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The accuracy of the ACSM cycle ergometry equation.

The purpose of this study was to determine the accuracy of the American College of Sports Medicine's equation for estimating the oxygen cost of exercise performed on a cycle ergometer. Sixty healthy males, ages 19-39 yr old, performed a five stage (30, 60, 90, 120, and 150 W) submaximal cycle ergometer test while their oxygen uptake was measured. Results indicated the standard error of estimate for the predicted oxygen values ranged from 0.11 to 0.22 l.min-1, with correlations between the actual and predicted values ranging from r = 0.22 to r = 0.50. Total errors ranged from 0.23 to 0.31 l.min-1. The actual oxygen cost was underestimated from 0.16 to 0.29 l.min-1 (P less than 0.05) by the equation at each workload. A revised equation was developed based upon the actual VO2-power relationship. The resulting slope was lower and the intercept higher when compared with the current ACSM equation. The slope and intercept of the revised equation are more consistent with values published in the literature. This equation appears as: VO2 (ml.min-1) = kgm.min-1 x 1.9 ml.min-1) + ((3.5 ml.kg-1.min-1 x kg body weight) + 260 ml.min-1). Predicted values from the revised equation were more accurate as reflected by slightly higher correlations, lower total errors, and lower mean differences from actual VO2 measurements than those from the current equation.

Adult↗

Comparison of fixation disparity curve parameters obtained with the Wesson and Saladin fixation disparity cards.

PURPOSE: This study compared fixation curve parameters with two commercially available fixation disparity cards, one that has been available for several years, the Wesson card, and a new one, the Saladin card. METHODS: Fixation disparity curves were measured on 50 subjects with the Wesson fixation disparity card and the Saladin fixation disparity card. RESULTS: The x intercepts were on average more in the base-in direction with the Wesson card than with the Saladin card. The y intercepts were shifted in the exo direction with the Wesson card compared with the Saladin card. The slope with the Wesson card was steeper than the slope obtained with the Saladin card. The distribution of curve types was also different with the two different instruments. CONCLUSION: Fixation disparity curves measured with these two instruments are different, and separate norms should be used for each fixation disparity measurement method.

Adult↗

Evaluation of alkaline phosphatase activity assay for the Reflotron system after substitution of the comparison method.

The alkaline phosphatase (ALP) assay for the Reflotron system is a dry chemistry method applicable for decentralized testing. The ALP diethanolamine method has been applied as the comparison method, which is now replaced by the more widely distributed aminomethylpropanol method. The new comparison method measures ALP activities by approximately 59% lower compared to the former method. The analytical performance of the newly calibrated ALP Reflotron method was evaluated at three clinical laboratories. The study of the imprecision showed coefficients of variation ranging from 1.6-3.0% (intraassay) and 2.7-5.7% (interassay). Blood samples from liver disease patients (n=192), adolescents (n=40) and pregnant women in the third trimester (n=34) were collected in order to evaluate the impact of different ALP isoenzymes. The comparison between ALP Reflotron and the new comparison method revealed an excellent agreement in Passing-Bablok regression analysis (slope: 1.004; intercept: 0.14 U/l; median difference: 0.5%) for samples with prevailing liver ALP. However, in plasma samples with predominantly elevated bone or placental isoenzyme the Reflotron method measured lower or higher activities, respectively (slope: 0.912, 1.394; intercept: -4.16, -17.26 U/l; median difference: -10.58, 26.33%). The ALP Reflotron assay is an adequate method for decentralized testing. It shows a good precision and agreement with the comparison method, although the systematic differences for placental and bone ALP isoenzymes have to be considered.

Adolescent↗

Experimental abatement data of underflow baffles for removal of floatables in the CSOs of the Greater Montréal (Canada) area.

Underflow baffles have gained in popularity over the years as a viable mean to intercept floatables in Combined Sewer Overflows (CSOs). This choice was mainly justified by the extremely low capital cost (CAPEX) and operational cost (OPEX) of this solution, although the efficiency of underflow baffles has never been clearly proven. The only similar application to underflow baffles are scum boards in grit chambers and clarifier. However, the flow conditions at CSOs vary considerably from those in grit chambers and clarifier. For this reason, review of the behavior of floatables in a rapid flow is paramount. Only then can comprehensive design criteria for underflow baffles and overflow chambers be suggested. Pilot scale tests, performed in a 17 metres long basin at various flowrates, had already shown that a critical horizontal velocity for floatables (Vcr) may develop in the overflow chambers. In this follow up study, the fate of intercepted floatables was investigated. It appears from this latest data that permanent capture of floatables decreases rapidly with an increase in the horizontal velocity of the flow, no matter what the baffle depth. Baffle depth increases capture at lower velocities (0.17 m/s) but become irrelevant at higher velocities (0.61 m/s). This data suggests that capture efficiency of existing underflow baffles in overflow chambers can be, at best, very low whenever the horizontal velocity increases above 0.30 m/s or 1 ft/s.

Canada↗

Kinetics and regulation of hepatoma mitochondrial NAD(P) malic enzyme.

Kinetic studies of Morris 7777 hepatoma mitochondrial NAD(P) malic enzyme were consistent with an ordered mechanism where NAD adds to the enzyme before malate and dissociation of NADH from the enzyme is rate-limiting. In addition to its active site, malate apparently also associates with a lower affinity with an activator site. The activator fumarate competes with malate at the activator site and facilitates dissociation of NADH from the enzyme. The ratio of NAD(P) malic enzyme to malate dehydrogenase activity in the hepatoma mitochondrial extract was found to be too low, even in the presence of known inhibitors of malate dehydrogenase, to account for the known ability of NAD(P) malic enzyme to intercept exogenous malate from malate dehydrogenase in intact tumor mitochondria (Moreadith, R.W., and Lehninger, A.L. (1984) J. Biol. Chem. 259, 6215-6221). However, NAD(P) malic enzyme may be able to intercept exogenous malate because according to the present results, it can associate with the pyruvate dehydrogenase complex, which could localize NAD(P) malic enzyme in the vicinity of the inner mitochondrial membrane. The activity levels of some key metabolic enzymes were found to be different in Morris 7777 mitochondria than in liver or mitochondria of other rapidly dividing tumors. These results are discussed in terms of differences among tumors in their ability to utilize malate, glutamate, and citrate as respiratory fuels.

Animals↗

Silent reading rate and memory span.

This paper reports two experiments concerned with the form of the linear function relating memory span to pronunciation rate. Experiment 1 asked whether the intercept of the equation is attributable to an interaction between modality, word-length, and serial position. The results lead us to reject this possibility. Experiment 2 examined the shape of the span function for visual presentation of lists read aloud or silently. The results show that the intercept of the span function disappears for silent presentation but not for aloud presentation. The results are discussed in terms of a balance between two opposing effects of word-length.

Acoustic Stimulation↗

A survey of undergraduate orthodontic training and orthodontic practices by general dental practitioners.

PURPOSE OF THE STUDY: To assess satisfaction with undergraduate orthodontic training, the variety of treatments undertaken in general practice, practitioners' perceived competence in orthodontics and the level of interest in continuing education in orthodontics. DESIGN: Cross-sectional questionnaire-based study. MATERIALS AND METHODS: A questionnaire was mailed to 520 general practitioners in Dublin, Kildare and Wicklow as listed in Irish Dental Council Register of Dentists 2003. RESULTS: Forty-six percent of dentists responded. More than half (54 per cent) of the respondents were satisfied with both academic and clinical aspects of undergraduate training. Twenty-nine percent regularly perform orthodontic treatment. Only 60 percent feel comfortable treating orthodontic emergencies. Over 70 percent have either already attended or aspire to attend further training in orthodontic diagnosis and interceptive orthodontics. CONCLUSIONS: Our study indicates that in the greater Dublin area, graduates (those qualified less than 10 years) are increasingly satisfied with undergraduate teaching. Orthodontic treatment is performed regularly in general dental practice with interceptive procedures most often carried out. While ability to deal with orthodontic emergencies is not universal, practitioners do appear confident to perform a variety of orthodontic procedures. Interest in continuing education in orthodontics is very high. Our study indicates that participation in continuing education in orthodontics appears to translate into greater provision of orthodontic care in general practice.

Clinical Competence↗

[Effects of artificial seabuckthorn forest on soil and water conservation in loess hilly region].

Seabuckthorn is regarded as a main eco-economical tree species, and plays an increasing important role in eco-environmental construction in Northwest, Northeast and North China. Our study on artificial seabuckthorn forest in loess hilly region showed that the average rainfall interception rate of 7-10 ages seabuckthorn canopy was 8.5%, and the litter layer of 5-10 ages seabuckthorn forest could intercept 0.89 mm rainfall. Seabuckthorn forest could improve soil infiltration and anti-strike ability through improving soil physical and chemical properties, and the numbers of its hair roots and the depth of its litter layer were the main indices of soil anti-strike ability. The effects of seabuckthorn forest on soil and water conservation increased with its increasing age. In 2-3 ages stage, the effects were weak, and the runoff and sediment were mainly affected by the characters of rainfall. In 4-5 ages stage when the forest became maturing, the annual runoff depth and annual erosion modulus were 1.8-3.2 mm and 24.64 t x km(-2), respectively. In 6-12 ages stage when the forest matured, the runoff and sediment on seabuckthorn woodland changed slowly, the annual runoff depth and annual erosion modulus being 0.3 -3.4 mm and 0-6.75 t x km(-2), respectively, and the characters of rainfall had much less effect on them. In the stage from young (2-5 ages) to mature forest, the sediment charge in runoff changed sharply, ranged from 77. 31 kg x m(-3) to 9.12 kg x m(-3), but in 6-12 ages stage, the sediment content in runoff changed very slowly, and the range was 0-5.09 kg x m(-3).

Conservation of Natural Resources↗

Influence of reagent formulation on mRNA quantification by RT-PCR using imported external standard curves.

Use of an imported external standard curve is common in real-time quantitative RT-PCR. Two practical strategies for long-term experiments include importing a grand mean standard curve to all accumulated runs or using daily imported standard curves, fixing the slope at the beginning of the experiment and calibrating successive runs with curves generated from this imported slope, adding a single standard that registers the variation in the y-intercept. This study determines the influence that a change in reagent lots has on these two calibration approaches when determining mRNA copy numbers of the ornithine decarboxylase and porphobilinogen deaminase genes. Two sets of determinations were run with the use of lot A and lot B. A marked decrease in the crossing points (Cp) in the standards for both genes at all concentration levels was observed with the change in lots. A grand mean standard curve was generated for each gene and each set and comparisons between the sets were performed. Statistically significant differences were found with respect to the y-intercept but not the slope, suggesting that the change of reagent lot affected the detection sensitivity but not the efficiency of the reaction. The excellent correlation coefficients obtained for these curves for each gene were not achieved when overall data from both sets were combined to generate an overall grand mean standard curve. We conclude that when faced with a change of RT-PCR reagent lot that will affect the detection sensitivity of the method, samples should be calculated with either the daily imported standard curves or with the respective grand mean standard curve for each lot.

Base Sequence↗

[Ultrasound screening for hip dysplasia in newborns and treatment with Frejka pillow].

BACKGROUND: The prevailing strategy concerning ultrasound screening for DDH in newborns in Norway does not intercept all who should be treated. In recent years typical rates for hospital treatment of late hip dislocations in newborn have been 15-20 cases. By universal ultrasound examination, 10-20 % of the newborns present with "physiological immature" hips. By this we mean hips with subnormal ultrasound values that will normalise in the course of the neonatal period. An agreed basis of defined and standardised criteria in order to diagnose and treat physiological immature hips is required. We hope tat this study will contribute to the final solution to these questions. MATERIAL AND METHODS: Over the period 1 February 1998 through 2002 we had 2466 alive newborns at our hospital. 26 were directly transferred to another hospital, 130 were left out because of limited skills or inadequate training in ultrasound among temporary staff. The hips have been graduated morphologically in accordance with Graf's alpha angle. All newborns have been investigated by ultrasound and clinical examination with Ortolani/Barlow test 1-3 day after birth. Those with diagnosed dysplasia (alpha < 50 masculine) and those with positive clinic and physiological immature hip were immediately treated with Frejka pillow. Those with negative clinic and physiological immature hip were revaluated after 4 weeks by ultrasound, and those still immature were given Frejka pillow. Duration of pillow treatment was 4 months, followed by further clinically and radiological surveillance. All infants given the pillow treatment were clinically examined 2-3 months after they were able to walk without support, and again 1-5 years later radiologically. RESULTS: Of the newborn, 31 (1.3%) had a positive Ortolani/Barlow test. Among them, 7 had dysplasia, 20 immature hip; 4 were normal. Among the 2275 infants with normal clinic, 9 had dysplasia and 232 (10.9%) had at least one physiological immature hip. After 4 weeks, 26 still had immature hip by ultrasound evaluation. A total of 62 infants (2.7%) were treated with Frejka pillow. At the "walk alone" control and the radiological control 1-5 years later, there were no pathological findings, specially no sign of aseptic necrosis. In the total material we had 2 girls with late subluxations, detected at the age of 8 and 10 months. Both had normal clinic with an ultrasound immature hip at birth. They should have been followed up, but were missed, for uncertain reasons. Both attained normal hips after treatment. CONCLUSION: Our study of universal ultrasound screening for DDH of the hips in newborns shows that 1 % of the infants born with normal hips clinically still have physiological immature hips at the age of 4 weeks. Taking those into account as potentially dysplastic, it gives an overall treatment rate of 2.7%. Today, the only possible way to intercept those physiological immature hips that will not normalise is by universal ultrasound examination. For these children, early treatment with Frejka pillow is effective, without any risk of iatrogenic injury.

Cohort Studies↗

[A comparative study of the development of drug differentiation between mexidol and phenazepam].

Interceptive stimulus properties of mexidol (50 and 100 mg/kg, i.p.) and phenazepam (2 mg/kg, i.p.) were compared using the standard operant model of liquid-reinforced drug discrimination (DD) procedure in male albino rats. Successful DD development has been shown in 100% of phenazepam-pretreated rats, while only 10% of mexidol-treated animals demonstrated DD. In the case of a high stimulus control, both mexidol and phenazepam DD manifestations showed high reproducibility (not less than 80% adequate reactions) and stability. The results suggest that mexidol, while possessing interceptive stimulus properties, belongs to the group of moderately discriminated psychotropic drugs.

Animals↗

[Evapotranspiration of natural Quercus litaotungensis and Tilia paucicostata secondary stands in Liupan Mountains of Ningxia].

With heat dissipation probe technique and combined with microlysimeter and hydrological methods, this paper studied the evapotranspiration of secondary Quercus liaotungensis and Tilia paucicostata stands, and its relationship to forest structure from August to September 2004. The results indicated that the stem sap flux density (SFD) of Quercus liaotungensis and Tilia paucicostata changed regularly from day to night in later growth season. In relatively still period (nighttime), the SFD kept low values continuously, usually below 0.05 microl x cm(-2). min(-1), while in active period (daytime), it increased quickly, usually below 0.25 microl x cm(-2) x min(-1). The daily transpiration of whole-tree was estimated based on the calculation of daily cumulative SFD, which showed that there existed a significant difference between two tree species. The daily transpiration of Quercus liaotungensis reached 5.31 and 2.48 L x d(-1) in sunny- and cloudy-days, 2.35 and 3.75 folds as that of Tilia paucicostata, respectively. There was no significant difference in daily leaf transpiration rate between these two shrub species. During measurement periods, the average daily stand evapotranspiration was 1.45 mm x d(-1), including transpiration (0.72 mm x d(-1)), soil evaporation (0.19 mm x d(-1)), and canopy interception (0.54 mm x d(-1)), which accounted for 49.6%, 13.3% and 37.1% of the total evapotranspiration, respectively. The results showed that the difference of whole-tree transpiration between tree species contributed significantly to the difference of tree canopy transpiration, while the difference of shrub canopy transpiration was on account of the leaf amount in the canopy. The effects of vertical layers in the stand on total stand evapotranspiration also differed, with a percentage of 65.8%, 20.9% and 13.3% for tree canopy, shrub canopy and floor, respectively, which meant that the transpiration and interception of tree canopy contributed most to the total evpotranspiration, followed by shrub transpiration, soil evaporation, and grass transpiration.

China↗

[Ecological mechanisms of the effects of vegetation restoration on the controls of non-point source pollution on barren tableland in Dianchi Watershed of China].

Surface runoff, soil erosion and the leaching of the different forms of nitrogen and phosphorus were observed and the hygroscopic volume of branch and leaves of all plant species and soil penetration were determined to understand the ecological mechanisms of the effects of vegetation restoration on the controls of non-point source pollution on barren tableland in Dianchi Watershed of China. Results indicated that there were significantly relationships between surface runoff volume and the output of non-point pollution matters. The different manmade vegetation systems, consisted respectively of A. nepalensis, A. mearnsii, R. pseudoacacia and V. zizanioides clump, had shown the different potentials to control the leaching of TN, TP, soluble TP, soluble TN. Strong hygroscopic functions of leaves and branch was able to promote the interception of rainfalls and give rise to the less of surface runoff. The leaves, that were small, with low water content, no leathery and have rough face and epidermal wools, were able to got the highly ratio of the hygroscopic volume to above ground fresh standing crops and strengthened the interception of forest canopy. Preparing soil, growth of root system of plant and the natural recovery of vegetation at the gap of trees enhanced surface runoff penetration, as lightened the surface runoff leaching the different forms of nitrogen, phosphorus of soil on the stands. The leaching of different forms of nitrogen and phosphorus went down with the controls of surface runoff in different stands as well.

China↗

High content of MYHC II in vastus lateralis is accompanied by higher VO2/power output ratio during moderate intensity cycling performed both at low and at high pedalling rates.

The aim of this study was to examine the relationship between the content of various types of myosin heavy chain isoforms (MyHC) in the vastus lateralis muscle and pulmonary oxygen uptake during moderate power output incremental exercise, performed at low and at high pedalling rates. Twenty one male subjects (mean +/- SD) aged 24.1 +/- 2.8 years; body mass 72.9 +/- 7.2 kg; height 179.1 +/- 4.8 cm; BMI 22.69 +/- 1.89 kg.m(-2); VO2max 50.6 +/- 5.3 ml.kg.min(-1), participated in this study. On separate days, they performed two incremental exercise tests at 60 rev.min(-1) and at 120 rev.min(-1), until exhaustion. Gas exchange variables were measured continuously breath by breath. Blood samples were taken for measurements of plasma lactate concentration prior to the exercise test and at the end of each step of the incremental exercise. Muscle biopsies were taken from the vastus lateralis muscle, using Bergström needle, and they were analysed for the content of MyHC I and MyHC II using SDS--PAGE and two groups (n=7, each) were selected: group H with the highest content of MyHC II (60.7 % +/- 10.5 %) and group L with the lowest content of MyHC II (27.6 % +/- 6.1 %). We have found that during incremental exercise at the power output between 30-120 W, performed at 60 rev.min(-1), oxygen uptake in the group H was significantly greater than in the group L (ANCOVA, p=0.003, upward shift of the intercept in VO2/power output relationship). During cycling at the same power output but at 120 rev.min(-1), the oxygen uptake was also higher in the group H, when compared to the group L (i.e. upward shift of the intercept in VO2/power output relationship, ANCOVA, p=0.002). Moreover, the increase in pedalling rate from 60 to 120 rev.min(-1) was accompanied by a significantly higher increase of oxygen cost of cycling and by a significantly higher plasma lactate concentration in subjects from group H. We concluded that the muscle mechanical efficiency, expressed by the VO2/PO ratio, during cycling in the range of power outputs 30-120 W, performed at 60 as well as 120 rev.min(-1), is significantly lower in the individuals with the highest content of MyHC II, when compared to the individuals with the lowest content of MyHC II in the vastus lateralis.

Adult↗

Attributable risk estimation from case-control data via logistic regression.

By fitting an unconditional logistic regression model to unmatched case-control data, an estimate of the joint population attributable risk for the factor included is obtained. This estimate and its asymptotic variance can easily be computed from the intercept parameter and its asymptotic variance. A generalization to the analysis of stratified data with large strata enables the calculation of stratum-specific attributable risks and their variances via stratum-specific intercept parameters. If sampling of cases is independent of strata, an estimate of the summary attributable risk and its asymptotic variance may be obtained as a weighted sum of the stratum-specific attributable risks.

Biometry↗

Activity patterns in a panel of outdoor workers exposed to oxidant pollution.

We investigated summer activity patterns in a panel of volunteers drawn from a population segment with potentially high exposure to ambient oxidant pollution. The subjects were 15 men and 5 women aged 19-50, all of whom worked outdoors in the Los Angeles area at least 10 hr per week. The general approach was to (i) calibrate the relationship between ventilation rate (VR) and heart rate (HR) for each subject in controlled exercise; (ii) have subjects monitor their own normal activities with diaries and electronic HR recorders; (iii) estimate VR from HR recordings; and (iv) relate VR with diary descriptions of activities. Calibration data were fit to the equation log (VR) = (intercept) + (slope x HR), intercept and slope being determined separately for each individual to provide a specific equation to predict her/his VR from measured HR. Individuals' correlation coefficients relating log (VR) with HR ranged from 0.83 to 0.95. Subjects monitored themselves for three 24-hr periods during one week, including their most active work day and their most active non-work day. They wore Heart Watch(R) athletic training instruments which recorded HR once per minute; and recorded each change in their activity, location, or breathing rate in diaries. Breathing rates were classified as sleep, slow (like slow or normal walking), medium (like fast walking), or fast (like running). Diaries showed that sleep occupied about 33% of subject's time, slow activity 59%, medium 7%, and fast 1%. Fast activity was reported only at leisure, never at work. For the group, arithmetic means and standard deviations of predicted VR were 7 +/- 3 L/min for sleep, 12 +/- 7 for slow activity, 14 +/- 8 for medium, and 44 +/- 36 for fast. For the group and for most individuals, distributions of predicted VR within a given activity level (breathing rate) were approximately lognormal, with many values in a narrow range below the arithmetic mean and fewer values in a broader range above it. In the most active individuals, predicted VR exceeded 100 L/min for a total of 5 to 30 min during the three days. These data should prove useful in estimating outdoor workers' inhaled doses of ambient pollutants at existing or projected levels of air quality. Activity diary records are of significant value in pollutant dose estimation, but concurrent heart rate recording improves the estimates substantially.

Adult↗

[New analysis algorithm for regional cerebral blood flow and partition coefficient with dynamic SPECT and N-isopropyl-p-[123I]iodoamphetamine: graphical plot method].

We developed a new analysis algorithm based on multiple-time graphical plot to estimate the regional cerebral blood flow and partition coefficient using dynamic SPECT and N-isopropyl-p-[123I]iodoamphetamine (123I-IMP). By assuming the 2-compartment model of the kinetic for 123I-IMP, we derived a linear relationship between the ratio of the tissue activity concentration at the times to the time-integral arterial concentration at the respective times (formula; see text) and the ratio of the time-integral tissue concentration to the time-integral arterial concentration (formula; see text), and demonstrated that the Y-intercept and X-intercept of the plot line represent the regional cerebral blood flow (K1) and partition coefficient (lambda), respectively. The slope of the line represents a clearance constant k2. The present method was applied to data on four normal subjects measured by dynamic SPECT. Values of the K1 and lambda for the gray matter were obtained 40.8 +/- 6.5 ml/100 g/min and 28.8 +/- 5.3 ml/g, respectively, and the corresponding values for the white matter were 29.1 +/- 4.7 ml/100 g/min and 28.1 +/- 7.1 ml/g. The new method enabled a rapid estimation of both K1 and lambda.

Algorithms↗

Evidence that a single gene with gender- and age-dependent effects influences systolic blood pressure determination in a population-based sample.

A biometrical study was carried out to evaluate the role of genetic variation in determining interindividual differences in systolic blood pressure (SBP) in the population at large. SBP was measured in 1,266 Caucasian individuals in 278 pedigrees ascertained through children enrolled in the Rochester, MN, school system. The sample included 646 males and 620 females 550 years of age and not taking antihypertensive medication or oral contraceptives. Complex segregation analysis was first applied to these data by using a regression model for age, in which the intercept was gender and ousiotype specific but in which the slope was only gender specific. When the slope was independent of ousiotype, neither variation at a single gene combined with polygenic effects (mixed genetic model) nor variation in a single environmental factor combined with polygenetic effects (mixed environmental model) explained the distribution of SBP in this sample. However, when the regression model for age allowed both the intercept and slope to be gender and ousiotype specific, the mixed environmental model was rejected whereas the mixed genetic model was not. These results suggest that variability in SBP may be influenced by major effects of allelic variation at a single gene that are both gender and age dependent. This study (1) suggests that particular genotypes determined by a single gene are associated with a steeper increase of SBP with age among males and females 550 years of age in the general population and (2) illustrates the need to consider models that more realistically represent the relationship between genotypic variability and phenotypic variability, to understand the genetics of human quantitative traits.

Adolescent↗