92 resultados para Nutritional Requirements


Relevância:

20.00% 20.00%

Publicador:

Resumo:

Changes to software requirements occur during initial development and subsequent to delivery, posing a risk to cost and quality while at the same time providing an opportunity to add value. Provision of a generic change source taxonomy will support requirements change risk visibility, and also facilitate richer recording of both pre- and post-delivery change data. In this paper we present a collaborative study to investigate and classify sources of requirements change, drawing comparison between those pertaining to software development and maintenance. We begin by combining evolution, maintenance and software lifecycle research to derive a definition of software maintenance, which provides the foundation for empirical context and comparison. Previously published change ‘causes’ pertaining to development are elicited from the literature, consolidated using expert knowledge and classified using card sorting. A second study incorporating causes of requirements change during software maintenance results in a taxonomy which accounts for the entire evolutionary progress of applications software. We conclude that the distinction between the terms maintenance and development is imprecise, and that changes to requirements in both scenarios arise due to a combination of factors contributing to requirements uncertainty and events that trigger change. The change trigger taxonomy constructs were initially validated using a small set of requirements change data, and deemed sufficient and practical as a means to collect common requirements change statistics across multiple projects.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Background & aims: Little is known about energy requirements in brain injured (TBI) patients, despite evidence suggesting adequate nutritional support can improve clinical outcomes. The study aim was to compare predicted energy requirements with measured resting energy expenditure (REE) values, in patients recovering from TBI.

Methods: Indirect calorimetry (IC) was used to measure REE in 45 patients with TBI. Predicted energy requirements were determined using FAO/WHO/UNU and Harris–Benedict (HB) equations. Bland– Altman and regression analysis were used for analysis.

Results: One-hundred and sixty-seven successful measurements were recorded in patients with TBI. At an individual level, both equations predicted REE poorly. The mean of the differences of standardised areas of measured REE and FAO/WHO/UNU was near zero (9 kcal) but the variation in both directions was substantial (range 591 to þ573 kcal). Similarly, the differences of areas of measured REE and HB demonstrated a mean of 1.9 kcal and range 568 to þ571 kcal. Glasgow coma score, patient status, weight and body temperature were signi?cant predictors of measured REE (p < 0.001; R2= 0.47).

Conclusions: Clinical equations are poor predictors of measured REE in patients with TBI. The variability in REE is substantial. Clinicians should be aware of the limitations of prediction equations when estimating energy requirements in TBI patients.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Developing a desirable framework for handling inconsistencies in software requirements specifications is a challenging problem. It has been widely recognized that the relative priority of requirements can help developers to make some necessary trade-off decisions for resolving con- flicts. However, for most distributed development such as viewpoints-based approaches, different stakeholders may assign different levels of priority to the same shared requirements statement from their own perspectives. The disagreement in the local levels of priority assigned to the same shared requirements statement often puts developers into a dilemma during the inconsistency handling process. The main contribution of this paper is to present a prioritized merging-based framework for handling inconsistency in distributed software requirements specifications. Given a set of distributed inconsistent requirements collections with the local prioritization, we first construct a requirements specification with a prioritization from an overall perspective. We provide two approaches to constructing a requirements specification with the global prioritization, including a merging-based construction and a priority vector-based construction. Following this, we derive proposals for handling inconsistencies from the globally prioritized requirements specification in terms of prioritized merging. Moreover, from the overall perspective, these proposals may be viewed as the most appropriate to modifying the given inconsistent requirements specification in the sense of the ordering relation over all the consistent subsets of the requirements specification. Finally, we consider applying negotiation-based techniques to viewpoints so as to identify an acceptable common proposal from these proposals.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Background: This is an update of a Cochrane review first published in The Cochrane Library in Issue 3, 2010.
For many patients with head and neck cancer, oral nutrition will not provide adequate nourishment during treatment with radiotherapy or chemoradiotherapy due to the acute toxicity of treatment, obstruction caused by the tumour, or both. The optimal method of enteral feeding for this patient group has yet to be established.

Objectives: To compare the effectiveness of different enteral feeding methods used in the nutritional management of patients with head and neck cancer receiving radiotherapy or chemoradiotherapy using the clinical outcomes, nutritional status, quality of life and rates of complications.

Search methods: Our extensive search included the Cochrane ENT Group Trials Register, CENTRAL, PubMed, EMBASE, CINAHL, AMED and ISI Web of Science. The date of the most recent search was 13 February 2012.

Selection criteria:Randomised controlled trials comparing one method of enteral feeding with another, e.g. nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) feeding, for adult patients with a diagnosis of head and neck cancer receiving radiotherapy and/or chemoradiotherapy.

Data collection and analysis:Two authors independently assessed trial quality and extracted data using standardised forms. We contacted study authors for additional information.

Main results: One randomised controlled trial met the criteria for inclusion in this review. No further studies were identified when we updated the searches in 2012.
Patients diagnosed with head and neck cancer, being treated with chemoradiotherapy, were randomised to PEG or NG feeding. In total only 33 patients were eligible for analysis as the trial was terminated early due to poor accrual. A high degree of bias was identified in the study.
Weight loss was greater for the NG group at six weeks post-treatment than for the PEG group (P = 0.001). At six months post-treatment, however, there was no significant difference in weight loss between the two groups. Anthropometric measurements recorded six weeks post-treatment demonstrated lower triceps skin fold thickness for the NG group compared to the PEG group (P = 0.03). No statistically significant difference was found between the two different enteral feeding techniques in relation to complication rates or patient satisfaction. The duration of PEG feeding was significantly longer than for the NG group (P = 0.0006). In addition, the study calculated the cost of PEG feeding to be 10 times greater than that of NG, though this was not found to be significant. There was no difference in the treatment received by the two groups. However, four PEG fed patients and two NG fed patients required unscheduled treatment breaks of a median of two and six days respectively.
We identified no studies of enteral feeding involving any form of radiologically inserted gastrostomy (RIG) feeding or comparing prophylactic PEG versus PEG for inclusion in the review.

Authors' conclusions: There is not sufficient evidence to determine the optimal method of enteral feeding for patients with head and neck cancer receiving radiotherapy and/or chemoradiotherapy. Further trials of the two methods of enteral feeding, incorporating larger sample sizes, are required.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

NDRG1 is phosphorylated by SGK1 (but not PKB) in vivo at three residues each contained within three nonapeptide repeats. Here, we demonstrate that this nonapeptide, like the NDRG1 protein, is phosphorylated by SGK1, but not by PKBalpha or RSK1 in vitro. The inability of PKBa and RSK1 to phosphorylate the nonapeptide was traced to residues n + 1, n + 2 and n - 4 (where n is the phosphorylation site). Changing them from Ser, Glu and Ser to Phe, Ala and Pro, respectively, transformed the nonapeptide into an excellent substrate for PKBalpha and RSK1. Our results identify a specific substrate for SGK1 and may facilitate detection of additional physiological substrates for this enzyme. (C) 2005 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Background. The assembly of the tree of life has seen significant progress in recent years but algae and protists have been largely overlooked in this effort. Many groups of algae and protists have ancient roots and it is unclear how much data will be required to resolve their phylogenetic relationships for incorporation in the tree of life. The red algae, a group of primary photosynthetic eukaryotes of more than a billion years old, provide the earliest fossil evidence for eukaryotic multicellularity and sexual reproduction. Despite this evolutionary significance, their phylogenetic relationships are understudied. This study aims to infer a comprehensive red algal tree of life at the family level from a supermatrix containing data mined from GenBank. We aim to locate remaining regions of low support in the topology, evaluate their causes and estimate the amount of data required to resolve them. Results. Phylogenetic analysis of a supermatrix of 14 loci and 98 red algal families yielded the most complete red algal tree of life to date. Visualization of statistical support showed the presence of five poorly supported regions. Causes for low support were identified with statistics about the age of the region, data availability and node density, showing that poor support has different origins in different parts of the tree. Parametric simulation experiments yielded optimistic estimates of how much data will be needed to resolve the poorly supported regions (ca. 103 to ca. 104 nucleotides for the different regions). Nonparametric simulations gave a markedly more pessimistic image, some regions requiring more than 2.8 105 nucleotides or not achieving the desired level of support at all. The discrepancies between parametric and nonparametric simulations are discussed in light of our dataset and known attributes of both approaches. Conclusions. Our study takes the red algae one step closer to meaningful inclusion in the tree of life. In addition to the recovery of stable relationships, the recognition of five regions in need of further study is a significant outcome of this work. Based on our analyses of current availability and future requirements of data, we make clear recommendations for forthcoming research.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

For any proposed software project, when the software requirements specification has been established, requirements changes may result in not only a modification of the requirements specification but also a series of modifications of all existing artifacts during the development. Then it is necessary to provide effective and flexible requirements changes management. In this paper, we present an approach to managing requirements changes based on Booth’s negotiation-style framework for belief revision. Informally, we consider the current requirements specification as a belief set about the system-to-be. The request of requirements change is viewed as new information about the same system-to-be. Then the process of executing the requirements change is a process of revising beliefs about the system-to-be. We design a family of belief negotiation models appropriate for different processes of requirements revision, including the setting of the request of requirements change being fully accepted, the setting of the current requirements specification being fully preserved, and that of the current specification and the request of requirements change reaching a compromise. In particular, the prioritization of requirements plays an important role in reaching an agreement in each belief negotiation model designed in this paper.

Relevância:

20.00% 20.00%

Publicador:

Resumo:

Importance of the field: Tacrolimus is the most commonly used immunosuppressive agent following solid-organ transplantation in children. Its clinical use, however, is complicated by side effects (mainly nephrotoxicity), narrow therapeutic index and pharmacokinetic variability which can result in an increased risk of treatment failure or toxicity. Studies examining inter-individual differences in the expression of the ABCB1 (ATP-binding cassette, subfamily B, member 1) gene (which encodes the drug transporter, P-gp) and its genetic polymorphisms have attempted to elucidate variations in tacrolimus response and disposition in children.