1,131 research outputs found
Geloven in een technologische cultuur
Wetensch. publicatieFaculty of Theolog
Body composition, blood pressure, and lipid metabolism before and during long-term growth hormone (GH) treatment in children with short stature born small for gestational age either with or without GH deficiency
To assess the effects of long-term continuous GH treatment on body
composition, blood pressure (BP), and lipid metabolism in children with
short stature born small for gestational age (SGA), body mass index (BMI),
skinfold thickness measurements, systemic BP measurements, and levels of
blood lipids were evaluated in 79 children with a baseline age of 3-11 yr
with short stature (height SD-score, < -1.88) born SGA (birth length
SD-score, < -1.88). Twenty-two of the 79 children were GH deficient (GHD).
All children participated in a randomized, double-blind, dose-response
multicenter GH trial. Four- and 6-yr data were compared between two GH
dosage groups (3 vs. 6 IU/m2 body surface/day). Untreated children with
short stature born SGA are lean (mean BMI SD-score, -1.3; mean SD-score
skinfolds, -0.8), have a higher systolic BP (SD-score, 0.7) but normal
diastolic BP (SD-score, -0.1), and normal lipids (total cholesterol, 4.7
mmol/L; low-density lipoprotein, 2.9 mmol/L; high-density lipoprotein, 1.3
mmol/L) compared with healthy peers. During long-term continuous GH
treatment, the BMI normalized without overall changes in sc fat compared
with age-matched references, whereas the BP SD-score and the atherogenic
index decreased significantly. Although the mean 6-yr increase in height
SD-score was significantly higher in the children receiving GH treatment
with 6 IU/m2 x day (2.7) than in those receiving treatment with 3 IU/m2
day (2.2), no differences in the changes in BMI, skinfold measurements,
BP, and lipids were found between the GH dosage groups. The pretreatment
SD-scores for BMI, skinfold, and BP, as well as the lipid levels, were not
significantly different between GHD and non-GHD children, but after 6 yr
of GH treatment the skinfold SD-score and BP SD-score had decreased
significantly more in the GHD than in the non-GHD children. Our data
indicate that GH treatment has at least up to 6 yr positive instead of
negative effects on body composition, BP, and lipid metabolism. In view of
the reported higher risk of cardiovascular diseases in later life in
children born SGA, further research into adulthood remains warranted
Validation and calibration of the Kabi Pharmacia International Growth Study prediction model for children with idiopathic growth hormone deficiency
In 1999 a model was published for prediction of growth in children with
idiopathic GH deficiency (IGHD) during GH therapy, derived using data from
the Kabi Pharmacia International Growth Study (KIGS) database (Pharmacia
\\|[amp ]\\| Upjohn, Inc., International Growth Database). We validated and
calibrated this KIGS model for growth in the first year of GH therapy
using data from 136 Dutch children with IGHD. Observed vs. predicted
outcomes were plotted, and the fitted regression line was significantly
different from the line of identity (P = 0.03). It appeared that the
predictions were too extreme: relatively low predictions were too low,
relatively high predictions were too high. This is a well known phenomenon
in the context of prediction models, called overoptimism. For valid
application to other data the KIGS predictions should be calibrated.
Calibrated predictions are obtained using Y(cal) = Y(orig) + (2.153 -
0.192 x Y(orig)), where Y(cal) is the calibrated prediction, and Y(orig)
is the KIGS prediction. The calibrated prediction will be higher than the
original KIGS prediction when the original prediction is less than 11.2
cm/yr and will be lower otherwise. The variability of the prediction
errors of the calibrated predictions was positively related to the value
of the prediction (P < 0.001), described by the equation SD(pred err) =
-1.017 + 0.286 x Y(cal). Our calibrated model will give better predictions
for children with IGHD fulfilling the same criteria
Fatness and muscularity as risk indicators of child mortality in rural Congo
OBJECTIVES: To examine the relationship of anthropometrical indicators of
fatness and muscularity with mortality in children in a rural African
community. BACKGROUND: A prospective cohort study was carried out in the
rural health zone of Bwamanda, Northern Congo using a random cluster
sample of 5167 children, aged 0-5 years. MAIN OUTCOME MEASURES: Short- and
long-term mortality rates, being deaths within 3 months and deaths in
3-month periods observed 3-30 months after enrolment. Rates of all cause
mortality and of mortality from kwashiorkor or marasmus, by level of
baseline fatness and muscularity. Indicators of fatness and muscularity
were obtained by correcting anthropometric arm fat and arm muscle areas
for age, sex, weight and height. RESULTS: The relationship of both the
fatness and muscularity scores with short-term mortality was marked by a
clear threshold (-0.5 SDS) below which there was a significant rise in
mortality from all causes as well as from kwashiorkor and marasmus. These
excess mortalities were also found in normal weight children. Fatness and
muscularity scores remained significant determining factors of short-term
mortality in a multiple logistic regression analysis with sex, age, season
and weight-for-age. A ROC curve analysis showed that fat and muscularity
scores had better predictive abilities than weight-for-age. Low fat status
had a bad prognosis on the long-term in underweight children. CONCLUSIONS:
Measures of current nutritional status should not be based on weight
indices alone. Objective and/or clinical evaluation of fat and muscle
status (also in normal weight children) should be added in order to detect
a higher proportion of malnourished children and to more accurately
evaluate mortality risk
Lights, Camera, Action! Exploring Effects of Visual Distractions on Completion of Security Tasks
Human errors in performing security-critical tasks are typically blamed on
the complexity of those tasks. However, such errors can also occur because of
(possibly unexpected) sensory distractions. A sensory distraction that produces
negative effects can be abused by the adversary that controls the environment.
Meanwhile, a distraction with positive effects can be artificially introduced
to improve user performance.
The goal of this work is to explore the effects of visual stimuli on the
performance of security-critical tasks. To this end, we experimented with a
large number of subjects who were exposed to a range of unexpected visual
stimuli while attempting to perform Bluetooth Pairing. Our results clearly
demonstrate substantially increased task completion times and markedly lower
task success rates. These negative effects are noteworthy, especially, when
contrasted with prior results on audio distractions which had positive effects
on performance of similar tasks. Experiments were conducted in a novel (fully
automated and completely unattended) experimental environment. This yielded
more uniform experiments, better scalability and significantly lower financial
and logistical burdens. We discuss this experience, including benefits and
limitations of the unattended automated experiment paradigm
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