Le développement de nouvelles options thérapeutiques est à l’origine d’un changement de paradigme dans le processus de décision médicale. L'émergence de la médecine individualisée et la complexité croissante des données médicales ont conduit à l'avènement des modèles de prédiction. Pour le cancer de l'endomètre, ces modèles (algorithmes, scores et nomogrammes) ont été développés pour stratifier, estimer et prédire le risque de métastase ganglionnaire et de récidive. Le principal enjeu clinique est d’intégrer ces outils en vu d’optimiser les stratégies de prévention, de diagnostic et de traitement. Nous nous sommes intéressés au risque de récidive et d’envahissement ganglionnaire sur la base d’une analyse en population, puis individuelle. À l’échelle de la population, nous avons proposé : i) un travail de comparaison des principales classifications internationales, ii) une nouvelle classification clinicopathologique reposant sur l’incorporation d’un prédicteur histologique, iii) le développement de scores de stratification du risque. À l’échelle individuelle, nous avons développé : i) une méthodologie de validation externe des modèles prédictifs, point de départ indispensable à leur utilisation en pratique, ii) un nomogramme clinicopathologique spécifique d’envahissement ganglionnaire et son seuil de décision clinique. La modélisation mathématique en cancérologie est susceptible de transformer notre façon d’appréhender les stratégies préventives et curatives dans le cancer de l’endomètre. Les pistes d’optimisation sont multiples et laissent entrevoir la possibilité, dans un avenir proche, d’une application clinique à ces outils. / With the abundance of new options in diagnostic and treatment modalities, a shift in the medical decision process for endometrial cancer has been observed. The emergence of individualized medicine and the increasing complexity of available medical data have lead to the development of prediction models. In endometrial cancer, those clinical models (algorithms, nomograms, and risk scoring systems) have been reported, for stratifying and subgrouping patients, with various unanswered questions regarding such things as the optimal surgical staging for lymph node metastasis as well as the assessment of recurrence and survival outcomes. Through this manuscript we developed the question of the risk stratification for recurrence at the population level and the probability of lymph node involvement estimation at an individual level in early stage endometrial cancer. This double approach was adopted with the aim to illustrate the interest of these tools in clinical practice. At the population level, we proposed: i) a comparison of the main international clinicopathological classifications ii) a new clinicopathological classification based on a pathological predictor iii) two risk stratification systems for recurrence and lymph node metastasis. At the individual level we developed: i) a reproducible methodology for external validation of predictive models, ii) a specific clinic pathological nomogram for lymph node metastasis. In the future, the emerging field of molecular or biochemical markers research may substantially improve the predictive approach for preventive and curative strategies in endometrial cancer.

As zoos and aquariums have become increasingly focused on conservation education, their menageries of unique and diverse learning opportunities have been underutilized. Through a new postsecondary-level animal behavior laboratory experience at an aquarium (“ZooU”), this study demonstrates that active learning pedagogy aligned with the Next Generation Science Standards (NGSS) could facilitate expansion of education at zoos and aquariums beyond their conservation education niche. Generally, students indicated that ZooU provided new opportunities for them to explore their own interests, demonstrate their learning, and augment their previous laboratory and aquarium experiences. Following both self- and researcher assessments of the students’ work, integrated analyses revealed that students who engaged in more active learning activities at the aquarium demonstrated a greater increase in skills aligned with the NGSS. Additionally, a novel intra-individual analysis was utilized to embrace the variation between learners that typically confounds the results of education studies with repeated measures design. Common challenges for education at zoos and aquariums are discussed through the context of ZooU as a foundation for future investigations. A practical NGSS-aligned guide to field trips at zoos and aquariums—written specifically for science teachers—is also included to support broader utilization of zoos and aquariums as educational resources.

Estudos realizados com crianças após os 7 anos de idade não são claros em descrever se há efeito da idade e sexo no desempenho dos padrões fundamentais de movimento (PFM). Além disso, estes estudos se utilizaram do método transversal e focaram apenas as questões gerais do desenvolvimento, com pouca atenção para as diferenças individuais no desenvolvimento dos PFM. O presente estudo teve como objetivo investigar o desenvolvimento dos PFM de crianças dos 7 aos 9,5 anos de idade, analisando tanto as semelhanças e diferenças na trajetória das classes de movimento locomotor e manipulativo. A amostra constou de 31 crianças (64% meninos, 36% meninas) que foram acompanhadas dos 7 aos 9,5 anos de idade, com avaliações semestrais. Estas crianças fazem parte do estudo de crescimento e desenvolvimento motor longitudinal misto de Muzambinho-MG. As habilidades motoras e os critérios de avaliação utilizados foram baseados no TGMD-II. As crianças foram filmadas individualmente e posteriormente avaliadas com auxilio do software Kinovea. Para avaliar o desempenho optou-se por utilizar a soma dos critérios em cada uma das classes - locomoção e manipulação. A análise da mudança média foi realizada através da análise de variância de modelos mistos no software SAS. Para estimar as diferenças interindividuais na mudança intraindividual (estabilidade normativa) foram utilizados os testes de ? de Foulkes e Davis e o ? de Cohen, a partir do software LDA. Para identificar semelhanças e diferenças entre os sujeitos nas suas trajetórias foram utilizados os valores individuais do ? de Cohen e os canais modais de desempenho. Com base nessa informação foram formados os subgrupos: estabilidade com desempenho superior, intermediário e inferior, e com instabilidade ascendente e oscilatória. Os resultados médios apontam que com exceção das meninas na classe locomotora, após os 7 anos ocorre mudança no desempenho nos PFM, e há diferenças entre os sexos. Tanto o resultado do ? de Foulkes e Davis quanto o ? de Cohen indicaram estabilidade fraca, ou seja, houve heterogeneidade entre os sujeitos na mudança intraindividual ao longo da idade. Os valores individuais de estabilidade indicaram que há estabilidade boa para aproximadamente 57% das crianças na classe locomotora e 65% na manipulativa. Estes resultados permitiram inferir que mesmo após os 7 anos ocorre melhora na qualidade dos PFM, no entanto, cada classe de movimento e sexo tem particularidades. Além disso, apesar de haver heterogeneidade entre os sujeitos na mudança intraindividual ao longo dos 7 aos 9,5 anos, indicando que há iferenças na magnitude da mudança, foi possível discutir sobre a possibilidade de existir trajetórias diferenciadas / Studies of children older than 7 years old are not clear in describing whether there is effect of age and gender on performance of fundamental movement patterns (FMP). Moreover, these studies use cross-sectional method and focus only general development issues, with little attention to individual differences in the development of FMP. The present study aimed to investigate the development of PFM of children from 7 to 9.5 years old, analyzing both the similarities and differences in the trajectory of classes of locomotor and manipulative movement. The sample consisted of 31 children (64% boys, 36% girls) who were followed from 7 and 9.5 years old, through biannual evaluations. These children are part of the study of growth and mixed longitudinal motor development of Muzambinho-MG. The motor skills and evaluation criteria used were based on TGMD-II. The children were individually filmed and then evaluated with the aid of Kinovea software. To evaluate the performance it was chosen to use the sum of the criteria in each classes - locomotion and manipulation.The analysis of mean change was performed by analysis of variance of mixed models in SAS software. In order to estimate the interindividual differences in intraindividual change (stability normative), tests of ? de Foulkes and Davis and K de Cohen were used from the LDA software. To identify similarities and differences among the subjects in their trajectories, the individual values of ? de Cohen and performance channels were used. Based on this information the subgroups were formed: stability with upper, intermediate and lower performance and ascending and oscillatory instability. The average results indicate that, except girls in the locomotor class, after 7 years old, change occurs in FMP performance, and there are differences between the genders. Both ? de Foulkes and Davis and K de Cohen results indicate a poor stability, ie, over the age there was heterogeneity between the subjects in intra-individual change. The individual values of stability indicated that there is good stability for approximately 57% of children in locomotor class and 65% in manipulative class. These results showed that even after 7 years old, there is improvement in the quality of FMP, however, each class of movement and gender have their own particularities. Furthermore, although there is heterogeneity between the subjects in intra-individual change over the 7 to 9.5 years old, indicating that there are differences in the magnitude of the change, it was possible to discuss the chance of different trajectories

Estudos realizados com crianças após os 7 anos de idade não são claros em descrever se há efeito da idade e sexo no desempenho dos padrões fundamentais de movimento (PFM). Além disso, estes estudos se utilizaram do método transversal e focaram apenas as questões gerais do desenvolvimento, com pouca atenção para as diferenças individuais no desenvolvimento dos PFM. O presente estudo teve como objetivo investigar o desenvolvimento dos PFM de crianças dos 7 aos 9,5 anos de idade, analisando tanto as semelhanças e diferenças na trajetória das classes de movimento locomotor e manipulativo. A amostra constou de 31 crianças (64% meninos, 36% meninas) que foram acompanhadas dos 7 aos 9,5 anos de idade, com avaliações semestrais. Estas crianças fazem parte do estudo de crescimento e desenvolvimento motor longitudinal misto de Muzambinho-MG. As habilidades motoras e os critérios de avaliação utilizados foram baseados no TGMD-II. As crianças foram filmadas individualmente e posteriormente avaliadas com auxilio do software Kinovea. Para avaliar o desempenho optou-se por utilizar a soma dos critérios em cada uma das classes - locomoção e manipulação. A análise da mudança média foi realizada através da análise de variância de modelos mistos no software SAS. Para estimar as diferenças interindividuais na mudança intraindividual (estabilidade normativa) foram utilizados os testes de ? de Foulkes e Davis e o ? de Cohen, a partir do software LDA. Para identificar semelhanças e diferenças entre os sujeitos nas suas trajetórias foram utilizados os valores individuais do ? de Cohen e os canais modais de desempenho. Com base nessa informação foram formados os subgrupos: estabilidade com desempenho superior, intermediário e inferior, e com instabilidade ascendente e oscilatória. Os resultados médios apontam que com exceção das meninas na classe locomotora, após os 7 anos ocorre mudança no desempenho nos PFM, e há diferenças entre os sexos. Tanto o resultado do ? de Foulkes e Davis quanto o ? de Cohen indicaram estabilidade fraca, ou seja, houve heterogeneidade entre os sujeitos na mudança intraindividual ao longo da idade. Os valores individuais de estabilidade indicaram que há estabilidade boa para aproximadamente 57% das crianças na classe locomotora e 65% na manipulativa. Estes resultados permitiram inferir que mesmo após os 7 anos ocorre melhora na qualidade dos PFM, no entanto, cada classe de movimento e sexo tem particularidades. Além disso, apesar de haver heterogeneidade entre os sujeitos na mudança intraindividual ao longo dos 7 aos 9,5 anos, indicando que há iferenças na magnitude da mudança, foi possível discutir sobre a possibilidade de existir trajetórias diferenciadas / Studies of children older than 7 years old are not clear in describing whether there is effect of age and gender on performance of fundamental movement patterns (FMP). Moreover, these studies use cross-sectional method and focus only general development issues, with little attention to individual differences in the development of FMP. The present study aimed to investigate the development of PFM of children from 7 to 9.5 years old, analyzing both the similarities and differences in the trajectory of classes of locomotor and manipulative movement. The sample consisted of 31 children (64% boys, 36% girls) who were followed from 7 and 9.5 years old, through biannual evaluations. These children are part of the study of growth and mixed longitudinal motor development of Muzambinho-MG. The motor skills and evaluation criteria used were based on TGMD-II. The children were individually filmed and then evaluated with the aid of Kinovea software. To evaluate the performance it was chosen to use the sum of the criteria in each classes - locomotion and manipulation.The analysis of mean change was performed by analysis of variance of mixed models in SAS software. In order to estimate the interindividual differences in intraindividual change (stability normative), tests of ? de Foulkes and Davis and K de Cohen were used from the LDA software. To identify similarities and differences among the subjects in their trajectories, the individual values of ? de Cohen and performance channels were used. Based on this information the subgroups were formed: stability with upper, intermediate and lower performance and ascending and oscillatory instability. The average results indicate that, except girls in the locomotor class, after 7 years old, change occurs in FMP performance, and there are differences between the genders. Both ? de Foulkes and Davis and K de Cohen results indicate a poor stability, ie, over the age there was heterogeneity between the subjects in intra-individual change. The individual values of stability indicated that there is good stability for approximately 57% of children in locomotor class and 65% in manipulative class. These results showed that even after 7 years old, there is improvement in the quality of FMP, however, each class of movement and gender have their own particularities. Furthermore, although there is heterogeneity between the subjects in intra-individual change over the 7 to 9.5 years old, indicating that there are differences in the magnitude of the change, it was possible to discuss the chance of different trajectories