Bryan Maguire’s research while affiliated with Cancer Care Ontario and other places

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Publications (24)


Predicting cardiometabolic markers in children using tri-ponderal mass index: A cross-sectional study
  • Article

January 2019

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98 Reads

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26 Citations

Archives of Disease in Childhood

Jillian Ashley-Martin

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Bryan Maguire

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Stefan Kuhle

Objective To model the development of the tri-ponderal mass index (TMI, kg/m ³ ) throughout childhood and adolescence and to compare the utility of the TMI with that of the body mass index (BMI, kg/m ² ) to predict cardiometabolic risk in a population-based sample of Canadian children and youth. Methods We used data from the Canadian Health Measures Survey to model TMI from 6 to 19 years of age. Percentile curves were developed using the LMS method. Logistic regression was used to predict abnormal levels of cardiometabolic markers; predictive accuracy was assessed using the area under the ROC curve (AUC). Results Mean TMI was relatively stable from ages 6 to 19 years for both sexes, but variability increased with age. There was no notable difference in AUC values for prediction models based on BMI z-score compared with TMI for any of the outcomes. For both BMI z-score and TMI, prediction accuracy was good for homeostasis model assessment insulin resistance and having ≥3 abnormal tests (AUC>0.80), fair for C-reactive protein and poor for the remainder of the outcomes. Conclusions The use of a single sex-specific TMI cut-off for overweight or obesity is hampered by the increasing variability of the measure with age. Weight-for-height indices likely have only limited ability to predict cardiometabolic marker levels, and changing the scaling power of height is unlikely to improve predictive accuracy.


Table 2 L, M, and S values, and percentiles of total cholesterol [mmol/L] by age and sex for Canadian children and youth aged 6 to 19 years
Table 3 L, M, and S values, and percentiles of HDL cholesterol [mmol/L] by age and sex for Canadian children and youth aged 6 to 19 years
Table 4 L, M, and S values, and percentiles of triglycerides [mmol/L] by age and sex for Canadian children and youth aged 6 to 19 years
Table 5 L, M, and S values, and percentiles of insulin [pmol/L] by age and sex for Canadian children and youth aged 6 to 19 years
Table 6 L, M, and S values, and percentiles of HOMA-IR by age and sex for Canadian children and youth aged 6 to 19 years

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Percentile curves for cardiometabolic disease markers in Canadian children and youth: a cross-sectional study
  • Article
  • Full-text available

September 2018

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1,581 Reads

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9 Citations

BMC Pediatrics

Background: The objective of this study to develop percentile curves for cardiometabolic disease markers in a population-based sample of Canadian children and youth. Methods: The analysis used data from 6116 children and adolescents between 6 and 19 years of age who participated in the Canadian Health Measures Survey cycles 1 (2007/2009), 2 (2009/2011), and 3 (2012/2013). Total cholesterol, HDL cholesterol, and hemoglobin A1c levels as well as fasting levels of triglycerides, insulin, and homeostasis model assessment insulin resistance were measured using standardized procedures. Age- and sex-specific centiles for all markers were calculated using Cole and Green's LMS method. Results: With the exception of hemoglobin A1c, all markers showed age- and sex-related differences during childhood and adolescence. Conclusions: We have developed centile curves for cardiometabolic disease markers in Canadian children and adolescents and demonstrated age and sex differences that should be considered when evaluating these markers in this age group.

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Table 1 Sample characteristics by parity and birthweight for gestational age category (N = 30,705)
Comparison of logistic regression with machine learning methods for the prediction of fetal growth abnormalities: A retrospective cohort study

August 2018

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202 Reads

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155 Citations

BMC Pregnancy and Childbirth

Background While there is increasing interest in identifying pregnancies at risk for adverse outcome, existing prediction models have not adequately assessed population-based risks, and have been based on conventional regression methods. The objective of the current study was to identify predictors of fetal growth abnormalities using logistic regression and machine learning methods, and compare diagnostic properties in a population-based sample of infants. Methods Data for 30,705 singleton infants born between 2009 and 2014 to mothers resident in Nova Scotia, Canada was obtained from the Nova Scotia Atlee Perinatal Database. Primary outcomes were small (SGA) and large for gestational age (LGA). Maternal characteristics pre-pregnancy and at 26 weeks were studied as predictors. Logistic regression and select machine learning methods were used to build the models, stratified by parity. Area under the curve was used to compare the models; relative importance of predictors was compared qualitatively. Results7.9% and 13.5% of infants were SGA and LGA, respectively; 48.6% of births were to primiparous women and 51.4% were to multiparous women. Prediction of SGA and LGA was poor to fair (area under the curve 60–75%) and improved with increasing parity and pregnancy information. Smoking, previous low birthweight infant, and gestational weight gain were important predictors for SGA; pre-pregnancy body mass index, gestational weight gain, and previous macrosomic infant were the strongest predictors for LGA. Conclusions The machine learning methods used in this study did not offer any advantage over logistic regression in the prediction of fetal growth abnormalities. Prediction accuracy for SGA and LGA based on maternal information is poor for primiparous women and fair for multiparous women.







Citations (10)


... It has been suggested that this measurement may be a more effective predictor of percent body fat and metabolic syndrome than BMI (13) . Moreover, TMI is observed to be fairly consistent throughout childhood and adolescence (14) . Therefore, utilising a single cut-off value for TMI can be a practical and convenient approach (12) . ...

Reference:

Comparison of BMI, triponderal mass index, and paediatric body adiposity Index for predicting body fat and screening obesity in preschool children
Predicting cardiometabolic markers in children using tri-ponderal mass index: A cross-sectional study
  • Citing Article
  • January 2019

Archives of Disease in Childhood

... However, the current HbA1c diagnostic criteria for prediabetes (HbA1c : 5.7%-6.4%) and diabetes (HbA1c ≥ 6.5%) are only recommended for adults, and the evidence-based reference ranges for HbA1c in children and adolescents remain unclear [9,11,12]. This gap in knowledge causes uncertainty, possibly exposing many youths to an increased risk of delayed diagnosis and nonstandardized care. ...

Percentile curves for cardiometabolic disease markers in Canadian children and youth: a cross-sectional study

BMC Pediatrics

... This relationship is useful in predicting the value of one of the factors based on the values given to the other factor. Logistic regression can give us only two values, for example 0 and 1 or yes and no, and in this case it is called binary classification, or it gives several values as a result of the prediction, and in this case it is called multi-valued prediction (classification) [25,26]. Classification is accomplished with a binary dependent variable (0/1, -1/1, or represented by true/false) and a binary independent variable or deprivation by using the sigma function. ...

Comparison of logistic regression with machine learning methods for the prediction of fetal growth abnormalities: A retrospective cohort study

BMC Pregnancy and Childbirth

... Dentro de ellos, la bupivacaína se aproxima al ideal para bloqueo subaracnoideo en operación cesárea. [15][16][17][18] Es un fármaco potente, con menos paso transplacentario y menor incidencia de síndrome neurológico transitorio. Si se logra una altura adecuada del bloqueo, el fármaco solo proporciona anestesia satisfactoria, con dosis recomendadas de 5 a 12 mg; 23-25 lo que fue constatado en la presente investigación, al encontrarse un número elevado de pacientes con respuesta al tratamiento satisfactoria. ...

Factors Associated with Trial of Labour and Mode of Delivery in Robson Group 5: A Select Group of Women With Previous Caesarean Section
  • Citing Article
  • March 2018

Journal of Obstetrics and Gynaecology Canada

... In another study based on 2,921,714 breast cancer cases diagnosed across 64 global regions over spans from 2 to 53 years, breast cancer was consistently diagnosed more often in spring and fall, both in the Northern and Southern Hemispheres, regardless of presumable menopausal status. Concerning paediatric cancers, seasonal trends in incidence and diagnosis have been sometimes detected but on average the results are inconsistent (Ross et al. 1999;Nurullah et al. 2018). Thus, largely because BOX 1 | Tasmanian devils as an example of the complex interplay between age, season and immunity shaping the cancer risk. ...

Seasonality in Pediatric Cancer
  • Citing Article
  • December 2017

The Indian Journal of Pediatrics

... There were 11,732 and 13,687 catheter days in CICCs and PICCs. The respective median catheter days were 20 (interquartile range [IQR]: 11-30) and 22 (IQR: [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. More than 95% of the inserted catheters were removed during the study period, the primary reason being the completion of treatment, followed by suspected infection, in both groups. ...

Reply to Weber, von Cube, Sommer, Wolkewitz: Necessity of a Competing Risk Approach in Risk Factor Analysis of Central-Line-Associated Bloodstream Infection
  • Citing Article
  • January 2017

Infection Control and Hospital Epidemiology

... Preterm birth was positively associated with SBP. Our results partially support previous studies indicating that unfavourable early life factors, particularly high birth weight for gestational age is associated with an increased cardiometabolic risk mainly in terms of higher MetS score and adiposity [31,32]. Being born SGA showed a negative association with WC z-score in children below the age of ten which became smaller in teens. ...

Birth Weight for Gestational Age, Anthropometric Measures, and Cardiovascular Disease Markers in Children
  • Citing Article
  • December 2016

The Journal of Pediatrics

... The tricipital (TSFT) and subscapular (SSFT) skin folds were collected using a Harpenden skin fold caliper with a precision of 0.2 mm from the average of 2 consecutive measurements. The oncology nurse measured the weight and height of the participants to the nearest 0.1 kg and 0.1 cm, and these measurements were used to compute body mass index (BMI (if >2 y old) or the weight-for-length (W-L) ratio (if <2 y old) Finally, the Microsoft ® Office Excel ® tool (developed by the British Columbia Children Hospital) and the Canadian Pediatric Endocrine Group (based on the 2014 version of Growth Charts for Canada) were used to calculate the BMI and W-L z-scores [61], while the WC, MUAC, TSFT, and SSFT z-scores were derived from populational reference data [62][63][64]. ...

Percentile curves for skinfold thickness for Canadian children and youth

... Among these, 25 studies were from North America. Of these, 19 studies were conducted in the United States of America [29,41,[43][44][45]53,55,58,60,63,64,66,67,78,84,85,87,88,90] and six studies in Canada [50][51][52]54,74,77]. ...

Maternal Exposure to Air Pollution and Adverse Birth Outcomes in Halifax, Nova Scotia
  • Citing Article
  • December 2015

Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine

... Indian girls had higher BMI values after the age of 10 years, with a more pronounced increase between the ages of 11 and 14 years; in boys, this increase was greater between the ages of 11 and 15 years 24 . The BMI of Canadian female adolescents showed a more pronounced increase from the age of 15 years (23.7 kg/m 2 ), whereas that of boys increased linearly from 10 to 19 years of age and was consistently higher than the WHO values 25 . In Brazil, the BMI trajectory of adolescents in the Pelotas Birth Cohort was analyzed at 11, 15 and 18 years of age, and the mean BMI values were consistently above the WHO reference values for boys and girls; however, fluctuations in BMI values were not identified throughout this phase, as in the present study 26 . ...

Percentile Curves for Anthropometric Measures for Canadian Children and Youth