Comparison of blood pressure levels among four age groups of Chinese children matched by height

How different face mask types affect interpersonal distance perception and threat feeling in social interaction

Due to the easing of the pandemic, public policies no longer mandated people to wear masks. People can choose to no wear or wear different types of masks based on personal preferences and safety perceptions during daily interaction. Available information about the influence of face mask type on interpersonal distance (IPD) by different aging populations is still lacking. Thus, this study aimed to investigate the face mask type (no wear, cloth, medical and N95 mask) and age group effect of avatars (children, adults and older adults) on IPD perception, threat feeling and physiological skin conductance response under active and passive approaching. One hundred participants with a range from 20 to 35 years old were recruited for this study. Twelve avatars (three age groups*four face mask conditions) were created and applied in a virtual reality environment. The results showed that age group, mask type and approach mode had significant effects on IPD and subjective threat feeling. A non-significant effect was found on skin conductance responses. Participants maintained a significantly longer IPD when facing the older adults, followed by adults and then children. In the passive approach condition, people tended to maintain a significantly greater comfort distance than during the active approach. For the mask type effect, people kept a significantly largest and shortest IPD when facing an avatar with no mask or the N95 mask, respectively. A non-significant IPD difference was found between the N95 and medical mask. Additionally, based on the subjective threat feeling, facing an avatar wearing a medical mask generated the lowest threat feeling compared to the others. The findings of this study indicated that wearing medical masks provided a benefit in bringing people closer for interaction during specific situations. Understanding that mask-wearing, especially medical one, brought to shortest IPD when compared to the unmasked condition can be utilized to enhance safety measures in crowded public spaces and health-care settings. This information could guide the development of physical distancing recommendations, taking into account both the type of mask and the age groups involved, to ensure the maintenance of appropriate distances.

The prevalence of hypertension in Chinese adolescents aged 15-17 years: A comparison of different criteria

This study intended to compare the prevalence of hypertension in adolescents aged 15–17 years in China according to different criteria defined by various guidelines. We included 28 715 adolescents aged 15–17 years from the China Hypertension Survey study (CHS) 2012–2015, and the 2017 American Association of Pediatrics (AAP) Clinical Practice Guideline and 2018 Chinese guidelines for children and adults were used to define hypertension. The prevalence of hypertension among Chinese adolescents aged 15–17 years was 24.4% according to the 2018 Chinese guidelines for children; the corresponding values were 18.6% according to the 2017 AAP Guidelines, and 3.5% according to 2018 Chinese guidelines for adults. The age‐specific prevalence of hypertension in the age of 15, 16, and 17 years in the same population was 26.2%, 24.4%, and 23.3% according to 2018 Chinese guidelines for children; 18.8%, 17.9%, and 19.2% as per the 2017 AAP Guidelines; 3.4%, 3.4%, and 3.6% as per the 2018 Chinese guidelines for adults. A highest prevalence of hypertension was observed according to 2018 Chinese guidelines for children than the other two guidelines. Compared with the 2018 Chinese guidelines for children, a higher 95^th percentile BP (systolic and diastolic) was also observed in the present study in each gender‐age‐height‐specific group. And the height, which was key factor to influence blood pressure, was similar between adolescents aged 15–17 and adults, and a paralleled result was seen in the present study. Therefore, the 2018 Chinese guidelines for adults may also be appropriate for adolescents aged 15–17 years.

Blood pressure standards for pre-school children in Saudi Arabia

The prevalence of hypertension (HTN) in children is increasing. Early detection of HTN in childhood may prevent the occurrence of complications in adult age. Blood pressure (BP) varies between populations according to ethnic and environmental factors. Based on these variations, reference norms developed for one particular population may not be applicable to others. Thus, this study aimed to provide age-, gender-, and height-related BP reference standards using oscillometric techniques for pre-school children in Saudi Arabia. A sub-sample of preschool children aged from 2 to 6 years was selected by multi-stage probability sampling of Saudi population. The samples represented Saudi children from the whole country. Data were collected through a house-to-house survey of all selected households in all 13 regions in the country. Oscillometric devices were used to measure the BP. Data were analyzed to study the distribution pattern of systolic (SBP) and diastolic BP (DBP) and to develop reference values based on age, gender, and height. The values for each age and height percentile were compared with the recent (2017) values of the North American children. A total of 2553 Saudi Arabian children (1299 boys and 1254 girls) aged 2-6 years with complete data on age, gender, height, SBP, and DBP were considered for analysis. Values for SBP and DBP were significantly higher in Saudi children than in the North American children. This study adds evidence to the BP variations between populations with influences such as genetic and environmental factors. The need of every population to define its normal BP standards is essential to avoid unnecessary investigations and anxiety in patients and their parents.

Midazolam and its effect on vital signs and behavior in children under conscious sedation in dentistry

Midazolam is a short acting sedative with small number of adverse effects. Administered orally, it is currently the most common form of conscious sedation in children. The objective of this paper is to describe effect of midazolam administered to children during dental treatment on their vital signs, and to monitor changes in children's behavior. We described values of vital signs and behavior in 418 sedations conducted in 272 children between 1-12 years of age. To achieve the following results, we used data from 272 all first-time sedations. After administration of midazolam arterial blood pressure and blood oxygen saturation decreased by values which were not clinically significant. The heart rate increased, with values staying within the limits of physiological range. The speed of onset of midazolam's clinical effects depends on age and dose. The lower age and dose correlated with the higher behavior score. The effectiveness of midazolam treatment is 97.8 %. Unwillingness of child to receive midazolam is predictor for disruptive behavior during sedation. 1.8 % of all sedation cases showed paradoxical reactions. The administration of midazolam in dose of 0.5 mg per 1 kg of child's body weight is safe and could be recommended for dental treatment in pediatric dentistry.

National Blood Pressure Reference for Chinese Han Children and Adolescents Aged 7 to 17 Years

We sought to develop and validate a national blood pressure (BP) reference based on age, sex, and height for Chinese children. Data were obtained on 197 430 children aged 7 to 17 who participated in the Chinese National Survey on Students' Constitution and Health in 2010. BP percentiles were estimated and fitted using the lambda, mu, and sigma method and then compared with a US reference and China existing reference. In an external independent validation sample of 59 653 children aged 7 to 18 from 7 Chinese provinces in 2013, the prevalence of elevated BP was compared applying the 3 references. BP values were similar for boys and girls at the younger ages (7-13 years) and lower height percentiles, whereas higher at the older ages (14-17 years) for boys than girls. At medial height in boys and girls aged 7 to 13, the 50th, 90th, 95th, and 99th percentiles of BP for the new national reference were consistent with US reference and lower than current Chinese reference. In the independent sample, elevated BP prevalence, based on the new national reference, ranged from 7.8% to 18.5% among children aged 7 to 17, which was higher than the US reference values (4.3%-14.5%) and lower than the current Chinese reference (12.9%-25.5%) in each age group. The new national BP reference for Chinese children based on age, sex, and height from large-scale and nationally representative data seems to improve the ability for identifying Chinese hypertensive children and for stratifying them with regard to cardiovascular risk.

Blood pressure tables for Chinese adolescents: justification for incorporation of important influencing factors of height, age and sex in the tables

Background

Elevated blood pressure (BP) in childhood was a predictor of hypertension in adulthood and contributes to the current epidemic of cardiovascular disease. It is necessary to identify abnormal BP in children and adolescents with accurate BP tables based on several crucial factors. The purpose of this study was to identify the important influencing factors of BP of Chinese adolescents.

Methods

BP, height, and body weight were assessed in 32221 normal-weight Chinese adolescents aged 12–17 years. An equal number of 6815 subjects from boys and girls were individually matched by height and age to assess the independent effect of sex on BP; and an equal number of 1422 subjects from each of the age groups (12, 13, 14, 15, 16 and 17 years) were individually matched by sex and height to estimate the independent effect of age on BP. Height of each sex and age was divided into eight height groups - ~5^th, ~10^th, ~25^th, ~50^th, ~75^th, ~90^th, ~95^th, and 95^th ~ percentiles- and the Spearman’s correlation between height percentiles and BP was used to examine the independent effect of height on BP.

Results

Boys had higher systolic BP (SBP) and diastolic BP (DBP) than girls after controlling for age and height. BP increased with age after controlling for sex and height. In each age group, both SBP and DBP increased alongside increasing height in boys and girls.

Conclusions

Sex, age and height are all independent determinants for BP levels in Chinese adolescents. It is essential to incorporate these three factors for the establishment of the BP reference tables.

Blood pressure to height ratio: A novel method for detecting hypertension in paediatric age groups

BACKGROUND

A novel method for detecting hypertension in paediatric age groups has recently been formulated using ratios of systolic blood pressure to height (SBPHR) and diastolic blood pressure to height (DBPHR).

AIM

To validate this approach and assess its applicability to children.

METHODS

A cross-sectional study of 6837 children and adolescents five to 18 years of age was conducted. Blood pressure (BP) readings obtained were stratified using population-based percentiles from the United States.

RESULTS

For SBPHR and DBPHR, areas under the ROC curve were >0.9 for BP at or above the 95th percentile. Performance of the cut-off points for detecting elevated BP in adolescents 13 to 18 years of age compared favourably with previous studies, showing high sensitivity and specificity (>95%). SBPHR and DBPHR also proved satisfactory when applied to children five to 12 years of age. Nevertheless, performance was lower for BP between the 90th and 95th percentiles.

CONCLUSIONS

BP to height ratios are a practical means for detecting elevated BP in adolescents and children.

Quantifying the relationships of blood pressure with weight, height and body mass index in Chinese children and adolescents

AIM

The aim of this study was to quantify the relationships of height, weight and body mass index (BMI) with blood pressure (BP) levels in Chinese children and adolescents.

METHODS

Height, weight, BMI and BP measurements were obtained from a nationally representative sample of 231,227 children aged 7-18 years. Body size measurements were converted to age- and sex-specific standard deviation (SD) scores. The relationships between body size and BP measurements were assessed using linear regression analysis.

RESULTS

All body size measurements were significantly associated with BP levels. Systolic BP increased 4.14, 3.70 and 2.88 mmHg in boys and 2.98, 2.63 and 1.87 mmHg in girls, corresponding to 1 SD increase in weight, BMI and height, respectively. A similar pattern was also observed for diastolic BP. After adjustment for height, systolic BP increased substantially with increasing weight (3.96 mmHg/SD increase for boys and 2.92 mmHg for girls). With adjustment for weight, systolic BP increased slightly with 1 SD increase in height (0.27 mmHg for boys and 0.10 mmHg for girls). The strength of the association between a body size measurement and BP varied among different ages, peaked at 10-11 years in girls and around 12-14 years in boys.

CONCLUSIONS

Weight is the most powerful driving force of BP in children and adolescents, followed by BMI and height. Height has little impact on BP in children with a given weight, while weight has considerable impact on BP in children with a given height.