypical data. The variables used for stratification were: gender, age, race/color, schooling, and income, and the weighted Kappa Coefficient and the Intraclass Correlation Coefficient (ICC) were used to analyze agreement between the nutritional status categories. Accuracy was analyzed based on sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). For construct validity, a Poisson regression was performed for each outcome (measured and self-reported), with the independent variables \"gender\", \"color/race\", \"schooling\", and \"family income\". All the analyses showed positive results for validation. There was greater reproducibility among adults (18 to 59 years old) compared to the elderly and among men compared to women. This validation indicates a concrete possibility of carrying out an association of observational studies using reported nutritional status as the outcome variable, as an efficient strategy which could minimize the operational difficulties often encountered.

Background and Objectives: Phenylketonuria (PKU) is a rare genetic disorder characterized by the inability to convert the essential amino acid phenylalanine into tyrosine. Early dietary treatment can successfully prevent complications, but controversies still exist regarding the attainment of normal growth in these patients. Materials and Methods: Eighteen patients with PKU from two Romanian reference centers were compared to eighteen non-PKU controls, matched for age and gender. The comparisons used weight-for-height, weight-for-age, height/length-for-age, and body mass index-for-age z-scores from birth to three years of age. Results: The PKU study group consisted of nine boys and nine girls, with a median follow-up period of thirty-six months (interquartile range = 9.75). While median values of all four growth metrics remained within the normal range across the entire study period, weight-for-age z-scores were significantly lower in PKU patients throughout most of the study (p < 0.001). Conclusions: The persistent lower weight-for-age z-scores of the PKU patients compared to controls indicate that ongoing monitoring and potential adjustments in dietary therapy may be necessary to further optimize growth outcomes.

OBJECTIVE: To study the diagnosis, treatment, and complications of hypophosphatemic rickets (HR) in children, explore effectiveness evaluation indicators for the disease, and understand the pattern in height growth among these patients.
METHODS: A retrospective analysis of the initial clinical data and five-year follow-up data of 85 children with HR treated at Children\'s Hospital of Nanjing Medical University from January 2008 to December 2022.
RESULTS: Among the 85 children with HR, there were 46 males (54%) and 39 females (46%). The age at initial diagnosis ranged from 6 months to 13 years and 9 months, with a median age of 2.75 years. The average height standard deviation score was -2.0±1.1. At initial diagnosis, children exhibited reduced blood phosphate levels and elevated alkaline phosphatase (ALP), with 99% (84/85) presenting with lower limb deformities. The positive rate for PHEX gene mutations was 93% (55/59). One year post-treatment, there was a significant reduction in ALP levels and the gap between the lower limbs (P<0.05). The fastest height growth occurred in the first year after treatment, at 8.23 cm/year, with a peak height velocity (PHV) phase lasting about two years during puberty. The height increased by 9-20 cm in male children during the PHV stage and 10-15 cm in female children. Major complications included nephrocalcinosis and hyperparathyroidism. The incidence rate of nephrocalcinosis in the first year after treatment was 55% (22/40), which increased with the duration of the disease (P<0.001); an increased urinary phosphate/creatinine ratio was positively associated with a higher risk of nephrocalcinosis (OR=1.740, P<0.001). The incidence of hyperparathyroidism in the first year after treatment was 64% (27/42).
CONCLUSIONS: For children presenting with lower limb deformities, short stature, and slow growth, early testing for blood levels of phosphate, calcium, and ALP, along with imaging examinations of the lower limbs, can aid in the early diagnosis of HR. Genetic testing may be utilized for definitive confirmation when necessary. ALP combined with improvements in skeletal deformities and annual height growth can serve as indicators of therapeutic effectiveness for HR. Compared to normal children, children with HR demonstrate a lower height increase during the PHV phase, necessitating close follow-up and timely adjustment of treatment plans Citation:Chinese Journal of Contemporary Pediatrics, 2024, 26(7): 677-682.
目的: 了解低血磷性佝偻病（hypophosphatemic rickets, HR）患儿的诊断、治疗及并发症情况，探讨疾病疗效评价指标，了解患儿身高增长规律。方法: 回顾性分析2008年1月—2022年12月于南京医科大学附属儿童医院诊治的85例HR患儿的首诊临床资料及5年随访资料。结果: 85例HR患儿中，男性46例（54%），女性39例（46%）；首诊年龄范围为6个月至13岁9个月，中位年龄为2.75岁；平均身高标准差数值为-2.0±1.1。首诊时患儿血磷降低，血碱性磷酸酶（alkaline phosphatase, ALP）升高，99%（84/85）患儿存在下肢畸形，PHEX基因突变阳性率为93%（55/59）。患儿治疗1年后ALP水平及双下肢间距较前明显减低（P<0.05）。患儿身高在治疗后第1年增长最快，为8.23 cm/年；存在青春期身高突增峰速度（peak height velocity, PHV）阶段，持续约2年，男性患儿PHV阶段身高共增长9~20 cm，女性患儿PHV阶段身高共增长10~15 cm。患儿主要并发症为肾钙质沉着及甲状旁腺功能亢进。肾钙质沉着治疗后第1年发生率为55%（22/40），其发生率随病程延长而增加（P<0.001）；尿磷/尿肌酐比值升高与肾钙质沉着的风险升高呈正性关联（OR=1.740，P<0.001）。甲状旁腺功能亢进治疗后第1年发生率为64%（27/42）。结论: 对存在下肢畸形、身材矮小、生长缓慢的儿童，及早进行血磷、血钙、ALP检测及下肢影像学检查有助HR的早期诊断，必要时可结合基因检测确诊。ALP结合骨骼畸形改善及身高年增长情况可作为HR治疗疗效的评价指标。患儿青春期PHV阶段身高总增长小于正常儿童，需密切随访，及时调整治疗方案。.

In clinical settings, standing height measurement is often difficult to perform due to patients\' inability to stand upright. Height prediction equations derived from measurements of the length of other body segments have been published; however, they are not readily applicable to all populations since ethnic differences affect the relationship between standing height and body segment length. This cross-sectional study aimed to examine the accuracy of height prediction using the Malnutrition Universal Screening Tool (MUST) height predictive equations among Greek patients and to develop new, nationally representative equations. The study population consisted of 1198 Greek adult outpatients able to stand upright without assistance and without medical conditions that affected their height. Standing height, ulna length, knee height and demi-span measurements were obtained from 599 males and 599 females. Patients were stratified into age groups of <55 and ≥55 years, <60 and ≥60 years and <65 and ≥65 years according to the categories indicated by the MUST for height prediction from alternative measurements. There were positive correlations between standing height and ulna length and knee height and demi-span length (p < 0.001) in both sexes and all age categories. A strong correlation was observed between the measured and predicted standing height using ulna length (rho = 0.870, p < 0.001), knee height (rho = 0.923, p < 0.001) and demi-span length (rho = 0.906, p < 0.001). The average difference between the MUST indicative equations\' height predictions from alternative measurements and actual height was -3.04 (-3.32, -2.76), -1.21 (-1.43, -0.988) and 2.16 (1.92, 2.41), respectively. New height prediction equations for Greek patients were identified, with the predicted values closer to the measured standing heights than those predicted with the MUST indicative equations for height prediction from alternative measurements.

The study employed event-related potential (ERP), time-frequency analysis, and functional connectivity to comprehensively explore the influence of male\'s relative height on third-party punishment (TPP) and its underlying neural mechanism. The results found that punishment rate and transfer amount are significantly greater when the height of the third-party is lower than that of the recipient, suggesting that male\'s height disadvantage promotes TPP. Neural results found that the height disadvantage induced a smaller N1. The height disadvantage also evoked greater P300 amplitude, more theta power, and more alpha power. Furthermore, a significantly stronger wPLI between the rTPJ and the posterior parietal and a significantly stronger wPLI between the DLPFC and the posterior parietal were observed when third-party was at the height disadvantage. These results imply that the height disadvantage causes negative emotions and affects the fairness consideration in the early processing stage; the third-party evaluates the blame of violators and makes an appropriate punishment decision later. Our findings indicate that anger and reputation concern caused by height disadvantage promote TPP. The current study holds significance as it underscores the psychological importance of height in males, broadens the perspective on factors influencing TPP, validates the promoting effect of personal disadvantages on prosocial behavior, enriches our understanding of indirect reciprocity theory, and extends the application of the evolution theory of Napoleon complex.