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Introduction: Excessive ultrafiltration is associated with intra-dialytic symptoms, loss of residual function, and mortality in haemodialysis patients. A major contributor to excessive ultrafiltration is within-individual variation in pre-dialysis weight and the concept of achieving a fixed target weight by the end of each dialysis session. Haemodialysis protocols which allow variable post-dialysis weight have not been proposed. Methods: Weight variation was observed in haemodialysis patients and healthy controls to estimate the proportion of pre-dialysis weight variation which could be considered natural variation. These estimates were used to derive a novel protocol for setting ultrafiltration, which was evaluated by mathematical modelling. Results: Amongst 20 haemodialysis patients, mean (SD) pre-dialysis weight was 102.74 (0.94)% of target weight after a 2-day gap and 103.50 (0.94)% after a 3-day gap. Amongst 10 healthy individuals, mean (SD) daily weight was 100.0 (0.71)% of average weight. A 4-component model of pre-dialysis weight was derived using these estimates, in which the best estimate of pre-dialysis excess fluid is the midpoint of excess weight and average fluid gain, and used to propose a novel protocol for ultrafiltration setting. In simulations, the novel protocol reduced ultrafiltration variation by more than half (standard deviation 0.6 vs. 1.3% of target weight, p < 0.001), without increasing the variation in post-dialysis fluid excess. Excessive ultrafiltration rates (over 13 mL/h/kg) were far less frequent using this protocol (2.6% vs. 7.5% of sessions, p = 0.001). Conclusion: Considering natural weight variation allows the development of a novel protocol for ultrafiltration in which target weight does not have to be achieved precisely: it is therefore a soft target. This protocol, which is predicted to substantially reduce excessive ultrafiltration variation, is a zero-cost intervention with the potential to improve symptoms and clinical outcome for haemodialysis patients.

Label-specific features learning can effectively exploit the unique features of each label, which alleviates the high dimensionality and improves the classification performance of multi-label. However, most existing label-specific features learning algorithms assume that label space is complete, ignoring the effect of missing labels on the classification accuracy. Some methods try to recover the missing labels first and then learn the mapping between the completed label matrix and the feature matrix. However, early intervention in the recovery of missing labels may affect the distribution of original labels to a certain extent. In this paper, feature-label dual-mapping for missing label-specific features learning is proposed. According to the information that the label depends on the feature, the dual-mapping weight of the complete feature space and the missing label space is jointly learned. Therefore, the proposed algorithm is to conduct latent missing labels recovery by feature-label dual-mapping to directly obtain target weight in this paper, avoiding the negative influence of early label recovery intervention. Compared with several state-of-the-art methods in 10 benchmark multi-label data sets, the results show that the proposed algorithm is reasonable and effective.

Background: Human milk fortifier (HMF) is defined as a supplement added to breastmilk to increase calories, proteins, vitamins, and various nutrition of breastmilk. The purpose of HMF administration is to increase the concentration of breastmilk nutrients to improve the weight of very low birth weight preterm infants. The administration of HMF is insufficient to fulfill protein needs in 20-40% very low birth weight babies, thus the weight gain did not meet the expected target.Objective: To analyze characteristic differences between very low birth weight preterm infants who experienced weight gain according to the target and not according to the target on the administration of HMF.Methods: An analytical study with a case-control approach comparing case and control group, which was observed to determine characteristic differences between both groups. The samples were 52 very low birth weight preterm infants obtained by consecutive sampling. Data analysis includes descriptive analysis and hypothesis testing. Results: Data were obtained from medical records and consisted of 52 participants, including 26 very low birth weight premature infants who experienced weight gain according to the target and 26 who experienced weight gain not according to the target. There was no characteristic difference of cyanosis clinical symptoms (OR 2.3; 95% CI 0.51-10.4), chest retraction (OR 1.0; 95% CI 0.32-3.1), apnea of prematurity comorbid (OR 1.0; 95% CI 0.25-3.9), neonatal infections (OR 0.62; 95% CI 0.21-1.9), starting age of HMF administration (OR 0.62; 95% CI 0.21-1.89), bloating (OR 0.57; 95% CI 0.17-1.9), and vomiting (OR 1.18; 95% CI 0.38-3.7) in both groups.Conclusion: There was no characteristic difference between very low birth weight preterm infants who experienced weight gain according to the target and not according to the target on the administration of HMF.

European eating disorders review 29(3), 427-442 (2021). doi:10.1002/erv.2755 special issue: "Special Issue: Value of Treatment / Issue edite by: Janet Treasure, Philip Gorwood, Fernando Fernandez-Aranda", Published by Wiley, Chichester

Deferred grazing is a common management practice in which pastures are rested from grazing between mid-spring and the end of summer/early autumn. It has been used to rejuvenate pastures and better manage the spring pasture surplus although its impact on farm profitability is unknown. FARMAX was used to explore the impact of deferred grazing on profitability on a north-western Waikato beef and sheep hill country farm based on experimental data and likely management responses. The Base Scenario modelled farm profitability assuming spring surplus in a typical year. When 15% of the farm was deferred and it was assumed that the increased grazing pressure on the rest of the farm led to greater control of the spring feed surplus and improved pasture quality, there was an increase in ewe performance and the number lambs sold at target weight. Per head and total farm gross margins increased by 8%. Results demonstrate how the use of deferred grazing as a pasture management tool to increase resilience can also enhance livestock performance and profitability at the whole-farm level.

Background Decisions around planned ultrafiltration volumes are the only part of the haemodialysis prescription decided upon at every session. Removing too much fluid or too little is associated with both acute symptoms and long-term outcomes. The degree to which patients engage with or influence decision-making is not clear. We explored patient perspectives of prescribing ultrafiltration volumes, their understanding of the process and engagement with it. Methods A questionnaire developed for this study was administered to 1077 patients across 10 UK Renal Units. Factor analysis reduced the dataset into factors representing common themes. Relationships between survey results and factors were investigated using regression models. ANCOVA was used to explore differences between Renal Units. Results Patients generally felt in control of their fluid management and that they were given the final say on planned ultrafiltration volumes. Around half of the respondents reported they take an active role in their treatment. However, respondents were largely unable to relate signs and symptoms to fluid management practice and a third said they would not report common signs and symptoms to clinicians. A fifth of patients reported not to know how ultrafiltration volumes were calculated. Patients responded positively to questions relating to healthcare staff, though with significant variation between units, highlighting differences in perception of care. Conclusions Despite a lack of formal acknowledgement in fluid management protocols, patients have significant involvement in decisions regarding fluid removal during dialysis. Furthermore, substantial gaps remain in patient knowledge and engagement. Formalizing the role of patients in these decisions, including patient education, may improve prescription and achievement of target weights.

Nutrients 13(4), 1265 (2021). doi:10.3390/nu13041265 special issue: "Special Issue "Eating and Feeding Disorders with Restrictive Food Intake" / Special Issue Editor: Ricarda Schmidt, Guest Editor", Published by MDPI, Basel

Acute anorexia nervosa (AN) constitutes an extreme physiological state. We aimed to detect state related metabolic alterations during inpatient admission and upon short- and long-term weight regain. In addition, we tested the hypothesis that metabolite concentrations adapt to those of healthy controls (HC) after long-term weight regain. Thirty-five female adolescents with AN and 25 female HC were recruited. Based on a targeted approach 187 metabolite concentrations were detected at inpatient admission (T0), after short-term weight recovery (T1, half of target-weight) and close to target weight (T2). Pattern hunter and time course analysis were performed. The highest number of significant differences in metabolite concentrations (N = 32) were observed between HC and T1. According to the detected main pattern, metabolite concentrations at T2 became more similar to those of HC. The course of single metabolite concentrations (e.g., glutamic acid) revealed different metabolic subtypes within the study sample. Patients with AN after short-term weight regain are in a greater &ldquo, metabolic imbalance&rdquo, than at starvation. After long-term weight regain, patients reach a metabolite profile similar to HC. Our results might be confounded by different metabolic subtypes of patients with AN.

The AUSL-IRCCS of Reggio Emilia Transfusion Unit operates in two blood donor centers. Plasmapheresis protocols and machines are identical in both centers, except for the final unit weight setting: 700 g in Center 1 and 720 g in Center 2. Within a wider study to assess the anticoagulant content in plasma units through proton nuclear magnetic resonance, we compared the efficiency of the two settings. We analyzed 215 and 100 consecutive samples from Centers 1 and 2, respectively. We collected processed blood volume, net plasma collected and anticoagulant volume in the plasma units. In our experience, setting the machine at 720 g instead of 700 g was associated with a small increase in plasma content of the final unit (only 4 mL), but implied an increase of more than 100 mL of the total processed blood and a higher amount of anticoagulant in the unit. On the contrary, the difference in donor's reinfused anticoagulant was negligible. Our findings come from an observational study suggesting that, in view of a minimal advantage in terms of collected net plasma, there might be relevant disadvantages for the donor in prolonging plasmapheresis over 700 g. Since observed differences may be attributed to confounding factors, we recommend always checking the marginal efficiency of the procedure when the balance target value of the setting is increased. Randomized cross-over studies are needed to find the optimal target weight for plasma units. These studies could also help defining personalized plasmapheresis procedures, thus further optimizing donor safety.

Objectif : La malnutrition aigue est frequente chez les enfants infectes par le VIH. L’objectif de notre travail etait d’evaluer l’efficacite et l’acceptabilite des protocoles de recuperation nutritionnelle ambulatoire bases sur les aliments prets a l’emploi (ATPE) chez les EVVIH. Materiel et methodes : Il s’agissait d’une etude prospective, realisee a la pediatrie du CHRZ du 7 janvier au 31 Septembre 2018. Ont ete inclus les EVVIH, âges de 6 mois a 19 ans presentant une malnutrition aigue moderee ou severe sans complication. Le suivi etait bimensuel jusqu’a l’atteinte du poids cible. Un bilan clinico-biologique et anthropometrique, la delivrance des ATPE et la mesure de l’observance aux prescriptions etaient realises. Resultats : Douze enfants vivants avec le VIH ont ete inclus dont 3 MAS et 9 MAM sur un total de 25 enfants suivis soit une prevalence de 48%. Le sexe ratio (1,4) en faveur des garcons. L’âge median (9,5 ans). Ils etaient sous ARV dans 92% des cas. La moitie des patients avait un âge > a 10 ans. La toux etait le symptome le plus retrouve (67%) suivie de la diarrhee (58,3%), des vomissements (8,3%), une otite moyenne chronique (8,3%). La charge virale au debut de l'etude a montre (5cas 15 000 copies). Le taux d'hemoglobine etait < 10g/dl dans 92% des cas. Un probleme d'observance de la prise d'ATPE a ete note dans 58,3%. Onze enfants ont atteint leur poids cible. Nous n’avons pas note de perdu de vu ni d’hospitalise. Conclusion : Les ATPE bien que efficaces, pausent souvent un probleme d’acceptabilite. On gagnerait a ameliorer le gout et la presentation pour permettre une meilleure observance. Objective: Acute malnutrition is common in children with HIV infection. The objective of our work was to evaluate the efficiency and acceptability of ambulatory nutritional recovery protocols (ATPE) based on ready-to-use food) in HIV-positive children (EVVIH). Methods: This was a prospective study, conducted at the pediatrics of the regional hospital center of Ziguinchor (CHRZ) from January 7th to September 31st, 2018. We included all HIV-positive children (EVVIH), aged between 6 months and 19 years with relatively acute or severe malnutrition without complication. The follow-up was done every two months until target weight was reached. A clinic-biological and anthropometric report, the issuing of ATPE and the measurement of compliance with prescriptions were carried out. Results: We chose 12 children living with HIV, including 3 MAS and 9 MAM out of a total of 25 children followed, with a prevalence of 48%. The sex ratio (1.4) was in favor of boys. The medium age was (9.5 years). They were under ARV in 92% of cases. Half of the patients were > 10 years old. Coughing was the most common symptom (67%) followed by diarrhea (58.3%), vomiting (8.3%), medium chronic otitis (8.3%). The viral affection at the beginning of the study showed (5cases 15,000 copies). The hemoglobin level was

Objective This study aimed to test the feasibility of a 12-month weight loss intervention using telephone-based counseling plus community-situated physical activity (PA) in female breast cancer (BC) and colorectal cancer (CRC) survivors. Methods This multisite cooperative group study enrolled sedentary, female, postmenopausal BC and CRC survivors with BMI ≥ 25 kg/m2 to receive 12-month fitness center memberships and telephone counseling encouraging 150 min/wk of PA and a 500-kcal/ddecrease in energy intake. Feasibility criteria included accrual, adherence, and retention. Target weight loss was ≥ 5%. Results Among 25 BC survivors, median baseline BMI was 37.2 (range: 27.7-54.6), accrual occurred in 10 months, 60% and 28% met diet and exercise goals, 80% provided 12-month measures, and average weight loss was 7.6% (95% CI: -3.9%, 19.2%). Among 23 CRC survivors, median BMI was 31.8 (range: 26.4-48.7), accrual occurred in 24 months, 61% and 17% met diet and exercise goals, 87% provided measures, and average weight loss was 2.5% (95% CI: -8.2%, 13.3%). Conclusions It is feasible to recruit and retain BC survivors in a cooperative group diet and PA weight loss trial. BC survivors achieved clinically meaningful weight loss but did not meet a priori adherence goals. In CRC survivors, recruitment was more difficult, and the intervention was less effective.

Never selling stocks is optimal for investors with a long horizon and a realistic range of preference and market parameters, if relative risk aversion, investment opportunities, proportional transaction costs, and dividend yields are constant. Such investors should buy stocks when their portfolio weight is too low, and otherwise hold them, letting dividends rebalance to cash over time rather than selling. With capital gain taxes, this policy outperforms both static buy-and-hold and dynamic rebalancing strategies that account for transaction costs. Selling stocks becomes optimal if either their target weight is low, or intermediate consumption is substantial.

BACKGROUND AND OBJECTIVES: Fluid overload and intradialytic hypotension are associated with cardiovascular events and mortality in patients on hemodialysis. We investigated associations between hemodialysis facility practices related to fluid volume and intradialytic hypotension and patient outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data were analyzed from 10,250 patients in 273 facilities across 12 countries, from phase 4 of the Dialysis Outcomes and Practice Patterns Study (DOPPS; 2009–2012). Cox regression models (shared frailty) were used to estimate associations between facility practices reported by medical directors in response to the DOPPS Medical Directors Survey and all-cause and cardiovascular mortality and hospitalization, and cardiovascular events, adjusting for country, age, sex, dialysis vintage, predialysis systolic BP, cardiovascular comorbidities, diabetes, body mass index, smoking, residual kidney function, dialysis adequacy, and vascular access type. RESULTS: Of ten facility practices tested (chosen a priori), having a protocol that specifies how often to assess dry weight in most patients was associated with lower all-cause (hazard ratio [HR], 0.78; 99% confidence interval [99% CI], 0.64 to 0.94) and cardiovascular mortality (HR, 0.72; 99% CI, 0.55 to 0.95). Routine orthostatic BP measurement to assess dry weight was associated with lower all-cause hospitalization (HR, 0.86; 99% CI, 0.77 to 0.97) and cardiovascular events (HR, 0.85; 99% CI, 0.73 to 0.98). Routine use of lower dialysate temperature to limit or prevent intradialytic hypotension was associated with lower cardiovascular mortality (HR, 0.76; 99% CI, 0.58 to 0.98). Routine use of an online volume indicator to assess dry weight was associated with higher all-cause hospitalization (HR, 1.19; 99% CI, 1.02 to 1.38). Routine use of sodium modeling/profiling to limit or prevent intradialytic hypotension was associated with higher all-cause mortality (HR, 1.36; 99% CI, 1.14 to 1.63), cardiovascular mortality (HR, 1.34; 99% CI, 1.04 to 1.73), and cardiovascular events (HR, 1.21; 99% CI, 1.03 to 1.43). CONCLUSIONS: Hemodialysis facility practices relating to the management of fluid volume and intradialytic hypotension are associated with patient outcomes.

Introduction: Adequate volume management removing excess volume and at the same time avoiding intradialytic morbid events (IME) remains a core problem in current hemodialysis (HD) therapy. Recently, we developed a feasible method to determine absolute blood volume (Vs, in mL/kg) in patients on HD. The aim of this study was to investigate the suitability of Vs measurements for volume management. Methods: Following a 4 week baseline phase to quantify the frequency of IME, volume status was determined in a single specified HD session during which Vs was measured using dialysate dilution, volume overload (Vo, L) was measured using bioimpedance spectroscopy, and the occurrence of IME was recorded. Target weight was then adjusted and the frequency of IME was recorded during 4 weeks of follow-up. Findings: Forty-five patients participated in this study. Twenty-two (49%) patients experienced 66 IME in 12% of HD treatments during baseline. In 15 (33%) patients who experienced IME during volume assessment both Vs (60.7 ± 4.0 vs. 73.7 ± 11.3 mL/kg, P

The collaborative very light rail project involves the development of a novel railcar designed to revolutionise the rail industry: a self-powered, very light rail vehicle. Each of the two bogies contains a complete diesel–electric series-hybrid drive system, while the whole vehicle has undergone significant lightweighting activity to realise a target weight of less than 18 t, or 1 t per linear metre. The target cost is £500 000, which is to be achieved through the use of standardised, modular components, and appropriate materials and structural design methodologies. The research covers several aspects of the GB Rail Technical Strategy chapter relating to rolling stock. Lightweighting leads to a reduction in the propulsion requirements and reduces the infrastructure installation and maintenance costs. The use of higher-efficiency drive systems achieved through on-board energy systems enables a reduction in carbon dioxide emissions. These hybridisation activities improve the passenger experience through quieter operation, decreased vibration and the possible elimination of exhaust emissions in stations. Combining new drive systems with modular lightweight structures will lead to lower life-cycle costs and thus could enable the economical reopening of lines.

Dry weight is the lowest weight patients on hemodialysis can tolerate; correct dry weight estimation is necessary to minimize morbi-mortality, but is difficult to achieve. Here, we used artificial intelligence to improve the accuracy of dry weight assessment in hemodialysis patients.We designed a neural network which used bio-impedancemetry, blood volume monitoring, and blood pressure values as inputs; output was artificial intelligence dry weight. Fourteen pediatric patients were switched from nephrologist to artificial intelligence dry weight. Artificial intelligence dry weight was higher (28.6%), lower (50%), or identical to nephrologist dry weight. Mean difference between artificial intelligence and nephrologist dry weights was 0.497 kg (- 1.33 to + 1.29 kg). In patients for whom artificial intelligence dry weight was lower than nephrologist dry weight, systolic blood pressure significantly decreased after dry weight decrease to artificial intelligence dry weight (77th to 60th percentile, p = 0.022); anti-hypertensive treatments were successfully decreased or discontinued in 28.7% of cases. In patients for whom artificial intelligence dry weight was higher than nephrologist dry weight, no hypertension was observed after dry weight increase to artificial intelligence dry weight; when present, symptoms of dry weight underestimation receded.Neural network predictions outperformed those of experienced nephrologists in most cases, proving artificial intelligence is a powerful tool for predicting dry weight in hemodialysis patients.

Background: Achieving euvolaemia using ultrafiltration (UF) during haemodialysis (HD) without inducing haemodynamic instability presents a major clinical challenge. Transcapillary refill is a key factor in sustaining the circulating blood volume (BV) during UF, which is in turn predicted by the rate of refilling. However, absolute plasma refilling rate (PRR), its determinants and variability with UF rate (UFR), have not been reported in the literature. Method: We studied paired HD sessions (n = 48) in 24 patients over 2 consecutive mid-week HD treatments. Plasma refilling was measured using real-time, minute-by-minute relative BV changes obtained from the integrated BV monitoring device during UF. A fixed bolus dilution approach at the start of HD was used to calculate absolute BV. The first control HD session was undertaken with a standard UFR required to achieve the prescribed target weight, while during the second study session, a fixed (high) UFR (1 L/h) was applied, either in the first (n = 12 patients) or in the final hour (n = 12 patients) of the HD session. Participants’ had their hydration status measured pre- and post-HD using multifrequency bioimpedance (BIS). Blood pressure was measured at 15-min intervals and blood samples were collected at 7 intervals during HD sessions. Results: The mean PRR during a standard 4-hr HD session was 4.3 ± 2.0 mL/kg/h and varied between 2 and 6 mL/kg/h. There was a mean time delay of 22 min (range 13.3–35.0 min) for onset of plasma refilling after the application of UF irrespective of standard or high UFRs. The maximum refilling occurred during the second hour of HD (mean max PRR 6.8 mL/kg/h). UFR (beta = 0.60, p < 0.01) and BIS derived pre-HD overhydration index (beta = 0.44, p = 0.01) were consistent, independent predictors of the mean PRR (R2 = 0.49) in all HD sessions. At high UFRs, PRR exceeded 10 mL/kg/h. The total overall plasma refill contribution to UF volume was not significantly different between standard and high UF. During interventions no significant haemodynamic instability was observed in the study. Conclusion:We describe absolute transcapillary refilling rate and its profile during HD with UF. The findings provide the basis for the development of UF strategies to match varying PRRs during HD. An approach to fluid removal, which is tailored to patients’ refilling rates and capacity, provides an opportunity for more precision in the practice of UF.

The aim of the study was to verify the effects of dart weight and target distance on kinematic variables of the movement control of the underarm dart throwing task. Four women and one man performed the task of throwing a dart at two horizontal circular targets located at 2m (Nt) and 3m (Ft) away, with two different weights, 22g (Ld) and 44g (Hd). On the first phase of the experiment, the human volunteers performed 200 trials per day during four sessions. On the fifth day, it had 40 more trials in a pseudo random order that were recorded and analysed. A high precision camera recorded the kinematic variables amplitude of the movement (AOM), release height, movement time, release velocity and release angle, with a frequency of acquisition of 100 Hz. Performance was measured by the distance from the actual dart position to the target bull’s eye. The analysis revealed that increasing the mass of the dart diminished only the release angle. However, increasing the distance of the target increased in the AOM and the movement time of the arm, the release velocity of the dart and increased the absolute error. The results show that the motor control system has ability to deal with external constraints adjusting control strategies, which is represented by kinematic features. Moreover, our results suggests that varying the mass of implements, as a constraint may be a good candidate to improve the analysis for both motor control and ability during practice.

Purpose Many dialysis centres have no formal program for assessing and adjusting post-haemodialysis (HD) target weight. Apart from clinical assessment, there are bioimpedance devices and natriuretic peptides that could potentially aid clinical management. We wished to determine whether pre- or post-HD bioimpedance assessment of extracellular water (ECW) or N terminal probrain natriuretic peptide (NT-proBNP) affected patient outcomes. Methods Multi-frequency bioimpedance assessments (MFBIA) were made before and after the midweek dialysis session, along with a post-dialysis NT-proBNP measurement. Results Data from 362 patients, median age of 63 (50–76) years, 59.7% male, 41.2% Caucasoid, with a median dialysis vintage of 31.4 (13.5–61.7) months were available for review. During a median follow-up of 49.6 (21.9–50.2) months there were 110 (30.4%) deaths. Patients who died had significantly increased ECW, as % over-hydrated both pre-HD 6.6 (5.8–7.6)% vs. survivors 5.1 (4–6.6)%, and post-HD 5.1 (4–6.6)% vs. 0.5 (-1-2.2.0, pConclusions ECW excess is associated with increased mortality for HD patients, with ECW excess pre-dialysis being the strongest association, although these patients also had increased ECW post dialysis. Future trials are required to determine whether achieving euvolaemia as determined by bioimpedance improves patient survival.

Nutritional restoration is a core treatment component in eating disorders. Early detection and treatment of nutritional compromise are crucial to reduce the physical and psychological complications associated with the illness. Although risks of refeeding exist and variations in refeeding practices occur, there is consensus regarding the need to prevent underfeeding, refeed cautiously and manage medical complications associated with refeeding. Paper 1 of this series discussed the importance of nutrition, effects of inadequate nutrition and elements of healthy eating. This paper will cover the key aspects of assessment, refeeding and rehydration, while Paper 3 (to follow in the next issue of Advances in Eating Disorders, Vol. 4, No. 3) will explore special considerations for nutrition in eating disorders.

Background: Children with severe acute malnutrition require immediate attention along with proper nutritional rehabilitation for which nutritional rehabilitation centers (NRC) has been established. Even with establishment of NRCs the proportion of severe acute malnutrition in community has not been reduced. Thus it is necessary to know the effect of nutritional interventions on children admitted to these centers. Present study was done to analyze the effect of nutritional interventions on the children admitted to nutritional rehabilitation centre by reviewing the anthropometric indicators. Methods: A longitudinal observational study was done among the children admitted to NRC from January 2013 to June 2014. A predesigned and pre-tested proforma was used to collect the socio demographic information. Admitted children were observed to analyze the effects of interventional measures on select anthropometric indicators. The data collected was entered in Microsoft excel sheet and analyzed. Results: Majority of the admitted children (41.77%) was in 12-23 months age group. 88(51.76%) were females and 82(48.24%) were males. Overall mean weight at admission was 7.19±1.57 kgs; for males it was 7.23±1.54 kgs and for females it was 7.16±1.60 kgs. The overall mean weight at discharge is 7.94±1.77 kgs for males it was 8.01±1.82 kgs and for females it was 7.88±1.72 kgs. The average weight gain for the study group during their stay at the centre was 7.9±1.6 g/kg/day. The target weight was achieved only by 26% of admitted children. Conclusions: Nutritional rehabilitation centers are effective in management of severe malnutrition. However improvements are necessary to ensure the full recovery of all children admitted.

Introduction: Bioelectrical impedance spectroscopy (BIS) devices are being used to determine ultrafiltration requirements to achieve target weight for haemodialysis (HD) patients. Pre-dialysis measurements are more convenient for both patients and staff. We wished to compare the changes in pre- and post-dialysis hydration measured by BIS with actual weight loss. Methods: We compared paired BIS measurements made pre and post HD using a BIS device based on a 3-compartmental model, designed to provide information on extracellular water (ECW) excess. Results: BIS was measured in 49 HD patients, 35 male (71.4%) with mean age 67.6 ± 14.2. Weight fell significantly from 69.2 ± 17.8 to 67.6 ± 17.4 kg, and BIS over hydration (OH) from 4.5 ± 3.3.4 to 3.4 ± 2.9 litres, and ECW from 16.8 ± 4.8 to 15.5 ± 4.4 litres, but there was no change in the amount of intracellular water. Weight loss correlated positively with the change in ECW, but exceeded the fall in OH; mean bias -0.58 (95% confidence limits -3.6 to 4.8 kg). Summary: We measured OH pre and post HD, but did not find that the change in OH correlated with changes in body weight. Although there was a correlation between changes in OH and ECW, there was none for weight. Our findings do not support total reliance on pre-dialysis BIS alone for assessing volume status in HD patients, but rather BIS should be considered an aid to clinical assessment of volume status.

Objective During medical emergencies, underweight and obese children are at a higher risk of weight-estimation errors than 'average' children, which may lead to poorer outcomes. In obese children, optimum drug dosing requires a measure of both total body weight (TBW) and ideal body weight (IBW) for appropriate scaling. We evaluated the ability of the Broselow tape, the Mercy method and the PAWPER XL tape to estimate TBW and IBW in obese and underweight children. Participants and methods Data for children aged 0-18 years were extracted and pooled from three previous weight-estimation studies. The accuracy of estimation of TBW and IBW by each method was evaluated using percentage of estimations within 10% of target weight (PW10) as the primary outcome measure. Results The Broselow tape estimated TBW poorly in obese and underweight children (PW10: 3.9 and 41.4%), but estimated IBW extremely accurately (PW10: 90.6%). The Mercy method estimated TBW accurately in both obese and underweight children (PW10: 74.3 and 76.3%) but did not predict IBW accurately (PW10: 14.3%). The PAWPER XL tape predicted TBW well (PW10: 73.0% in obese children and 74.9% in underweight children) and predicted IBW extremely accurately (PW10: 100%). Conclusion The Broselow tape predicted IBW, but not TBW, accurately. The Mercy method estimated TBW very accurately, but not IBW. The PAWPER XL tape estimated both TBW and IBW accurately. The PAWPER XL tape should be considered when choosing a weight-estimation strategy for obese and underweight children.

Background and objectives Fluid removal via ultrafiltration is a primary function of hemodialysis, and inadequate volume control is associated with significant morbidity and mortality among chronic dialysis patients. Treatment-to-treatment fluid removal goals are typically calculated on the basis of interdialytic weight gain and prescribed target weight. The clinical effect of frequent missed target weights is unclear. This study was designed to evaluate the associations of postdialysis weights above and below the prescribed target weight (separately) and outcomes. Design, setting, participants, & measurements Data were taken from a national cohort of 10,785 prevalent, thrice-weekly, in-center hemodialysis patients dialyzing from 2005 to 2008 (median time at risk, 2.1 [25th percentile, 75th percentile] years) at a single dialysis organization. Patients were characterized as having an above target weight miss if their postdialysis weight was >2 kg above target weight in at least 30% of baseline treatments (14.6% of cohort), or they were characterized as control otherwise. Below target weight miss characterization was analogous for patients with postdialysis weight >2 kg below target weight (6.6% of cohort). Coprimary endpoints were all-cause and cardiovascular mortality. Results Above target weight miss in at least 30% of treatments (versus not) was associated with greater all-cause mortality (adjusted hazard ratio, 1.28; 95% confidence interval, 1.15 to 1.43); and below target weight miss in at least 30% of treatments (versus not) was associated with greater all-cause mortality (adjusted hazard ratio, 1.22; 95% confidence interval, 1.05 to 1.40). Both above and below target weight misses were also significantly associated with greater cardiovascular mortality. Secondary analyses demonstrated dose-response relationships between target weight misses and mortality. Results from sensitivity analyses considering the difference in postdialysis and target weights as a proportion of body weight were analogous to the primary results. Conclusions Postdialysis weights >2 kg above and below target weight are associated with higher all-cause and cardiovascular mortality. Consistent target weight achievement is a viable target for improving fluid management.

Despite evidence to the contrary, exercise interventions for obese youth target weight loss as a means of improving health. Using Exercise is Medicine® as a framework, we present a conceptual model for the beneficial effects of exercise independent of weight loss in obese youth and highlight novel biomarkers of cardiometabolic health that could prove useful as interventional targets for this population.

Objectives In 2009 the IOM revised prenatal weight gain guidelines. The primary purpose of this pilot study was to assess if provider education and use of prenatal weight gain charts to track weight gain and counsel patients was associated with better patient and provider knowledge and communication about the guidelines. Methods A prospective non-randomized study conducted in four OB practices (two control, two intervention). Data sources included provider surveys (n = 16 intervention, 21 control), patient surveys (n = 332), and medical records. Intervention clinics received provider education on the IOM guidelines and used patient education materials and prenatal weight gain charts to track weight gain and as a counseling tool. Comparison clinics received no education and did not use the charts or patient education information. Results More patients at intervention clinics (92.3%) reported that a provider gave them advice about weight gain, compared to patients from comparison clinics (66.4%) (p

Evidence about the impact of psychological factors on weight loss after bariatric surgery is scarce. This study explores whether patients’ preoperative estimate of target weight influences actual weight loss for different types of bariatric procedures. Patients eligible for bariatric surgery were instructed twice on how to calculate their expected target weight. They were divided into three groups based on their percentage excess weight loss (%EWL) and percentage total body weight loss (%TBWL). Weight loss 12 and 24 months after surgery was analyzed for each group and per type of surgery. Six hundred fifty-six patients participated in this study. Types of surgery performed were the Roux-en-Y gastric bypass (RYGB, 75%), sleeve gastrectomy (SG, 8.1%), REDO-RYGB (12.5%), and laparoscopic adjustable gastric banding (LAGB, 4.4%). Data of 622 and 410 patients were available for analysis at 12 and 24 months, respectively. Surprisingly, 415 patients (63.3%) overestimated their expected weight loss as opposed to our calculation, based on our own historic data. One hundred thirty-four patients (20.4%) estimated their weight loss correctly and 107 patients (16.3%) underestimated their weight loss. There was a significant higher %EWL 12 months after RYGB surgery for patients who overestimated their weight loss compared to those who estimated their weight loss correctly (p = 0.001). After 24 months and for other types of procedures, no statistically significant differences were found between the three groups. Despite instructions on how to calculate target weight, the majority of patients overestimated their weight loss. Actual %EWL 12 months after RYGB surgery might be influenced by setting a low target weight.

[EN] Modified control charts are used to monitor and control manufacturing processes which are considered to be six-sigma processes. The use of these charts is based on the idea that the cost of identifying and correcting special causes is much higher than the cost of off-target products. Therefore, the process mean is essentially acceptable as long as it is anywhere within the specification limits. These concepts are applied to the packaging process in multihead weighers. The weight of the packed product, seen as the quality characteristic to be monitored, must be as close to a specified target weight as possible and comply with applicable regulations. The packaging process was previously optimized and improved using a packaging strategy, which was evaluated through a proposed packing algorithm. In this way, a set of numerical experiments were conducted to examine the solutions generated, which were subsequently monitored., [ES] Los gráficos de control modificados se utilizan para el seguimiento y control de procesos de fabricación que son considerados como procesos seis-sigma. El uso de estos gráficos se basa en la idea de que el costo de identificar y corregir causas especiales de variación es mucho más alto que el costo de productos alejados de su valor nominal. Por lo tanto, la media del proceso es esencialmente aceptable siempre que esté dentro de los límites de especificación. Estos conceptos han sido aplicados al proceso de envasado en pesadoras multicabezal. El peso del producto envasado, visto como la característica de calidad a ser monitoreada, debe ser lo más cercano posible a un peso objetivo y cumplir con la normativa. El proceso ha sido previamente optimizado y mejorado mediante una estrategia de envasado, la cual es evaluada a través de un algoritmo de envasado. De esta manera, un conjunto de experimentos numéricos fueron realizados para examinar las soluciones generadas, las cuales son posteriormente monitoreadas.

Objectives The influence of the amount and rate of weight loss on subsequently regaining weight and dropout from treatment in severely obese patients targeting 5% weight loss was investigated. Methods A total of 120 consecutive hospital patients with severe obesity (BMI: 42 ± 9 kg/m2) participated in an inpatient program targeting 5% weight loss that involved goal setting, charting weight four times daily, and diet and exercise. They were followed after discharge to assess subsequent regaining of weight and dropout. Results Mean weight loss was 4.9 ± 2.4% after a mean of 19 days in the hospital, and 43% of the patients achieved the target weight loss (>5%). Over the median 2-year follow-up period, greater than 5% in-hospital weight loss was associated with a significantly lower risk of regaining weight after adjustment for various factors (>5% to ≤7% loss: hazard ratio 0.30 [0.11-0.85] for regaining all of the lost weight and 0.32 [0.13-0.78] for regaining half of the lost weight). No significant relation between the amount or rate of weight loss and dropout from subsequent outpatient treatment was seen. Conclusions Successfully achieving the target weight loss in a comprehensive program predicts subsequent maintenance of lower weight without increasing the risk of dropout. Successful in-hospital weight loss might increase the motivation of obese patients.

SUMMARY Background The body composition monitor (BCM) provides an objective assessment of fluid status, which has been shown to improve outcomes in patients undergoing haemodialysis. The models used by the BCM were developed and validated using standard wrist-to-ankle bioimpedance measurements, made between electrodes on the hand and foot. However, in patients with inaccessible or amputated feet it is not possible to use standard electrode configurations. Objective To compare hydration measurements made with ‘hand-to-hand’ (H-H) and ‘hand-to-foot’ (H-F) electrode configurations in patients with accessible feet or no amputations. Methods One hundred and one consecutive patients referred for a BCM measurement were recruited to have H-H measurements at the same time as the usual H-F measurement using the same height and weight. Patients with obvious localised oedema were excluded. Results Compared with H-F, H-H measurements showed a bias of −0.1 L. For 61% of patients the difference between the readings was within 0.5 L; for 81% it was within 1.0 L. Conclusion The agreement between H-H and H-F measurements was close enough to encourage us to use H-H measurements in patients with inaccessible or amputated feet. Prior to amputation, height and weight are recorded. Target weight (TW) reductions are made gradually when close to normal hydration. Clinically, changes based on H-H measurements appear to be as appropriate as those using H-F. The desired hydration at TW can be established and then TW adjusted to maintain this hydration as the flesh weight fluctuates.

OBJECTIVE: To study the effectiveness of Domiciliary Treatment in severely malnourished children. METHOD: This is a prospective study conducted on 25 severely malnourished children, carried out in the Department of Pediatrics, Shyam Shah Medical College and Gandhi Memorial Hospital, Rewa (M.P), during the period of one year from July 2007 to June 2008. INTERVENTION: Treatment was carried out at home by parents under adequate supervision. They were educated about the nutrition need of the child and how to prepare energy and nutrient dense food. They were also educated to provide sensory stimulation, emotional support, and structured play therapy. Regular follow-up was done for 16 week. RESULTS: Domiciliary treatment of severe uncomplicated malnutrition appears to be satisfactory. Moderate weight gain was observed (Mean rate of weight gain 8.36+2.42gms/kg/day). 40% children could achieve their target weight for length. CONCLUSION: Domiciliary treatment with adequate supervision can be recommended for children with uncomplicated SAM.

Haemodialysis patients with little or no urine output usually experience periods of overhydration as they accumulate fluid between treatments through intake of salt and water. Many are also dehydrated when fluid is removed during dialysis. The time-averaged deviation from normal hydration will depend on the patient's fluid status after dialysis and his or her interdialytic fluid gains. Attempts to minimise the adverse effects of abnormal hydration begin by setting patients' ‘target’ weight to optimise their post-dialysis fluid status. However, the clinical indicators that are traditionally used to adjust target weight can be ambiguous or misleading. Body composition monitoring using multifrequency bioimpedance measurements can now provide an objective assessment of fluid status. The measurements are non-invasive and can be made in a few minutes before or after dialysis. If added to the complete clinical picture, this technology can improve outcomes and quality of life for patients.

Safety work of coal mine is complicated system engineering. Analyzing the safety condition of coal mines by using the theory of man-machine-environment system engineering can effectively prevent the disasters and accidents. Taking the man-machine-environment system as the foundation to establish safety assessment target system of coal mines and determine the system level structure and the safety assessment target weight of coal mines. Then the whole synthesis judgment of man-machine-environment three single factors of coal mines is done by the fuzzy comprehensive evaluation method separately, and get qualitative and quantitative evaluation results which is direct viewing, scientific, reasonable and reliable to know the overall safety condition of the system, has the practical application value.

Most hemodialysis (HD) patients are able to finish dialysis at or below the normally hydrated weight determined using the body composition monitor (BCM). However, a minority become symptomatic when they are still fluid overloaded based on BCM-measured overhydration (OH). Malnourished patients frequently fall into this group, suggesting that they may have OH that is inaccessible to ultrafiltration. To isolate any effect of malnutrition on BCM-measured OH from those relating to renal failure, OH measurements for 20 elderly subjects with normal renal function who were classified as malnourished were compared with an age-matched cohort with no known nutritional issues. Body composition monitor measurements were also made on five malnourished HD patients. Mean OH for malnourished subjects with normal renal function was not significantly different from an age-matched cohort without known nutritional deficiencies (1.3 and 1.1 L, respectively; p = 0.5). Post-dialysis OH for HD patients ranged from −0.1 to +4.5 L. A slightly elevated BCM-measured OH appears to be common in elderly subjects and may be explained by changes in the composition of adipose tissue. The effect of malnutrition could not be isolated from sarcopenia, but this study supports the need for caution when reducing target weight in vulnerable patients.

Hypervolemia is associated with increased mortality and morbidity in heart failure patients. While there are many methods to assess volume status, monitoring change in weight is valuable and easy to replicate. MaineHealth (MH) uses Target Weight (TW) to coordinate the care of heart failure (HF)

All children admitted to two nutritional rehabilitation centres (NRCs) during 2011-2012 in Madhya Pradesh, India.To determine 1) adherence to in-patient care and follow-up visits, 2) attainment and maintenance of target weight gain, and 3) association with the children's demographic characteristics.A retrospective record review. The 74-day programme included 14 days of in-patient care, with subsequent home-based care and four follow-up visits to the NRC at 15-day intervals. The first three visits were part of the treatment, while the fourth was for assessment of sustained weight gain.Of the 1027 children admitted, 900 (88%) completed in-patient care. Of these, 685 (76%) attended the first three follow-up visits, 482 (70%) of whom gained15% of their admission weight. Of these, 409 (85%) completed four visits, 314 (77%) of whom were able to sustain their weight gain. Those unable to gain15% weight by the third visit had a significantly lower proportion of sustained weight gain at the fourth visit. Children aged ⩾6 months had significantly higher odds (OR 4.5, 95%CI 3.1-6.2, P0.05) of completing in-patient care.In-patient care combined with community-based follow-up was effective in adherence to follow-up visits; however, there is still room for improvement in attaining and sustaining the target weight.Tous les enfants admis dans deux Centres de Réhabilitation Nutritionnelle (NRC) en 2011–2012 au Madhya Pradesh, Inde.Déterminer 1) l’adhésion aux soins hospitaliers et aux visites de suivi, 2) la réalisation et le maintien du gain de poids visé et 3) l’association avec les caractéristiques démographiques des enfants.Il s’agit d’une revue rétrospective des dossiers. Le programme de 74 jours a comporté 14 jours de soins hospitaliers et ultérieurement des soins au domicile accompagnés de quatre visites au NRC à 15 jours d’intervalle. Les trois premières visites faisaient partie du traitement, alors que la quatrième visait à évaluer la persistance du gain de poids.Sur 1027 enfants admis, 900 (88%) ont achevé les soins intra-hospitaliers. Parmi ceux-ci, 685 (76%) se sont présentés aux trois premières visites de suivi, dont 482 (70%) ont gagné15% du poids d’admission. Parmi ceux-ci, 409 (85%) ont achevé les quatre visites et chez 314 d’entre eux (77%), on a observé la persistance du gain de poids. Chez ceux incapables de gagner15% de poids lors de la troisième visite, la proportion maintenant un gain de poids lors de la quatrième visite est significativement plus faible. L’odds d’achèvement des soins hospitaliers est significativement plus élevé (OR 4,5 ;Des soins hospitaliers combinés avec un suivi dans la collectivité s’avèrent efficaces pour l’adhésion aux visites de suivi ; l’objectif qui reste à améliorer est l’obtention du poids-cible et son maintien.Todos los niños que ingresaron a dos Centros de Rehabilitación Nutricional del 2011 al 2012 en Madhya Pradesh, en la India.Determinar: 1) la aceptación de la atención en el centro y el cumplimiento de las citas de seguimiento; 2) el logro de la ganancia de peso prevista y su mantenimiento; y 3) la asociación de la evolución con las características demográficas de los niños.Fue este un estudio retrospectivo de análisis de las historias clínicas. El programa de 74 días comportaba 14 días de atención con permanencia en el centro, continuados con un cuidado en el hogar y cuatro consultas de seguimiento en el Centro de Rehabilitación Nutricional con intervalos de 15 días. Las tres primeras citas formaban parte del tratamiento y la cuarta consistía en una evaluación del mantenimiento de la ganancia de peso.De 1027 niños que ingresaron al centro, 900 completaron el tratamiento institucional (88%). De estos, 685 acudieron a las tres primeras consultas de seguimiento (76%) y 482 de ellos (70%) habían ganado más del 15% del peso que presentaban en el momento del ingreso. De estos, 409 niños completaron las cuatro citas de seguimiento (85%) y de ellos, 314 conservaron su ganancia de peso (77%). De los niños que no habían podido ganar más de 15% del peso inicial en la tercera consulta, una proporción significativamente más baja mantuvo su ganancia de peso en el cuarto control. Fue mucho más probable que los niños de 6 meses de edad y mayores completaran el tratamiento institucional (OR 4,5;Un tratamiento que asocia una etapa con el niño interno en una institución y un seguimiento en la comunidad demostró su eficacia con respecto al cumplimiento de las citas de seguimiento; el objetivo de la iniciativa sigue siendo mejorar el logro del peso previsto y su mantenimiento.

Postnatal nutrition has immediate and long-lasting effects on beef heifer reproductive efficiency, longevity, and productivity. This article reviews the effects of nutrients and nutritional management on reproduction in developing heifers. In addition, the current debate on the preferred target weight for heifers at breeding is discussed.

This paper puts forward environmental bearing capacity relative surplus rate and calculation model based on the theory of environmental bearing capacity, Through collecting and estimating the predictive value and ideal value of each index in different development stages and schemes, using analytic hierarchy process to established the target weight, environmental bearing capacity relative surplus rate of the rule layer and index level in Qian’an Mining area are calculated through the gradual convergence principle, accordingly the optimal solution to improve the environmental bearing capacity of Qian’an mining area is determined ,which provides scientific basis for promoting to realize the sustainable development of Qian’an Mining area.

Obesity is now recognised as the most important medical disease in pets worldwide. All current strategies for weight management involve dietary energy restriction with a purpose-formulated diet. Whilst current weight management regimes can be successful, outcomes are often disappointing with the rate of weight loss progressively slowing down as time goes on. Success is most challenging for the most obese dogs and cats that are more likely to discontinue the programme before reaching target weight. To improve outcomes, clinicians must focus carefully on better tailoring programmes, paying particular to setting an appropriate target weight so as to maximise the benefits for the individual. In this opinionated review, the author will discuss findings from recent clinical research studies examining weight management in obese dogs and cats. A strategy for tailoring weight management targets will then be discussed, illustrated with case examples. Electronic supplementary material The online version of this article (doi:10.1186/s13028-016-0238-z) contains supplementary material, which is available to authorized users.

A preoperative weight loss of 8 % is a prerequisite to undergo bariatric surgery (BS) in Denmark. The aim of the present study was to evaluate the efficacy of a 7- or an 11-week low-energy diet (LCD) for achieving preoperative target weight before BS. A total of thirty obese patients (BMI 46·0 (sd 4·4) kg/m2) followed an LCD (Cambridge Weight Plan®, 4184 kJ/d (1000 kcal/d)) for 7 or 11 weeks as preparation for BS. Anthropometric measurements including body composition (dual-energy X-ray absorptiometry), blood parameters and blood pressure were assessed at weeks 0, 7 and 11. At week 7, the majority of patients (77 %) had reached their target weight, and this was achieved after 5·4 (sem 0·3) weeks. Mean weight loss was 9·3 (sem 0·5) % (P sem 2·3) and 7·3 (sem 1·8) mmHg, respectively, all P sem 1·8) % decrease in fasting glucose (P sem 6·4) % decrease in fasting insulin (P sem 2·2) % decrease in LDL (P sem 4·7) % decrease in TAG (P P

Protein energy malnutrition (PEM) occurs when energy and protein intake do not meet requirements. It has a functional and structural impact and increases both morbidity and mortality of a given disease. The Nutrition Committee of the French Pediatric Society recommends weighing and measuring any child when hospitalized or seen in consultation. The body mass index (BMI) must be calculated and analyzed according to references any time growth kinetics cannot be analyzed. Any child with a BMI below the third centile or -2 standard deviations for age and sex needs to be examined looking for clinical signs of malnutrition and signs orienting toward an etiology and requires having his BMI and height dynamics plotted on a chart. PEM warrants drawing up a nutritional strategy along with the overall care plan. A target weight needs to be determined as well as the quantitative and qualitative nutritional care including its implementation. This plan must be evaluated afterwards in order to adapt the nutritional therapy.

ObjectiveIn malnourished populations, the weight-for-height Z-score (WHZ) distribution is shifted to the left. The aim of nutrition interventions should be to restore a normal WHZ distribution for the whole population. The present paper examines the WHZ change needed by each individual to achieve this objective.DesignWe developed a mathematical model of required individual change in WHZ as a function of characteristics of the initial population to restore a normal distribution. This model was then tested by simulating WHZ change needed to restore a normal WHZ distribution in a test population.SettingA rural area of Democratic Republic of the Congo with a high prevalence of undernutrition.SubjectsChildren under 5 years of age.ResultsTo restore a normal distribution for the whole population, the WHZ of all children should be shifted. The desired WHZ change of each individual should be higher when the individual's initial WHZ is low, when the mean WHZ of the whole population is low and, for the most wasted individual, when the variance of WHZ and WHZ change in the population are high. Using the suggested model in a simulation on the test population resulted in a WHZ distribution close to the growth standard.ConclusionsTo restore a normal WHZ distribution in wasted populations, nutritional programmes should cover the whole population with a higher weight gain in areas where mean WHZ is low.

The objective of this study is to investigate the nutritional status of patients with cleft lip and/or palate when compared to non-cleft lip or palate patients. A retrospective analysis was carried out of all patients aged less than 1 year who were operated on in the Comprehensive Rehabilitation Services in Uganda hospital since opening in April 2009 to November 2010. The data was divided into three groups: cleft lip patients; cleft lip and palate patients and non-cleft patients. The WHO anthropometric calculator was used to calculate weight-for-age Z scores on each patient for the initial outpatient appointment and the operation. The demographic data and Z scores were compared using independent T tests. Three hundred and twenty-one patients were identified, 131 patients had cleft lip alone, 112 patients had cleft lip and palate and 78 patients had no cleft. The cleft lip and palate group had significantly lower Z scores for both the outpatient appointment and operation (i.e. were more malnourished) than either the cleft lip group or the non-cleft group. Malnutrition is a well-documented problem associated with cleft lip and palate. Our research confirms this malnutrition but also highlights the severity of the malnutrition. The patients with cleft lip and palate are unable to feed adequately and therefore need intervention. We operate on these patients once they reach a target weight of 3 kg and repair both lip and palate in one operation to enable patients to feed and improve their nutritional status.

Evaluation of urban public transportation system plays an important role in developing urban public transportation system. When evaluating urban public transportation system, Support vector machine method can overcome the subjective problem of setting target weight, which is difficult to be solved by fuzzy comprehensive evaluation. Evaluation index system can be established according to the procurability and the effectiveness of the index. By studying several bus systems, the effectiveness of support vector machine evaluation could be proved, which shows that support vector machine model is applicable for the evaluation of urban public transportation system.

Adequate nutrition during the periconceptional and prenatal periods is important for healthy pregnancy outcomes. By enhancing maternal nutritional status, health care providers can help pregnant women lower their risk of certain pregnancy complications and decrease their children's risk of adverse birth outcomes and later chronic disease. Use of evidence-based tools and recommendations will assist in the assessment of pregnant women's diets and streamline the counseling session to optimize their nutritional status. This article contains a review of the literature related to nutrition intervention studies during pregnancy that were designed to improve habits or achieve target weight gains and nutrition recommendations specific for the pregnancy state, as well as tools/resources for the health care provider for implementation of these recommendations into their busy practices.

According to the size of the projector function to evaluate the merits of the program, Projection Pursuit method is applied to real estate investment decision-making by using the real coding based on Accelerating Genetic Algorithm (RAGA) to optimize the Projection Pursuit Classification (PPC) process and a wide range of indicators value was projected linearly. The results are reasonable and verified with an example. At the same time, the subjective of the target weight can be avoided. It provides decision-makers with comprehensive information on all the indicators of new ideas and new methods

Correctly identifying malnourished or at-risk children is the critical first step towards appropriate nutritional interventions. To improve weight-for-height assessment and classification of nutritional status, we present a novel, low-cost, weight-for-height slide chart. We also describe a target weight system for monitoring children's progress towards nutritional recovery.

OBJECTIVE We attempted to study the impact of the ultrafiltration (UF) rate on heart rate variability (HRV) parameters by maintaining sufficient session time, Kt/V, and UF. METHODS The 16 Chinese hemodialysis (HD) patients in the study were divided into 3 subgroups according to UF rate: 5 patients in subgroup A with a UF rate ≤0.5 L/h, 7 patients in subgroup B with a UF rate >0.5 L/h and ≤1 L/h, and 4 patients in subgroup C with a UF rate >1 L/h. The research included 3 phases. In the first phase, baseline Holter and blood pressure recording was performed. In the second phase, the patients were admitted for HD with continuous Holter and blood pressure recording. The third phase was after HD with continuous Holter and blood pressure recording. The tape recordings were analyzed by an independent, blinded investigator. RESULTS In our study, systolic blood pressure, diastolic blood pressure, and mean arterial pressure remained unchanged in the 3 subgroups before, during, and after the HD process. In HRV, several parameters began to show changes at the start of HD. PNN50 was reduced significantly (p 0.05). The SDNN and low-frequency/high-frequency ratio increased significantly (p 1 L/h, especially at the 3-hour point during HD. To prevent HD-related augmented sympathetic activity, prolonged HD sessions with low UF rates (