Complementary feeding at 4 versus 6 months of age for preterm infants born at less than 34 weeks of gestation: a randomised, open-label, multicentre trial

Background Evidence on the optimal time to initiation of complementary feeding in preterm infants is scarce. We examined the effect of initiation of complementary feeding at 4 months versus 6 months of corrected age on weight for age at 12 months corrected age in preterm infants less than 34 weeks of gestation. Methods In this open-label, randomised trial, we enrolled infants born at less than 34 weeks of gestation with no major malformation from three public health facilities in India. Eligible infants were tracked from birth and randomly assigned (1:1) at 4 months corrected age to receive complementary feeding at 4 months corrected age (4 month group), or continuation of milk feeding and initiation of complementary feeding at 6 months corrected age (6 month group), using computer generated randomisation schedule of variable block size, stratified by gestation (30 weeks or less, and 31–33 weeks). Iron supplementation was provided as standard. Participants and the implementation team could not be masked to group assignment, but outcome assessors were masked. Primary outcome was weight for age Z-score at 12 months corrected age (WAZ12) based on WHO Multicentre Growth Reference Study growth standards. Analyses were by intention to treat. The trial is registered with Clinical Trials Registry of India, number CTRI/2012/11/003149. Findings Between March 20, 2013, and April 24, 2015, 403 infants were randomly assigned: 206 to receive complementary feeding from 4 months and 197 to receive complementary feeding from 6 months. 22 infants in the 4 month group (four deaths, two withdrawals, 16 lost to follow-up) and eight infants in the 6 month group (two deaths, six lost to follow-up) were excluded from analysis of primary outcome. There was no difference in WAZ12 between two groups: –1·6 (SD 1·2) in the 4 month group versus –1·6 (SD 1·3) in the 6 month group (mean difference 0·005, 95% CI –0·24 to 0·25; p=0·965). There were more hospital admissions in the 4 month group compared with the 6 month group: 2·5 episodes per 100 infant-months in the 4 month group versus 1·4 episodes per 100 infant-months in the 6 month group (incidence rate ratio 1·8, 95% CI 1·0–3·1, p=0·03). 34 (18%) of 188 infants in the 4 month group required hospital admission, compared with 18 (9%) of 192 infants in the 6 month group. Interpretation Although there was no evidence of effect for the primary endpoint of WAZ12, the higher rate of hospital admission in the 4 month group suggests a recommendation to initiate complementary feeding at 6 months over 4 months of corrected age in infants less than 34 weeks of gestation

City of Buffalo Comprehensive Plan 2018-2038

The City of Buffalo Comprehensive Plan 2038 focuses on factors of growth and development including: public participation, development considerations, transportation, economic development, housing, and community facilities. The plan includes a Future Land Use Map, which increases development opportunities and indicates preferred or suitable land use for the city.The City of Buffalo Comprehensive Plan 2038 provides a guide for the future growth of the city. This document was developed by Texas Target Communities in partnership with the City of Buffalo. The document was developed through collaboration with Texas Target Communities (TTC) and a City Advisory Committee representing the City of Buffalo. The purpose of the collaboration was to assess current community conditions, develop goals, objectives, and implementation strategies related to future development & growth strategies, through a public participatory process, in order to help guide the future growth of the City

City of Buffalo Comprehensive Plan 2018-2038

The City of Buffalo Comprehensive Plan 2038 focuses on factors of growth and development including: public participation, development considerations, transportation, economic development, housing, and community facilities. The plan includes a Future Land Use Map, which increases development opportunities and indicates preferred or suitable land use for the city.The City of Buffalo Comprehensive Plan 2038 provides a guide for the future growth of the city. This document was developed by Texas Target Communities in partnership with the City of Buffalo. The document was developed through collaboration with Texas Target Communities (TTC) and a City Advisory Committee representing the City of Buffalo. The purpose of the collaboration was to assess current community conditions, develop goals, objectives, and implementation strategies related to future development & growth strategies, through a public participatory process, in order to help guide the future growth of the City

City of Ivanhoe Comprehensive Plan 2018-2038

the City of Ivanhoe is located in Tyler County, which is in southeastern Texas near the Louisiana border. The land is gently rolling, with an elevation ranging from 100 to 400 feet above sea level. Texas Target Communities developed this document in partnership with the City of Ivanhoe. In the summer of 2016, Tyler County and the City of Ivanhoe collaborated with Texas Target Communities to assess current community conditions and explore future development strategies. The project aimed to enhance community-wide discussion through a public participatory process, resulting in developing a comprehensive plan to help guide the future growth of the County and City. A representative task force of community members engaged in a participatory planning process, including visioning, goal setting, alternative scenario exploration, and strategies for implementation. Using courses on campus, TAMU urban planning students were exposed to the planning process and explored innovative ideas. The result of this collaboration is this document, which provides strategies for the community’s growth utilizing the natural resource and the assets of the City.The Ivanhoe Comprehensive Plan 2017-2037 provides guidance for the future development of the city. In the summer of 2016, Tyler County and the City of Ivanhoe collaborated with Texas Target Communities to assess current community conditions and explore future development strategies., which resulted in this comprehensive plan document.Texas Target Communitie

Rough Set Theory: Approach for Similarity Measure in Cluster Analysis

Abstract- Clustering of data is an important data mining application. One of the problems with traditional partitioning clustering methods is that they partition the data into hard bound number of clusters. Rough set based Indiscernibility relation combined with indiscernibility graph, leads to knowledge discovery in an elegant way. Indiscernibilty relation has a strong appeal to be applied in clustering as it creates natural clusters in data. Indiscernibility relation is used for measuring the similarity among the data items based on which clustering is performed. In the proposed approach the strict notion of indiscernibility is relaxed and classes are formed on the basis that objects are similar rather then identical. Indiscernibility relation creates indiscernible classes and representation of these classes with indiscernibility graph aids in better representation of clusters

City of Ivanhoe Comprehensive Plan 2018-2038

the City of Ivanhoe is located in Tyler County, which is in southeastern Texas near the Louisiana border. The land is gently rolling, with an elevation ranging from 100 to 400 feet above sea level. Texas Target Communities developed this document in partnership with the City of Ivanhoe. In the summer of 2016, Tyler County and the City of Ivanhoe collaborated with Texas Target Communities to assess current community conditions and explore future development strategies. The project aimed to enhance community-wide discussion through a public participatory process, resulting in developing a comprehensive plan to help guide the future growth of the County and City. A representative task force of community members engaged in a participatory planning process, including visioning, goal setting, alternative scenario exploration, and strategies for implementation. Using courses on campus, TAMU urban planning students were exposed to the planning process and explored innovative ideas. The result of this collaboration is this document, which provides strategies for the community’s growth utilizing the natural resource and the assets of the City.The Ivanhoe Comprehensive Plan 2017-2037 provides guidance for the future development of the city. In the summer of 2016, Tyler County and the City of Ivanhoe collaborated with Texas Target Communities to assess current community conditions and explore future development strategies., which resulted in this comprehensive plan document.Texas Target Communitie