950 resultados para age-appropriate restraint
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Coastal and estuarine landforms provide a physical template that not only accommodates diverse ecosystem functions and human activities, but also mediates flood and erosion risks that are expected to increase with climate change. In this paper, we explore some of the issues associated with the conceptualisation and modelling of coastal morphological change at time and space scales relevant to managers and policy makers. Firstly, we revisit the question of how to define the most appropriate scales at which to seek quantitative predictions of landform change within an age defined by human interference with natural sediment systems and by the prospect of significant changes in climate and ocean forcing. Secondly, we consider the theoretical bases and conceptual frameworks for determining which processes are most important at a given scale of interest and the related problem of how to translate this understanding into models that are computationally feasible, retain a sound physical basis and demonstrate useful predictive skill. In particular, we explore the limitations of a primary scale approach and the extent to which these can be resolved with reference to the concept of the coastal tract and application of systems theory. Thirdly, we consider the importance of different styles of landform change and the need to resolve not only incremental evolution of morphology but also changes in the qualitative dynamics of a system and/or its gross morphological configuration. The extreme complexity and spatially distributed nature of landform systems means that quantitative prediction of future changes must necessarily be approached through mechanistic modelling of some form or another. Geomorphology has increasingly embraced so-called ‘reduced complexity’ models as a means of moving from an essentially reductionist focus on the mechanics of sediment transport towards a more synthesist view of landform evolution. However, there is little consensus on exactly what constitutes a reduced complexity model and the term itself is both misleading and, arguably, unhelpful. Accordingly, we synthesise a set of requirements for what might be termed ‘appropriate complexity modelling’ of quantitative coastal morphological change at scales commensurate with contemporary management and policy-making requirements: 1) The system being studied must be bounded with reference to the time and space scales at which behaviours of interest emerge and/or scientific or management problems arise; 2) model complexity and comprehensiveness must be appropriate to the problem at hand; 3) modellers should seek a priori insights into what kind of behaviours are likely to be evident at the scale of interest and the extent to which the behavioural validity of a model may be constrained by its underlying assumptions and its comprehensiveness; 4) informed by qualitative insights into likely dynamic behaviour, models should then be formulated with a view to resolving critical state changes; and 5) meso-scale modelling of coastal morphological change should reflect critically on the role of modelling and its relation to the observable world.
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Introduction
Standard treatment for neovascular age-related macular degeneration (nAMD) is intravitreal injections of anti-VEGF drugs. Following multiple injections, nAMD lesions often become quiescent but there is a high risk of reactivation, and regular review by hospital ophthalmologists is the norm. The present trial examines the feasibility of community optometrists making lesion reactivation decisions.
Methods
The Effectiveness of Community vs Hospital Eye Service (ECHoES) trial is a virtual trial; lesion reactivation decisions were made about vignettes that comprised clinical data, colour fundus photographs, and optical coherence tomograms displayed on a web-based platform. Participants were either hospital ophthalmologists or community optometrists. All participants were provided with webinar training on the disease, its management, and assessment of the retinal imaging outputs. In a balanced design, 96 participants each assessed 42 vignettes; a total of 288 vignettes were assessed seven times by each professional group.The primary outcome is a participant's judgement of lesion reactivation compared with a reference standard. Secondary outcomes are the frequency of sight threatening errors; judgements about specific lesion components; participant-rated confidence in their decisions about the primary outcome; cost effectiveness of follow-up by optometrists rather than ophthalmologists.
Discussion
This trial addresses an important question for the NHS, namely whether, with appropriate training, community optometrists can make retreatment decisions for patients with nAMD to the same standard as hospital ophthalmologists. The trial employed a novel approach as participation was entirely through a web-based application; the trial required very few resources compared with those that would have been needed for a conventional randomised controlled clinical trial.
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L’objet de la présente étude est le développement, l’application et la diffusion de la technologie associée à divers types d’alliages de cuivre, en particulier l’alliage du plomb-bronze, en Grèce ancienne, dans ses colonies, ainsi qu’en Étrurie. Le plomb-bronze est un mélange de diverses proportions d’étain, de cuivre et de plomb. Le consensus général chez les archéométallurgistes est que le plomb-bronze n’était pas communément utilisé en Grèce avant la période hellénistique; par conséquent, cet alliage a reçu très peu d’attention dans les documents d’archéologie. Cependant, les analyses métallographiques ont prouvé que les objets composés de plomb ajouté au bronze ont connu une distribution étendue. Ces analyses ont aussi permis de différencier la composition des alliages utilisés dans la fabrication de divers types de bronzes, une preuve tangible que les métallurgistes faisaient la distinction entre les propriétés du bronze d’étain et celles du plomb-bronze. La connaissance de leurs différentes caractéristiques de travail permettait aux travailleurs du bronze de choisir, dans bien des cas, l’alliage approprié pour une utilisation particulière. L’influence des pratiques métallurgiques du Proche-Orient a produit des variations tant dans les formes artistiques que dans les compositions des alliages de bronze grecs durant les périodes géométrique tardive et orientalisante. L’utilisation du plomb-bronze dans des types particuliers d’objets coulés montre une tendance à la hausse à partir de la période orientalisante, culminant dans la période hellénistique tardive, lorsque le bronze à teneur élevée en plomb est devenu un alliage commun. La présente étude analyse les données métallographiques de la catégorie des objets coulés en bronze et en plomb-bronze. Elle démontre que, bien que l’utilisation du plomb-bronze n’était pas aussi commune que celle du bronze d’étain, il s’agissait néanmoins d’un mélange important d’anciennes pratiques métallurgiques. Les ères couvertes sont comprises entre les périodes géométrique et hellénistique.
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Article
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An experiment was designed to test the response of growing pullets to two changes in photoperiod (an increase from 8 to 14 h followed 5 weeks later by the reverse change, or a decrease from 14 to 8 h followed by an increase). The first change was made either at 35 days or at 56 days of age, to test the influence of age on the responses observed. Control groups were kept oil constant 8-h and constant 14-h photoperiods and the responses to appropriate single changes were also tested. Mean age at first egg varied from 111 days for birds given a single increment at 56 days to 166 days for pullets given an increase in photoperiod at 35 days followed by a reduction at 70 days. Responses to the single changes confirmed earlier reports that sensitivity to change in photoperiod varies with age ill a manner that is quantitatively predictable. Responses to the double changes could be explained by Postulating that the initial change altered the 'physiological age' of the bird to all extent that was also quantitatively predictable. An early increase in photoperiod advances sexual development and makes the bird more sensitive to a subsequent decrease than would be expected by reference to its chronological age. An early decrease in photoperiod delays sexual development, which can have the effect of making the bird more or less sensitive to a subsequent increase since, ill layer-strain pullets, sensitivity to an increment in photoperiod normally increases Lip to about 9 weeks of age but decreases thereafter. Mean age at first egg predicted using these concepts was very highly correlated with observed age at first egg. The results provide a rational basis for constructing a model to predict age at first egg for any combination of increases and decreases in photoperiod applied to growing pullets.
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Objective: The combination of twho anthropometric parameters has been more appropriate to assess body composition and proportions in children, with special attention to the Body Mass Index (BMI), as it relates weight and length. However the BMI values for the neonatal period have not been determined yet. This study shows the BMI for newborns at different gestational ages represented in a normal smoothed percentile curve. Methods: Retrospective study including 2,406 appropriate for gestational age newborns following the Alexander et al curve (1996) from 29 to 42 weeks of gestational age. Weight and lenght were measured following standard procedures. For the construction aof a normal smoothed percentile curve, the 3(rd) 5(th), 10(th), 25(th), 5(th), 75(th), 90(th) and 95(th) percentiles were determined and a statistical procedure based on the mathematical model ""sinosuoidal fit"" was applied to establish a curve that estimates biological growth parameters. Results: The Body Mass Index values for gestational age in all percentiles shows a steady increase up to 38 weeks, levels off up to the 40(th) week, followed by a slight decrease to the 42(nd) week in both genders. Conclusion: The results show a direct correlation between gestational age and Body Mass Index for both genders in the nine percentiles, and can provide a useful reference to assess intra-uterine proportional growth.
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Virtual Pole from Magnetic Anomaly (VPMA) is a new multi-disciplinary methodology that estimates the age of a source rock from its magnetic anomaly, taken directly from available aeromagnetic data. The idea is to use those anomalies in which a strong remanent magnetic component is likely to occur. Once the total magnetization of the anomaly is computed through any of the currently available methods, the line that connects all virtual paleogeographic poles is related with the position, on a paleogeographic projection, of the appropriate age fragment of the APWT curve. We applied this procedure to five (5) well-known magnetic anomalies of the South American plate in SE Brazil, all of them associated to alkaline complexes of Mesozoic age. The apparent ages obtained from VPMA on three of the anomalies where the radiometric age of the source rock is known - Tapira, Araxa and Juquia were inside the error interval of the published ages. The VPMA apparent ages of the other two, where the age of the source rock is not known (Registro and Pariqueracu magnetic anomalies) were geologically coherent. We expect that the application of the VPMA methodology as a reconnaissance geochronological tool may contribute to geological knowledge over continental areas, especially when the source rocks of the magnetic anomalies am unknown or buried below superficial sediments. (C) 2009 Elsevier B.V. All rights reserved.
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Availability of nutrients is influenced by extremes of age, and a better characterization of this influence is necessary for appropriate development of foods and nutritional management throughout life stages of cats. This study investigated nutrient digestibility, mineral absorption, faeces and urine production in three groups of six young, mature and old cats fed two diets containing different energy densities. Apparent digestibility and mineral absorption were calculated by total collection method and values were tested with ANOVA and regression analysis. A quadratic relationship was detected between age and digestibility of dry matter, organic matter, crude protein, acid-hydrolysed fat and starch in the low-energy diet. Starch digestibility showed the same response in the high-energy diet. Young adult cats had intermediate digestibility, mature cats the highest and old cats the lowest. Mineral absorption (calcium, phosphorus, magnesium, sodium, potassium and chloride) and urinary pH were not different among groups. These findings confirm previous studies that found low digestibility of nutrients in some old cats, and support evidence that this trend is even more important in less digestible dry foods. on the contrary, data suggest that mineral formulations do not need to be varied in diets for adult cats of different ages.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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PURPOSE: To describe the Brainstem Auditory Evoked Potential (BAEP) results of full-term small-for-gestational-age newborns, comparing them to the results of full-term appropriate-for-gestational-age newborns, in order to verify whether the small-for-gestational-age condition is a risk indicator for retrocochlear hearing impairment. METHODS: This multicentric prospective cross-sectional study assessed 86 full-term newborns - 47 small- (Study Group) and 39 appropriate-for-gestational-age (Control Group - of both genders, with ages between 2 and 12 days. Newborns with presence of transient evoked otoacoustic emissions and type A tympanometry were included in the study. Quantitative analysis was based on the mean and standard deviation of the absolute latencies of waves I, III and V and interpeak intervals I-III, III-V and I-V, for each group. For qualitative analysis, the BAEP results were classified as normal or altered by analyzing these data considering the age range of the newborn at the time of testing. RESULTS: In the Study Group, nine of the 18 (38%) subjects with altered BAEP results had the condition of small-for-gestational-age as the only risk factor for hearing impairments. In the Control Group, seven (18%) had altered results. Female subjects from the Study Group tended to present more central alterations. In the Control Group, the male group tended to have more alterations. CONCLUSION: Full-term children born small or appropriate for gestational age might present transitory or permanent central hearing impairments, regardless of the presence of risk indicators.
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Fluoxetine (FLX) is commonly used to treat anxiety and depressive disorders in pregnant women. Since FLX crosses the placenta and is excreted in milk, maternal treatment with this antidepressant may expose the fetus and neonate to increased levels of serotonin (5-HT). Long-term behavioral abnormalities have been reported in rodents exposed to higher levels of 5-HT during neurodevelopment. In this study we evaluated if maternal exposure to FLX during pregnancy and lactation would result in behavioral and/or stress response disruption in adolescent and adult rats. Our results indicate that exposure to FLX influenced restraint stress-induced Fos expression in the amygdala in a gender and age-specific manner. In male animals, a decreased expression was observed in the basolateral amygdala at adolescence and adulthood; whereas at adulthood, a decrease was also observed in the medial amygdala. A lack of FLX exposure effect was observed in females and also in the paraventricular nucleus of both genders. Regarding the behavioral evaluation, FLX exposure did not induce anhedonia in the sucrose preference test but decreased the latency to feed of both male and female adolescent rats evaluated in the novelty-suppressed feeding test. In conclusion, FLX exposure during pregnancy and lactation decreases acute amygdalar stress response to a psychological stressor in males (adolescents and adults) as well as influences the behavior of adolescents (males and females) in a model that evaluates anxiety and/or depressive-like behavior. Even though FLX seems to be a developmental neurotoxicant, the translation of these findings to human safe assessment remains to be determined since it is recognized that not treating a pregnant or lactating woman may also impact negatively the development of the descendants.
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[EN]The age and growth of the sand sole Pegusa lascaris from the Canarian Archipelago were studied from 2107 fish collected between January 2005 and December 2007. To find an appropriate method for age determination, sagittal otoliths were observed by surface-reading and frontal section and the results were compared. The two methods did not differ significantly in estimated age but the surface-reading method is superior in terms of cost and time efficiency. The sand sole has a moderate life span, with ages up to 10 years recorded. Individuals grow quickly in their first two years, attaining approximately 48% of their maximum standard length; after the second year, their growth rate drops rapidly as energy is diverted to reproduction. Males and females show dimorphism in growth, with females reaching a slightly greater length and age than males. Von Bertalanffy, seasonalized von Bertalanfy, Gompertz, and Schnute growth models were fitted to length-at-age data. Akaike weights for the seasonalized von Bertalanffy growth model indicated that the probability of choosing the correct model from the group of models used was >0.999 for males and females. The seasonalized von Bertalanffy growth parameters estimated were: L? = 309 mm standard length, k = 0.166 yr?1, t0 = ?1.88 yr, C = 0.347, and ts = 0.578 for males; and L? = 318 mm standard length, k = 0.164 yr?1, t0 = ?1.653 yr, C = 0.820, and ts = 0.691 for females. Fish standard length and otolith radius are closely correlated (R2 = 0.902). The relation between standard length and otolith radius is described by a power function (a = 85.11, v = 0.906)
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Gastroesophageal junction (GEJ) adenocarcinoma are uncommon before age of 40 years. While certain clinical, pathological and molecular features of GEJ adenocarcinoma in older patients have been extensively studied, these characteristics in the younger population remain to be determined. In the recent literature, a high sensitivity and specificity for the detection of dysplasia and esophageal adenocarcinoma was demonstrated by using multicolor fluorescence in situ hybridization (FISH) DNA probe set specific for the locus specific regions 9p21 (p16), 20q13.2 and Y chromosome. We evaluated 663 patients with GEJ adenocarcinoma and further divided them into 2 age-groups of
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Over the last decade, translational science has come into the focus of academic medicine, and significant intellectual and financial efforts have been made to initiate a multitude of bench-to-bedside projects. The quest for suitable biomarkers that will significantly change clinical practice has become one of the biggest challenges in translational medicine. Quantitative measurement of proteins is a critical step in biomarker discovery. Assessing a large number of potential protein biomarkers in a statistically significant number of samples and controls still constitutes a major technical hurdle. Multiplexed analysis offers significant advantages regarding time, reagent cost, sample requirements and the amount of data that can be generated. The two contemporary approaches in multiplexed and quantitative biomarker validation, antibody-based immunoassays and MS-based multiple (or selected) reaction monitoring, are based on different assay principles and instrument requirements. Both approaches have their own advantages and disadvantages and therefore have complementary roles in the multi-staged biomarker verification and validation process. In this review, we discuss quantitative immunoassay and multiple reaction monitoring/selected reaction monitoring assay principles and development. We also discuss choosing an appropriate platform, judging the performance of assays, obtaining reliable, quantitative results for translational research and clinical applications in the biomarker field.
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The aim of this study was (1) to examine whether childhood BMI is a significant predictor of restrained eating in preadolescents, (2) to investigate gender differences in restrained and emotional eating, and (3) to determine whether emotional problems, and body esteem were related to eating problems of preadolescents. In this longitudinal study with two measurement points, data from 428 children (50% female) were used. At time 1 (t1) children were on average 5.9 years old. BMI was assessed using objective measures. At time 2 (t2) participants were 12 years old. The adolescents and their parents completed questionnaires assessing restrained and emotional eating, body esteem, emotional problems, and BMI. Multiple regression analysis showed that restrained eating was significantly predicted by t1 BMI, by change in BMI between t1 and t2, and t2 body esteem. Emotional eating was, as expected, not predicted by t1 BMI, but associated with t2 body esteem and t2 emotional problems. Gender was not a significant predictor. The stability of BMI between childhood and preadolescence and its ability to predict restrained eating suggests that it is important to start prevention of overweight, body dissatisfaction and disordered eating at an early age