Models predicting the growth response to growth hormone treatment in short children independent of GH status, birth size and gestational age

<p>Abstract</p> <p>Background</p> <p>Mathematical models can be used to predict individual growth responses to growth hormone (GH) therapy. The aim of this study was to construct and validate high-precision models to predict the growth response to GH treatment of short children, independent of their GH status, birth size and gestational age. As the GH doses are included, these models can be used to individualize treatment.</p> <p>Methods</p> <p>Growth data from 415 short prepubertal children were used to construct models for predicting the growth response during the first years of GH therapy. The performance of the models was validated with data from a separate cohort of 112 children using the same inclusion criteria.</p> <p>Results</p> <p>Using only auxological data, the model had a standard error of the residuals (SD_res), of 0.23 SDS. The model was improved when endocrine data (GH_maxprofile, IGF-I and leptin) collected before starting GH treatment were included. Inclusion of these data resulted in a decrease of the SD_resto 0.15 SDS (corresponding to 1.1 cm in a 3-year-old child and 1.6 cm in a 7-year old). Validation of these models with a separate cohort, showed similar SD_resfor both types of models. Preterm children were not included in the Model group, but predictions for this group were within the expected range.</p> <p>Conclusion</p> <p>These prediction models can with high accuracy be used to identify short children who will benefit from GH treatment. They are clinically useful as they are constructed using data from short children with a broad range of GH secretory status, birth size and gestational age.</p

The first-year growth response to growth hormone treatment predicts the long-term prepubertal growth response in children

<p>Abstract</p> <p>Background</p> <p>Pretreatment auxological variables, such as birth size and parental heights, are important predictors of the growth response to GH treatment. For children with missing pretreatment data, published prediction models cannot be used.</p> <p>The objective was to construct and validate a prediction model for children with missing background data based on the observed first-year growth response to GH. The accuracy and reliability of the model should be comparable with our previously published prediction model relying on pretreatment data. The design used was mathematical curve fitting on observed growth response data from children treated with a GH dose of 33 μg/kg/d.</p> <p>Methods</p> <p>Growth response data from 162 prepubertal children born at term were used to construct the model; the group comprised of 19% girls, 80% GH-deficient and 23% born SGA. For validation, data from 205 other children fulfilling the same inclusion and treatment criteria as the model group were used. The model was also tested on data from children born prematurely, children from other continents and children receiving a GH dose of 67 μg/kg/d.</p> <p>Results</p> <p>The GH response curve was similar for all children, but with an individual amplitude. The curve SD score depends on an individual factor combining the effect of dose and growth, the 'Response Score', and time on treatment, making prediction possible when the first-year growth response is known. The prediction interval (± 2 SD_res) was ± 0.34 SDS for the second treatment year growth response, corresponding to ± 1.2 cm for a 3-year-old child and ± 1.8 cm for a 7-year-old child. For the 1–4-year prediction, the SD_reswas 0.13 SDS/year and for the 1–7-year prediction it was 0.57 SDS (i.e. < 0.1 SDS/year).</p> <p>Conclusion</p> <p>The model based on the observed first-year growth response on GH is valid worldwide for the prediction of up to 7 years of prepubertal growth in children with GHD/ISS, born AGA/SGA and born preterm/term, and can be used as an aid in medical decision making.</p

Diagnosis, Genetics, and Therapy of Short Stature in Children: A Growth Hormone Research Society International Perspective

The Growth Hormone Research Society (GRS) convened a Workshop in March 2019 to evaluate the diagnosis and therapy of short stature in children. Forty-six international experts participated at the invitation of GRS including clinicians, basic scientists, and representatives from regulatory agencies and the pharmaceutical industry. Following plenary presentations addressing the current diagnosis and therapy of short stature in children, breakout groups discussed questions produced in advance by the planning committee and reconvened to share the group reports. A writing team assembled one document that was subsequently discussed and revised by participants. Participants from regulatory agencies and pharmaceutical companies were not part of the writing process. Short stature is the most common reason for referral to the pediatric endocrinologist. History, physical examination, and auxology remain the most important methods for understanding the reasons for the short stature. While some long-standing topics of controversy continue to generate debate, including in whom, and how, to perform and interpret growth hormone stimulation tests, new research areas are changing the clinical landscape, such as the genetics of short stature, selection of patients for genetic testing, and interpretation of genetic tests in the clinical setting. What dose of growth hormone to start, how to adjust the dose, and how to identify and manage a suboptimal response are still topics to debate. Additional areas that are expected to transform the growth field include the development of long-acting growth hormone preparations and other new therapeutics and diagnostics that may increase adult height or aid in the diagnosis of growth hormone deficiency.info:eu-repo/semantics/publishedVersio

International meta-analysis of stated preference studies of transportation noise nuisance

The final publication is available at Springer via http://dx.doi.org/10.1007/s11116-014-9527-4This paper reports the first meta-analysis and most extensive review of stated preference studies of transportation noise nuisance. The meta-analysis is based on a newly compiled data set of 258 values from 49 studies and 23 countries and spanning more than 40 years. Contrast this with the most extensive meta-analysis of the more conventional hedonic pricing approach which includes 53 noise valuations. Moreover, the sample compares favourably with the 444 observations from the very first meta-analysis of the value of travel time savings which is by far the most widely examined parameter in transport planning. A particularly significant finding of the study is that the intertemporal income elasticity is close to one, somewhat larger than the cross-sectional income elasticity typically obtained from individual studies. This demonstrates the importance of distinguishing the effects of 2 income variations that occur over time, which tend to drive policy, from variations across individuals at one point in time, and such findings are typical of those observed in other markets. Importantly, the values derived are transferable across countries and may be used to benchmark existing evidence and provide values in contexts where none exist. Other key results are that values for aircraft noise exceed those for other modes, whilst those exposed to higher noise levels and those who are highly annoyed also have higher values in line with expectations. A wide range of design effects were tested but few were significant and these included the consumer surplus measure, the representation of noise and the context

Monetary Forestry Accounting including Environmental Goods and Services

En la actualidad existe sustancial interés en expandir los sistemas de contabilidad de forma tal que se incluyen servicios apropiados de los sistemas ecológicos. Muchas de las actividades desarrolladas se han centrado alrededor de los recursos forestales; actualmente existen más de 100 estudios de contabilidad forestal «verde» en diferentes países del mundo. Este artículo provee una visión de aspectos teóricos y empíricos de la contabilidad forestal «verde». En este se discute el cálculo de la renta «real» del bosque, así como los problemas de medición generados al valorar servicios sin precio de mercado. También se revisan los esfuerzos recientes de la Oficina Estadística de la Unión Europea (Eurostat) y se incluye una presentación detallada de las aplicaciones oficiales de la contabilidad forestal «verde» en Suecia. Este artículo concluye argumentando que los trabajos futuros de contabilidad forestal «verde» deberían dirigirse a través de la integración de la teoría y la práctica hacia un alcance mayor al que tiene la actual propuesta de Eurostat

Contabilidad forestal incluyendo bienes y servicios ambientales

There is substantial current interest in expanding accounting systems, such that they include services appropriated from the ecological systems. Much of this activity has focused upon forest resources; there are currently more than 100 «green» forest accounting studies, covering many different countries. This paper provides a view of some theoretical and empirical issues on «green» forest accounting. It discusses some issues in calculating «true» income from forests, as well as the measurement problems that arise when valuing non-priced services. It also reviews recent efforts at EUROSTAT and includes a detailed illustration of a comprehensive official Swedish application on «green» forest accounting. The paper concludes by arguing that future work on green forest accounting should be directed towards tying together theory and practice to a even larger extent than what is currently the case.En la actualidad existe sustancial inter&eacute;s en expandir los sistemas de contabilidad de forma tal que se incluyen servicios apropiados de los sistemas ecol&oacute;gicos. Muchas de las actividades desarrolladas se han centrado alrededor de los recursos forestales; actualmente existen m&aacute;s de 100 estudios de contabilidad forestal &laquo;verde&raquo; en diferentes pa&iacute;ses del mundo. Este art&iacute;culo provee una visi&oacute;n de aspectos te&oacute;ricos y emp&iacute;ricos de la contabilidad forestal &laquo;verde&raquo;. En este se discute el c&aacute;lculo de la renta &laquo;real&raquo; del bosque, as&iacute; como los problemas de medici&oacute;n generados al valorar servicios sin precio de mercado. Tambi&eacute;n se revisan los esfuerzos recientes de la Oficina Estad&iacute;stica de la Uni&oacute;n Europea (Eurostat) y se incluye una presentaci&oacute;n detallada de las aplicaciones oficiales de la contabilidad forestal &laquo;verde&raquo; en Suecia. Este art&iacute;culo concluye argumentando que los trabajos futuros de contabilidad forestal &laquo;verde&raquo; deber&iacute;an dirigirse a trav&eacute;s de la integraci&oacute;n de la teor&iacute;a y la pr&aacute;ctica hacia un alcance mayor al que tiene la actual propuesta de Eurostat

El método de la valoración contingente: aplicaciones al medio rural español

Desde la economía se ha producido un interés creciente por la estimación del valor de los bienes ambientales, especialmente los agroambientales. Esto ha ayudado a que se hayan desarrollado sofisticados métodos de valoración de bienes cuya provisión no se asigna mediante el mercado. El método de la valoración contingente es, con mucho, el más utilizado y desarrollado. Este articulo pone de relieve cómo la simplicidad de su planteamiento intuitivo no se corresponde con su complejidad teórica y, sobre todo, aplicada. Se revisan de forma breve algunos de los más importantes aspectos del método, y se comparan diversas aplicaciones al medio rural español