Bone density, structure, and estimated strength in children with congenital heart disease. A CHAMPS* cohort study
Bibliographic record
Abstract
INTRODUCTION: Children with congenital heart disease (CHD) have lower levels of physical activity, lower birth weights, and lower nutrient intake compared to their typically developing peers (TDP); which can put children with CHD at increased risk of impaired skeletal development. Therefore, the purpose of this study was to assess the bone architecture of children with CHD compared to TDP. Our secondary objective was to evaluate differences between CHD lesion complexity. METHODS: Forty-two children with CHD 7 to 15 years of age (10.9±2.5) were age and sex-matched to 41 TDP. Peripheral quantitative computed tomography (pQCT) scans were obtained at the distal (4%) and shaft (65%, 66%) sites for the radius and tibia, respectively. pQCT bone parameters were compared between groups using multiple analysis of covariance (MANCOVA), using sex, age, height, weight, maturity, and physical activity as covariates. RESULTS: There were no significant differences between children with CHD and TDP at the distal radius or distal tibia (p>0.05). Children with CHD had significantly lower total area, cortical content, cortical area, cortical thickness, and polar stress-strain index at the radial and tibial shaft compared to TDP (p<0.05). When sub-dividing children with CHD by lesion severity, the complex CHD group had significantly lower cortical content, cortical area, cortical thickness, and polar stress-strain index at the radius and tibia shaft when compared to TDP (p<0.05). Additionally, children with complex lesions had greater cortical density at the radius and tibia shaft when compared to TDP (p<0.05). Finally, children with simple lesions had greater cortical density at the radius shaft when compared to TDP (p<0.05). CONCLUSION: Children with complex CHD had worse bone parameters when compared to TDP. Children with complex CHD lesions may be at increased risk of impaired bone density, structure, and estimated strength at both the radius and tibia shaft.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".